Drug & supplement interaction

Polypodium Leucotomos + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

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

Polypodium Leucotomos has a minor interaction with Nintedanib Esylate. Theoretically, Polypodium leucotomos might increase levels of drugs metabolized by CYP3A4.

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

Polypodium Leucotomos and Nintedanib Esylate

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Nintedanib Esylate

Nintedanib Esylate falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Polypodium Leucotomos interacts with.

Theoretically, Polypodium leucotomos might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggests that Polypodium leucotomos can decrease the metabolism of midazolam by a mechanism possibly related to the inhibition of CYP3A4. However, a small study in humans suggests that taking Polypodium leucotomos with midazolam does not affect the metabolism of midazolam.
Severity Minor Likelihood Unlikely Evidence B

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 situation with Ofev (nintedanib) and this fern extract. Nintedanib is partly handled by a liver enzyme called CYP3A4, though it isn't a major route for this drug. The concern on paper is that Polypodium leucotomos might slow that enzyme a bit, which could let nintedanib levels creep up. If that happened, you might notice more of its usual side effects, things like diarrhea, nausea, stomach upset, or changes in liver tests.

The good news: this is very theoretical. It comes mostly from lab and animal work, and a small human study actually showed no real effect on a similar test drug. So a meaningful problem is unlikely. Still, since nintedanib already tends to cause stomach and liver issues, it's worth a quick chat with your pharmacist or doctor before you add this supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Shinya K, Nishimura Y, Ryu K, et al. Short-term administration of Polypodium leucotomos extract does not inhibit CYP3A4-mediated metabolism of midazolam in healthy subjects: an open-label, two-period, fixed-sequence study. Int J Dermatol 2022.

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

Polypodium Leucotomos Also Interacts With Other Medications

Polypodium Leucotomos has 642 minor known drug interactions in our database — the Nintedanib Esylate one above is one of them. If you take anything else, check it against the full list below.

Minor 642 No known interaction 2,188 (incl. Nintedanib Esylate)
Taking anything else?

Check Another of Your Medications Against Polypodium Leucotomos

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

Everything else you take

See Every Supplement That Interacts With Nintedanib Esylate

This page covers Polypodium Leucotomos only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate interaction page

One more smart check

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

We hold 26 real supplement products containing Polypodium Leucotomos, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Polypodium Leucotomos. Your product may carry other ingredients that interact with Nintedanib Esylate too, on top of Polypodium Leucotomos — 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 Polypodium Leucotomos and Nintedanib Esylate 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 Polypodium Leucotomos
Steady interest

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

29 days ago today
Medication Nintedanib Esylate
Top half

#1,169 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 Polypodium Leucotomos

What is Polypodium Leucotomos?

  • Sun sensitivity and sunburn protection
  • Skin conditions like vitiligo and melasma
  • Polymorphic light eruption
  • Skin aging and photoaging
  • Atopic dermatitis support

Polypodium leucotomos is a fern extract taken by mouth, mostly studied as an add-on to (not a replacement for) sunscreen and for certain light-triggered skin conditions. Some early research is promising for reducing sun sensitivity, but the evidence is still limited and it should not replace standard sun protection. Talk with your pharmacist or doctor before starting it.

Read the full Polypodium Leucotomos monograph & all interactions
Medication

About Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib drug information
Keep checking

Other Drugs & Polypodium Leucotomos

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

0Major
0Moderate
642Minor
2,187No known interaction
642 Minor 2,187 No interaction
Minor

642 interactions

Showing 60 of 642 minor interactions — see all 642 on the Polypodium Leucotomos page.

No interaction 2,187 drugs checked — show the list

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

Showing the 60 most looked-up of 2,187 medications checked with no known interaction — see the full Polypodium Leucotomos list.

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

Can you take Polypodium Leucotomos with Nintedanib Esylate?
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 Polypodium Leucotomos and Nintedanib Esylate 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 Nintedanib Esylate and Polypodium Leucotomos?

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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.