Drug & supplement interaction

Fermented Wheat Germ Extract + Nelarabine

Nelarabine brand name: Atriance.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Fermented Wheat Germ Extract has a moderate interaction with Nelarabine. Theoretically, fermented wheat germ extract might decrease the effects of immunosuppressants.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fermented Wheat Germ Extract and Nelarabine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Nelarabine

Nelarabine falls under IMMUNOSUPPRESSANTS — the group Fermented Wheat Germ Extract interacts with.

Theoretically, fermented wheat germ extract might decrease the effects of immunosuppressants.
Animal research suggests that fermented wheat germ extract can stimulate immune function.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thinking behind this pairing. Fermented wheat germ extract has shown, mostly in lab and animal studies, that it may nudge the immune system to be more active. Nelarabine (Atriance) works in the opposite direction, since it's a chemotherapy drug that kills certain cancerous white blood cells and tends to suppress immune activity along the way. The concern is that a supplement revving up immune function could, in theory, work against what your nelarabine treatment is trying to do.

I want to be honest that this is theoretical, based on how things behave in the lab, not proven in people taking nelarabine. Still, during a treatment this important, please don't add fermented wheat germ extract without first running it by your oncologist or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hidvegi M, Raso E, Tomoskozi Farkas R, Lapis K, Szende B. Effect of MSC on the immune response of mice. Immunopharmacology 1999;41(3):183-186. PubMed
  2. Sukkar SG, Rossi E. Oxidative stress and nutritional prevention in autoimmune rheumatic diseases. Autoimmun Rev 2004;3(3):199-206. PubMed
  3. Ehrenfeld M, Blank M, Shoenfeld Y, Hidvegi M. AVEMAR (a new benzoquinone-containing natural product) administration interferes with the Th2 response in experimental SLE and promotes amelioration of the disease. Lupus 2001;10(9):622-627. PubMed
  4. Gidali J, Hidvégi M, Fehér I, et al. The effect of Avemar treatment on the regeneration of leukocytes, thrombocytes and reticulocytes in sublethally irradiated or cyclophosphamide treated mice. First Congress of the Hungarian Society of Clinical Oncology,
  5. Vucskits, AV, Hullar, I, Bersenyi, A, Andrasofszky, E, Kulcsar, M, Szabo, J. Effect of fulvic and humic acids on performance, immune response and thyroid function in rats. J Anim Physiol Anim Nutr (Berl) 2010;94(6):721-728. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Fermented Wheat Germ Extract Also Interacts With Other Medications

Fermented Wheat Germ Extract has 302 moderate known drug interactions in our database — the Nelarabine one above is one of them. If you take anything else, check it against the full list below.

Moderate 302 No known interaction 2,528 (incl. Nelarabine)
Taking anything else?

Check Another of Your Medications Against Fermented Wheat Germ Extract

Covers the 2,830 medications we’ve checked against Fermented Wheat Germ Extract. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Nelarabine

This page covers Fermented Wheat Germ Extract only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nelarabine page lists 130 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Kava (major) and L-tryptophan (major).

By severity: 6 major · 118 moderate · 6 minor.

From our pharmacist’s overview on the Nelarabine page

“Nelarabine (Atriance) is chemotherapy for a rare T-cell leukemia and lymphoma, and its most feared side effect is damage to the nervous system, from heavy drowsiness up to seizures. Most of the 130 supplement and herbal ingredients on this list press on exactly that weak point.”

Reviewed by 2 · Jul 18, 2026

Open the Nelarabine interaction page

How much people look this up

Where Fermented Wheat Germ Extract and Nelarabine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Fermented Wheat Germ Extract
Steady interest

#1,247 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Nelarabine
Steady interest

#2,221 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Fermented Wheat Germ Extract

What is Fermented Wheat Germ Extract?

  • Cancer supportive care (as a complementary product)
  • Immune support
  • General wellness during cancer treatment
  • Antioxidant support
  • Fatigue during illness

Fermented wheat germ extract is a supplement made by fermenting wheat germ with yeast, and it is most often marketed for people going through cancer treatment. While some early research and a few small studies are interesting, the overall evidence is limited and far from conclusive, so it should never replace standard medical care. Talk with your oncologist or pharmacist before using it, since it is a supplement and not an approved treatment.

Read the full Fermented Wheat Germ Extract monograph & all interactions
Medication

About Nelarabine Injection

What Is Nelarabine Injection Used For?

Brand name: Atriance

Nelarabine injection (brand name Arranon) is used to treat two aggressive blood cancers: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL). It is approved for adult and pediatric patients age 1 year and older whose disease has not responded to — or has come back after — at least two prior chemotherapy regimens.

Nelarabine injection may also be given in combination with multi-agent chemotherapy as part of treatment for newly diagnosed T-ALL and T-LBL in certain settings, as studied in clinical trials.

See full Nelarabine Injection drug information
Keep checking

Other Drugs & Fermented Wheat Germ Extract

Browse every other medication we’ve checked against Fermented Wheat Germ Extract — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
302Moderate
0Minor
2,527No known interaction
302 Moderate 2,527 No interaction
Moderate

302 interactions

Showing 60 of 302 moderate interactions — see all 302 on the Fermented Wheat Germ Extract page.

No interaction 2,527 drugs checked — show the list

We also checked Fermented Wheat Germ Extract against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,527 medications checked with no known interaction — see the full Fermented Wheat Germ Extract list.

See the full Fermented Wheat Germ Extract interactions page
See every supplement checked against Nelarabine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Fermented Wheat Germ Extract monograph › Uses, safety, and every drug interaction in one place Nelarabine supplement interactions › Every supplement checked against Nelarabine, ranked by severity Nelarabine Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Fermented Wheat Germ Extract and Nelarabine Together: Common Questions

Can you take Fermented Wheat Germ Extract with Nelarabine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Fermented Wheat Germ Extract and Nelarabine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Nelarabine and Fermented Wheat Germ Extract?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.