Drug & supplement interaction

Hirudotherapy + Letrozole, Ribociclib Succinate

Letrozole, Ribociclib Succinate brand name: Kisqali Femara Co-Pack.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Hirudotherapy and Letrozole, Ribociclib Succinate 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

Hirudotherapy and Letrozole, Ribociclib Succinate

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 Letrozole, Ribociclib Succinate and Hirudotherapy in our sources. This does not guarantee that the combination is completely free of risk — research on Hirudotherapy alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Hirudotherapy at all — not against Letrozole, Ribociclib Succinate, 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.

Hirudotherapy is a treatment rather than something you take. Tell whoever provides it which medicines you use, and ask your prescriber whether it is appropriate for your health and treatment. 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.

Hirudotherapy safety at a glance

Hirudotherapy overall Use caution Should only be performed by trained practitioners using medical-grade leeches due to infection and bleeding risks.
Pregnancy Avoid Not enough safety data; the bleeding and infection risks make it best avoided in pregnancy.
Breastfeeding Avoid Safety during breastfeeding is unknown, so it is best avoided unless a doctor advises otherwise.

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

Still wondering about combining Letrozole, Ribociclib Succinate and Hirudotherapy? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Hirudotherapy Itself Has Been Linked To

This is not an interaction — nothing below involves Letrozole, Ribociclib Succinate. It is the side-effect record for Hirudotherapy on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Hirudotherapy, this list is the first place to look. 3 entries are worth acting on rather than waiting out — marked below.

  • Bleeding in the gut Worth acting on Additional detail

    “Topically, hirudotherapy has been associated with an infected anal abscess. A 32-year-old male presented with severe anal pain and swelling 3 days after hirudotherapy for hemorrhoids. The abscess required surgical drainage and treatment with antibiotics. The predominant organism identified was Escherichia coli.”

    Hirudotherapy · Natural Medicines adverse-effect record, reported in gastrointestinal bleeding.

    2 sources cited
    1. 106755. Mentes BB, Leventoglu S, Osmanov I, Kösehan D, Erol T. Anal abscess due to leech therapy of hemorrhoids: mumbo jumbo is still in vogue. J Surg Case Rep. 2019 Jul 31;2019(7):rjz218. PubMed
    2. 112898. Dolek UC, Ozdemir S, Babayeva K, Gol M. Leech Application-related Upper Gastrointestinal Bleeding: A Case Report. Bull Emerg Trauma 2023;11(1):47-50.
  • Anemia / Bleeding or bruising Worth acting on Additional detail

    “Topically, hirudotherapy can cause prolonged bleeding and anemia. In a case report, a young adult male presented with neck bleeding after self-applying leeches for acne. Bleeding was controlled by suturing. A case series in critically ill pediatric patients describes bleeding that led to hirudotherapy discontinuation in 5 of 7 cases, and 4 of the patients expired secondary to multiorgan failure.”

    Hirudotherapy · Natural Medicines adverse-effect record, reported in acne.

    4 sources cited
    1. 99399. Zengin S, Yarbil P, Kilic H, Al B. Prolonged bleeding due to a medicinal leech bite: another treatment method, primary suture. BMJ Case Rep. 2012;2012. pii: bcr0220125759. PubMed
    2. 106752. Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed
    3. 106753. Temiz SA, Özer I, Ataseven A, Dursun R, Findik S. Cutaneous pseudolymphoma due to hirudotherapy. Turkiye Parazitol Derg. 2019;43(1):50-2. PubMed
    4. 112900. Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A. Hirudotherapy for limb ischemia in the pediatric intensive care unit: A retrospective observational cohort. Front Pediatr 2023;10:1011171. PubMed
  • A higher chance of infection Worth acting on Additional detail

    “Topically, hirudotherapy can cause itching, pain, vesicle formation, and skin redness at the application site. Less often, it can cause necrotic ulcers, keloid formation, allergic or irritant contact dermatitis, and skin infections. Use of leeches can sometimes cause infections with Aeromonas hydrophila, which is found in the leech gut, and also with parasites.”

