Drug & supplement interaction

Sweet Annie + Epirubicin

Epirubicin brand name: Ellence.

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 Sweet Annie and Epirubicin 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 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

Sweet Annie and Epirubicin

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 Epirubicin and Sweet Annie 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.

Sweet Annie safety at a glance

Sweet Annie overall Use caution Generally used short-term, but quality and dose vary widely and it should not replace proven treatments.
Pregnancy Avoid Avoid during pregnancy because of possible harm to the developing baby.
Breastfeeding Avoid Not enough safety information, so avoid while breastfeeding.

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

Still wondering about combining Epirubicin and Sweet Annie? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Epirubicin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Epirubicin is filed under 3 classifications — topoisomerase ii inhibitors, antitumor antibiotics, oral drugs. Sweet Annie has documented interactions with 3 drug classes — the most serious being cytochrome p450 2b6 (cyp2b6) substrates (moderate), cytochrome p450 3a4 (cyp3a4) substrates (moderate) and hepatotoxic drugs (moderate) — and none of Epirubicin’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

Sweet Annie Does Interact With Other Medications

Sweet Annie has 889 moderate known drug interactions in our database — Epirubicin isn’t one of them. If you take anything else, check it against the full list below.

Moderate 889 No known interaction 1,941 (incl. Epirubicin)
Taking anything else?

Check Another of Your Medications Against Sweet Annie

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

What to actually watch for

No Interaction Found — But Data Suggests Sweet Annie and Epirubicin 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.

  • An allergic reaction Worth acting on Additional detail

    Sweet Annie

    “One case of a mild allergic reaction to Sweet Annie tea has been reported. The reaction was characterized by a rash and cough that resolved quickly and did not require treatment. When low doses are taken sublingually by individuals allergic to Sweet Annie, numbness of the tongue and throat itching have been reported.”

    Sweet Annie · Natural Medicines adverse-effect record, reported in cough.

    5 sources cited
    1. 11059. Rath K, Taxis K, Walz G, et al. Pharmacokinetic study of artemisinin after oral intake of a traditional preparation of Artemisia annua L. (annual wormwood). Am J Trop Med Hyg 2004;70:128-32. DOI
    2. 109315. Yang J, Shen Z, Liu L, et al. Clinical efficacy and safety of Artesimia annua-Sublingual immunotherapy in seasonal allergic rhinitis patients based on different intervention time. Int Arch Allergy Immunol 2022;183(8):852-859.
    3. 112392. Feng Y, Cao Y, Liu Y, et al. Clinical efficacy and safety of coseasonal initiation of Artemisia annua sublingual immunotherapy on patients with Artemisia-induced rhinoconjunctivitis. Am J Otolaryngol 2023;44(5):103942. PubMed
    4. 112393. Yang J, Wang W, Shen Z, et al. Efficacy and safety of Artemisia annua sublingual immunotherapy in patients with seasonal allergic rhinoconjunctivitis over two pollen seasons. Eur Arch Otorhinolaryngol. 2023;280(11):4939-4947. PubMed
    5. 112394. Shen Z, Zhang P, Kang W, et al. Clinical efficacy in one-year treatment with Artemisia annua-SLIT drops in monosensitized and polysensitized individuals. Am J Otolaryngol 2023;44(6):104002. PubMed

    Epirubicin

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

  • Reduced appetite / Fever / Stomach pain / Tiredness Additional detail

    Sweet Annie

    “Orally, Sweet Annie might cause hepatic adverse effects. In one case, a 52-year-old patient developed hepatitis after taking the Sweet Annie constituent artemisinin 200 mg three times daily for 10 days. The patient developed abdominal pain and dark urine and was found to have elevated liver enzymes consistent with hepatitis. Symptoms resolved within 2 weeks of discontinuing use.”

    Sweet Annie · Natural Medicines adverse-effect record, reported in anorexia.

