Drug & supplement interaction

Strawberry + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

Moderate Interaction
The bottom line Moderate

Nintedanib Esylate falls into 2 drug categories that Strawberry can interact with; the most serious is rated moderate. In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Strawberry and Nintedanib Esylate

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Strawberry interacts with whole categories of medication. Nintedanib Esylate falls into 2 of those categories, so it can interact with Strawberry in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 2

Why this applies to Nintedanib Esylate

Nintedanib Esylate falls under P-GLYCOPROTEIN SUBSTRATES — the group Strawberry interacts with.

In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux. Theoretically, strawberry might inhibit p-glycoprotein mediated drug efflux and potentially increase levels of drugs that are substrates of p-glycoprotein. Until more is known, strawberry should be used cautiously in people taking p-glycoprotein substrates.
Drugs that might be affected include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
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 simple version: your body uses a kind of cellular bouncer called P-glycoprotein to push nintedanib (Ofev) back out and keep its levels in check. Lab studies hint that strawberry compounds might slow that bouncer down. If that happened in real life, a bit more nintedanib could stay in your system, which may mean more of its usual side effects, things like diarrhea, nausea, stomach upset, poor appetite, and liver enzyme changes.

The key word is theoretical. This is based only on test-tube research, not on people, so I wouldn't lose sleep over it. Eating strawberries as food is very unlikely to cause trouble. Concentrated strawberry supplements are the bigger question mark, so check with your pharmacist or doctor before starting one.

References
  1. Van Gelder, J., Deferme, S., Naesens, L., De Clercq, E., van den, Mooter G., Kinget, R., and Augustijns, P. Intestinal absorption enhancement of the ester prodrug tenofovir disoproxil fumarate through modulation of the biochemical barrier by defined este
  2. Deferme, S., Van Gelder, J., and Augustijns, P. Inhibitory effect of fruit extracts on P-glycoprotein-related efflux carriers: an in-vitro screening. J Pharm Pharmacol 2002;54(9):1213-1219.
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Nintedanib Esylate also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content. Theoretically, strawberry might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
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 gist with Ofev (nintedanib) and strawberries. Nintedanib itself can raise the risk of bleeding as a known side effect, things like nosebleeds, bruising, or bleeding gums. The concern on file is that compounds in strawberries (their plant polyphenols) might slightly slow down platelets, the cells that help blood clot. Put together, the worry is a small, theoretical bump in bleeding risk.

I'd keep this in perspective. This is based only on lab and animal research, not on people, so the evidence is weak. Eating strawberries as food is very unlikely to be a problem. Concentrated strawberry supplements are a bigger unknown, so chat with your pharmacist or doctor before adding one, and let them know right away if you notice unusual bruising or bleeding.

References
  1. Dutta-Roy, A. K., Crosbie, L., and Gordon, M. J. Effects of tomato extract on human platelet aggregation in vitro. Platelets. 2001;12(4):218-227. PubMed
  2. Naemura, A., Mitani, T., Ijiri, Y., Tamura, Y., Yamashita, T., Okimura, M., and Yamamoto, J. Anti-thrombotic effect of strawberries. Blood Coagul.Fibrinolysis 2005;16(7):501-509. 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

Strawberry Also Interacts With Other Medications

Strawberry has 315 moderate known drug interactions in our database — the Nintedanib Esylate one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Strawberry

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

Everything else you take

See Every Supplement That Interacts With Nintedanib Esylate

This page covers Strawberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate interaction page

One more smart check

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

We hold 2,806 real supplement products containing Strawberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Strawberry. Your product may carry other ingredients that interact with Nintedanib Esylate too, on top of Strawberry — 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 Strawberry and Nintedanib Esylate 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 Strawberry
Top 10%

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

29 days ago today
Medication Nintedanib Esylate
Top half

#1,054 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 Strawberry

What is Strawberry?

  • General antioxidant support
  • Heart and blood vessel health
  • Blood sugar support
  • Skin and oral health
  • Source of vitamin C and fiber

Strawberry is a popular, nutrient-rich fruit that supplies vitamin C, fiber, and antioxidant plant compounds. Eating strawberries as part of a balanced diet is healthy for most people, but concentrated supplement forms have only limited research behind specific health claims. If you have allergies or take it as a supplement, check with your pharmacist or doctor.

Read the full Strawberry monograph & all interactions
Medication

About Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib drug information
Keep checking

Other Drugs & Strawberry

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

0Major
315Moderate
0Minor
2,514No known interaction
Moderate

315 interactions

Showing 60 of 315 moderate interactions — see all 315 on the Strawberry page.

No interaction 2,514 drugs checked — show the list
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
Pharmacist Counseling Corner

Taking Strawberry and Nintedanib Esylate Together: Common Questions

Can you take Strawberry with Nintedanib Esylate?
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 2 interactions listed for Strawberry and Nintedanib Esylate?
Nintedanib Esylate belongs to more than one drug category, and Strawberry 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 Strawberry and Nintedanib Esylate 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 Nintedanib Esylate and Strawberry?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.