    Hirudotherapy · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 99392. Bibbo C, Fritsche T, Stemper M, Hall M. Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms. J Reconstr Microsurg. 2013;29(7):457-60. PubMed
    2. 99394. Michalsen A, Lüdtke R, Cesur O, et al. Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial. Pain. 2008;137(2):452-9. PubMed
    3. 99395. Pietrzak A, Kanitakis J, Tomasiewicz K, et al. Cutaneous complications of improper leech application. Ann Agric Environ Med. 2012;19(4):790-2.
    4. 99397. van Alphen NA, Gonzalez A, McKenna MC, McKenna TK, Carlsen BT, Moran SL. Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases. J Hand Surg Am. 2014;39(3):499-502. PubMed
    5. 99398. Wang H, Zhang J, Chen L. The efficacy and safety of medical leech therapy for osteoarthritis of the knee: A meta-analysis of randomized controlled trials. Int J Surg. 2018;54(Pt A):53-61. PubMed
    6. 106752. Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed
  • Acne Additional detail

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

  • Pain in an arm or leg / Fever Additional detail

    Recorded for Hirudotherapy in the same Natural Medicines adverse-effect record shown under A higher chance of infection above.

  • Low blood pressure Additional detail

    “Topically, hirudotherapy has been associated with hypotension and vasovagal attacks.”

    Hirudotherapy · Natural Medicines adverse-effect record, reported in hypotension.

    1 source cited
    1. 106753. Temiz SA, Özer I, Ataseven A, Dursun R, Findik S. Cutaneous pseudolymphoma due to hirudotherapy. Turkiye Parazitol Derg. 2019;43(1):50-2. PubMed
  • Itching Additional detail

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

  • Swelling Additional detail

    Recorded for Hirudotherapy in the same Natural Medicines adverse-effect record shown under A higher chance of infection above.

Showing the 10 most notable of 12 recorded effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

Everything above comes from the Natural Medicines adverse-effect record for Hirudotherapy — expand a row for the licensed statement it rests on. We haven’t matched Letrozole, Ribociclib Succinate 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 Letrozole, Ribociclib Succinate.

Everything else you take

See Every Supplement That Interacts With Letrozole, Ribociclib Succinate

This page covers Hirudotherapy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Letrozole, Ribociclib Succinate page lists 155 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 109 moderate · 38 minor.

From our pharmacist’s overview on the Letrozole, Ribociclib Succinate page

“Grapefruit tops my worry list for anyone taking the Kisqali Femara Co-Pack (letrozole and ribociclib), because it blocks the enzyme, CYP3A4, that clears ribociclib and can push levels of this breast cancer drug higher than intended. That enzyme thread runs through 121 of the 155 ingredients on this page, and with eight rated major, rea…”

Reviewed by 2 · Jul 18, 2026

Open the Letrozole, Ribociclib Succinate interaction page

How much people look this up

Where Hirudotherapy and Letrozole, Ribociclib Succinate 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 Hirudotherapy
Steady interest

#1,143 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Letrozole, Ribociclib Succinate
Top half

#1,175 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 Hirudotherapy reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Hirudotherapy and Letrozole, Ribociclib Succinate 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 .
Treatment approach

About Hirudotherapy

What is Hirudotherapy?

  • Reconstructive and plastic surgery (relieving blood congestion in reattached tissue)
  • Osteoarthritis and joint pain
  • Circulation problems
  • Varicose veins
  • Traditional treatment for various inflammatory conditions

Hirudotherapy is the medical use of living leeches placed on the skin to draw blood and release saliva compounds that thin blood and ease congestion. It has a real, accepted role in some surgical settings (such as saving reattached fingers or skin flaps), but evidence for most other uses is limited. It should only be done by trained professionals because of risks of infection and bleeding.

Hirudo medicinalis · Hirudinidae · Whole living medicinal leech (and its saliva) · Live medicinal leeches applied to the skin by a trained practitioner

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

Hirudotherapy: dosing

There is no standardized "dose" for hirudotherapy. The number of leeches, where they are placed, and how long treatment continues are decided by the treating clinician based on the medical situation, such as how much blood is congested in a tissue flap.This is a medical procedure, not a supplement you take at home.

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

Read the full Hirudotherapy monograph & all interactions
Keep checking

Other Drugs & Hirudotherapy

Browse every other medication we’ve checked against Hirudotherapy — 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
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Hirudotherapy list.

