Drug & supplement interaction

Scotch Thistle + Neratinib Maleate

Neratinib Maleate brand name: Nerlynx.

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

We found no known interaction between Scotch Thistle and Neratinib Maleate 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 Neratinib Maleate states a food rule worth keeping to.

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Interaction report

Scotch Thistle and Neratinib Maleate

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 Neratinib Maleate and Scotch Thistle 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.

Worth understanding: our licensed dataset holds no drug-interaction record for Scotch Thistle at all — not against Neratinib Maleate, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

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.

Scotch Thistle safety at a glance

Scotch Thistle overall Not established There is little high-quality research on its safety in humans.
Pregnancy Avoid Not enough safety data, so avoid use during pregnancy.
Breastfeeding Avoid Safety is unknown while breastfeeding, so it is best avoided.

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

Still wondering about combining Neratinib Maleate and Scotch Thistle? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Neratinib Maleate’s Own FDA Label Lists

This is not an interaction — none of it involves Scotch Thistle. These are the most notable effects listed in the ADVERSE REACTIONS section of Neratinib Maleate’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 6 of them are worth acting on rather than waiting out — marked below.

  • Pain or burning when passing urine Worth acting on
  • Dehydration Worth acting on
  • Kidney problems Worth acting on
  • Liver problems Worth acting on
  • Bleeding or bruising Worth acting on
  • A higher chance of infection Worth acting on
  • Diarrhea mentioned in 54.4% of FDA reports for Neratinib Maleate
  • Acne
  • Reduced appetite mentioned in 11.0% of FDA reports for Neratinib Maleate
  • Dry skin

Showing the 10 most notable of 26 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Neratinib Maleate. Read the label on DailyMed › Where a percentage is shown, it is the share of 2,294 voluntary FDA FAERS reports for Neratinib Maleate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Scotch Thistle’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Scotch Thistle side to compare — that is a limit of the record, not a statement that Scotch Thistle has no side effects.

How to take them

Some Neratinib Maleate Products Have a Food Rule — Scotch Thistle Should Not Break It

At least one FDA label for a product containing Neratinib Maleate says to take it with food. If you take Scotch Thistle on an empty stomach out of habit, keep them separate — and take Neratinib Maleate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Neratinib Maleate 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.

( 2.1 , 2.2 ) Extended adjuvant treatment of early-stage breast cancer: 240 mg (6 tablets) given orally once daily, with food, continuously until disease recurrence or for up to one year.

From the Dosage and Administration section of the FDA label we read for Neratinib Maleate — 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 Neratinib Maleate

This page covers Scotch Thistle only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Neratinib Maleate page lists 168 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 124 moderate · 38 minor.

From our pharmacist’s overview on the Neratinib Maleate page

“This list deserves a careful read, not a quick skim. Neratinib (Nerlynx) treats HER2-positive breast cancer, and 121 of the 168 supplements on file can raise or lower its blood level by acting on CYP3A4, the enzyme that clears it.”

Reviewed by 2 · Jul 18, 2026

Open the Neratinib Maleate interaction page

How much people look this up

Where Scotch Thistle and Neratinib Maleate 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 Scotch Thistle
Steady interest

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

29 days ago today
Medication Neratinib Maleate
Steady interest

#2,249 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. Scotch Thistle is not yet covered by that licensed database, so its write-up cites publicly available medical sources directly (see the references below).
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Scotch Thistle reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Scotch Thistle and Neratinib Maleate records this page draws on were last updated June 22, 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 Scotch Thistle

What is Scotch Thistle?

Scotch Thistle
  • Digestive upset
  • Liver and gallbladder support
  • Mild diuretic
  • Skin sores and wound care (traditional/topical)
  • General tonic

Scotch Thistle is a tall, spiny plant used in folk medicine for digestion, liver complaints, and as a mild diuretic, but there is very little modern scientific evidence to support these uses. Because reliable safety and dosing information is lacking, it is best to talk with a pharmacist or doctor before trying it, and to avoid it during pregnancy and breastfeeding.

Onopordum acanthium · Asteraceae · Aerial parts (flowers, leaves, stems) and roots; sometimes seeds · Tea (dried herb infusion), tincture, capsules, dried herb

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

Scotch Thistle: dosing

There is no established, standardized dose for Scotch Thistle. Because it has not been well studied in people, safe and effective amounts are simply not known.If you choose to use a commercial product, follow the directions on the label and do not exceed the recommended amount.

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

Read the full Scotch Thistle monograph & all interactions
Medication

About Neratinib

What Is Neratinib Used For?

Brand name: Nerlynx

Nerlynx (neratinib) is used on its own as extended adjuvant treatment — meaning ongoing therapy after initial treatment is done — for adults with early-stage HER2-positive breast cancer who have already completed trastuzumab-based therapy.

Nerlynx is also used in combination with another chemotherapy drug, capecitabine, for adults with advanced or metastatic (spread) HER2-positive breast cancer who have already received two or more prior HER2-targeted regimens in the metastatic setting.

See full Neratinib drug information
Keep checking

Other Drugs & Scotch Thistle

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Scotch Thistle list.

See the full Scotch Thistle interactions page
See every supplement checked against Neratinib Maleate, ranked by severity
Evidence & sources

Scotch Thistle References

The 2 sources that drive our Scotch Thistle monograph — publicly available pages from reputable medical and government organizations. Every link was verified to work before publishing. Scotch Thistle is not covered by the licensed Natural Medicines interaction database, so its page cites these public sources directly.

  1. Herbs and Supplements — MedlinePlus (U.S. National Library of Medicine) Source
  2. Using Dietary Supplements Wisely — NIH National Center for Complementary and Integrative Health (NCCIH) Source

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 Scotch Thistle and Neratinib Maleate Together: Common Questions

Is it safe to take Scotch Thistle with Neratinib Maleate?
We do not list a known interaction between Scotch Thistle and Neratinib Maleate. 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.
Should I take Scotch Thistle and Neratinib Maleate at the same time of day?
At least one FDA label for a product containing Neratinib Maleate says to take it with food. If you take Scotch Thistle on an empty stomach out of habit, keep them separate and take Neratinib Maleate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Neratinib Maleate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Does Neratinib Maleate interact with any supplements?
Yes. Neratinib Maleate has documented interactions with 168 supplements in our database — Scotch Thistle is not one of them. The Neratinib Maleate 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

Scotch Thistle monograph Uses, safety profile, and every drug interaction in one place Neratinib drug information The full plain-English guide to this medication Neratinib Maleate supplement interactions Every supplement checked against Neratinib Maleate, 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 2 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Neratinib Maleate and Scotch Thistle?

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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.