Drug & supplement interaction

Indian Snakeroot + Nivolumab

Nivolumab brand name: Opdivo.

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 Indian Snakeroot and Nivolumab 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 Nivolumab states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Indian Snakeroot and Nivolumab

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 Nivolumab and Indian Snakeroot 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 Snakeroot safety at a glance

Indian Snakeroot overall Use caution Contains potent alkaloids that can cause serious side effects and should only be used under medical supervision.
Pregnancy Avoid Avoid during pregnancy, as its alkaloids may harm the developing baby.
Breastfeeding Avoid Avoid while breastfeeding, since reserpine can pass into breast milk.

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

Still wondering about combining Nivolumab and Indian Snakeroot? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Nivolumab

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nivolumab is filed under a single classification — antineoplastics. Indian Snakeroot has documented interactions with 13 drug classes — the most serious being antipsychotic drugs (major), beta-blockers (major) and digoxin (lanoxin) (major) — and none of Nivolumab’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 Snakeroot Does Interact With Other Medications

Indian Snakeroot has 83 major, 760 moderate known drug interactions in our database — Nivolumab isn’t one of them. If you take anything else, check it against the full list below.

Major 83 Moderate 760 No known interaction 1,987 (incl. Nivolumab)
Taking anything else?

Check Another of Your Medications Against Indian Snakeroot

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

What to actually watch for

No Interaction Found — But Data Suggests Indian Snakeroot and Nivolumab May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 8 of them are worth acting on rather than waiting out — marked below.

  • A heart attack / An irregular heartbeat Worth acting on Additional detail

    Indian Snakeroot

    “Orally, Indian snakeroot has been associated with reports of bradycardia and mild hypotension. These adverse effects are thought to be related to the constituent reserpine. Adverse reactions to reserpine also include angina-like symptoms.”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in angina.

    6 sources cited
    1. 94331. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.
    2. 94440. Wilkins RW, Judson WE. The use of Rauwolfia serpentina in hypertensive patients. N Engl J Med. 1953 Jan 8;248(2):48-53.
    3. 94328. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.
    4. 3312. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
    5. 17465. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
    6. 86801. Giampreti, A., Lonati, D., Locatelli, C., Rocchi, L., and Campailla, M. T. Acute neurotoxicity after yohimbine ingestion by a body builder. Clin Toxicol.(Phila) 2009;47(8):827-829. PubMed

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Chest pain / Raised blood pressure Worth acting on Additional detail

    Indian Snakeroot

    Recorded for Indian Snakeroot in the same Natural Medicines adverse-effect record shown under A heart attack / An irregular heartbeat above.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • A low platelet count / A low white blood cell count Worth acting on Additional detail

    Indian Snakeroot

    “Indian snakeroot contains small amounts of reserpine and yohimbine and may theoretically cause some of the adverse effects associated with these constituents. A case of drug-induced agranulocytosis has been reported following prolonged use of oral yohimbine. Reserpine may cause thrombocytopenia.”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in thrombocytopenia.

    2 sources cited
    1. 86877. Siddiqui, M. A., More-O'Ferrall, D., Hammod, R. S., Baime, R. V., and Staddon, A. P. Agranulocytosis associated with yohimbine use. Arch.Intern.Med 6-10-1996;156(11):1235-1237.
    2. 275. Young DS. Effects of Drugs on Clinical Laboratory Tests 4th ed. Washington: AACC Press, 1995.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Kidney problems Worth acting on Additional detail

    Indian Snakeroot

    “There is one report of a hypersensitivity reaction to yohimbine, a constituent of Indian snakeroot. Symptoms included fever, chills, malaise, itchy, scaly skin, progressive kidney failure, and a lupus-like syndrome.”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in kidney failure.

    1 source cited
    1. 6169. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed

    “Orally, Indian snakeroot may cause increased urination.

    Indian snakeroot contains small amounts of yohimbine and may theoretically cause some of the adverse effects associated with this constituent. A case of acute kidney failure related to yohimbine-induced systemic lupus erythematosus has been reported.”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in kidney failure.

    2 sources cited
    1. 94332. Vakil RJ. A clinical trial of Rauwolfia serpentina in essential hypertension. Br Heart J. 1949 Oct;11(4):350-5. PubMed
    2. 6169. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Shortness of breath Worth acting on Additional detail

    Indian Snakeroot

    “Orally, Indian snakeroot can cause nasal stuffiness or congestion and shortness of breath. One study shows that Indian snakeroot may increase the risk for nasal congestion more than the constituent reserpine.. Reserpine is also associated with rare reports of allergic reactions that can precipitate asthma (15,94328).”

