Drug & supplement interaction

Rauwolscine + Nivolumab

Nivolumab brand name: Opdivo.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Rauwolscine 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

Rauwolscine 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 Rauwolscine 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.

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.

Rauwolscine safety at a glance

Rauwolscine overall Use caution It is a potent stimulant with limited human safety data and can affect heart rate and blood pressure.
Pregnancy Avoid Not enough safety data; avoid during pregnancy.
Breastfeeding Avoid Not enough safety data; avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Nivolumab and Rauwolscine? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Nivolumab

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nivolumab is filed under a single classification — antineoplastics. Rauwolscine has documented interactions with 6 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), calcium channel blockers (moderate) and clonidine (catapres) (moderate) — and none of Nivolumab’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Rauwolscine Does Interact With Other Medications

Rauwolscine has 677 moderate known drug interactions in our database — Nivolumab isn’t one of them. If you take anything else, check it against the full list below.

Moderate 677 No known interaction 2,153 (incl. Nivolumab)
Taking anything else?

Check Another of Your Medications Against Rauwolscine

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

What to actually watch for

No Interaction Found — But Data Suggests Rauwolscine 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. One of them is worth acting on rather than waiting out — marked below.

  • Kidney problems Worth acting on Additional detail

    Rauwolscine

    “Since rauwolscine is structurally related to yohimbine, rauwolscine might theoretically cause similar adverse effects. A case of acute renal failure related to yohimbine-induced systemic lupus erythematosus has been reported.”

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

    1 source cited
    1. 6169. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed

    “Since rauwolscine is structurally related to yohimbine, rauwolscine might theoretically cause similar adverse effects. There is one report of a hypersensitivity reaction including fever, chills, malaise, itchy and scaly skin, progressive renal failure, and lupus-like syndrome associated with ingestion of a one-day dose of yohimbine.”

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

    1 source cited
    1. 6169. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed

    Nivolumab

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

  • Chills Additional detail

    Rauwolscine

    “Since rauwolscine is structurally related to yohimbine, rauwolscine might theoretically cause similar adverse effects. Orally, yohimbine has been associated with reports of tremulousness, head twitching, seizures, loss of consciousness, enhanced brain norepinephrine release, decreased energy, dizziness, vertigo, headache, feeling cold, flushing, diaphoresis, and paralysis (11,18,3312,3971,17465,86786,86801,86804,8682…”

    Rauwolscine · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 11. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
    2. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    3. 3312. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
    4. 3971. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
    5. 17465. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
    6. 86786. Adeniyi, A. A., Brindley, G. S., Pryor, J. P., and Ralph, D. J. Yohimbine in the treatment of orgasmic dysfunction. Asian J Androl 2007;9(3):403-407. PubMed

    Nivolumab

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

  • Cough Additional detail

    Rauwolscine

    “Since rauwolscine is structurally related to yohimbine, rauwolscine might theoretically cause similar adverse effects. Orally, yohimbine may cause bronchospasm, tachypnea, cough, sinusitis, and rhinorrhea.”

    Rauwolscine · Natural Medicines adverse-effect record, reported in cough.

    4 sources cited
    1. 17465. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
    2. 86825. Landis, E. and Shore, E. Yohimbine-induced bronchospasm. Chest 1989;96(6):1424. PubMed
    3. 86850. Charney, D. S., Heninger, G. R., and Sternberg, D. E. Assessment of alpha 2 adrenergic autoreceptor function in humans: effects of oral yohimbine. Life Sci 6-7-1982;30(23):2033-2041.
    4. 94112. Wylie KR. Yohimbine and sinusitis. Br J Psychiatry. 1996;169(3):384-5. PubMed

    Nivolumab

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

  • Fever / Tiredness reported in 4.3% of FDA reports for Nivolumab Additional detail

    Rauwolscine

    Recorded for Rauwolscine 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 ›

  • Stomach upset / Diarrhea / Vomiting / Nausea reported in 5.4% of FDA reports for Nivolumab Additional detail

    Rauwolscine

    “Since rauwolscine is structurally related to yohimbine, rauwolscine might theoretically cause similar adverse effects. Nausea, vomiting, increased salivation, diarrhea, and gastrointestinal distress may occur with yohimbine use.”

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

    6 sources cited
    1. 3970. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
    2. 17465. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
    3. 86780. Bagheri, H., Schmitt, L., Berlan, M., and Montastruc, J. L. Effect of 3 weeks treatment with yohimbine on salivary secretion in healthy volunteers and in depressed patients treated with tricyclic antidepressants. Br J Clin Pharmacol 1992;34(6):555-558. PubMed
    4. 86786. Adeniyi, A. A., Brindley, G. S., Pryor, J. P., and Ralph, D. J. Yohimbine in the treatment of orgasmic dysfunction. Asian J Androl 2007;9(3):403-407. PubMed
    5. 86804. Myers, A. and Barrueto, F., Jr. Refractory priapism associated with ingestion of yohimbe extract. J Med Toxicol. 2009;5(4):223-225.
    6. 86827. Susset, J. G., Tessier, C. D., Wincze, J., Bansal, S., Malhotra, C., and Schwacha, M. G. Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol. 1989;141(6):1360-1363. PubMed

    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 ›

  • Dizziness Additional detail

    Rauwolscine

    “Orally, no adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted.

    Serious Adverse Effects (Rare):

    Orally: A related chemical, yohimbine, has been reported to cause serious adverse effects, such as loss of consciousness, paralysis, seizures, and vertigo.”

    Rauwolscine · Natural Medicines adverse-effect record, reported in epilepsy.

