Drug & supplement interaction

Phenibut + Nelarabine

Nelarabine brand name: Atriance.

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

Phenibut has a moderate interaction with Nelarabine. Theoretically, phenibut might increase the risk of sedation and respiratory depression when taken with CNS depressants.

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

Phenibut and Nelarabine

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

Moderate

CNS DEPRESSANTS

Why this applies to Nelarabine

Nelarabine falls under CNS DEPRESSANTS — the group Phenibut interacts with.

Theoretically, phenibut might increase the risk of sedation and respiratory depression when taken with CNS depressants.
Phenibut has been associated with sedation and respiratory depression in several case reports, especially when taken at high doses.
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 thing to know about this pairing: nelarabine itself isn't usually a sedating drug. It's a chemotherapy medicine that fights leukemia and lymphoma. But it does have well-known nervous system side effects of its own, things like drowsiness, dizziness, confusion, weakness, and sometimes numbness or tingling in the hands and feet.

Phenibut is a brain-slowing (CNS depressant) substance, so layering it on top could deepen that sleepiness and mental fog, and in higher amounts it has been tied to slowed breathing. This concern is theoretical, based on how the two work rather than direct studies. Still, I'd strongly urge you not to use phenibut at all, and please talk with your oncology team or pharmacist about safer options for sleep or anxiety during treatment.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Downes MA, Berling IL, Mostafa A, Grice J, Roberts MS, Isbister GK. Acute behavioural disturbance associated with phenibut purchased via an internet supplier. Clin Toxicol (Phila). 2015;53(7):636-8. PubMed
  2. O'Connell CW, Schneir AB, Hwang JQ, Cantrell FL. Phenibut, the appearance of another potentially dangerous product in the United States. Am J Med. 2014 Aug;127(8):e3-4. PubMed
  3. Sankary S, Canino P, Jackson J. Phenibut overdose. AM J Emerg Med. 2017 Mar;35(3):516.e1-516.e2.
  4. Graves JM, Dilley J, Kubsad S, Liebelt E. Notes from the field: phenibut exposures reported to poison centers - United States, 2009-2019. MMWR Morb Mortal Wkly Rep 2020;69(35):1227-8. 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

Phenibut Also Interacts With Other Medications

Phenibut has 247 moderate known drug interactions in our database — the Nelarabine one above is one of them. If you take anything else, check it against the full list below.

Moderate 247 No known interaction 2,583 (incl. Nelarabine)
Taking anything else?

Check Another of Your Medications Against Phenibut

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

Everything else you take

See Every Supplement That Interacts With Nelarabine

This page covers Phenibut 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

One more smart check

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

We hold 41 real supplement products containing Phenibut, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Phenibut. Your product may carry other ingredients that interact with Nelarabine too, on top of Phenibut — 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 Phenibut 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 Phenibut
Top half

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

29 days ago today
Medication Nelarabine
Top 25%

#668 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 Phenibut

What is Phenibut?

Phenibut
  • Anxiety and stress
  • Insomnia and sleep problems
  • Stress relief
  • Mood and focus
  • Reducing alcohol withdrawal symptoms (unproven)

Phenibut is a synthetic, lab-made central nervous system depressant—not a natural herb—that some people use for anxiety and sleep, but it carries a serious risk of tolerance, dependence, and dangerous withdrawal. It is not an approved medication or dietary supplement in the United States, and we do not recommend its use. Talk to a doctor or pharmacist about safer, proven options for anxiety or sleep.

Read the full Phenibut 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.

See full Nelarabine Injection drug information
Keep checking

Other Drugs & Phenibut

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

0Major
247Moderate
0Minor
2,582No known interaction
247 Moderate 2,582 No interaction
Moderate

247 interactions

Showing 60 of 247 moderate interactions — see all 247 on the Phenibut page.

No interaction 2,582 drugs checked — show the list

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

Showing the 60 most looked-up of 2,582 medications checked with no known interaction — see the full Phenibut list.

See the full Phenibut interactions page
See every supplement checked against Nelarabine, 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
Phenibut monograph › Uses, safety, and every drug interaction in one place Nelarabine supplement interactions › Every supplement checked against Nelarabine, ranked by severity Nelarabine Injection 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 Phenibut and Nelarabine Together: Common Questions

Can you take Phenibut with Nelarabine?
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 Phenibut and Nelarabine 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 Nelarabine and Phenibut?

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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.