Drug & supplement interaction

Greater Celandine + Melphalan Flufenamide

Melphalan Flufenamide brand name: Pepaxto.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Greater Celandine and Melphalan Flufenamide 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.

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Interaction report

Greater Celandine and Melphalan Flufenamide

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 Melphalan Flufenamide and Greater Celandine 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.

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.

Greater Celandine safety at a glance

Greater Celandine overall Avoid Oral use has been linked to serious, sometimes severe liver damage.
Pregnancy Avoid Not enough safety data and known toxicity make it unsafe during pregnancy.
Breastfeeding Avoid No reliable safety information, so it is best avoided while breastfeeding.

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

Still wondering about combining Melphalan Flufenamide and Greater Celandine? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Melphalan Flufenamide

Interactions in our licensed database are recorded against drug classes, not just single drug names. Melphalan Flufenamide is filed under a single classification — alkylating agents. Greater Celandine has documented interactions with 4 drug classes — the most serious being cytochrome p450 2d6 (cyp2d6) substrates (moderate), hepatotoxic drugs (moderate) and immunosuppressants (moderate) — and none of Melphalan Flufenamide’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Greater Celandine Does Interact With Other Medications

Greater Celandine has 625 moderate known drug interactions in our database — Melphalan Flufenamide isn’t one of them. If you take anything else, check it against the full list below.

Moderate 625 No known interaction 2,205 (incl. Melphalan Flufenamide)
Taking anything else?

Check Another of Your Medications Against Greater Celandine

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

What to actually watch for

What Greater Celandine Itself Has Been Linked To

This is not an interaction — nothing below involves Melphalan Flufenamide. It is the side-effect record for Greater Celandine on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Greater Celandine, this list is the first place to look. 4 entries are worth acting on rather than waiting out — marked below.

  • Yellowing of the skin or eyes Worth acting on Additional detail

    “Orally, greater celandine has been implicated in dozens of cases of liver damage. The cause is unknown, but appears to be idiopathic. It seems to be independent of dose, and the amount of time before development of liver disease is generally long and variable. The main symptom is usually jaundice. Liver enzymes are elevated at least two-fold in all cases where measurements were completed.”

    Greater Celandine · Natural Medicines adverse-effect record, reported in cirrhosis.

    3 sources cited
    1. 363. Benninger J, Schneider HT, Schuppan D, et al. Acute hepatitis induced by greater celandine (Chelidonium majus). Gastroenterology 1999;117:1234-7. PubMed
    2. 53506. Teschke, R., Glass, X., and Schulze, J. Herbal hepatotoxicity by Greater Celandine (Chelidonium majus): causality assessment of 22 spontaneous reports. Regul.Toxicol.Pharmacol. 2011;61(3):282-291. PubMed
    3. 94282. Pantano F, Mannocchi G, Marinelli E, Gentili S, Graziano S, Busardò FP, di Luca NM. Hepatotoxicity induced by greater celandine (Chelidonium majus L.): a review of the literature. Eur Rev Med Pharmacol Sci. 2017 Mar;21(1 Suppl):46-52.
  • A low platelet count / Kidney problems Worth acting on Additional detail

    “Orally, greater celandine extract has caused a single case of hemolytic anemia. This resulted in thrombocytopenia, destruction of liver cells, and kidney failure, requiring treatment.

    Intravenously, a derivative of the greater celandine constituent chelidonine (Ukrain) can cause bleeding.”

    Greater Celandine · Natural Medicines adverse-effect record, reported in anemia.

    3 sources cited
    1. 53508. Pinto, Garcia, V, Vicente, P. R., Barez, A., Soto, I., Candas, M. A., and Coma, A. [Hemolytic anemia induced by Chelidonium majus. Clinical case]. Sangre (Barc.) 1990;35(5):401-403.
    2. 13409. Ernst E, Schmidt K. Ukrain - a new cancer cure? A systematic review of randomised clinical trials. BMC Cancer 2005;5:69. PubMed
    3. 53460. Gansauge, F., Ramadani, M., Pressmar, J., Gansauge, S., Muehling, B., Stecker, K., Cammerer, G., Leder, G., and Beger, H. G. NSC-631570 (Ukrain) in the palliative treatment of pancreatic cancer. Results of a phase II trial. Langenbecks Arch.Surg. 2002;38 PubMed
  • Anemia / Bleeding or bruising Worth acting on Additional detail

    “Orally, greater celandine has been implicated in dozens of cases of liver damage. Greater celandine can also cause rash. Greater celandine extract has caused a single case of hemolytic anemia.

    Topically, greater celandine can cause contact dermatitis.

    Intravenously, a derivative of the greater celandine constituent chelidonine (Ukrain) can cause gastrointestinal symptoms, increased body temperature, general burning s…”

    Greater Celandine · Natural Medicines adverse-effect record, reported in anemia.

