Drug & supplement interaction

Podophyllum + Nivolumab

Nivolumab brand name: Opdivo.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Podophyllum and Nivolumab in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Nivolumab states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Podophyllum and Nivolumab

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Nivolumab and Podophyllum in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Podophyllum at all — not against Nivolumab, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Podophyllum safety at a glance

Podophyllum overall Avoid The plant and its crude resin are toxic; only standardized prescription topical products should be used under supervision.
Pregnancy Likely Unsafe When used orally or topically for self-medication; avoid using. Podophyllum is potentially embryotoxic and teratogenic. Oral and topical use can result in birth... Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally or topically for self-medication; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Nivolumab and Podophyllum? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Podophyllum and Nivolumab May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 5 of them are worth acting on rather than waiting out — marked below.

  • Low potassium Worth acting on Additional detail

    Podophyllum

    “Orally, chronic use of podophyllum as a cathartic can cause hypokalemia and metabolic alkalosis.”

    Podophyllum · Natural Medicines adverse-effect record, reported in hypokalemia.

    1 source cited
    1. 5617. Cassidy DE, Drewry J, Fanning JP. Podophyllum toxicity: a report of a fatal case and a review of the literature. J Toxicol Clin Toxicol 1982;19:35-44. PubMed

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Kidney problems Worth acting on Additional detail

    Podophyllum

    “Orally and topically, podophyllum resin can cause kidney failure.”

    Podophyllum · Natural Medicines adverse-effect record, reported in kidney failure.

    3 sources cited
    1. 5617. Cassidy DE, Drewry J, Fanning JP. Podophyllum toxicity: a report of a fatal case and a review of the literature. J Toxicol Clin Toxicol 1982;19:35-44. PubMed
    2. 12898. Frasca T, Brett AS, Yoo SD. Mandrake toxicity. A case of mistaken identity. Arch Intern Med 1997;157:2007-9.
    3. 12900. Mack RB. Living mortals run mad. Mandrake (podophyllum) poisoning. N C Med J 1992;53:98-9.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Raised blood pressure Worth acting on Additional detail

    Podophyllum

    “Orally and topically, podophyllum resin can cause tachycardia, hypertension or hypotension, and cardiotoxicity.”

    Podophyllum · Natural Medicines adverse-effect record, reported in hypertension.

    3 sources cited
    1. 5617. Cassidy DE, Drewry J, Fanning JP. Podophyllum toxicity: a report of a fatal case and a review of the literature. J Toxicol Clin Toxicol 1982;19:35-44. PubMed
    2. 12898. Frasca T, Brett AS, Yoo SD. Mandrake toxicity. A case of mistaken identity. Arch Intern Med 1997;157:2007-9.
    3. 12900. Mack RB. Living mortals run mad. Mandrake (podophyllum) poisoning. N C Med J 1992;53:98-9.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Shortness of breath / Liver problems Worth acting on Additional detail

    Podophyllum

    Recorded for Podophyllum in the same Natural Medicines adverse-effect record shown under Kidney problems above.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • A change in taste Additional detail

    Podophyllum

    “Orally and topically, podophyllum resin can cause nausea, severe vomiting, diarrhea, abdominal pain, and ileus.

    Topically, podophyllum resin applied to the tongue or oral mucosa can cause transient loss of taste and local irritation.”

    Podophyllum · Natural Medicines adverse-effect record, reported in diarrhea.

    6 sources cited
    1. 5617. Cassidy DE, Drewry J, Fanning JP. Podophyllum toxicity: a report of a fatal case and a review of the literature. J Toxicol Clin Toxicol 1982;19:35-44. PubMed
    2. 12898. Frasca T, Brett AS, Yoo SD. Mandrake toxicity. A case of mistaken identity. Arch Intern Med 1997;157:2007-9.
    3. 12900. Mack RB. Living mortals run mad. Mandrake (podophyllum) poisoning. N C Med J 1992;53:98-9.
    4. 12897. Lozada-Nur F, Costa C. Retrospective findings of the clinical benefits of podophyllum resin 25% sol on hairy leukoplakia. Clinical results in nine patients. Oral Surg Oral Med Oral Pathol 1992;73:555-8. PubMed
    5. 68895. Moura, M. D., Guimaraes, T. R., Fonseca, L. M., de, Almeida Pordeus, I, and Mesquita, R. A. A random clinical trial study to assess the efficiency of topical applications of podophyllin resin (25%) versus podophyllin resin (25%) together with acyclovir c
    6. 68942. Gowdey, G., Lee, R. K., and Carpenter, W. M. Treatment of HIV-related hairy leukoplakia with podophyllum resin 25% solution. Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod. 1995;79(1):64-67. PubMed

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Low blood pressure Additional detail

    Podophyllum

    Recorded for Podophyllum in the same Natural Medicines adverse-effect record shown under Kidney problems above.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Itching Additional detail

    Podophyllum

    “Topically, podophyllum resin can cause severe local irritation and ulcerations.