    Indian Snakeroot · Natural Medicines adverse-effect record, reported in asthma.

    6 sources cited
    1. 94330. Lowinger P. Rauwolfia serpentina in the control of anxiety. Psychiatr Q. 1957 Jul;31(3):445-53. PubMed
    2. 94332. Vakil RJ. A clinical trial of Rauwolfia serpentina in essential hypertension. Br Heart J. 1949 Oct;11(4):350-5. PubMed
    3. 94438. Achor RW, Hanson NO, Gifford RW Jr. Hypertension treated with Rauwolfia serpentina (whole root) and with reserpine; controlled study disclosing occasional severe depression. J Am Med Assoc. 1955 Oct 29;159(9):841-5. PubMed
    4. 94440. Wilkins RW, Judson WE. The use of Rauwolfia serpentina in hypertensive patients. N Engl J Med. 1953 Jan 8;248(2):48-53.
    5. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    6. 94328. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Chills Additional detail

    Indian Snakeroot

    “Orally, Indian snakeroot may cause headaches, feeling cold, dizziness, drowsiness, nightmares, and mild sedation. Indian snakeroot contains small amounts of reserpine and yohimbine and may theoretically cause some of the adverse effects associated with these constituents. Doses of reserpine of greater than 0.5 mg daily can increase the risk of side effects.”

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

    6 sources cited
    1. 94331. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.
    2. 94332. Vakil RJ. A clinical trial of Rauwolfia serpentina in essential hypertension. Br Heart J. 1949 Oct;11(4):350-5. PubMed
    3. 94438. Achor RW, Hanson NO, Gifford RW Jr. Hypertension treated with Rauwolfia serpentina (whole root) and with reserpine; controlled study disclosing occasional severe depression. J Am Med Assoc. 1955 Oct 29;159(9):841-5. PubMed
    4. 94440. Wilkins RW, Judson WE. The use of Rauwolfia serpentina in hypertensive patients. N Engl J Med. 1953 Jan 8;248(2):48-53.
    5. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    6. 94328. Lobay D. Rauwolfia in the Treatment of Hypertension. Integr Med (Encinitas). 2015 Jun;14(3):40-6.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • A stuffy or runny nose Additional detail

    Indian Snakeroot

    Recorded for Indian Snakeroot in the same Natural Medicines adverse-effect record shown under Shortness of breath above.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

Showing the 10 most notable of 24 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Indian Snakeroot but not commonly for Nivolumab: fainting, passing urine more often, increased appetite and an allergic reaction.

Effects for Nivolumab come from the ADVERSE REACTIONS section of its FDA label; effects for Indian Snakeroot come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 96,645 voluntary FDA FAERS reports for Nivolumab that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Nivolumab Products Have a Food Rule — Indian Snakeroot Should Not Break It

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

Table 2: Recommended Dosages of Intravenous OPDIVO in Combination with Other Therapeutic Agents Indication Recommended OPDIVO Dosage Duration of Therapy Unresectable or metastatic melanoma 1 mg/kg every 3 weeks with ipilimumab 3 mg/kg In combination with ipilimumab for a maximum of 4 doses or until unacceptable toxicity, whichever occurs earlier Adult patients and pediatric patients aged 12 years

From the Dosage and Administration section of the FDA label we read for Nivolumab — 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 Nivolumab

This page covers Indian Snakeroot only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nivolumab page lists 1 supplement it has a documented interaction with, worst first, each one explained.

The most serious there right now: American Pawpaw (minor).

By severity: 1 minor.

From our pharmacist’s overview on the Nivolumab page

“Nivolumab (Opdivo) is an immunotherapy infusion that trains the body's own immune system to recognize and attack cancer cells, the kind of drug you might expect to carry a long list of supplement warnings. It does not.”

Reviewed by 2 · Jul 18, 2026

Open the Nivolumab interaction page

One more smart check

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

We hold 70 real supplement products containing Indian Snakeroot, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Indian Snakeroot. Even though Indian Snakeroot itself has no known interaction with Nivolumab, 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 Snakeroot and Nivolumab 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 Snakeroot
Top half

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

29 days ago today
Medication Nivolumab
Top 25%

#292 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 Snakeroot reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Indian Snakeroot and Nivolumab 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 Indian Snakeroot

What is Indian Snakeroot?

Indian Snakeroot
  • High blood pressure
  • Anxiety and stress
  • Insomnia
  • Agitation
  • Fever (traditional use)

Indian snakeroot is a traditional Ayurvedic plant that contains reserpine, a compound with real blood-pressure-lowering and sedative effects. Because its potent alkaloids can cause serious side effects like depression and very low blood pressure, it should never be used without medical supervision. It is not a safe or simple home remedy, and many countries restrict its use.

