Drug & supplement interaction

Lorenzo's Oil + Nelarabine

Nelarabine brand name: Atriance.

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 Lorenzo's Oil and Nelarabine 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 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

Lorenzo's Oil and Nelarabine

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 Nelarabine and Lorenzo's Oil 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.

Worth understanding: our licensed dataset holds no drug-interaction record for Lorenzo's Oil at all — not against Nelarabine, 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.

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.

Lorenzo's Oil safety at a glance

Lorenzo's Oil overall Use caution It is a medical treatment for a rare disease and should only be used under specialist supervision, not as a general supplement.
Pregnancy Avoid Safety in pregnancy is not established; use only if a specialist directs it.
Breastfeeding Avoid Safety while breastfeeding is not established; talk to your doctor first.

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

Still wondering about combining Nelarabine and Lorenzo's Oil? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Lorenzo's Oil and Nelarabine 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. 4 of them are worth acting on rather than waiting out — marked below.

  • A low white blood cell count / A low platelet count / Bleeding or bruising Worth acting on reported in 7.8% of FDA reports for Nelarabine Additional detail

    Lorenzo's Oil

    “Orally, Lorenzo's oil can cause thrombocytopenia, neutropenia, purpura, petechiae, and bleeding (6,924,926,927).”

    Lorenzo's Oil · Natural Medicines adverse-effect record, reported in thrombocytopenia.

    4 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 924. Aubourg P, Adamsbaum C, Lavallard-Rousseau MC, et al. A two-year trial of oleic and erucic acids (Lorenzo's oil) as treatment for adrenomyeloneuropathy. N Engl J Med 1993;329:745-52. PubMed
    3. 926. Chai BC, Etches WS, Stewart MW, Siminoski K. Bleeding in a patient taking Lorenzo's oil: evidence for a vascular defect. Postgrad Med J 1996;72:113-4.
    4. 927. Revell P, Green A, Green S. Platelets in treated adrenoleukodystrophy: a brief report. J Inherit Metab Dis 1995;18:635-7. PubMed

    “Orally, Lorenzo's oil can cause thrombocytopenia, purpura, petechiae, bleeding, and neutropenia (6,924,926,927).”

    Lorenzo's Oil · Natural Medicines adverse-effect record, reported in thrombocytopenia.

    4 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 924. Aubourg P, Adamsbaum C, Lavallard-Rousseau MC, et al. A two-year trial of oleic and erucic acids (Lorenzo's oil) as treatment for adrenomyeloneuropathy. N Engl J Med 1993;329:745-52. PubMed
    3. 926. Chai BC, Etches WS, Stewart MW, Siminoski K. Bleeding in a patient taking Lorenzo's oil: evidence for a vascular defect. Postgrad Med J 1996;72:113-4.
    4. 927. Revell P, Green A, Green S. Platelets in treated adrenoleukodystrophy: a brief report. J Inherit Metab Dis 1995;18:635-7. PubMed

    Nelarabine

    Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • A higher chance of infection Worth acting on reported in 5.9% of FDA reports for Nelarabine Additional detail

    Lorenzo's Oil

    “In one case report, a 39-year-old man with adrenoleukodystrophy developed lipoid pneumonia while taking Lorenzo's oil. He presented with respiratory failure; bronchoalveolar lavage produced fluid with an oily appearance.”

    Lorenzo's Oil · Natural Medicines adverse-effect record, reported in adrenoleukodystrophy (ald).

    1 source cited
    1. 99422. Majori M, Scarascia A, Anghinolfi M, et al. Lipoid pneumonia as a complication of Lorenzo's oil therapy in a patient with adrenoleukodystrophy. J Bronchology Interv Pulmonol 2014;21(3):271-3. doi: 10.1097/LBR.0000000000000084. PubMed

    Nelarabine

    Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Effects for Nelarabine come from the ADVERSE REACTIONS section of its FDA label; effects for Lorenzo's Oil come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 956 voluntary FDA FAERS reports for Nelarabine 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.

Everything else you take

See Every Supplement That Interacts With Nelarabine

This page covers Lorenzo's Oil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nelarabine page lists 130 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Kava (major) and L-tryptophan (major).

By severity: 6 major · 118 moderate · 6 minor.

From our pharmacist’s overview on the Nelarabine page

“Nelarabine (Atriance) is chemotherapy for a rare T-cell leukemia and lymphoma, and its most feared side effect is damage to the nervous system, from heavy drowsiness up to seizures. Most of the 130 supplement and herbal ingredients on this list press on exactly that weak point.”

Reviewed by 2 · Jul 18, 2026

Open the Nelarabine interaction page

How much people look this up

Where Lorenzo's Oil and Nelarabine 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 Lorenzo's Oil
Steady interest

#1,367 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Nelarabine
Steady interest

#2,087 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 Lorenzo's Oil reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Lorenzo's Oil and Nelarabine 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 Lorenzo's Oil

What is Lorenzo's Oil?

  • Adrenoleukodystrophy (ALD)
  • Adrenomyeloneuropathy (AMN)
  • Lowering very long-chain fatty acids in blood
  • Slowing progression of certain inherited disorders

Lorenzo's Oil is not a typical herbal supplement—it is a specially formulated mixture of two fatty acids (glyceryl trioleate and glyceryl trierucate, in a 4:1 ratio) developed to lower very long-chain fatty acids in people with adrenoleukodystrophy (ALD). It can normalize blood fatty acid levels and may help delay disease in some boys who are not yet showing symptoms, but it is not a cure and should only be used under specialist medical supervision.

