Drug & supplement interaction

Fir + Methylnaltrexone

Methylnaltrexone brand name: Relistor.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Fir and Methylnaltrexone in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Methylnaltrexone states a food rule worth keeping to.

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Interaction report

Fir and Methylnaltrexone

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Methylnaltrexone and Fir in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Fir at all — not against Methylnaltrexone, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Fir safety at a glance

Fir overall Use caution Generally used topically or by inhalation in small amounts; the essential oil should never be swallowed undiluted.
Pregnancy Avoid Not enough safety data, so avoid medicinal or essential-oil use during pregnancy.
Breastfeeding Avoid Safety is unknown while breastfeeding, so it is best avoided.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Methylnaltrexone and Fir? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Methylnaltrexone’s Own FDA Label Lists

This is not an interaction — none of it involves Fir. These are the most notable effects listed in the ADVERSE REACTIONS section of Methylnaltrexone’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both.

  • Chills
  • Tremor or shakiness
  • Flushing
  • Bloating or gas
  • Sweating
  • Anxiety or restlessness
  • Muscle pain
  • Stomach upset
  • Constipation
  • Stomach pain

Showing the 10 most notable of 15 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Methylnaltrexone. Read the label on DailyMed › Fir’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Fir side to compare — that is a limit of the record, not a statement that Fir has no side effects.

How to take them

Some Methylnaltrexone Products Have a Food Rule — Fir Should Not Break It

At least one FDA label for a product containing Methylnaltrexone says to take it on an empty stomach. Most supplements — Fir included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Methylnaltrexone on its own and move Fir to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Methylnaltrexone products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

o In patients with chronic non-cancer pain and OIC, take RELISTOR tablets with water on an empty stomach at least 30 minutes before the first meal of the day.

From the Dosage and Administration section of the FDA label we read for Methylnaltrexone — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Methylnaltrexone

This page covers Fir only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methylnaltrexone page lists 3 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Fever Bark (moderate), Iboga (moderate) and Yohimbe (moderate).

By severity: 3 moderate.

From our pharmacist’s overview on the Methylnaltrexone page

“If you take methylnaltrexone (Relistor) for opioid-induced constipation, the supplement list to know is short: three ingredients, all rated moderate, none major. Yohimbe, fever bark, and iboga are all cleared by the same liver enzyme, CYP2D6, and methylnaltrexone can slow that enzyme, letting their active compounds build up in your blood.”

Reviewed by 2 · Jul 18, 2026

Open the Methylnaltrexone interaction page

One more smart check

Taking Fir as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2 real supplement products containing Fir, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fir. Even though Fir itself has no known interaction with Methylnaltrexone, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Fir and Methylnaltrexone 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 Fir
Steady interest

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

29 days ago today
Medication Methylnaltrexone
Steady interest

#2,793 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions. Fir is not yet covered by that licensed database, so its write-up cites publicly available medical sources directly (see the references below).
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Fir reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Fir and Methylnaltrexone records this page draws on were last updated June 22, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Fir

What is Fir?

  • Coughs and congestion
  • Muscle and joint aches (topical)
  • Aromatherapy and inhalation
  • Minor wounds and skin care
  • Cleaning and air freshening

Fir refers to several evergreen trees whose needles, resin, and essential oil are used traditionally for respiratory comfort, sore muscles, and aromatherapy. Solid human evidence for these uses is limited, and fir essential oil can be irritating or toxic if swallowed. Use it cautiously, mostly diluted and topical or inhaled, and check with a pharmacist or doctor first.

Pinaceae · Needles, young shoots, bark, resin, and essential oil · Essential oil, tea, syrup, extract, balms and inhalant rubs

An interaction check asks whether these two react with each other — it does not ask whether Fir is a good idea for someone in your situation. Here is what our Fir record says about it on its own.

Fir: dosing

There is no well-established standardized dose for fir. Products vary widely in strength, from teas to concentrated essential oils.The safest approach is to follow the directions on the product label and use the smallest amount that works. For the essential oil, dilute it in a carrier oil for skin use or use only a few drops for inhalation.

From our Fir monograph — the full record covers uses, side effects and every documented interaction.

Read the full Fir monograph & all interactions
Medication

About Methylnaltrexone

What Is Methylnaltrexone Used For?

Brand name: Relistor

Methylnaltrexone, sold as Relistor, treats opioid-induced constipation (OIC) — constipation caused by opioid pain medications. Both Relistor tablets and Relistor injection are approved for adults with chronic non-cancer pain, including those with pain related to a prior cancer or its treatment who do not need frequent opioid dose increases.

Relistor injection is also approved for adults with advanced illness or active cancer pain who require increasing opioid doses as part of palliative care.

See full Methylnaltrexone drug information
Keep checking

Other Drugs & Fir

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

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Fir References

The 1 sources that drive our Fir monograph — publicly available pages from reputable medical and government organizations. Every link was verified to work before publishing. Fir is not covered by the licensed Natural Medicines interaction database, so its page cites these public sources directly.

  1. Balsam Fir / Conifer needles and oils (herbal information) — MedlinePlus Source

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Fir and Methylnaltrexone Together: Common Questions

Is it safe to take Fir with Methylnaltrexone?
We do not list a known interaction between Fir and Methylnaltrexone. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Should I take Fir and Methylnaltrexone at the same time of day?
At least one FDA label for a product containing Methylnaltrexone says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Methylnaltrexone on its own and move Fir to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.
Does Methylnaltrexone interact with any supplements?
Yes. Methylnaltrexone has documented interactions with 3 supplements in our database — Fir is not one of them. The Methylnaltrexone interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Methylnaltrexone and Fir?

Our pharmacists answer your medication & supplement questions — free.

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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.