    6 sources cited
    1. 363. Benninger J, Schneider HT, Schuppan D, et al. Acute hepatitis induced by greater celandine (Chelidonium majus). Gastroenterology 1999;117:1234-7. PubMed
    2. 13410. Stickel F, Poschl G, Seitz HK, et al. Acute hepatitis induced by Greater Celandine (Chelidonium majus). Scand J Gastroenterol 2003;38:565-8.
    3. 16839. Moro PA, Cassetti F, Giugliano G, et al. Hepatitis from greater celandine (Chelidonium majus L.): Review of literature and report of a new case. J Ethnopharmacol 2009;124:328-32. PubMed
    4. 41412. Stickel, F., Seitz, H. K., Hahn, E. G., and Schuppan, D. [Liver toxicity of drugs of plant origin]. Z.Gastroenterol. 2001;39(3):225-227.
    5. 53502. Hardeman, E., Van, Overbeke L., Ilegems, S., and Ferrante, M. Acute hepatitis induced by greater celandine (Chelidonium majus). Acta Gastroenterol.Belg. 2008;71(2):281-282.
    6. 53504. Gilca, M., Gaman, L., Panait, E., Stoian, I., and Atanasiu, V. Chelidonium majus--an integrative review: traditional knowledge versus modern findings. Forsch.Komplementmed. 2010;17(5):241-248. PubMed
  • Liver problems Worth acting on Additional detail

    Recorded for Greater Celandine in the same Natural Medicines adverse-effect record shown under Anemia / Bleeding or bruising above.

  • Diarrhea / Nausea Additional detail

    “Intravenously, a derivative of the greater celandine constituent chelidonine (Ukrain) can cause gastrointestinal symptoms, including obstipation, nausea, and diarrhea.”

    Greater Celandine · Natural Medicines adverse-effect record, reported in diarrhea.

    2 sources cited
    1. 13409. Ernst E, Schmidt K. Ukrain - a new cancer cure? A systematic review of randomised clinical trials. BMC Cancer 2005;5:69. PubMed
    2. 53460. Gansauge, F., Ramadani, M., Pressmar, J., Gansauge, S., Muehling, B., Stecker, K., Cammerer, G., Leder, G., and Beger, H. G. NSC-631570 (Ukrain) in the palliative treatment of pancreatic cancer. Results of a phase II trial. Langenbecks Arch.Surg. 2002;38 PubMed
  • A skin rash Additional detail

    “Orally, greater celandine can cause rash. Topically, greater celandine can cause contact dermatitis.”

    Greater Celandine · Natural Medicines adverse-effect record, reported in dermatitis.

    2 sources cited
    1. 13410. Stickel F, Poschl G, Seitz HK, et al. Acute hepatitis induced by Greater Celandine (Chelidonium majus). Scand J Gastroenterol 2003;38:565-8.
    2. 13411. Etxenagusia MA, Anda M, Gonzalez-Mahave I, et al. Contact dermatitis from Chelidonium majus (greater celandine). Contact Dermatitis 2000;43:47.

Everything above comes from the Natural Medicines adverse-effect record for Greater Celandine — expand a row for the licensed statement it rests on. We haven’t matched Melphalan Flufenamide to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Melphalan Flufenamide.

Overlapping uses

What Melphalan Flufenamide Is Prescribed For, and What Greater Celandine Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Melphalan Flufenamide is a prescription medicine with approved uses on its FDA label. Greater Celandine is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Greater Celandine has been studied for:

  • Cancer studied, not established Greater Celandine has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Greater Celandine for cancer

    Preliminary clinical research suggests that injecting a specific semi-synthetic derivative of the greater celandine constituent chelidonine (Ukrain; not available in North America) intravenously helps improve survival of some patients with colorectal, bladder, pancreatic, lung, or breast cancer. However, poor study design makes it difficult to draw conclusions about the efficacy of Ukrain for cancer.