    Topically, the podophyllum constituent podophyllotoxin causes erythema, erosions, burning, pain, itching, and tenderness associated with wart necrosis.”

    Podophyllum · Natural Medicines adverse-effect record, reported in erythema.

    4 sources cited
    1. 12900. Mack RB. Living mortals run mad. Mandrake (podophyllum) poisoning. N C Med J 1992;53:98-9.
    2. 68905. Martin, L. K., Rubin, A. I., Theocharous, C., and Murrell, D. F. Podophyllin reaction mimicking Bowen's disease in a patient with delusions of verrucosis. Clin Exp.Dermatol 2008;33(4):443-445. PubMed
    3. 12902. Longstaff E, von Krogh G. Condyloma eradication: self-therapy with 0.15-0.5% podophyllotoxin versus 20-25% podophyllin preparations--an integrated safety assessment. Regul Toxicol Pharmacol 2001;33:117-37. PubMed
    4. 12903. Wiley DJ, Douglas J, Beutner K, et al. External genital warts: diagnosis, treatment, and prevention. Clin Infect Dis 2002;35:S210-24. PubMed

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab. Read the label on DailyMed ›

  • Stomach pain / Diarrhea reported in 5.4% of FDA reports for Nivolumab Additional detail

    Podophyllum

    Recorded for Podophyllum in the same Natural Medicines adverse-effect record shown under Kidney problems above.

    Nivolumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Nivolumab, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Showing the 10 most notable of 12 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Podophyllum but not commonly for Nivolumab: hallucinations, a fast or pounding heartbeat and a bowel blockage.

Effects for Nivolumab come from the ADVERSE REACTIONS section of its FDA label; effects for Podophyllum come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 96,645 voluntary FDA FAERS reports for Nivolumab that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Podophyllum in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally or topically for self-medication; avoid using. Podophyllum is potentially embryotoxic and teratogenic. Oral and topical use can result in birth defects and fetal death.

Lactation Likely Unsafe

When used orally or topically for self-medication; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Nivolumab Products Have a Food Rule — Podophyllum Should Not Break It

At least one FDA label for a product containing Nivolumab says to take it on an empty stomach. Most supplements — Podophyllum included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Nivolumab on its own and move Podophyllum to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Nivolumab products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Table 2: Recommended Dosages of Intravenous OPDIVO in Combination with Other Therapeutic Agents Indication Recommended OPDIVO Dosage Duration of Therapy Unresectable or metastatic melanoma 1 mg/kg every 3 weeks with ipilimumab 3 mg/kg In combination with ipilimumab for a maximum of 4 doses or until unacceptable toxicity, whichever occurs earlier Adult patients and pediatric patients aged 12 years

From the Dosage and Administration section of the FDA label we read for Nivolumab — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Nivolumab

This page covers Podophyllum only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nivolumab page lists 1 supplement it has a documented interaction with, worst first, each one explained.

The most serious there right now: American Pawpaw (minor).

By severity: 1 minor.

From our pharmacist’s overview on the Nivolumab page

“Nivolumab (Opdivo) is an immunotherapy infusion that trains the body's own immune system to recognize and attack cancer cells, the kind of drug you might expect to carry a long list of supplement warnings. It does not.”

Reviewed by 2 · Jul 18, 2026

Open the Nivolumab interaction page

One more smart check

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

We hold 9 real supplement products containing Podophyllum, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Podophyllum. Even though Podophyllum itself has no known interaction with Nivolumab, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Podophyllum and Nivolumab 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 Podophyllum
Steady interest

#1,005 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Nivolumab
Top 25%

#353 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Podophyllum reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Podophyllum and Nivolumab records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Podophyllum

What is Podophyllum?

  • Genital and skin warts (topical)
  • Constipation (historical/traditional laxative)
  • Digestive complaints (homeopathic)
  • Watery diarrhea (homeopathic)
  • Liver and gallbladder remedies (traditional)

Podophyllum (American mayapple) is a toxic plant whose resin contains podophyllotoxin, used in prescription topical products to treat warts. The raw plant and crude resin are poisonous if taken by mouth and should never be self-used. Only use FDA-approved wart products exactly as directed and under medical guidance.

Podophyllum peltatum · Berberidaceae · Dried root and rhizome (and the resin extracted from it, called podophyllin) · Topical resin/solution (prescription podophyllin and podofilox), homeopathic preparations; historically a crude purgative

An interaction check asks whether these two react with each other — it does not ask whether Podophyllum is a good idea for someone in your situation. Here is what our Podophyllum record says about it on its own.

Podophyllum: dosing

There is no safe self-care oral dose for podophyllum, and the whole plant should not be taken by mouth. For warts, dosing is determined entirely by the strength of the prescription product and your clinician's instructions.If you are prescribed a topical podophyllin or podofilox product, use only the amount directed, apply it only to the warts, and follow the schedule and wash-off instructions exactly. Never increase the amount or frequency on your own.

