Drug & supplement interaction

Slippery Elm + 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 Slippery Elm 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

Slippery Elm 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 Slippery Elm 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.

Slippery Elm safety at a glance

Slippery Elm overall Use caution Generally well tolerated for short-term use, but high-quality safety data are limited.
Pregnancy Use caution Not enough reliable safety data; some sources caution against using it during pregnancy.
Breastfeeding Use caution There is too little information on safety while breastfeeding, so caution is advised.

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

Still wondering about combining Nivolumab and Slippery Elm? 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. Slippery Elm has documented interactions with 1 drug class — the most serious being oral 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

Slippery Elm Does Interact With Other Medications

Slippery Elm has 2,022 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 2,022 No known interaction 808 (incl. Nivolumab)
Taking anything else?

Check Another of Your Medications Against Slippery Elm

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

What to actually watch for

No Interaction Found — But Data Suggests Slippery Elm 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.

  • Hives Worth acting on Additional detail

    Slippery Elm

    “Topically, slippery elm extracts can cause contact dermatitis. The pollen is an allergen (6). Contact dermatitis and urticaria have been reported after exposure to slippery elm or an oleoresin contained in the slippery elm bark.”

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

    2 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 75131. Czarnecki D, Nixon R, Bekhor P, and et al. Delayed prolonged contact urticaria from the elm tree. Contact Dermatitis 1993;28:196-197. PubMed

    Nivolumab

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

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

    Slippery Elm

    Recorded for Slippery Elm in the same Natural Medicines adverse-effect record shown under Hives 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 ›

Effects for Nivolumab come from the ADVERSE REACTIONS section of its FDA label; effects for Slippery Elm 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 — Slippery Elm Should Not Break It

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

Slippery Elm has been studied for:

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

    Slippery Elm for cancer

    Oral slippery elm has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

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 Slippery Elm for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Slippery Elm or Nivolumab

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Slippery Elm or Nivolumab, 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 Nivolumab

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

We hold 1,490 real supplement products containing Slippery Elm, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Slippery Elm. Even though Slippery Elm 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 Slippery Elm 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 Slippery Elm
Top 10%

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

29 days ago today
Medication Nivolumab
Top half

#819 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 Slippery Elm reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Slippery Elm 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 Slippery Elm

What is Slippery Elm?

Slippery Elm
  • Sore throat and cough
  • Heartburn and acid reflux
  • Digestive upset and IBS
  • Skin irritation (topical)
  • Constipation or diarrhea

Slippery elm is a traditional herbal remedy made from the inner bark of a North American elm tree, used mainly to soothe sore throats and irritated digestive tracts. Its mucilage can coat and calm mucous membranes, but solid human evidence for most uses is limited. It is generally considered low-risk for short-term use, but you should still check with your pharmacist or doctor first.

Ulmus rubra · Ulmaceae · Inner bark · Capsules, tablets, lozenges, powder, tea, throat lozenges, topical pastes

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

Slippery Elm: dosing

There is no official standardized dose for slippery elm. The right amount can vary depending on the form (lozenge, capsule, powder, or tea) and the product.The safest approach is to follow the directions on the product label. When using the powder or capsules, take them with a full glass of water.

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

Read the full Slippery Elm 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 & Slippery Elm

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

0Major
2,022Moderate
0Minor
807No known interaction
2,022 Moderate 807 No interaction
Moderate

2,022 interactions

Showing 60 of 2,022 moderate interactions — see all 2,022 on the Slippery Elm page.

No interaction 807 drugs checked — show the list

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

Showing the 60 most looked-up of 807 medications checked with no known interaction — see the full Slippery Elm list.

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

Slippery Elm References

The 3 references that drive our Slippery Elm 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. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Czarnecki D, Nixon R, Bekhor P, and et al. Delayed prolonged contact urticaria from the elm tree. Contact Dermatitis 1993;28:196-197. PubMed

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 Slippery Elm and Nivolumab Together: Common Questions

Is it safe to take Slippery Elm with Nivolumab?
We do not list a known interaction between Slippery Elm 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 Slippery Elm and Nivolumab have any of the same side effects?
Yes — our sources link each of them separately to 2 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 Slippery Elm 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 Slippery Elm 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 Slippery Elm 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 Slippery Elm in each. That is a conversation for your prescriber, especially if Nivolumab is being adjusted to a target.
How was the Slippery Elm and Nivolumab combination checked?
Interactions in our licensed database are recorded against drug classes. Nivolumab is filed under 1 classification, and Slippery Elm has documented interactions with 1 drug class — 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 Slippery Elm interact with any other medications?
Yes. Slippery Elm has 2,022 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 — Slippery Elm 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

Slippery Elm 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 3 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nivolumab and Slippery Elm?

Our pharmacists answer your medication & supplement questions — free.

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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.