Rauvolfia serpentina · Apocynaceae · Root · Powder, capsules, tablets, dried root, traditional preparations

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

Indian Snakeroot: dosing

There is no well-established safe dose of Indian snakeroot for self-care. The amount of active alkaloids in herbal products can vary widely, which makes safe dosing difficult.If a healthcare provider recommends a product, follow the label and their instructions exactly. Do not increase the dose on your own.

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

Read the full Indian Snakeroot monograph & all interactions
Medication

About Nivolumab Injection

What Is Nivolumab Injection Used For?

Brand name: Opdivo

Opdivo (nivolumab) is used to treat many types of cancer in adults, and some in patients 12 years and older. It can be used alone or in combination with other therapies depending on the cancer type and stage. Cancers it treats include melanoma (including after surgery to reduce the chance of the cancer coming back), non-small cell lung cancer, malignant pleural mesothelioma, advanced renal cell carcinoma (kidney cancer), classical Hodgkin lymphoma, squamous cell carcinoma of the head and neck, urothelial carcinoma (bladder cancer), colorectal cancer with specific genetic features (MSI-H or dMMR), hepatocellular carcinoma (liver cancer), esophageal cancer, gastroesophageal junction cancer, and gastric (stomach) cancer.

Some uses require the tumor to test positive for a protein called PD-L1, and some are specific to certain stages of disease or prior treatments received. Your oncologist will determine which use applies to your situation.

Most-Reported Side Effects for Nivolumab

From FAERS, the FDA’s public side-effect reporting system (96,645 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Malignant neoplasm progression 9,878 reports
Diarrhea 5,251 reports
Fatigue 4,195 reports
Fever 3,721 reports
Nausea 3,182 reports
See full Nivolumab Injection drug information
Keep checking

Other Drugs & Indian Snakeroot

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

83Major
760Moderate
0Minor
1,986No known interaction
83 Major 760 Moderate 1,986 No interaction
Major

83 interactions

Showing 60 of 83 major interactions — see all 83 on the Indian Snakeroot page.

Moderate

760 interactions

Showing 60 of 760 moderate interactions — see all 760 on the Indian Snakeroot page.

No interaction 1,986 drugs checked — show the list

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

Showing the 60 most looked-up of 1,986 medications checked with no known interaction — see the full Indian Snakeroot list.

See the full Indian Snakeroot interactions page
See every supplement checked against Nivolumab, ranked by severity
Evidence & sources

Indian Snakeroot References

The 43 references that drive our Indian Snakeroot 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. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  5. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  6. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  7. Young DS. Effects of Drugs on Clinical Laboratory Tests 4th ed. Washington: AACC Press, 1995.
  8. Milman N, Scheibel J, Jessen O. Lysine prophylaxis in recurrent herpes simplex labialis: a double-blind, controlled crossover study. Acta Derm Venereol 1980;60:85-7.
  9. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
  10. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
  11. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
  12. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed
  13. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
  14. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed
  15. Mustonen, P., Savola, J., and Lassila, R. Atipamezole, an imidazoline-type alpha(2)-adrenoceptor inhibitor, binds to human platelets and inhibits their adrenaline-induced aggregation more effectively than yohimbine. Thromb.Res 8-1-2000;99(3):231-237.

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 Snakeroot and Nivolumab Together: Common Questions

Is it safe to take Indian Snakeroot with Nivolumab?
We do not list a known interaction between Indian Snakeroot and Nivolumab. 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.
Do Indian Snakeroot and Nivolumab have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Indian Snakeroot and Nivolumab at the same time of day?
At least one FDA label for a product containing Nivolumab 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 Nivolumab on its own and move Indian Snakeroot 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.
How was the Indian Snakeroot and Nivolumab combination checked?
Interactions in our licensed database are recorded against drug classes. Nivolumab is filed under 1 classification, and Indian Snakeroot has documented interactions with 13 drug classes — none of Nivolumab'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 Snakeroot interact with any other medications?
Yes. Indian Snakeroot has 843 documented drug interactions in our database — Nivolumab 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 Nivolumab interact with any supplements?
Yes. Nivolumab has documented interactions with 1 supplement in our database — Indian Snakeroot is not one of them. The Nivolumab 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 Snakeroot monograph Uses, safety profile, and every drug interaction in one place Nivolumab Injection drug information The full plain-English guide to this medication Nivolumab supplement interactions Every supplement checked against Nivolumab, 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 43 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nivolumab and Indian Snakeroot?

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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.