See the full Hirudotherapy interactions page
See every supplement checked against Letrozole, Ribociclib Succinate, ranked by severity
Evidence & sources

Hirudotherapy References

The 15 references that drive our Hirudotherapy 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. Altamura D, Calonje E, Liau Jl, Rogers M, Verdolini R. Diffuse cutaneous pseudolymphoma due to therapy with medicinal leeches. JAMA Dermatol. 2014;150(7):783-4. PubMed
  2. Bibbo C, Fritsche T, Stemper M, Hall M. Flap infection associated with medicinal leeches in reconstructive surgery: two new drug-resistant organisms. J Reconstr Microsurg. 2013;29(7):457-60. PubMed
  3. Khelifa E, Kaya G, Laffitte E. Cutaneous pseudolymphomas after leech therapy. J Dermatol. 2013;40(8):674-5. doi: PubMed
  4. Michalsen A, Lüdtke R, Cesur O, et al. Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial. Pain. 2008;137(2):452-9. PubMed
  5. Pietrzak A, Kanitakis J, Tomasiewicz K, et al. Cutaneous complications of improper leech application. Ann Agric Environ Med. 2012;19(4):790-2.
  6. van Alphen NA, Gonzalez A, McKenna MC, McKenna TK, Carlsen BT, Moran SL. Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases. J Hand Surg Am. 2014;39(3):499-502. PubMed
  7. Wang H, Zhang J, Chen L. The efficacy and safety of medical leech therapy for osteoarthritis of the knee: A meta-analysis of randomized controlled trials. Int J Surg. 2018;54(Pt A):53-61. PubMed
  8. Zengin S, Yarbil P, Kilic H, Al B. Prolonged bleeding due to a medicinal leech bite: another treatment method, primary suture. BMJ Case Rep. 2012;2012. pii: bcr0220125759. PubMed
  9. Sepaskhah M, Yazdanpanah N, Sari Aslani F, Akbarzadeh Jahromi M. Cutaneous pseudolymphoma as a rare adverse effect of medicinal leech therapy: a case report and review of the literature. Cureus. 2020 Apr 2;12(4):e7517. PubMed
  10. Temiz SA, Özer I, Ataseven A, Dursun R, Findik S. Cutaneous pseudolymphoma due to hirudotherapy. Turkiye Parazitol Derg. 2019;43(1):50-2. PubMed
  11. Daye M, Isik B, Kilinç F. Lichen planus due to hirudotherapy. Turkiye Parazitol Derg. 2021;45(2):149-52. PubMed
  12. Mentes BB, Leventoglu S, Osmanov I, Kösehan D, Erol T. Anal abscess due to leech therapy of hemorrhoids: mumbo jumbo is still in vogue. J Surg Case Rep. 2019 Jul 31;2019(7):rjz218. PubMed
  13. Kiliç M, Ak R. Orbital cellulitis due to leech therapy. Bull Emerg Trauma. 2019 Jul;7(3):335-6. PubMed
  14. Dolek UC, Ozdemir S, Babayeva K, Gol M. Leech Application-related Upper Gastrointestinal Bleeding: A Case Report. Bull Emerg Trauma 2023;11(1):47-50.
  15. Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A. Hirudotherapy for limb ischemia in the pediatric intensive care unit: A retrospective observational cohort. Front Pediatr 2023;10:1011171. PubMed

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

Having Hirudotherapy While Taking Letrozole, Ribociclib Succinate: Common Questions

Is it safe to have Hirudotherapy while taking Letrozole, Ribociclib Succinate?
We do not list a known interaction between Hirudotherapy and Letrozole, Ribociclib Succinate. 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.
Does Letrozole, Ribociclib Succinate interact with any supplements?
Yes. Letrozole, Ribociclib Succinate has documented interactions with 155 supplements in our database — Hirudotherapy is not one of them. The Letrozole, Ribociclib Succinate 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

Hirudotherapy monograph Uses, safety profile, and every drug interaction in one place Letrozole, Ribociclib Succinate supplement interactions Every supplement checked against Letrozole, Ribociclib Succinate, 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 15 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

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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.