Drug & supplement interaction

Rauvolfia Vomitoria + Nelarabine

Nelarabine brand name: Atriance.

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

Rauvolfia Vomitoria has a moderate interaction with Nelarabine. Theoretically, taking Rauvolfia vomitoria might cause additive sedative effects.

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

Rauvolfia Vomitoria 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 Rauvolfia Vomitoria interacts with.

Theoretically, taking Rauvolfia vomitoria might cause additive sedative effects.
Rauvolfia vomitoria has sedative effects in animal research.
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 these two together. Nelarabine is a strong chemotherapy drug, and one of its known side effects is on the nervous system, things like drowsiness, dizziness, confusion, and feeling unusually sleepy or fatigued. Rauvolfia vomitoria contains alkaloids that can have their own calming or sedating effect, at least based on animal studies.

The concern on file is that stacking the two could add up to more drowsiness or grogginess than you'd get from the chemo alone. I want to be honest that this is a theoretical worry drawn from how these compounds behave, not something proven in people taking both. Still, since nelarabine is serious treatment, please loop in your oncology team or pharmacist before adding this herb.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ekong MB, Peter AI, Edagha IA, et al. Rauwolfia vomitoria inhibits olfaction and modifies olfactory bulb cells. Brain Res Bull 2016;124:206-13. PubMed
  2. Amole OO, Yemitan OK, Oshikoya KA. Anticonvulsant activity of Rauvol?a Vomitoria (Afzel). Afr J Pharmacy Pharmacol 2009;3:319-322.
  3. Campbell JI, Mortensen A, Mølgaard P. Tissue lipid lowering-effect of a traditional Nigerian anti-diabetic infusion of Rauwolfia vomitoria foilage and Citrus aurantium fruit. J Ethnopharmacol 2006;104:379-86. 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

Rauvolfia Vomitoria Also Interacts With Other Medications

Rauvolfia Vomitoria has 230 major, 522 moderate, 87 minor 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.

Major 230 Moderate 522 Minor 87 No known interaction 1,991 (incl. Nelarabine)
Taking anything else?

Check Another of Your Medications Against Rauvolfia Vomitoria

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

Everything else you take

See Every Supplement That Interacts With Nelarabine

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

We hold 17 real supplement products containing Rauvolfia Vomitoria, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rauvolfia Vomitoria. Your product may carry other ingredients that interact with Nelarabine too, on top of Rauvolfia Vomitoria — 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 Rauvolfia Vomitoria 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 Rauvolfia Vomitoria
Steady interest

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

29 days ago today
Medication Nelarabine
Steady interest

#2,332 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 Rauvolfia Vomitoria

What is Rauvolfia Vomitoria?

  • High blood pressure
  • Anxiety and agitation
  • Sleep problems
  • Mental health symptoms (traditional use)
  • Fever and general ailments

Rauvolfia vomitoria is an African shrub whose root contains powerful alkaloids, including reserpine, that have historically been used for high blood pressure and agitation. Because these compounds can strongly affect blood pressure, mood, and the nervous system, the plant can cause serious side effects and is not a casual supplement. Always talk to a doctor or pharmacist before using it.

Read the full Rauvolfia Vomitoria 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 & Rauvolfia Vomitoria

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

230Major
522Moderate
87Minor
1,990No known interaction
230 Major 522 Moderate 87 Minor 1,990 No interaction
Major

230 interactions

Showing 60 of 230 major interactions — see all 230 on the Rauvolfia Vomitoria page.

Moderate

522 interactions

Showing 60 of 522 moderate interactions — see all 522 on the Rauvolfia Vomitoria page.

Minor

87 interactions

Showing 60 of 87 minor interactions — see all 87 on the Rauvolfia Vomitoria page.

No interaction 1,990 drugs checked — show the list

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

Showing the 60 most looked-up of 1,990 medications checked with no known interaction — see the full Rauvolfia Vomitoria list.

See the full Rauvolfia Vomitoria 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
Rauvolfia Vomitoria 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 Rauvolfia Vomitoria and Nelarabine Together: Common Questions

Can you take Rauvolfia Vomitoria 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 Rauvolfia Vomitoria 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 Rauvolfia Vomitoria?

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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.