    3 sources cited
    1. 16895. Centers for Disease Control and Prevention (CDC). Hepatitis temporally associated with an herbal supplement containing artemisinin-Washington, 2008. MMWR Morb Mortal Wkly Rep 2009;58:854-8.
    2. 103254. Savage RL, Hill GR, Barnes J, Kenyon SH, Tatley MV. Suspected hepatotoxicity with a supercritical carbon dioxide extract of Artemisia annua in grapeseed oil used in New Zealand. Front Pharmacol. 2019;10:1448. PubMed
    3. 103255. Ruperti-Repilado FJ, Haefliger S, Rehm S, et al. Danger of herbal tea: a case of acute cholestatic hepatitis due to Artemisia annua tea. Front Med (Lausanne). 2019;6:221. PubMed

    Epirubicin

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

  • Itching / A skin rash Additional detail

    Sweet Annie

    Recorded for Sweet Annie in the same Natural Medicines adverse-effect record shown under An allergic reaction above.

    Epirubicin

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

  • Vomiting / Nausea Additional detail

    Sweet Annie

    “Orally, Sweet Annie is generally well-tolerated.

    Most Common Adverse Effects:

    Orally: Nausea and vomiting.

    Serious Adverse Effects (Rare):

    Orally: Hepatotoxicity.”

    Sweet Annie · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    Epirubicin

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

Reported for Sweet Annie but not commonly for Epirubicin: stomach upset, liver problems, headache and numbness or tingling.

Effects for Epirubicin come from the ADVERSE REACTIONS section of its FDA label; effects for Sweet Annie come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Epirubicin

This page covers Sweet Annie only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Epirubicin page lists 24 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Acerola (moderate), Alpha-lipoic Acid (moderate), Coffee Charcoal (moderate) and European Mandrake (moderate).

By severity: 1 major · 14 moderate · 9 minor.

From our pharmacist’s overview on the Epirubicin page

“Epirubicin (Ellence) is chemotherapy, most often used for breast cancer, and when a supplement can weaken the treatment itself, the 24 ingredients on this list deserve real caution. The lone major entry is activated charcoal, which can pull the drug back out of the body even though epirubicin is given by IV, since the medicine recircul…”

Reviewed by 2 · Jul 18, 2026

Open the Epirubicin interaction page

One more smart check

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

We hold 243 real supplement products containing Sweet Annie, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sweet Annie. Even though Sweet Annie itself has no known interaction with Epirubicin, 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 Sweet Annie and Epirubicin 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 Sweet Annie
Steady interest

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

29 days ago today
Medication Epirubicin
Steady interest

#1,437 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 Sweet Annie reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Sweet Annie and Epirubicin records this page draws on were last updated July 10, 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 Sweet Annie

What is Sweet Annie?

Sweet Annie
  • Malaria (traditional)
  • Fever
  • Inflammation
  • Digestive complaints
  • Antimicrobial support
  • Insect repellent

Sweet Annie (Artemisia annua) is the source of artemisinin, a compound used in prescription antimalarial drugs. While the purified drug is well studied for malaria, the herb itself as a supplement is not proven for the wide range of conditions people use it for, and self-treating malaria with the raw herb is dangerous. Talk to a pharmacist or doctor before using it.

Artemisia annua · Asteraceae · Aerial parts (leaves and flowering tops) · Tea, dried herb, capsules, tablets, tinctures, standardized extracts

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

Sweet Annie: dosing

There is no well-established standard dose for Sweet Annie as a supplement, and the amount of artemisinin in plant products varies widely. Because of this, it is hard to know how much active compound you are actually getting.If you choose to use a product, follow the directions on the label and do not exceed them. Look for reputable brands that provide quality testing. Never use Sweet Annie or its tea as a substitute for proven malaria treatment.

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

Read the full Sweet Annie monograph & all interactions
Medication

About Epirubicin

What Is Epirubicin Used For?

Brand name: Ellence

Ellence (epirubicin), given as an intravenous injection, is used as part of adjuvant (post-surgery) combination chemotherapy in patients with breast cancer who have evidence of tumor involvement in the axillary lymph nodes (lymph nodes under the arm) following surgical removal of the primary tumor.

It is not used alone — Ellence is always given as part of a multi-drug regimen alongside other chemotherapy agents.

See full Epirubicin drug information
Keep checking

Other Drugs & Sweet Annie

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

0Major
889Moderate
0Minor
1,940No known interaction
889 Moderate 1,940 No interaction
Moderate

889 interactions

Showing 60 of 889 moderate interactions — see all 889 on the Sweet Annie page.

