Drug & supplement interaction

Lentinan + Cyclophosphamide

Cyclophosphamide brand names: Cytoxan, Neosar.

Moderate Interaction
The bottom line Moderate

Cyclophosphamide falls into 2 drug categories that Lentinan can interact with; the most serious is rated moderate. Laboratory research suggests that lentinan might increase the activity of cytochrome P450 2C19 (CYP2C19).

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Lentinan and Cyclophosphamide

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Lentinan interacts with whole categories of medication. Cyclophosphamide falls into 2 of those categories, so it can interact with Lentinan in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 2

Why this applies to Cyclophosphamide

Cyclophosphamide falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Lentinan interacts with.

Laboratory research suggests that lentinan might increase the activity of cytochrome P450 2C19 (CYP2C19). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP2C19 in patients taking lentinan.
Some drugs metabolized by CYP2C19 include proton pump inhibitors including omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.
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 something worth knowing about cyclophosphamide: it's actually a prodrug. That means it arrives in your body inactive, and your liver enzymes (including CYP2C19) have to convert it into its working, cancer-fighting form. So this enzyme is part of what turns the drug "on," not what clears it away.

Lab and animal studies hint that lentinan might speed up CYP2C19. In theory, a faster enzyme could change how much active drug you make. The honest truth is this has never been shown in real people, so it's a possibility on paper only. Still, because cyclophosphamide is powerful chemotherapy where dosing matters a great deal, please don't add lentinan without first checking with your oncologist or pharmacist.

References
  1. Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Cyclophosphamide also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Laboratory research suggests that lentinan might increase the activity of cytochrome P450 3A4 (CYP3A4). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP3A4 in patients taking lentinan.
Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others.
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 something worth knowing about cyclophosphamide: it's actually a prodrug. That means it arrives in your body inactive and has to be switched on by liver enzymes, including CYP3A4, before it can fight cancer. So this interaction works a little differently than you might expect.

Lab and animal research hints that lentinan may speed up CYP3A4. With most drugs that would lower their levels, but because cyclophosphamide needs that enzyme to become active, faster activity could shift how much active drug forms. The honest truth is that this has never been shown in people, so it's theoretical for now. Still, with a serious chemo drug like this, I wouldn't add lentinan on your own. Please run it past your oncologist or pharmacist first.

References
  1. Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.

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

Lentinan Also Interacts With Other Medications

Lentinan has 813 moderate known drug interactions in our database — the Cyclophosphamide one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Lentinan

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

Everything else you take

See Every Supplement That Interacts With Cyclophosphamide

This page covers Lentinan only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cyclophosphamide page lists 220 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 176 moderate · 38 minor.

Open the Cyclophosphamide interaction page

One more smart check

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

We hold 1 real supplement products containing Lentinan, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Lentinan. Your product may carry other ingredients that interact with Cyclophosphamide too, on top of Lentinan — 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 Lentinan and Cyclophosphamide 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 Lentinan
Top half

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

29 days ago today
Medication Cyclophosphamide
Top half

#818 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 Lentinan

What is Lentinan?

Lentinan
  • Immune support
  • Used alongside cancer treatment
  • Anti-inflammatory
  • General wellness/tonic
  • Antimicrobial support

Lentinan is a beta-glucan polysaccharide from shiitake mushrooms that is studied mainly as an immune-modulating add-on to cancer chemotherapy, where it is given by injection in a few countries. Evidence for oral supplements is limited, and quality varies widely between products. Talk with your pharmacist or doctor before using it, especially if you have a health condition or are pregnant or breastfeeding.

Read the full Lentinan monograph & all interactions
Medication

About Cyclophosphamide

What Is Cyclophosphamide Used For?

Brand names: Cytoxan, Neosar

Cyclophosphamide is used to treat many types of cancer in adults and children, including malignant lymphomas (such as Hodgkin's disease and Burkitt's lymphoma), multiple myeloma, several forms of leukemia, breast cancer, ovarian cancer, neuroblastoma, retinoblastoma, and advanced mycosis fungoides (a type of skin lymphoma). It is often given alongside other chemotherapy drugs rather than on its own.

Oral and injectable powder formulations (but not the Cyclophosphamide Injection solution concentrate) are also approved for minimal change nephrotic syndrome — a kidney condition — in children who have not responded well to, or cannot tolerate, steroid therapy. The injectable solution concentrate is approved for adult patients only due to its alcohol content, and is not approved for use in children.

See full Cyclophosphamide drug information
Keep checking

Other Drugs & Lentinan

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

0Major
813Moderate
0Minor
2,016No known interaction
Moderate

813 interactions

Showing 60 of 813 moderate interactions — see all 813 on the Lentinan page.

No interaction 2,016 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 Lentinan and Cyclophosphamide Together: Common Questions

Can you take Lentinan with Cyclophosphamide?
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.
Why are there 2 interactions listed for Lentinan and Cyclophosphamide?
Cyclophosphamide belongs to more than one drug category, and Lentinan interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Lentinan and Cyclophosphamide 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

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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.