Drug & supplement interaction

Indian Long Pepper + Palifermin

Palifermin brand name: Kepivance.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated June 2026 · Pair last verified Sep 20, 2026

The bottom line No known interaction

We found no known interaction between Indian Long Pepper and Palifermin 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

Indian Long Pepper and Palifermin

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 Palifermin and Indian Long Pepper 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.

Indian Long Pepper safety at a glance

Indian Long Pepper overall Use caution Likely fine as a food spice, but concentrated supplements lack strong safety data and piperine can affect how other substances are absorbed.

Pregnancy Avoid Medicinal amounts are not well studied and traditionally discouraged, so avoid supplement doses during pregnancy.

Breastfeeding Avoid There is not enough safety information, so avoid medicinal amounts while breastfeeding.

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

Still wondering about combining Palifermin and Indian Long Pepper? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Palifermin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Palifermin is filed under a single classification — oral drugs. Indian Long Pepper has documented interactions with 14 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), antidiabetes drugs (moderate) and cyclosporine (neoral, sandimmune) (moderate) — and none of Palifermin’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

Indian Long Pepper Does Interact With Other Medications

Indian Long Pepper has 893 moderate, 3 minor known drug interactions in our database — Palifermin isn’t one of them. If you take anything else, check it against the full list below.

Moderate 893 Minor 3 No known interaction 1,934 (incl. Palifermin)

Taking anything else?

Check Another of Your Medications Against Indian Long Pepper

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

What to actually watch for

What Palifermin’s Own FDA Label Lists

This is not an interaction — none of it involves Indian Long Pepper. These are the most notable effects listed in the ADVERSE REACTIONS section of Palifermin’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. One of them is worth acting on rather than waiting out — marked below.

A higher chance of infection Worth acting on mentioned in 6.2% of FDA reports for Palifermin
Fever mentioned in 16.0% of FDA reports for Palifermin
Numbness or tingling
Joint pain
A skin rash mentioned in 10.1% of FDA reports for Palifermin
Itching
Swelling

From the ADVERSE REACTIONS section of the FDA label for Palifermin. Read the label on DailyMed › Where a percentage is shown, it is the share of 388 voluntary FDA FAERS reports for Palifermin that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Indian Long Pepper’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Indian Long Pepper side to compare — that is a limit of the record, not a statement that Indian Long Pepper has no side effects.

Overlapping uses

What Palifermin Is Prescribed For, and What Indian Long Pepper Has Been Studied For

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

Palifermin is prescribed for: Kepivance (palifermin) is used to decrease how often and how long severe oral mucositis — painful sores in the mouth and throat — occurs in patients with hematologic malignancies (blood cancers such as lymphoma, leukemia, or multiple myeloma) who are receiving high-dose, cell-damaging (myelotoxic) therapy before an autologous hematopoietic stem cell transplant (a transplant using the patient's own stem cells). Kepivance is specifically indicated when the preparative chemotherapy or radiation regimen is expected to cause severe mucositis in most patients. It is not recommended for use with a high-dose melphalan conditioning regimen, and it was not found to be effective in the setting of allogeneic stem cell transplant (using a donor's cells). Its safety and effectiveness have not been established for patients with non-blood cancers (non-hematologic malignancies).

Indian Long Pepper has been studied for:

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

Indian Long Pepper for cancer

Although there has been interest in using oral Indian long pepper for cancer, there is insufficient reliable information about the clinical effects of Indian long pepper for this purpose.

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 Palifermin on your own; if you are taking Indian Long Pepper 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 Palifermin

This page covers Indian Long Pepper only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Palifermin page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Palifermin page

“Palifermin (Kepivance) is given by IV to prevent the severe mouth sores that intensive chemotherapy can cause, most often in patients heading into a stem cell transplant, and I read its interaction list with genuine caution because of how fragile those patients already are. All 17 supplements on file act on absorption through the gut,…”

Reviewed by 2 · Jul 18, 2026

Open the Palifermin interaction page

One more smart check

Taking Indian Long Pepper as Part of a Dietary Supplement Product? Check It for Interactions

We hold 597 real supplement products containing Indian Long Pepper, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Indian Long Pepper. Even though Indian Long Pepper itself has no known interaction with Palifermin, 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 Indian Long Pepper and Palifermin 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 Indian Long Pepper

Top 25%

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

29 days ago today

Medication Palifermin

Steady interest

#2,237 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 Indian Long Pepper reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Indian Long Pepper and Palifermin 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 Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Indian Long Pepper

What is Indian Long Pepper?

Digestive upset
Respiratory and cough complaints
Boosting absorption of other supplements
Pain and inflammation
General wellness in Ayurveda

Indian long pepper (pippali) is a spice long used in Ayurvedic medicine and is best known for its piperine content, which may increase how well the body absorbs certain other substances. Modern human research on its health benefits is limited, so use it cautiously and let your pharmacist or doctor know if you take it regularly.

Piper longum · Piperaceae · Dried fruit (and sometimes the root) · Dried fruit (spice), powder, capsules, extracts, and traditional Ayurvedic formulas

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

Indian Long Pepper: dosing

There is no well-established standard dose of Indian long pepper for any health condition. Traditional Ayurvedic use and modern supplement products vary widely.The safest approach is to follow the directions on the product label and not exceed them.

