Drug & supplement interaction

Lentinan + Enasidenib

Enasidenib brand name: Idhifa.

Moderate Interaction
The bottom line Moderate

Enasidenib falls into 4 drug categories that Lentinan can interact with; the most serious is rated moderate. Laboratory evidence suggests that lentinan might increase the activity of cytochrome P450 1A2 (CYP1A2).

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Lentinan and Enasidenib

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Lentinan interacts with whole categories of medication. Enasidenib falls into 4 of those categories, so it can interact with Lentinan in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 4

Why this applies to Enasidenib

Enasidenib falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Lentinan interacts with.

Laboratory evidence suggests that lentinan might increase the activity of cytochrome P450 1A2 (CYP1A2). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP1A2 in patients taking lentinan.
Some drugs metabolized by CYP1A2 include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), 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 the gist for Enasidenib (Idhifa): lab studies hint that lentinan from shiitake mushrooms may rev up a liver enzyme called CYP1A2. Since enasidenib is partly handled by that same enzyme, speeding it up could, in theory, clear the drug out a little faster and lower its levels. For a leukemia medicine you're relying on, you don't want it working less well than expected.

I want to be honest about the strength of this, though. This is only seen in test tube and animal work, and it has never actually been reported in people. So this is more of a cautious heads-up than a real alarm. Still, because enasidenib is serious cancer treatment, please run any lentinan supplement 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.
Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

2 of 4

Enasidenib also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.

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 the gist for Idhifa (enasidenib). Your body partly clears this leukemia drug using a liver enzyme called CYP2C19. Lab studies hint that lentinan, the shiitake mushroom beta-glucan, might speed that enzyme up. If it did, your body could clear enasidenib a little faster, which in theory could lower its blood levels and make it work less well against your AML.

I want to be honest about how thin this evidence is: it comes only from test-tube and animal research, and nothing like it has actually been seen in people taking these together. Still, since enasidenib is a serious cancer treatment where you really need full effect, please don't add lentinan on your own. Run it by 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.
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

3 of 4

Enasidenib also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Laboratory research suggests that lentinan might increase the activity of cytochrome P450 2D6 (CYP2D6). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP2D6 in patients taking lentinan.
Some drugs metabolized by CYP2D6 include tricyclic antidepressants such as imipramine (Tofranil) and amitriptyline (Elavil); antipsychotics such as haloperidol (Haldol), risperidone (Risperdal), and chlorpromazine (Thorazine); beta-blockers such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), and carvedilol (Coreg); tamoxifen (Nolvadex); 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 the gist for shiitake-derived lentinan paired with your leukemia medicine enasidenib (Idhifa). Lentinan has been shown, in lab dishes and animal studies only, to speed up an enzyme called CYP2D6. Enasidenib is partly handled by that same enzyme, and it is an active drug (not a prodrug), so if the enzyme runs faster, your body could clear the medicine a little quicker. In theory, that might mean slightly lower drug levels and a weaker effect against the cancer.

I want to be honest: this has never been seen in real people, and oral lentinan products vary a lot. Still, because enasidenib treats a serious illness, please loop in your oncologist or pharmacist before adding it.

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

4 of 4

Enasidenib 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 the situation with shiitake-derived lentinan and your leukemia medicine, Idhifa (enasidenib). Your body partly clears enasidenib using a liver enzyme called CYP3A4. Lab tests hint that lentinan may speed that enzyme up. If that happened in real life, it could push enasidenib out of your system a little faster, which in theory might mean slightly less of the cancer-fighting effect you're counting on.

I want to be honest about the strength of this: it comes only from test-tube and animal research, and it has not been seen in actual patients. So this is more of a caution than a known problem. Still, because enasidenib treats a serious illness, don't add lentinan or any new supplement without first checking with your oncology team 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.

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 Enasidenib 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 Enasidenib

This page covers Lentinan only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Enasidenib page lists 203 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), 1,3-dmaa (moderate) and Acacia Rigidula (moderate).

By severity: 3 major · 156 moderate · 44 minor.

From our pharmacist’s overview on the Enasidenib page

“Anyone taking enasidenib (Idhifa) for acute myeloid leukemia should treat this supplement list with genuine care, beginning with the major-rated entries: grapefruit, St. John's wort, and activated charcoal.”

Reviewed by 2 · Jul 18, 2026

Open the Enasidenib 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 Enasidenib 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 Enasidenib 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

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

29 days ago today
Medication Enasidenib
Steady interest

#1,734 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 Enasidenib

What Is Enasidenib Used For?

Brand name: Idhifa

Idhifa (enasidenib) is used to treat adult patients with acute myeloid leukemia (AML) — a fast-moving cancer of the blood and bone marrow — whose disease has come back after treatment (relapsed) or has stopped responding to treatment (refractory). It is specifically for patients whose leukemia has a mutation in the IDH2 gene, which must be confirmed by an FDA-approved test before starting therapy.

See full Enasidenib 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 Enasidenib Together: Common Questions

Can you take Lentinan with Enasidenib?
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 4 interactions listed for Lentinan and Enasidenib?
Enasidenib 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 Enasidenib 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.