Drug & supplement interaction

Mace + Pomalidomide

Pomalidomide brand name: Pomalyst.

Moderate Interaction
The bottom line Moderate

Pomalidomide falls into 2 drug categories that Mace can interact with; the most serious is rated moderate. Animal research suggests that intraperitoneal injections of myristicin, a constituent of mace, can induce cytochrome P450 1A2 (CYP1A2) enzyme system.

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

Mace and Pomalidomide

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

Why Are There 2 Interactions?

Mace interacts with whole categories of medication. Pomalidomide falls into 2 of those categories, so it can interact with Mace 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 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Pomalidomide

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

Animal research suggests that intraperitoneal injections of myristicin, a constituent of mace, can induce cytochrome P450 1A2 (CYP1A2) enzyme system. Theoretically, concomitant use of mace with drugs metabolized by CYP1A2 may increase the clearance of these drugs and reduce their effects. Some substrates of CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), 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 Pomalidomide (Pomalyst). Your body partly clears this cancer medicine using a liver enzyme called CYP1A2. Animal lab research hints that myristicin, a natural compound in mace, might speed up (induce) that same enzyme. If that held true in people, your body could clear pomalidomide a bit faster, which in theory could make it work less well against your multiple myeloma or Kaposi's sarcoma.

I want to be honest about how thin this evidence is. It comes from animal studies using injected myristicin, not from people taking mace by mouth, so this is mostly theoretical. Using mace as a normal cooking spice is very unlikely to matter. Concentrated mace supplements are a different story. Since pomalidomide is a serious cancer drug, please run any mace supplement by your oncology team or pharmacist first.

References
  1. Jeong HG, Yun CH. Induction of rat hepatic cytochrome P450 enzymes by myristicin. Biochem Biophys Res Commun 1995;217:966-71. PubMed
Moderate

IMMUNOSUPPRESSANTS

2 of 2

Pomalidomide also falls under IMMUNOSUPPRESSANTS.

Animal research suggests that mace lignans can suppress immune function. Theoretically, concomitant use might enhance the effects of immunosuppressant drugs. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), and other corticosteroids (glucocorticoids).
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 mace and your Pomalyst. Pomalidomide already does a lot of immune-related work in the body, and it commonly lowers your blood counts, which can leave you more open to infections, bruising, and fatigue. In some animal studies, certain compounds in mace appeared to dampen the immune system too. So the worry is that stacking the two could, in theory, push that immune-lowering effect a bit further.

I want to be honest about how soft this evidence is. It comes from lab and animal work, not from people taking pomalidomide, so we really don't know if it matters in real life. Cooking with mace as a spice is very unlikely to be an issue. Concentrated mace supplements are a different story, so please run those by your oncology team or pharmacist first.

References
  1. Checker R, Chatterjee S, Sharma D, et al. Immunomodulatory and radioprotective effects of lignans derived from fresh nutmeg mace (Myristica fragrans) in mammalian splenocytes. Int Immunopharmacol. 2008;8(5):661-669. PubMed

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

Mace Also Interacts With Other Medications

Mace has 499 moderate known drug interactions in our database — the Pomalidomide 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 Mace

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

Everything else you take

See Every Supplement That Interacts With Pomalidomide

This page covers Mace only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pomalidomide page lists 207 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), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 162 moderate · 42 minor.

From our pharmacist’s overview on the Pomalidomide page

“Pomalidomide (Pomalyst) treats multiple myeloma, and with a cancer medicine carrying stakes this high, my honest read is that this list calls for real vigilance. Start with the three entries rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Pomalidomide interaction page

One more smart check

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

We hold 38 real supplement products containing Mace, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Mace. Your product may carry other ingredients that interact with Pomalidomide too, on top of Mace — 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 Mace and Pomalidomide 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 Mace
Top half

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

29 days ago today
Medication Pomalidomide
Steady interest

#1,797 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 Mace

What is Mace?

  • Digestive upset and gas
  • Flavoring and culinary spice
  • Nausea
  • Appetite stimulation
  • Traditional pain or muscle relief

Mace is the lacy red covering of the nutmeg seed and comes from the same tree as nutmeg. It is mostly used as a cooking spice and in traditional medicine for digestion, but there is little solid human research to support its health uses. In normal food amounts it is generally safe, but large doses can be toxic, so use it as a spice and check with your pharmacist before taking concentrated supplements.

Read the full Mace monograph & all interactions
Medication

About Pomalidomide

What Is Pomalidomide Used For?

Brand name: Pomalyst

Pomalidomide capsules are used in adults with multiple myeloma (a blood cancer affecting plasma cells) who have already tried at least two prior treatments — including lenalidomide and a proteasome inhibitor — and whose disease has continued to progress. It is given in combination with dexamethasone for this use.

Pomalidomide capsules are also used to treat Kaposi sarcoma (KS) — a cancer that can cause lesions on the skin and in internal organs — both in adults with AIDS-related KS after antiretroviral therapy has stopped working, and in adults with KS who are HIV-negative. The KS indication was approved based on response rate; ongoing studies are confirming long-term benefit.

See full Pomalidomide drug information
Keep checking

Other Drugs & Mace

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

0Major
499Moderate
0Minor
2,330No known interaction
Moderate

499 interactions

Showing 60 of 499 moderate interactions — see all 499 on the Mace page.

No interaction 2,330 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 Mace and Pomalidomide Together: Common Questions

Can you take Mace with Pomalidomide?
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 Mace and Pomalidomide?
Pomalidomide belongs to more than one drug category, and Mace 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 Mace and Pomalidomide 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.