Drug & supplement interaction

Maritime Pine + Tivozanib Hydrochloride

Tivozanib Hydrochloride brand name: Fotivda.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Maritime Pine has a moderate interaction with Tivozanib Hydrochloride. Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.

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

Maritime Pine and Tivozanib Hydrochloride

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Tivozanib Hydrochloride

Tivozanib Hydrochloride falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Maritime Pine interacts with.

Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Clinical research suggests that maritime pine bark extract inhibits platelet aggregation. However, the clinical significance of this effect is unclear.
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 simple version: maritime pine bark (Pycnogenol) may make your platelets a little less sticky, which can slightly raise the chance of bleeding or easy bruising. Tivozanib (Fotivda) is a cancer medicine that can already cause bleeding on its own, since drugs in this family can affect blood vessels and the cells that help you clot. So the worry is that combining the two could nudge that bleeding risk a bit higher.

To be honest, this concern is theoretical and based on how these things work, not on strong studies, so we don't know how much it really matters. Still, watch for nosebleeds, bleeding gums, unusual bruising, blood in urine or stool, or cuts that won't stop. Please check with your oncologist or pharmacist before adding this supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Putter M, Grotemeyer KH, Wurthwein G, et al. Inhibition of smoking-induced platelet aggregation by aspirin and pycnogenol. Thromb Res 1999;95:155-61. PubMed
  2. Araghi-Niknam, M., Hosseini, S., Larson, D., Rohdewald, P., and Watson, R. R. Pine bark extract reduces platelet aggregation. Integr.Med. 3-21-2000;2(2):73-77. PubMed
  3. Wang S, Tan D Zhao Y et al. The effect of pycnogenol on the microcirculation, platelet function and ischemic myocardium in patients with coronary artery diseases. Eur Bull Drug Res 1999;7:19-25.

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

Maritime Pine Also Interacts With Other Medications

Maritime Pine has 326 moderate known drug interactions in our database — the Tivozanib Hydrochloride one above is one of them. If you take anything else, check it against the full list below.

Moderate 326 No known interaction 2,504 (incl. Tivozanib Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Maritime Pine

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

Everything else you take

See Every Supplement That Interacts With Tivozanib Hydrochloride

This page covers Maritime Pine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tivozanib Hydrochloride page lists 288 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Danshen (major), Grapefruit (major) and Piracetam (major).

By severity: 7 major · 239 moderate · 42 minor.

From our pharmacist’s overview on the Tivozanib Hydrochloride page

“Tivozanib (Fotivda), an oral targeted therapy for advanced kidney cancer, has a supplement list that calls for genuine vigilance. Seven of the 288 ingredients on file are rated major, and those seven deserve your attention first.”

Reviewed by 2 · Jul 18, 2026

Open the Tivozanib Hydrochloride interaction page

One more smart check

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

We hold 452 real supplement products containing Maritime Pine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Maritime Pine. Your product may carry other ingredients that interact with Tivozanib Hydrochloride too, on top of Maritime Pine — 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 Maritime Pine and Tivozanib Hydrochloride 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 Maritime Pine
Top 25%

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

29 days ago today
Medication Tivozanib Hydrochloride
Steady interest

#1,852 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 Maritime Pine

What is Maritime Pine?

Maritime Pine
  • Circulation and vein health
  • Antioxidant support
  • Skin health and aging
  • High blood pressure
  • Joint comfort

Maritime pine bark extract (often sold as Pycnogenol) is a plant-based antioxidant most studied for circulation, vein, and skin health. Some research is promising, but many studies are small or industry-funded, so benefits are not firmly proven. It is generally well tolerated, but talk to your pharmacist or doctor before starting it.

Read the full Maritime Pine monograph & all interactions
Medication

About Tivozanib

What Is Tivozanib Used For?

Brand name: Fotivda

Fotivda (tivozanib) is used to treat adults with advanced renal cell carcinoma (RCC) — a type of kidney cancer — that is relapsed or refractory (has come back or stopped responding to treatment) after two or more prior systemic therapies (cancer treatments given throughout the body).

See full Tivozanib drug information
Keep checking

Other Drugs & Maritime Pine

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

0Major
326Moderate
0Minor
2,503No known interaction
326 Moderate 2,503 No interaction
Moderate

326 interactions

Showing 60 of 326 moderate interactions — see all 326 on the Maritime Pine page.

No interaction 2,503 drugs checked — show the list

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

Showing the 60 most looked-up of 2,503 medications checked with no known interaction — see the full Maritime Pine list.

See the full Maritime Pine interactions page
See every supplement checked against Tivozanib Hydrochloride, ranked by severity
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

Keep exploring
Maritime Pine monograph › Uses, safety, and every drug interaction in one place Tivozanib Hydrochloride supplement interactions › Every supplement checked against Tivozanib Hydrochloride, ranked by severity Tivozanib drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Maritime Pine and Tivozanib Hydrochloride Together: Common Questions

Can you take Maritime Pine with Tivozanib Hydrochloride?
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.
How serious is the Maritime Pine and Tivozanib Hydrochloride 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

Still Have a Question About Tivozanib Hydrochloride and Maritime Pine?

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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.