Drug & supplement interaction

Sage + Nivolumab

Nivolumab brand name: Opdivo.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Sage 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

Sage 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 Sage 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.

Sage safety at a glance

Sage overall Use caution Generally safe as a food and short-term as tea, but concentrated extracts and the essential oil should be used cautiously.
Pregnancy Likely Unsafe When used orally. The constituent thujone can have menstrual stimulant and abortifacient effects. Read the full pregnancy detail
Breastfeeding Possibly Unsafe When used orally; sage is thought to reduce the supply of mother's milk. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Nivolumab and Sage? 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. Sage has documented interactions with 14 drug classes — the most serious being anticholinergic drugs (moderate), anticonvulsants (moderate) and antidiabetes drugs (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

Sage Does Interact With Other Medications

Sage has 1,296 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 1,296 No known interaction 1,534 (incl. Nivolumab)
Taking anything else?

Check Another of Your Medications Against Sage

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

What to actually watch for

No Interaction Found — But Data Suggests Sage 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.

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

    Sage

    “Orally, sage can cause nausea, vomiting, abdominal pain, and diarrhea.

    Topically, sage extract sprayed into the mouth and throat can cause dryness or mild burning of the throat.”

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

    3 sources cited
    1. 10810. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.
    2. 17177. Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed
    3. 72619. Hubbert, M., Sievers, H., Lehnfeld, R., and Kehrl, W. Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis - a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Eur

    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 ›

  • A skin rash reported in 3.2% of FDA reports for Nivolumab Additional detail

    Sage

    “Orally, sage extract has been reported to cause acneiform skin eruptions in one patient in a clinical trial.

    Topically, sage leaves can cause contact dermatitis. Sage extract can cause burning and pain.”

    Sage · Natural Medicines adverse-effect record, reported in dermatitis.

    5 sources cited
    1. 91970. Vandecasteele K, Ost P, Oosterlinck W, et al. Evaluation of the efficacy and safety of Salvia officinalis in controlling hot flashes in prostate cancer patients treated with androgen deprivation. Phytother Res. 2012;26(2):208-13.
    2. 46902. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
    3. 72661. Mayer, E., Gescheidt-Shoshany, H., and Weltfriend, S. Allergic contact dermatitis caused by Salvia officinalis extract. Contact Dermatitis 2011;64(4):237-238. PubMed
    4. 72710. Sertoli, A., Fabbri, P., Campolmi, P., and Panconesi, E. Allergic contact dermatitis to Salvia Officinalis, Inula Viscosa and Conyza Bonariensis. Contact Dermatitis 1978;4(5):314-315.
    5. 10437. Saller R, Buechi S, Meyrat R, Schmidhauser C. Combined herbal preparation for topical treatment of Herpes labialis. Forsch Komplementarmed Klass Naturheilkd 2001;8:373-82. 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

    Sage

    “Orally, sage can cause dizziness or agitation. Thujone, a constituent of common sage (Salvia officinalis), is a neurotoxin and can cause seizures. Camphor and cineol, constituents of common sage and Spanish sage, can also cause neurotoxicity and seizures in high doses. Generalized tonic-clonic seizures have been reported in adults, children, and infants after ingestion of sage oil.”

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

    6 sources cited
    1. 10810. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.
    2. 17177. Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed
    3. 10812. Perry NB, Anderson RE, Brennan NJ, et al. Essential oils from dalmatian sage (Salvia officinalis l.): variations among individuals, plant parts, seasons, and sites. J Agric Food Chem 1999;47:2048-54..
    4. 12868. Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. J Neurol 1999;246:667-70. PubMed
    5. 10334. Perry NS, Bollen C, Perry EK, Ballard C. Salvia for dementia therapy: review of pharmacological activity and pilot tolerability clinical trial. Pharmacol Biochem Behav 2003;75:651-9.. PubMed
    6. 72666. Halicioglu, O., Astarcioglu, G., Yaprak, I., and Aydinlioglu, H. Toxicity of Salvia officinalis in a newborn and a child: an alarming report. Pediatr.Neurol. 2011;45(4):259-260. PubMed

    Nivolumab

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

Reported for Sage but not commonly for Nivolumab: anxiety or restlessness and seizures.

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

Special populations

Sage in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally. The constituent thujone can have menstrual stimulant and abortifacient effects.

Lactation Possibly Unsafe

When used orally; sage is thought to reduce the supply of mother's milk.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

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

At least one FDA label for a product containing Nivolumab says to take it on an empty stomach. Most supplements — Sage 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 Sage 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.

Overlapping uses

What Nivolumab Is Prescribed For, and What Sage Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Nivolumab is a prescription medicine with approved uses on its FDA label. Sage is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Nivolumab is prescribed for: 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.