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

Read the full Indian Long Pepper monograph & all interactions

Medication

About Palifermin

What Is Palifermin Used For?

Brand name: Kepivance

Kepivance (palifermin) is used to decrease how often and how long severe oral mucositis — painful sores in the mouth and throat — occurs in patients with hematologic malignancies (blood cancers such as lymphoma, leukemia, or multiple myeloma) who are receiving high-dose, cell-damaging (myelotoxic) therapy before an autologous hematopoietic stem cell transplant (a transplant using the patient's own stem cells).

Kepivance is specifically indicated when the preparative chemotherapy or radiation regimen is expected to cause severe mucositis in most patients. It is not recommended for use with a high-dose melphalan conditioning regimen, and it was not found to be effective in the setting of allogeneic stem cell transplant (using a donor's cells). Its safety and effectiveness have not been established for patients with non-blood cancers (non-hematologic malignancies).

Most-Reported Side Effects for Palifermin

From FAERS, the FDA’s public side-effect reporting system (388 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Mucosal inflammation 56 reports

Febrile neutropenia 39 reports

Rash 39 reports

Stomatitis 34 reports

Erythema 28 reports

See full Palifermin drug information

Keep checking

Other Drugs & Indian Long Pepper

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

0Major

893Moderate

3Minor

1,933No known interaction

893 Moderate 3 Minor 1,933 No interaction

Moderate

893 interactions

Showing 60 of 893 moderate interactions — see all 893 on the Indian Long Pepper page.

Minor

3 interactions

No interaction 1,933 drugs checked — show the list

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

Showing the 60 most looked-up of 1,933 medications checked with no known interaction — see the full Indian Long Pepper list.

See the full Indian Long Pepper interactions page

See every supplement checked against Palifermin, ranked by severity

Evidence & sources

Indian Long Pepper References

The 12 references that drive our Indian Long Pepper 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.

Bano G, Amla V, Raina RK, et al. The effect of piperine on pharmacokinetics of phenytoin in healthy volunteers. Planta Med 1987;53:568-9. PubMed
Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50. PubMed
Pattanaik S, Hota D, Prabhakar S, et al. Pharmacokinetic interaction of a single dose of piperine with steady-state carbamazepine in epilepsy patients. Phytother Res 2009;23:1281-6.
Kasibhatta, R. and Naidu, M. U. Influence of piperine on the pharmacokinetics of nevirapine under fasting conditions: a randomised, crossover, placebo-controlled study. Drugs R.D. 2007;8(6):383-391. PubMed
Mujumdar, A. M., Dhuley, J. N., Deshmukh, V. K., Raman, P. H., Thorat, S. L., and Naik, S. R. Effect of piperine on pentobarbitone induced hypnosis in rats. Indian J Exp.Biol. 1990;28(5):486-487.
Panda, S. and Kar, A. Piperine lowers the serum concentrations of thyroid hormones, glucose and hepatic 5'D activity in adult male mice. Horm.Metab Res. 2003;35(9):523-526. PubMed
Hiwale, A. R., Dhuley, J. N., and Naik, S. R. Effect of co-administration of piperine on pharmacokinetics of beta-lactam antibiotics in rats. Indian J Exp.Biol. 2002;40(3):277-281.
Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289. PubMed
Sharma, P., Varma, M. V., Chawla, H. P., and Panchagnula, R. In situ and in vivo efficacy of peroral absorption enhancers in rats and correlation to in vitro mechanistic studies. Farmaco 2005;60(11-12):874-883. PubMed
Zutshi, R. K., Singh, R., Zutshi, U., Johri, R. K., and Atal, C. K. Influence of piperine on rifampicin blood levels in patients of pulmonary tuberculosis. J Assoc.Physicians India 1985;33(3):223-224.
Yadav V, Krishnan A, Vohora D. A systematic review on Piper longum L.: Bridging traditional knowledge and pharmacological evidence for future translational research. J Ethnopharmacol. 2020;247:112255. 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

Taking Indian Long Pepper and Palifermin Together: Common Questions

Is it safe to take Indian Long Pepper with Palifermin?

We do not list a known interaction between Indian Long Pepper and Palifermin. 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 Indian Long Pepper and Palifermin 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 Indian Long Pepper in each. That is a conversation for your prescriber, especially if Palifermin is being adjusted to a target.

How was the Indian Long Pepper and Palifermin combination checked?

Interactions in our licensed database are recorded against drug classes. Palifermin is filed under 1 classification, and Indian Long Pepper has documented interactions with 14 drug classes — none of Palifermin'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 Indian Long Pepper interact with any other medications?

Yes. Indian Long Pepper has 896 documented drug interactions in our database — Palifermin 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 Palifermin interact with any supplements?

Yes. Palifermin has documented interactions with 17 supplements in our database — Indian Long Pepper is not one of them. The Palifermin 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

Indian Long Pepper monograph Uses, safety profile, and every drug interaction in one place Palifermin drug information The full plain-English guide to this medication Palifermin supplement interactions Every supplement checked against Palifermin, 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 12 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Palifermin and Indian Long Pepper?

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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.