    8 sources cited
    1. 13409. Ernst E, Schmidt K. Ukrain - a new cancer cure? A systematic review of randomised clinical trials. BMC Cancer 2005;5:69. PubMed
    2. 53460. Gansauge, F., Ramadani, M., Pressmar, J., Gansauge, S., Muehling, B., Stecker, K., Cammerer, G., Leder, G., and Beger, H. G. NSC-631570 (Ukrain) in the palliative treatment of pancreatic cancer. Results of a phase II trial. Langenbecks Arch.Surg. 2002;38 PubMed
    3. 53472. Nowicky, J. W., Manolakis, G., Meijer, D., Vatanasapt, V., and Brzosko, W. J. Ukrain both as an anti cancer and immunoregulatory agent. Drugs Exp.Clin Res 1992;18 Suppl:51-54.
    4. 53473. Staniszewski, A., Slesak, B., Kolodziej, J., Harlozinska-Szmyrka, A., and Nowicky, J. W. Lymphocyte subsets in patients with lung cancer treated with thiophosphoric acid alkaloid derivatives from Chelidonium majus L. (Ukrain). Drugs Exp.Clin Res 1992;18
    5. 53497. Nowicky, J. W., Staniszewski, A., Zbroja-Sontag, W., Slesak, B., Nowicky, W., and Hiesmayr, W. Evaluation of thiophosphoric acid alkaloid derivatives from Chelidonium majus L. ("Ukrain") as an immunostimulant in patients with various carcinomas. Drugs Ex
    6. 53498. Gansauge, F., Ramadani, M., Schwarz, M., Beger, H. G., Lotspeich, E., and Poch, B. The clinical efficacy of adjuvant systemic chemotherapy with gemcitabine and NSC-631570 in advanced pancreatic cancer. Hepatogastroenterology 2007;54(75):917-920.
    7. 13412. Panzer A, Joubert AM, Bianchi PC, Seegers JC. The antimitotic effects of Ukrain, a Chelidonium majus alkaloid derivative, are reversible in vitro. Cancer Lett 2000;150:85-92. PubMed
    8. 53512. Xian, M. S., Hayashi, K., Lu, J. P., and Awai, M. Efficacy of traditional Chinese herbs on squamous cell carcinoma of the esophagus: histopathologic analysis of 240 cases. Acta Med.Okayama 1989;43(6):345-351.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Melphalan Flufenamide on your own; if you are taking Greater Celandine for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Melphalan Flufenamide

This page covers Greater Celandine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Melphalan Flufenamide page lists 7 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Acerola (moderate), Alpha-lipoic Acid (moderate), Coenzyme Q10 (moderate), Rose Hip (moderate) and Turmeric (moderate).

By severity: 7 moderate.

From our pharmacist’s overview on the Melphalan Flufenamide page

“The single most important thing on this page is antioxidants. Melphalan flufenamide (Pepaxto) is a chemotherapy used for multiple myeloma, and part of how it kills cancer cells is by generating free radicals.”

Reviewed by 2 · Jul 18, 2026

Open the Melphalan Flufenamide interaction page

One more smart check

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

We hold 11 real supplement products containing Greater Celandine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Greater Celandine. Even though Greater Celandine itself has no known interaction with Melphalan Flufenamide, 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 Greater Celandine and Melphalan Flufenamide 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 Greater Celandine
Top half

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

29 days ago today
Medication Melphalan Flufenamide
Steady interest

#2,216 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.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Greater Celandine reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Greater Celandine and Melphalan Flufenamide records this page draws on were last updated July 10, 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 Greater Celandine

What is Greater Celandine?

Greater Celandine
  • Digestive and gallbladder complaints
  • Stomach cramps and bloating
  • Topical use for warts and skin growths
  • Liver and gallbladder 'cleansing'
  • Mild pain relief

Greater celandine is a traditional herb most often promoted for digestive and gallbladder complaints, but solid human evidence for any use is lacking. More importantly, it has been linked to serious and sometimes severe liver injury, so most experts advise against taking it by mouth. If you are considering it, talk with your pharmacist or doctor first.

Chelidonium majus · Papaveraceae · Aerial parts (leaves, stems, flowers), root, and the yellow-orange latex (sap) · Capsules, tinctures, dried herb for tea, liquid extracts, and topical preparations

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

Greater Celandine: dosing

There is no well-established, standardized safe dose for greater celandine. Products vary widely in how they are made and how much alkaloid they contain, which makes consistent dosing difficult.Given the documented risk of liver injury, we do not recommend a specific dose. If you choose to use a product despite these concerns, follow the directions on the label and do not exceed them.

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

Read the full Greater Celandine monograph & all interactions
Medication

About Melphalan Flufenamide Injection

What Is Melphalan Flufenamide Injection Used For?

Brand name: Pepaxto

  • Melphalan flufenamide injection is used along with dexamethasone to treat multiple myeloma (a type of cancer of the bone marrow) in adults whose disease has returned or has not improved after receiving at least four other chemotherapy medications. Melphalan flufenamide is in a class of medications called alkylating agents. It works by stopping or slowing the growth of cancer cells in your body.

See full Melphalan Flufenamide Injection drug information
Keep checking

Other Drugs & Greater Celandine

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

0Major
625Moderate
0Minor
2,204No known interaction
625 Moderate 2,204 No interaction
Moderate

625 interactions

Showing 60 of 625 moderate interactions — see all 625 on the Greater Celandine page.

No interaction 2,204 drugs checked — show the list

We also checked Greater Celandine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,204 medications checked with no known interaction — see the full Greater Celandine list.