Read the rest of what Nivolumab is prescribed for

Your oncologist will determine which use applies to your situation.

Sage has been studied for:

  • Lung cancer studied, not established Sage has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Sage for lung cancer

    It is unclear if dietary sage is beneficial for lung cancer prevention.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Nivolumab on your own; if you are taking Sage for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Nivolumab

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

We hold 718 real supplement products containing Sage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sage. Even though Sage 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 Sage 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 Sage
Top 25%

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

29 days ago today
Medication Nivolumab
Top 25%

#376 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 Sage reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Sage and Nivolumab records this page draws on were last updated July 11, 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 Sage

What is Sage?

Sage
  • Sore throat and mouth irritation
  • Digestive upset
  • Excessive sweating
  • Memory and thinking
  • Menopause symptoms (hot flashes)
  • General antioxidant support

Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.

Salvia officinalis · Lamiaceae · Leaves and essential oil · Tea, capsules, tablets, tincture/extract, essential oil, lozenges, mouth rinse/gargle

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

Sage: dosing

There is no single official or standardized dose of sage, and the right amount depends on the form and the product. Sage tea, gargles, capsules, and extracts all differ in strength.The best approach is to follow the directions on the product label and not exceed the recommended amount.

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

Read the full Sage 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 & Sage

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

0Major
1,296Moderate
0Minor
1,533No known interaction
1,296 Moderate 1,533 No interaction
Moderate

1,296 interactions

Showing 60 of 1,296 moderate interactions — see all 1,296 on the Sage page.

No interaction 1,533 drugs checked — show the list

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

Showing the 60 most looked-up of 1,533 medications checked with no known interaction — see the full Sage list.

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

Sage References

The 27 references that drive our Sage 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. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Todorov S, Philianos S, Petkov V, et al. Experimental pharmacological study of three species from genus Salvia. Acta Physiol Pharmacol (Bulg) 1984;10:13-20.
  3. Perry NS, Bollen C, Perry EK, Ballard C. Salvia for dementia therapy: review of pharmacological activity and pilot tolerability clinical trial. Pharmacol Biochem Behav 2003;75:651-9.. PubMed
  4. Saller R, Buechi S, Meyrat R, Schmidhauser C. Combined herbal preparation for topical treatment of Herpes labialis. Forsch Komplementarmed Klass Naturheilkd 2001;8:373-82. PubMed
  5. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.
  6. Perry NB, Anderson RE, Brennan NJ, et al. Essential oils from dalmatian sage (Salvia officinalis l.): variations among individuals, plant parts, seasons, and sites. J Agric Food Chem 1999;47:2048-54..
  7. Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
  8. Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. J Neurol 1999;246:667-70. PubMed
  9. Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed
  10. Hellum BH, Nilsen OG. The in vitro inhibitory potential of trade herbal products on human CYP2D6-mediated metabolism and the influence of ethanol. Basic Clin Pharmacol Toxicol. 2007 Nov;101:350-8.
  11. Orhan, I., Kartal, M., Kan, Y., and Sener, B. Activity of essential oils and individual components against acetyl- and butyrylcholinesterase. Z.Naturforsch.C. 2008;63(7-8):547-553.
  12. Perry, N. S., Houghton, P. J., Theobald, A., Jenner, P., and Perry, E. K. In-vitro inhibition of human erythrocyte acetylcholinesterase by salvia lavandulaefolia essential oil and constituent terpenes. J Pharm Pharmacol 2000;52(7):895-902.
  13. Perry, N. S., Houghton, P. J., Sampson, J., Theobald, A. E., Hart, S., Lis-Balchin, M., Hoult, J. R., Evans, P., Jenner, P., Milligan, S., and Perry, E. K. In-vitro activity of S. lavandulaefolia (Spanish sage) relevant to treatment of Alzheimer's diseas
  14. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  15. Kavvadias, D., Monschein, V., Sand, P., Riederer, P., and Schreier, P. Constituents of sage (Salvia officinalis) with in vitro affinity to human brain benzodiazepine receptor. Planta Med. 2003;69(2):113-117.

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 Sage and Nivolumab Together: Common Questions

Is it safe to take Sage with Nivolumab?
We do not list a known interaction between Sage 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 Sage and Nivolumab have any of the same side effects?
Yes — our sources link each of them separately to 6 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 Sage 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 Sage 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.
Are Sage and Nivolumab used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Sage in each. That is a conversation for your prescriber, especially if Nivolumab is being adjusted to a target.
How was the Sage and Nivolumab combination checked?
Interactions in our licensed database are recorded against drug classes. Nivolumab is filed under 1 classification, and Sage has documented interactions with 14 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 Sage interact with any other medications?
Yes. Sage has 1,296 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 — Sage 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

Sage 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 27 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nivolumab and Sage?

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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.