From our Podophyllum monograph — the full record covers uses, side effects and every documented interaction.

Read the full Podophyllum monograph & all interactions
Medication

About Nivolumab Injection

What Is Nivolumab Injection Used For?

Brand name: Opdivo

Opdivo (nivolumab) is used to treat many types of cancer in adults, and some in patients 12 years and older. It can be used alone or in combination with other therapies depending on the cancer type and stage. Cancers it treats include melanoma (including after surgery to reduce the chance of the cancer coming back), non-small cell lung cancer, malignant pleural mesothelioma, advanced renal cell carcinoma (kidney cancer), classical Hodgkin lymphoma, squamous cell carcinoma of the head and neck, urothelial carcinoma (bladder cancer), colorectal cancer with specific genetic features (MSI-H or dMMR), hepatocellular carcinoma (liver cancer), esophageal cancer, gastroesophageal junction cancer, and gastric (stomach) cancer.

Some uses require the tumor to test positive for a protein called PD-L1, and some are specific to certain stages of disease or prior treatments received. Your oncologist will determine which use applies to your situation.

Most-Reported Side Effects for Nivolumab

From FAERS, the FDA’s public side-effect reporting system (96,645 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Malignant neoplasm progression 9,878 reports
Diarrhea 5,251 reports
Fatigue 4,195 reports
Fever 3,721 reports
Nausea 3,182 reports
See full Nivolumab Injection drug information
Keep checking

Other Drugs & Podophyllum

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

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Podophyllum References

The 13 references that drive our Podophyllum monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Cassidy DE, Drewry J, Fanning JP. Podophyllum toxicity: a report of a fatal case and a review of the literature. J Toxicol Clin Toxicol 1982;19:35-44. PubMed
  2. Rosenstein G, Rosenstein H, Freeman M, Weston N. Podophyllum-a dangerous laxative. Pediatrics 1976;57:419-21. DOI
  3. Lozada-Nur F, Costa C. Retrospective findings of the clinical benefits of podophyllum resin 25% sol on hairy leukoplakia. Clinical results in nine patients. Oral Surg Oral Med Oral Pathol 1992;73:555-8. PubMed
  4. Frasca T, Brett AS, Yoo SD. Mandrake toxicity. A case of mistaken identity. Arch Intern Med 1997;157:2007-9.
  5. Schwartz J, Norton SA. Useful plants of dermatology. VI. The mayapple (Podophyllum). J Am Acad Dermatol 2002;47:774-5. PubMed
  6. Mack RB. Living mortals run mad. Mandrake (podophyllum) poisoning. N C Med J 1992;53:98-9.
  7. Longstaff E, von Krogh G. Condyloma eradication: self-therapy with 0.15-0.5% podophyllotoxin versus 20-25% podophyllin preparations--an integrated safety assessment. Regul Toxicol Pharmacol 2001;33:117-37. PubMed
  8. Wiley DJ, Douglas J, Beutner K, et al. External genital warts: diagnosis, treatment, and prevention. Clin Infect Dis 2002;35:S210-24. PubMed
  9. Moura, M. D., Guimaraes, T. R., Fonseca, L. M., de, Almeida Pordeus, I, and Mesquita, R. A. A random clinical trial study to assess the efficiency of topical applications of podophyllin resin (25%) versus podophyllin resin (25%) together with acyclovir c
  10. Martin, L. K., Rubin, A. I., Theocharous, C., and Murrell, D. F. Podophyllin reaction mimicking Bowen's disease in a patient with delusions of verrucosis. Clin Exp.Dermatol 2008;33(4):443-445. PubMed
  11. Chamberlain, M. J., Reynolds, A. L., and Yeoman, W. B. Medical memoranda. Toxic effect of podophyllum application in pregnancy. Br.Med.J. 8-12-1972;3(823):391-392. PubMed
  12. Karol, M. D., Conner, C. S., Watanabe, A. S., and Murphrey, K. J. Podophyllum: suspected teratogenicity from topical application. Clin.Toxicol. 1980;16(3):283-286. PubMed
  13. Gowdey, G., Lee, R. K., and Carpenter, W. M. Treatment of HIV-related hairy leukoplakia with podophyllum resin 25% solution. Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod. 1995;79(1):64-67. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Podophyllum and Nivolumab Together: Common Questions

Is it safe to take Podophyllum with Nivolumab?
We do not list a known interaction between Podophyllum and Nivolumab. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Podophyllum and Nivolumab have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Podophyllum and Nivolumab at the same time of day?
At least one FDA label for a product containing Nivolumab says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Nivolumab on its own and move Podophyllum to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.
Does Nivolumab interact with any supplements?
Yes. Nivolumab has documented interactions with 1 supplement in our database — Podophyllum is not one of them. The Nivolumab interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Nivolumab and Podophyllum?

Our pharmacists answer your medication & supplement questions — free.

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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.