Drug & supplement interaction

Glucosamine + Irinotecan Hydrochloride

Moderate Interaction
The bottom line Moderate

Glucosamine has a moderate interaction with Irinotecan Hydrochloride. Theoretically glucosamine may induce resistance to topoisomerase II inhibitors.

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

Glucosamine and Irinotecan Hydrochloride

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

Moderate

TOPOISOMERASE II INHIBITORS

Why this applies to Irinotecan Hydrochloride

Irinotecan Hydrochloride falls under TOPOISOMERASE II INHIBITORS — the group Glucosamine interacts with.

Theoretically glucosamine may induce resistance to topoisomerase II inhibitors.
In vitro research suggests that glucosamine might induce resistance to etoposide (VP16, VePesid) and doxorubicin (Adriamycin) by reducing inhibition of topoisomerase II, an enzyme required for DNA replication in tumor cells. This effect has not been reported in humans.
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 honest picture with glucosamine and your irinotecan (Onivyde). The concern on file comes from lab dish studies where glucosamine seemed to make cancer cells more resistant to certain chemo drugs that block an enzyme called topoisomerase. In theory, that could mean the chemo works a little less hard against the tumor. I'll be straight with you though: this was seen in test tubes, not in people, and irinotecan actually targets a slightly different enzyme (topoisomerase I) than the drugs in those studies.

So the worry is mostly theoretical. Still, when you're fighting pancreatic cancer, you don't want to risk anything blunting your treatment. Please don't start or stop glucosamine on your own. Run it by your oncology team first so they can weigh in for your situation.

References
  1. Yun J, Tomida A, Nagata K, Tsuruo T. Glucose-regulated stresses confer resistance to VP-16 in human cancer cells through a decreased expression of DNA topoisomerase II. Oncol Res 1995;7:583-90.

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

Glucosamine Also Interacts With Other Medications

Glucosamine has 2 major, 12 moderate, 155 minor known drug interactions in our database — the Irinotecan Hydrochloride one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Glucosamine

Covers the 2,830 medications we’ve checked against Glucosamine. Pick one to open its full report.

From our Q&A

Questions About Glucosamine or Irinotecan Hydrochloride

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Glucosamine or Irinotecan Hydrochloride, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Irinotecan Hydrochloride

This page covers Glucosamine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Irinotecan Hydrochloride page lists 135 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Apple (major), Grapefruit (major), St. John's Wort (major), Sweet Orange (major) and Acacia Rigidula (moderate).

By severity: 4 major · 100 moderate · 31 minor.

From our pharmacist’s overview on the Irinotecan Hydrochloride page

“Irinotecan hydrochloride is chemotherapy, most often used against colorectal cancer, so the 135 supplements and foods on this page call for genuine care rather than a shrug. Four entries rate major, and St.”

Reviewed by 2 · Jul 18, 2026

Open the Irinotecan Hydrochloride interaction page

One more smart check

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

We hold 1,984 real supplement products containing Glucosamine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Glucosamine. Your product may carry other ingredients that interact with Irinotecan Hydrochloride too, on top of Glucosamine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Glucosamine and Irinotecan Hydrochloride 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 Glucosamine
Top 10%

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

29 days ago today
Medication Irinotecan Hydrochloride
Steady interest

#1,472 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 Glucosamine

What is Glucosamine?

Glucosamine
  • Osteoarthritis
  • Joint pain and stiffness
  • Cartilage support
  • Knee and hip joint health

Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of the knee. The evidence is mixed, with some people getting modest relief while others get little to no benefit. It is generally well tolerated, but talk to your pharmacist or doctor before starting it, especially if you have a shellfish allergy or diabetes.

Read the full Glucosamine monograph & all interactions
Medication

About Irinotecan Lipid Complex Injection

What Is Irinotecan Lipid Complex Injection Used For?

  • Irinotecan lipid complex is used in combination with other medications to treat pancreatic cancer that has spread to other parts of the body that has worsened after treatment with other chemotherapy medications. Irinotecan lipid complex is in a class of antineoplastic medications called topoisomerase I inhibitors. It works by stopping the growth of cancer cells.

See full Irinotecan Lipid Complex Injection drug information
Keep checking

Other Drugs & Glucosamine

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

2Major
12Moderate
155Minor
2,660No known interaction
Major

2 interactions

Moderate

12 interactions

Minor

155 interactions

Showing 60 of 155 minor interactions — see all 155 on the Glucosamine page.

No interaction 2,660 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Glucosamine and Irinotecan Hydrochloride Together: Common Questions

Can you take Glucosamine with Irinotecan Hydrochloride?
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 Glucosamine and Irinotecan Hydrochloride 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 Irinotecan Hydrochloride and Glucosamine?

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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.