Drug & supplement interaction

Marshmallow + Tenecteplase

Tenecteplase brand name: TNKase.

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

Marshmallow has a minor interaction with Tenecteplase. Theoretically, marshmallow flower might have antiplatelet effects.

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

Marshmallow and Tenecteplase

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

Minor

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Tenecteplase

Tenecteplase falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Marshmallow interacts with.

Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to keep in perspective: tenecteplase (TNKase) isn't a pill you take at home. It's a powerful clot-busting injection given in the hospital for emergencies like a heart attack. On its own it already raises bleeding risk, which is why doctors monitor you closely after it's given.

The worry on file is purely theoretical. Animal studies hint that marshmallow flower might thin the blood a little, and combining anything that does that with a clot-buster could, in theory, add to bleeding. But supplements usually contain marshmallow root or leaf, not the flower, so this likely doesn't apply to most products. Since tenecteplase is hospital-only, your care team is already managing your bleeding risk. Still, always tell them about any supplements you take.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol 2011;49(3):327-33.

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

Marshmallow Also Interacts With Other Medications

Marshmallow has 1 moderate, 2,038 minor known drug interactions in our database — the Tenecteplase one above is one of them. If you take anything else, check it against the full list below.

Moderate 1 Minor 2,038 No known interaction 791 (incl. Tenecteplase)
Taking anything else?

Check Another of Your Medications Against Marshmallow

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

Everything else you take

See Every Supplement That Interacts With Tenecteplase

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

The most serious there right now: Danshen (major), Piracetam (major), Aconite (moderate), Allspice (moderate) and Aloe (moderate).

By severity: 2 major · 184 moderate · 17 minor.

From our pharmacist’s overview on the Tenecteplase page

“Tenecteplase (TNKase) is a clot-busting drug given in the emergency room for strokes and heart attacks, so the real question is not what you would take alongside it but what is already in your system when the injection arrives. This list deserves genuine caution.”

Reviewed by 2 · Jul 18, 2026

Open the Tenecteplase interaction page

One more smart check

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

We hold 1,622 real supplement products containing Marshmallow, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Marshmallow. Your product may carry other ingredients that interact with Tenecteplase too, on top of Marshmallow — 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 Marshmallow and Tenecteplase 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 Marshmallow
Top 10%

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

29 days ago today
Medication Tenecteplase
Steady interest

#1,678 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 Marshmallow

What is Marshmallow?

Marshmallow
  • Cough and sore throat
  • Dry mouth and throat irritation
  • Digestive upset and heartburn
  • Skin irritation
  • Soothing inflamed tissue

Marshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for these uses is mostly traditional and preliminary, but it is generally considered gentle and well-tolerated for short-term use. As with any supplement, check with your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Marshmallow monograph & all interactions
Keep checking

Other Drugs & Marshmallow

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

0Major
1Moderate
2,038Minor
790No known interaction
1 Moderate 2,038 Minor 790 No interaction
Moderate

1 interaction

Minor

2,038 interactions

Showing 60 of 2,038 minor interactions — see all 2,038 on the Marshmallow page.

No interaction 790 drugs checked — show the list

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

Showing the 60 most looked-up of 790 medications checked with no known interaction — see the full Marshmallow list.

See the full Marshmallow interactions page
See every supplement checked against Tenecteplase, 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
Marshmallow monograph › Uses, safety, and every drug interaction in one place Tenecteplase supplement interactions › Every supplement checked against Tenecteplase, 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Marshmallow and Tenecteplase Together: Common Questions

Can you take Marshmallow with Tenecteplase?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Marshmallow and Tenecteplase interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tenecteplase and Marshmallow?

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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.