    Nivolumab

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

Showing the 10 most notable of 11 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Rauwolscine but not commonly for Nivolumab: fainting, an allergic reaction, wheezing and sweating.

Effects for Nivolumab come from the ADVERSE REACTIONS section of its FDA label; effects for Rauwolscine 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.

How to take them

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

At least one FDA label for a product containing Nivolumab says to take it on an empty stomach. Most supplements — Rauwolscine 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 Rauwolscine 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 Rauwolscine 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 Rauwolscine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 196 real supplement products containing Rauwolscine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rauwolscine. Even though Rauwolscine 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 Rauwolscine 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 Rauwolscine
Top half

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

29 days ago today
Medication Nivolumab
Steady interest

#2,015 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 Rauwolscine reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Rauwolscine and Nivolumab records this page draws on were last updated July 10, 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 Rauwolscine

What is Rauwolscine?

  • Fat loss and weight management
  • Bodybuilding and physique support
  • Energy and stimulant effects
  • Athletic performance
  • Libido support

Rauwolscine (alpha-yohimbine) is a stimulant alkaloid closely related to yohimbine that is marketed mainly in fat-burning and pre-workout supplements. Human evidence for its benefits is very limited, and it can raise heart rate and blood pressure and cause anxiety, so it should be used with caution and is not recommended for people with heart conditions, anxiety, or during pregnancy or breastfeeding.

Bark and roots (alkaloid extracted from plants such as Rauvolfia and Pausinystalia) · Capsules, tablets, powders (often in fat-burner and pre-workout blends)

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

Rauwolscine: dosing

There is no well-established or standardized dose for rauwolscine, and it has not been studied the way medicines are. Supplement products vary widely in how much they contain, and it is often combined with other stimulants.If you choose to use a product that contains it, follow the directions on the label, do not exceed the recommended amount, and consider starting with the lowest amount to see how you react.

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

Read the full Rauwolscine 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 & Rauwolscine

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

0Major
677Moderate
0Minor
2,152No known interaction
677 Moderate 2,152 No interaction
Moderate

677 interactions

Showing 60 of 677 moderate interactions — see all 677 on the Rauwolscine page.

No interaction 2,152 drugs checked — show the list

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

Showing the 60 most looked-up of 2,152 medications checked with no known interaction — see the full Rauwolscine list.

See the full Rauwolscine interactions page
See every supplement checked against Nivolumab, ranked by severity
Evidence & sources

Rauwolscine References

The 28 references that drive our Rauwolscine 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. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
  4. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
  5. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
  6. Sandler B, Aronson P. Yohimbine-induced cutaneous drug eruption, progressive renal failure, and lupus-like syndrome. Urol 1993;41:343-5. PubMed
  7. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
  8. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed
  9. Mustonen, P., Savola, J., and Lassila, R. Atipamezole, an imidazoline-type alpha(2)-adrenoceptor inhibitor, binds to human platelets and inhibits their adrenaline-induced aggregation more effectively than yohimbine. Thromb.Res 8-1-2000;99(3):231-237.
  10. Bagheri, H., Schmitt, L., Berlan, M., and Montastruc, J. L. Effect of 3 weeks treatment with yohimbine on salivary secretion in healthy volunteers and in depressed patients treated with tricyclic antidepressants. Br J Clin Pharmacol 1992;34(6):555-558. PubMed
  11. Swann, A. C., Birnbaum, D., Jagar, A. A., Dougherty, D. M., and Moeller, F. G. Acute yohimbine increases laboratory-measured impulsivity in normal subjects. Biol.Psychiatry 5-15-2005;57(10):1209-1211. PubMed
  12. Adeniyi, A. A., Brindley, G. S., Pryor, J. P., and Ralph, D. J. Yohimbine in the treatment of orgasmic dysfunction. Asian J Androl 2007;9(3):403-407. PubMed
  13. Giampreti, A., Lonati, D., Locatelli, C., Rocchi, L., and Campailla, M. T. Acute neurotoxicity after yohimbine ingestion by a body builder. Clin Toxicol.(Phila) 2009;47(8):827-829. PubMed
  14. Myers, A. and Barrueto, F., Jr. Refractory priapism associated with ingestion of yohimbe extract. J Med Toxicol. 2009;5(4):223-225.
  15. Berlin, I., Crespo-Laumonnier, B., Cournot, A., Landault, C., Aubin, F., Legrand, J. C., and Puech, A. J. The alpha 2-adrenergic receptor antagonist yohimbine inhibits epinephrine-induced platelet aggregation in healthy subjects. Clin Pharmacol.Ther. 199

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 Rauwolscine and Nivolumab Together: Common Questions

Is it safe to take Rauwolscine with Nivolumab?
We do not list a known interaction between Rauwolscine 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 Rauwolscine 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 Rauwolscine 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 Rauwolscine 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.
How was the Rauwolscine and Nivolumab combination checked?
Interactions in our licensed database are recorded against drug classes. Nivolumab is filed under 1 classification, and Rauwolscine has documented interactions with 6 drug classes — none of Nivolumab's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Rauwolscine interact with any other medications?
Yes. Rauwolscine has 677 documented drug interactions in our database — Nivolumab is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Nivolumab interact with any supplements?
Yes. Nivolumab has documented interactions with 1 supplement in our database — Rauwolscine 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

Where next

Keep Exploring

Rauwolscine monograph Uses, safety profile, and every drug interaction in one place Nivolumab Injection drug information The full plain-English guide to this medication Nivolumab supplement interactions Every supplement checked against Nivolumab, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 28 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nivolumab and Rauwolscine?

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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.