Drug & supplement interaction

Sesame + Tamoxifen Citrate

Tamoxifen Citrate brand names: Nolvadex, Soltamox.

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

Tamoxifen Citrate falls into 3 drug categories that Sesame can interact with; the most serious is rated moderate. Theoretically, sesame might increase the levels and clinical effects of CYP2C9 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Sesame and Tamoxifen Citrate

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Sesame interacts with whole categories of medication. Tamoxifen Citrate falls into 3 of those categories, so it can interact with Sesame in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 3

Why this applies to Tamoxifen Citrate

Tamoxifen Citrate falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Sesame interacts with.

Theoretically, sesame might increase the levels and clinical effects of CYP2C9 substrates.
In vitro, sesame inhibits CYP2C9. However, this interaction has not been reported in humans.
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 thing to know about tamoxifen and sesame. Your liver uses an enzyme called CYP2C9 to help process tamoxifen. In lab dishes, sesame compounds appear to slow that enzyme down a little. On paper, that could mean slightly more tamoxifen hanging around in your body, which in theory might bump up effects like hot flashes, fatigue, or leg swelling.

But I want to be honest with you: this has only been seen in test tubes and animals, never in actual people taking tamoxifen. The sesame in a meal, a sprinkle of seeds or a drizzle of oil, is very unlikely to cause trouble. Concentrated sesame supplements are less studied, so if you use those, just mention it to your oncologist or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. von Moltke LL, Weemhoff JL, Bedir E, et al. Inhibition of human cytochromes P450 by components of Ginkgo biloba. J Pharm Pharmacol 2004;56:1039-44.
Moderate

TAMOXIFEN (Nolvadex)

2 of 3
Theoretically, sesame might interfere with tamoxifen.
In animal research, sesame seed reduces the tumor-inhibitory effect of tamoxifen by reducing apoptosis and increasing proliferation. This interaction has not been reported in humans.
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 honest picture with sesame and tamoxifen. The only concern comes from animal research, where eating sesame seed seemed to blunt how well tamoxifen fought breast cancer tumors. In those lab studies, the cancer cells were a little less likely to die off and a bit more likely to keep growing. That's a worry because tamoxifen's whole job is to slow or prevent breast cancer.

That said, this has never been shown in actual people, so we really don't know if it matters in real life. Sesame sprinkled on food is a normal part of eating and very unlikely to be a problem. I'd be more cautious about concentrated sesame supplements or sesame lignan pills. Before adding any of those, just run it by your oncologist or pharmacist so you can keep tamoxifen working its best.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sacco, S. M., Chen, J., Power, K. A., Ward, W. E., and Thompson, L. U. Lignan-rich sesame seed negates the tumor-inhibitory effect of tamoxifen but maintains bone health in a postmenopausal athymic mouse model with estrogen-responsive breast tumors. Menop PubMed
  2. Sacco, S. M., Power, K. A., Chen, J., Ward, W. E., and Thompson, L. U. Interaction of sesame seed and tamoxifen on tumor growth and bone health in athymic mice. Exp Biol Med (Maywood) 2007;232(6):754-761.
Minor

P-GLYCOPROTEIN SUBSTRATES

3 of 3

Tamoxifen Citrate also falls under P-GLYCOPROTEIN SUBSTRATES.

Theoretically, sesame might alter the transport of P-glycoprotein substrates.
In vitro research suggests that sesamin, a constituent of sesame, can inhibit the multi-drug transporter protein, P-glycoprotein. However, this interaction has not been reported in humans.
Severity Minor 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 short version: this is a very theoretical concern, and there's no good reason to think your sesame intake is a problem with tamoxifen. A compound in sesame called sesamin can block a transporter pump called P-glycoprotein in a test tube. In theory, slowing that pump could let a bit more tamoxifen stay in the body. But this has only been seen in lab and animal studies, never in actual people.

