Drug & supplement interaction

Nutmeg + Amifampridine Phosphate

Amifampridine Phosphate brand name: Firdapse.

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

Nutmeg has a moderate interaction with Amifampridine Phosphate. Theoretically, concomitant use of nutmeg with other cholinergic drugs might have additive effects and increase the risk of cholinergic side effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Nutmeg and Amifampridine Phosphate

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

Moderate

CHOLINERGIC DRUGS

Why this applies to Amifampridine Phosphate

Amifampridine Phosphate falls under CHOLINERGIC DRUGS — the group Nutmeg interacts with.

Theoretically, concomitant use of nutmeg with other cholinergic drugs might have additive effects and increase the risk of cholinergic side effects.
Animal research suggests that nutmeg extract can inhibit acetylcholinesterase and might increase acetylcholine levels.
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

Firdapse (amifampridine) is used to treat the muscle weakness of Lambert-Eaton myasthenic syndrome. It works by helping nerves release more of a signaling chemical called acetylcholine, which improves muscle strength. Here's the concern: animal and lab studies hint that nutmeg may slow the enzyme that breaks acetylcholine down, which could also nudge those levels up. Stack the two together and you might get a little too much of a good thing.

In practice that could mean more cholinergic side effects, things like nausea, stomach cramps, diarrhea, extra saliva, sweating, or a slow heartbeat. Keep in mind this is theoretical and based only on lab work, and ordinary cooking amounts of nutmeg are unlikely to cause trouble. Large medicinal doses are a different story. If you want to use nutmeg as a supplement, check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mukherjee PK, Kumar V, Houghton PJ. Screening of Indian medicinal plants for acetylcholinesterase inhibitory activity. Phytother Res. 2007;21(12):1142-5. 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

Nutmeg Also Interacts With Other Medications

Nutmeg has 527 moderate known drug interactions in our database — the Amifampridine Phosphate one above is one of them. If you take anything else, check it against the full list below.

Moderate 527 No known interaction 2,303 (incl. Amifampridine Phosphate)
Taking anything else?

Check Another of Your Medications Against Nutmeg

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

Everything else you take

See Every Supplement That Interacts With Amifampridine Phosphate

This page covers Nutmeg only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amifampridine Phosphate page lists 44 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Bacopa (moderate), Bael (moderate), Betel Nut (moderate) and Biofeedback (moderate).

Open the Amifampridine Phosphate interaction page

One more smart check

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

We hold 182 real supplement products containing Nutmeg, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Nutmeg. Your product may carry other ingredients that interact with Amifampridine Phosphate too, on top of Nutmeg — 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 Nutmeg and Amifampridine Phosphate 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 Nutmeg
Top half

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

29 days ago today
Medication Amifampridine Phosphate
Steady interest

#2,109 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 Nutmeg

What is Nutmeg?

Nutmeg
  • Digestive upset
  • Diarrhea
  • Sleep and relaxation
  • Pain and inflammation
  • Flavoring spice

Nutmeg is a popular cooking spice that has long been used in traditional medicine for digestion and other complaints, but there is little solid human research to support its medicinal use. In normal cooking amounts it is generally safe, but larger "medicinal" doses can cause serious poisoning, so it should never be taken in high amounts.

Read the full Nutmeg monograph & all interactions
Keep checking

Other Drugs & Nutmeg

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

0Major
527Moderate
0Minor
2,302No known interaction
527 Moderate 2,302 No interaction
Moderate

527 interactions

Showing 60 of 527 moderate interactions — see all 527 on the Nutmeg page.

No interaction 2,302 drugs checked — show the list

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

Showing the 60 most looked-up of 2,302 medications checked with no known interaction — see the full Nutmeg list.

See the full Nutmeg interactions page
See every supplement checked against Amifampridine Phosphate, 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
Nutmeg monograph › Uses, safety, and every drug interaction in one place Amifampridine Phosphate supplement interactions › Every supplement checked against Amifampridine Phosphate, 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 Nutmeg and Amifampridine Phosphate Together: Common Questions

Can you take Nutmeg with Amifampridine Phosphate?
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 Nutmeg and Amifampridine Phosphate 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 Amifampridine Phosphate and Nutmeg?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.