No interaction 1,940 drugs checked — show the list

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

Showing the 60 most looked-up of 1,940 medications checked with no known interaction — see the full Sweet Annie list.

See the full Sweet Annie interactions page
See every supplement checked against Epirubicin, ranked by severity
Evidence & sources

Sweet Annie References

The 11 references that drive our Sweet Annie 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. Mueller MS, Karhagomba IB, Hirt HM, Wemakor E. The potential of Artemisia annua L. as a locally produced remedy for malaria in the tropics: agricultural, chemical and clinical aspects. J Ethnopharmacol 2000;73:487-93. PubMed
  2. Rath K, Taxis K, Walz G, et al. Pharmacokinetic study of artemisinin after oral intake of a traditional preparation of Artemisia annua L. (annual wormwood). Am J Trop Med Hyg 2004;70:128-32. DOI
  3. Centers for Disease Control and Prevention (CDC). Hepatitis temporally associated with an herbal supplement containing artemisinin-Washington, 2008. MMWR Morb Mortal Wkly Rep 2009;58:854-8.
  4. Xing J, Kirby BJ, Whittington D, et al. Evaluation of P450 inhibition and induction by artemisinin antimalarials in human liver microsomes and primary human hepatocytes. Drug Metabl Dispos 2012;40(9):1757-64. PubMed
  5. Savage RL, Hill GR, Barnes J, Kenyon SH, Tatley MV. Suspected hepatotoxicity with a supercritical carbon dioxide extract of Artemisia annua in grapeseed oil used in New Zealand. Front Pharmacol. 2019;10:1448. PubMed
  6. Ruperti-Repilado FJ, Haefliger S, Rehm S, et al. Danger of herbal tea: a case of acute cholestatic hepatitis due to Artemisia annua tea. Front Med (Lausanne). 2019;6:221. PubMed
  7. Yang J, Shen Z, Liu L, et al. Clinical efficacy and safety of Artesimia annua-Sublingual immunotherapy in seasonal allergic rhinitis patients based on different intervention time. Int Arch Allergy Immunol 2022;183(8):852-859.
  8. Kane NF, Kiani BH, Desrosiers MR, Towler MJ, Weathers PJ. Artemisia extracts differ from artemisinin effects on human hepatic CYP450s 2B6 and 3A4 in vitro. J Ethnopharmacol 2022. DOI
  9. Feng Y, Cao Y, Liu Y, et al. Clinical efficacy and safety of coseasonal initiation of Artemisia annua sublingual immunotherapy on patients with Artemisia-induced rhinoconjunctivitis. Am J Otolaryngol 2023;44(5):103942. PubMed
  10. Yang J, Wang W, Shen Z, et al. Efficacy and safety of Artemisia annua sublingual immunotherapy in patients with seasonal allergic rhinoconjunctivitis over two pollen seasons. Eur Arch Otorhinolaryngol. 2023;280(11):4939-4947. PubMed
  11. Shen Z, Zhang P, Kang W, et al. Clinical efficacy in one-year treatment with Artemisia annua-SLIT drops in monosensitized and polysensitized individuals. Am J Otolaryngol 2023;44(6):104002. 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 Sweet Annie and Epirubicin Together: Common Questions

Is it safe to take Sweet Annie with Epirubicin?
We do not list a known interaction between Sweet Annie and Epirubicin. 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 Sweet Annie and Epirubicin have any of the same side effects?
Yes — our sources link each of them separately to 9 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.
How was the Sweet Annie and Epirubicin combination checked?
Interactions in our licensed database are recorded against drug classes. Epirubicin is filed under 3 classifications, and Sweet Annie has documented interactions with 3 drug classes — none of Epirubicin'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 Sweet Annie interact with any other medications?
Yes. Sweet Annie has 889 documented drug interactions in our database — Epirubicin 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 Epirubicin interact with any supplements?
Yes. Epirubicin has documented interactions with 24 supplements in our database — Sweet Annie is not one of them. The Epirubicin 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

Sweet Annie monograph Uses, safety profile, and every drug interaction in one place Epirubicin drug information The full plain-English guide to this medication Epirubicin supplement interactions Every supplement checked against Epirubicin, 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 11 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Epirubicin and Sweet Annie?

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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.