Drug & supplement interaction

Propolis + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

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

Nintedanib Esylate falls into 2 drug categories that Propolis can interact with; the most serious is rated moderate. Theoretically, high doses of propolis might increase blood levels of drugs metabolized by CYP3A4.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Propolis and Nintedanib Esylate

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Propolis interacts with whole categories of medication. Nintedanib Esylate falls into 2 of those categories, so it can interact with Propolis in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Nintedanib Esylate

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

Theoretically, high doses of propolis might increase blood levels of drugs metabolized by CYP3A4.
Some in vitro research shows that propolis extract can inhibit CYP3A4; however, other in vitro research shows that propolis has no effect on CYP3A4 activity. Furthermore, animal research shows that propolis extract does not significantly affect CYP3A4 activity when administered to rats at doses up to 250 mg/kg. It is postulated that the constituents of propolis that might in inhibit CYP3A4 in vitro do not have significant effects in vivo due to low bioavailability and hepatic first-pass effect. This effect has not been reported in humans.
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 gist for Ofev (nintedanib): your body partly clears it through a liver pathway called CYP3A4. In some test-tube studies, propolis appeared to slow that pathway down. If that actually happened in people, more nintedanib could linger in your system, which might mean stronger side effects like diarrhea, nausea, stomach pain, poor appetite, or higher liver enzymes.

That said, I want to keep this in perspective. The evidence here is weak and only comes from lab and animal work, and animal studies didn't show a real effect, likely because propolis isn't well absorbed. This hasn't been reported in humans. Concentrated propolis supplements are more of a question than a dab on a cold sore. Still, since nintedanib is a serious medication, run it past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Naramoto K, Kato M, Ichihara K. Effects of an ethanol extract of Brazilian green propolis on human cytochrome P450 enzyme activities in vitro. J Agric Food Chem 2014;62(46):11296-302. PubMed
  2. Ryu CS, Oh SJ, Oh JM, et al. Inhibition of cytochrome P450 by propolis in human liver microsomes. Toxicol Res 2016;32(3):207-13. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Nintedanib Esylate also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, propolis might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that propolis water extract and the propolis constituent, caffeic acid phenethyl ester, can inhibit platelet aggregation. Additionally, evidence from an animal model shows that taking propolis in addition to warfarin decreases INR, suggesting that propolis can decrease the effectiveness of warfarin.
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 keep in mind with Ofev (nintedanib): this medication already carries its own bleeding risk on its own, separate from any supplement. In lab studies, propolis appears to make platelets a little less sticky, which in theory could add to that bleeding tendency. So the concern isn't that propolis changes how nintedanib is broken down. It's simply that two things that can nudge bleeding upward may stack together.

What might that look like in real life? Easy bruising, nosebleeds, bleeding gums, or longer bleeding from small cuts. I'll be honest, this is based only on test-tube and animal research, so it's theoretical and far from certain. Still, since nintedanib has bleeding warnings of its own, it's worth a quick chat with your pharmacist or doctor before adding concentrated propolis supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chen, T. G., Lee, J. J., Lin, K. H., Shen, C. H., Chou, D. S., and Sheu, J. R. Antiplatelet activity of caffeic acid phenethyl ester is mediated through a cyclic GMP-dependent pathway in human platelets. Chin J Physiol 6-30-2007;50(3):121-126.
  2. Akbay E, Özenirler Ç, Çelemli ÖG, Durukan AB, Onur MA, Sorkun K. Effects of propolis on warfarin efficacy. Kardiochir Torakochirurgia Pol. 2017;14(1):43-46. PubMed
  3. Zhang YX, Yang TT, Xia L, Zhang WF, Wang JF, Wu YP. Inhibitory Effect of Propolis on Platelet Aggregation In Vitro. J Healthc Eng. 2017;2017:3050895. 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

Propolis Also Interacts With Other Medications

Propolis has 920 moderate known drug interactions in our database — the Nintedanib Esylate one above is among them. If you take anything else, check it against the full list below.

Moderate 920 No known interaction 1,910 (incl. Nintedanib Esylate)
Taking anything else?

Check Another of Your Medications Against Propolis

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

Everything else you take

See Every Supplement That Interacts With Nintedanib Esylate

This page covers Propolis 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 Propolis as Part of a Dietary Supplement Product? Check It for Interactions

We hold 723 real supplement products containing Propolis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Propolis. Your product may carry other ingredients that interact with Nintedanib Esylate too, on top of Propolis — 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 Propolis 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 Propolis
Top 25%

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

29 days ago today
Medication Nintedanib Esylate
Steady interest

#1,957 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 Propolis

What is Propolis?

Propolis
  • Cold sores and herpes lesions (topical)
  • Sore throat and mouth sores
  • Wound and skin healing
  • Immune support
  • Oral and gum health

Propolis is a natural, resin-like substance made by bees that has antimicrobial and anti-inflammatory properties in lab studies. Early research suggests it may help with cold sores, mouth sores, and minor wounds, but high-quality evidence is limited for most uses. It is generally well tolerated, but allergic reactions can occur, especially in people allergic to bee products.

Read the full Propolis 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 & Propolis

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

0Major
920Moderate
0Minor
1,909No known interaction
920 Moderate 1,909 No interaction
Moderate

920 interactions

Showing 60 of 920 moderate interactions — see all 920 on the Propolis page.

No interaction 1,909 drugs checked — show the list

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

Showing the 60 most looked-up of 1,909 medications checked with no known interaction — see the full Propolis list.

See the full Propolis 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
Propolis 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 Propolis and Nintedanib Esylate Together: Common Questions

Can you take Propolis with Nintedanib Esylate?
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.
Why are there 2 interactions listed for Propolis and Nintedanib Esylate?
Nintedanib Esylate belongs to more than one drug category, and Propolis interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Propolis and Nintedanib Esylate 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

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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.