Drug & supplement interaction

Quillaia + Nelarabine

Nelarabine brand name: Atriance.

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

Quillaia has a moderate interaction with Nelarabine. Theoretically, concomitant use of quillaia with immunosuppressant drugs might decrease the effectiveness of these drugs.

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

Quillaia and Nelarabine

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Nelarabine

Nelarabine falls under IMMUNOSUPPRESSANTS — the group Quillaia interacts with.

Theoretically, concomitant use of quillaia with immunosuppressant drugs might decrease the effectiveness of these drugs.
In vitro research shows that some quillaia constituents have immunostimulant effects.
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 nelarabine (Atriance). This drug works by killing fast-growing cancer cells, and it's grouped here with medicines that quiet down the immune system. The concern with quillaia is purely a theoretical one: in lab dish studies, some of its saponin compounds seemed to nudge the immune system in the opposite direction, stimulating it. The worry is that this could, in theory, work against treatments meant to suppress immune activity.

Honestly, this is a weak, idea-stage signal, not something proven in people taking nelarabine. The tiny amounts of quillaia used to make foam in foods and drinks are very unlikely to matter. Still, while you're on a serious chemo medicine like this, please don't add a concentrated quillaia supplement without first checking with your oncology team or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. Wu JY, Gardner BH, Murphy CI, et al. Saponin adjuvant enhancement of antigen-specific immune responses to an experimental HIV-1 vaccine. J Immunol 1992;148:1519-25. DOI
  4. Fleck JD, Betti AH, da Silva FP, et al. Saponins from Quillaja saponaria and Quillaja brasiliensis: particular chemical characteristics and biological activities. Molecules 2019;24(1). pii: E171. 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

Quillaia Also Interacts With Other Medications

Quillaia has 120 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 120 No known interaction 2,710 (incl. Nelarabine)
Taking anything else?

Check Another of Your Medications Against Quillaia

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

Everything else you take

See Every Supplement That Interacts With Nelarabine

This page covers Quillaia 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

How much people look this up

Where Quillaia 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 Quillaia
Top half

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

29 days ago today
Medication Nelarabine
Steady interest

#1,736 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 Quillaia

What is Quillaia?

  • Cough and chest congestion
  • Foaming agent in beverages
  • Vaccine adjuvant (in pharmaceutical manufacturing)
  • Washing and cleansing (traditional soap)
  • Skin conditions

Quillaia (soap bark tree) is a plant whose bark contains foaming compounds called saponins, and it is widely used as an emulsifier in foods and drinks. As a supplement or herbal remedy its benefits are not well proven, and large amounts can be irritating or toxic, so it should be used cautiously and only as directed.

Read the full Quillaia 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 & Quillaia

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

0Major
120Moderate
0Minor
2,709No known interaction
120 Moderate 2,709 No interaction
Moderate

120 interactions

Showing 60 of 120 moderate interactions — see all 120 on the Quillaia page.

No interaction 2,709 drugs checked — show the list

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

Showing the 60 most looked-up of 2,709 medications checked with no known interaction — see the full Quillaia list.

See the full Quillaia 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
Quillaia 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 Quillaia and Nelarabine Together: Common Questions

Can you take Quillaia 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 Quillaia 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 Quillaia?

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.