The amount of sesame you'd get from food (tahini, hummus, a sprinkle on a bun) is extremely unlikely to matter. Even concentrated sesame supplements have no human evidence of changing tamoxifen levels. If you're taking sesame in pill form regularly, just mention it to your pharmacist or oncologist so it's on your record.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Okura, T., Ibe, M., Umegaki, K., Shinozuka, K., and Yamada, S. Effects of dietary ingredients on function and expression of P-glycoprotein in human intestinal epithelial cells. Biol Pharm Bull 2010;33(2):255-259. PubMed
  2. Nabekura, T., Yamaki, T., Ueno, K., and Kitagawa, S. Inhibition of P-glycoprotein and multidrug resistance protein 1 by dietary phytochemicals. Cancer Chemother Pharmacol 2008;62(5):867-873. 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

Sesame Also Interacts With Other Medications

Sesame has 342 moderate, 185 minor known drug interactions in our database — the Tamoxifen Citrate one above is among them. If you take anything else, check it against the full list below.

Moderate 342 Minor 185 No known interaction 2,303 (incl. Tamoxifen Citrate)
Taking anything else?

Check Another of Your Medications Against Sesame

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

From our Q&A

Questions About Sesame or Tamoxifen Citrate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Sesame or Tamoxifen Citrate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Tamoxifen Citrate

This page covers Sesame only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tamoxifen Citrate page lists 210 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Beer (major) and Cesium (major).

By severity: 11 major · 166 moderate · 33 minor.

From our pharmacist’s overview on the Tamoxifen Citrate page

“Tamoxifen (Nolvadex, Soltamox) often stands between a breast cancer patient and a recurrence, so the stakes on this page run higher than usual. Eleven of the 210 supplements and herbs on file carry a major rating, and those eleven deserve your attention ahead of everything else.”

Reviewed by 2 · Jul 18, 2026

Open the Tamoxifen Citrate interaction page

One more smart check

Taking Sesame as Part of a Dietary Supplement Product? Check It for Interactions

We hold 434 real supplement products containing Sesame, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sesame. Your product may carry other ingredients that interact with Tamoxifen Citrate too, on top of Sesame — 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 Sesame and Tamoxifen Citrate 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 Sesame
Top half

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

29 days ago today
Medication Tamoxifen Citrate
Top 10%

#256 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 Sesame

What is Sesame?

  • Heart and cholesterol health
  • Blood pressure support
  • Source of healthy fats and minerals
  • Skin and hair care (topical oil)
  • Antioxidant support
  • Cooking and nutrition

Sesame is a nutritious seed and oil widely used in cooking and traditional medicine, and it provides healthy fats, fiber, and antioxidant compounds called lignans. Some early research suggests sesame may modestly help with cholesterol and blood pressure, but the evidence is limited. Sesame is also a common, sometimes serious, food allergen, so people with seed allergies should be careful.

Read the full Sesame monograph & all interactions
Medication

About Tamoxifen

What Is Tamoxifen Used For?

Brand names: Nolvadex, Soltamox

Tamoxifen is used to treat estrogen receptor-positive metastatic breast cancer in both women and men, and as follow-up (adjuvant) therapy after surgery for early-stage breast cancer in women. It also reduces the occurrence of cancer in the opposite breast when used as adjuvant therapy.

In women with ductal carcinoma in situ (DCIS — an early, non-invasive breast change) following surgery and radiation, tamoxifen lowers the risk of developing invasive breast cancer. It is also approved to reduce the risk of breast cancer in women who are at high risk but have not yet been diagnosed. Both Tamoxifen Citrate tablets and Soltamox oral solution share these indications.

See full Tamoxifen drug information
Keep checking

Other Drugs & Sesame

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

0Major
342Moderate
185Minor
2,302No known interaction
342 Moderate 185 Minor 2,302 No interaction
Moderate

342 interactions

Showing 60 of 342 moderate interactions — see all 342 on the Sesame page.

Minor

185 interactions

Showing 60 of 185 minor interactions — see all 185 on the Sesame page.

No interaction 2,302 drugs checked — show the list

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

Showing the 60 most looked-up of 2,302 medications checked with no known interaction — see the full Sesame list.

See the full Sesame interactions page
See every supplement checked against Tamoxifen Citrate, 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
Sesame monograph › Uses, safety, and every drug interaction in one place Tamoxifen Citrate supplement interactions › Every supplement checked against Tamoxifen Citrate, ranked by severity Tamoxifen 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 Sesame and Tamoxifen Citrate Together: Common Questions

Can you take Sesame with Tamoxifen Citrate?
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.
Why are there 3 interactions listed for Sesame and Tamoxifen Citrate?
Tamoxifen Citrate belongs to more than one drug category, and Sesame interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Sesame and Tamoxifen Citrate 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 Tamoxifen Citrate and Sesame?

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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.