See the full Greater Celandine interactions page
See every supplement checked against Melphalan Flufenamide, ranked by severity
Evidence & sources

Greater Celandine References

The 25 references that drive our Greater Celandine monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Benninger J, Schneider HT, Schuppan D, et al. Acute hepatitis induced by greater celandine (Chelidonium majus). Gastroenterology 1999;117:1234-7. PubMed
  2. Holtmann G, Madisch A, Juergen H, et al. A double-blind, randomized, placebo-controlled trial on the effects of an herbal preparation in patients with functional dyspepsia [Abstract]. Ann Mtg Digestive Disease Week 1999 May.
  3. Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion 2004;69:45-52. PubMed
  4. Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279-87. PubMed
  5. Ernst E, Schmidt K. Ukrain - a new cancer cure? A systematic review of randomised clinical trials. BMC Cancer 2005;5:69. PubMed
  6. Stickel F, Poschl G, Seitz HK, et al. Acute hepatitis induced by Greater Celandine (Chelidonium majus). Scand J Gastroenterol 2003;38:565-8.
  7. Etxenagusia MA, Anda M, Gonzalez-Mahave I, et al. Contact dermatitis from Chelidonium majus (greater celandine). Contact Dermatitis 2000;43:47.
  8. Panzer A, Joubert AM, Bianchi PC, Seegers JC. The antimitotic effects of Ukrain, a Chelidonium majus alkaloid derivative, are reversible in vitro. Cancer Lett 2000;150:85-92. PubMed
  9. Moro PA, Cassetti F, Giugliano G, et al. Hepatitis from greater celandine (Chelidonium majus L.): Review of literature and report of a new case. J Ethnopharmacol 2009;124:328-32. PubMed
  10. Stickel, F., Seitz, H. K., Hahn, E. G., and Schuppan, D. [Liver toxicity of drugs of plant origin]. Z.Gastroenterol. 2001;39(3):225-227.
  11. Gansauge, F., Ramadani, M., Pressmar, J., Gansauge, S., Muehling, B., Stecker, K., Cammerer, G., Leder, G., and Beger, H. G. NSC-631570 (Ukrain) in the palliative treatment of pancreatic cancer. Results of a phase II trial. Langenbecks Arch.Surg. 2002;38 PubMed
  12. Nowicky, J. W., Manolakis, G., Meijer, D., Vatanasapt, V., and Brzosko, W. J. Ukrain both as an anti cancer and immunoregulatory agent. Drugs Exp.Clin Res 1992;18 Suppl:51-54.
  13. Staniszewski, A., Slesak, B., Kolodziej, J., Harlozinska-Szmyrka, A., and Nowicky, J. W. Lymphocyte subsets in patients with lung cancer treated with thiophosphoric acid alkaloid derivatives from Chelidonium majus L. (Ukrain). Drugs Exp.Clin Res 1992;18
  14. Nowicky, J. W., Staniszewski, A., Zbroja-Sontag, W., Slesak, B., Nowicky, W., and Hiesmayr, W. Evaluation of thiophosphoric acid alkaloid derivatives from Chelidonium majus L. ("Ukrain") as an immunostimulant in patients with various carcinomas. Drugs Ex
  15. Gansauge, F., Ramadani, M., Schwarz, M., Beger, H. G., Lotspeich, E., and Poch, B. The clinical efficacy of adjuvant systemic chemotherapy with gemcitabine and NSC-631570 in advanced pancreatic cancer. Hepatogastroenterology 2007;54(75):917-920.

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 Greater Celandine and Melphalan Flufenamide Together: Common Questions

Is it safe to take Greater Celandine with Melphalan Flufenamide?
We do not list a known interaction between Greater Celandine and Melphalan Flufenamide. 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.
Are Greater Celandine and Melphalan Flufenamide used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Greater Celandine in each. That is a conversation for your prescriber, especially if Melphalan Flufenamide is being adjusted to a target.
How was the Greater Celandine and Melphalan Flufenamide combination checked?
Interactions in our licensed database are recorded against drug classes. Melphalan Flufenamide is filed under 1 classification, and Greater Celandine has documented interactions with 4 drug classes — none of Melphalan Flufenamide's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Greater Celandine interact with any other medications?
Yes. Greater Celandine has 625 documented drug interactions in our database — Melphalan Flufenamide is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Melphalan Flufenamide interact with any supplements?
Yes. Melphalan Flufenamide has documented interactions with 7 supplements in our database — Greater Celandine is not one of them. The Melphalan Flufenamide interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Greater Celandine monograph Uses, safety profile, and every drug interaction in one place Melphalan Flufenamide Injection drug information The full plain-English guide to this medication Melphalan Flufenamide supplement interactions Every supplement checked against Melphalan Flufenamide, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 25 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Melphalan Flufenamide and Greater Celandine?

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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.