Refined plant-derived oils (rapeseed/olive oil sources) · Oral liquid oil (prescription-style medical formulation)

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

Lorenzo's Oil: dosing

There is no standard over-the-counter dose for Lorenzo's Oil. When used medically, the amount is calculated by a specialist based on the person's body and is adjusted using blood tests and a carefully controlled low-fat diet.Because dosing must be individualized and monitored, you should not try to dose this product yourself. Do not use it as a casual supplement.

From our Lorenzo's Oil monograph — the full record covers uses, side effects and every documented interaction.

Read the full Lorenzo's Oil monograph & all interactions
Medication

About Nelarabine Injection

What Is Nelarabine Injection Used For?

Brand name: Atriance

Nelarabine injection (brand name Arranon) is used to treat two aggressive blood cancers: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL). It is approved for adult and pediatric patients age 1 year and older whose disease has not responded to — or has come back after — at least two prior chemotherapy regimens.

Nelarabine injection may also be given in combination with multi-agent chemotherapy as part of treatment for newly diagnosed T-ALL and T-LBL in certain settings, as studied in clinical trials.

Most-Reported Side Effects for Nelarabine

From FAERS, the FDA’s public side-effect reporting system (956 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Febrile neutropenia 75 reports
Neuropathy peripheral 60 reports
Neurotoxicity 60 reports
Sepsis 56 reports
Muscular weakness 55 reports
See full Nelarabine Injection drug information
Keep checking

Other Drugs & Lorenzo's Oil

Browse every other medication we’ve checked against Lorenzo's Oil — 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 Lorenzo's Oil 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 Lorenzo's Oil list.

See the full Lorenzo's Oil interactions page
See every supplement checked against Nelarabine, ranked by severity
Evidence & sources

Lorenzo's Oil References

The 12 references that drive our Lorenzo's Oil 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. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Kaplan PW, Tusa RJ, Shankroff J, et al. Visual evoked potentials in adrenoleukodystrophy: a trial with glycerol trioleate and Lorenzo oil. Ann Neurol 1993;34:169-74.
  3. Poulos A, Gibson R, Sharp P, et al. Very long chain fatty acids in X-linked adrenoleukodystrophy brain after treatment with Lorenzo's oil. Ann Neurol 1994;36:741-6. PubMed
  4. Duchesne N, Dufour M, Bouchard G, et al. Adrenoleukodystrophy: magnetic resonance follow-up after Lorenzo's oil therapy. Can Assoc Radiol J 1995;46:386-91.
  5. Moser HW. Clinical and therapeutic aspects of adrenoleukodystrophy and adrenomyeloneuropathy. J Neuropathol Exp Neurol 1995;54:740-5. PubMed
  6. Aubourg P, Adamsbaum C, Lavallard-Rousseau MC, et al. A two-year trial of oleic and erucic acids (Lorenzo's oil) as treatment for adrenomyeloneuropathy. N Engl J Med 1993;329:745-52. PubMed
  7. Chai BC, Etches WS, Stewart MW, Siminoski K. Bleeding in a patient taking Lorenzo's oil: evidence for a vascular defect. Postgrad Med J 1996;72:113-4.
  8. Revell P, Green A, Green S. Platelets in treated adrenoleukodystrophy: a brief report. J Inherit Metab Dis 1995;18:635-7. PubMed
  9. Maeda K, Suzuki Y, Yajima S, et al. Improvement of clinical and MRI findings in a boy with adrenoleukodystrophy by dietary erucic acid therapy. Brain Dev 1992;14:409-12.
  10. Wong V. Adrenoleukodystrophy in a Chinese boy. Brain Dev 1992;14:276-7. PubMed
  11. Moser HW, Raymond GV, Lu SE, et al. Follow-up of 89 asymptomatic patients with adrenoleukodystrophy treated with Lorenzo's Oil. Arch Neurol 2005;62:1073-80. PubMed
  12. Majori M, Scarascia A, Anghinolfi M, et al. Lipoid pneumonia as a complication of Lorenzo's oil therapy in a patient with adrenoleukodystrophy. J Bronchology Interv Pulmonol 2014;21(3):271-3. doi: 10.1097/LBR.0000000000000084. 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 Lorenzo's Oil and Nelarabine Together: Common Questions

Is it safe to take Lorenzo's Oil with Nelarabine?
We do not list a known interaction between Lorenzo's Oil and Nelarabine. 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 Lorenzo's Oil and Nelarabine have any of the same side effects?
Yes — our sources link each of them separately to 4 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.
Does Nelarabine interact with any supplements?
Yes. Nelarabine has documented interactions with 130 supplements in our database — Lorenzo's Oil is not one of them. The Nelarabine 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

Lorenzo's Oil monograph Uses, safety profile, and every drug interaction in one place Nelarabine Injection drug information The full plain-English guide to this medication Nelarabine supplement interactions Every supplement checked against Nelarabine, 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 Nelarabine and Lorenzo's Oil?

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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.