Drug & supplement interaction

Terminalia Chebula + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Oct 4, 2026

The bottom line No known interaction

We found no known interaction between Terminalia Chebula and Nintedanib Esylate 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 Nintedanib Esylate 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

Terminalia Chebula and Nintedanib Esylate

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 Nintedanib Esylate and Terminalia Chebula 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.

Terminalia Chebula safety at a glance

Terminalia Chebula overall Use caution Generally used in traditional medicine, but human safety data are limited and quality of products varies.

Pregnancy Possibly Unsafe When used orally. One source warns against using Terminalia bellirica and Terminalia chebula during pregnancy; however, the reason for this warning is not descr... Read the full pregnancy detail

Breastfeeding Avoid Safety during breastfeeding is unknown, so it is best avoided.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Nintedanib Esylate and Terminalia Chebula? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Nintedanib Esylate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nintedanib Esylate is filed under 5 classifications — including anticoagulant/antiplatelet drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Terminalia Chebula has documented interactions with 3 drug classes — the most serious being antidiabetes drugs (moderate), chlorzoxazone (parafon forte, paraflex) (moderate) and omeprazole (prilosec) (moderate) — and none of Nintedanib Esylate’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

Terminalia Chebula Does Interact With Other Medications

Terminalia Chebula has 93 moderate known drug interactions in our database — Nintedanib Esylate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 93 No known interaction 2,737 (incl. Nintedanib Esylate)

Taking anything else?

Check Another of Your Medications Against Terminalia Chebula

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

What to actually watch for

No Interaction Found — But Data Suggests Terminalia Chebula and Nintedanib Esylate May Share a Side Effect

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.

A skin rash Additional detail
Terminalia Chebula
“In a small clinical study, two adults with hyperlipidemia developed a hypersensitivity rash, one with facial edema, within minutes of oral administration of Triphala (containing an aqueous extract of Terminalia chebula, Terminalia bellirica, and Indian gooseberry), together with guggul extract. It is unclear if this reaction was due to Triphala, guggul, or other factors.”

Terminalia Chebula · Natural Medicines adverse-effect record, reported in hypercholesterolemia.
1 source cited

105741. Donato F, Raffetti E, Toninelli G, Festa A, Scarcella C, Castellano M; TRIGU Project Working Group. Guggulu and Triphala for the Treatment of Hypercholesterolaemia: A Placebo-Controlled, Double-Blind, Randomised Trial. Complement Med Res 2021;28(3):216-22 PubMed
Nintedanib Esylate

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

Reported for Terminalia Chebula but not commonly for Nintedanib Esylate: an allergic reaction and swelling.

Effects for Nintedanib Esylate come from the ADVERSE REACTIONS section of its FDA label; effects for Terminalia Chebula come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 31,339 voluntary FDA FAERS reports for Nintedanib Esylate 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.

Special populations

Terminalia Chebula in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally. One source warns against using Terminalia bellirica and Terminalia chebula during pregnancy; however, the reason for this warning is not described. Until more is known, avoid use.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Nintedanib Esylate Products Have a Food Rule — Terminalia Chebula Should Not Break It

At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take Terminalia Chebula on an empty stomach out of habit, keep them separate — and take Nintedanib Esylate 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 Nintedanib Esylate 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 DOSAGE AND ADMINISTRATION Recommended dosage: 150 mg taken orally twice daily approximately 12 hours apart taken with food.

From the Dosage and Administration section of the FDA label we read for Nintedanib Esylate — 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 Nintedanib Esylate

This page covers Terminalia Chebula 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

How much people look this up

Where Terminalia Chebula 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 Terminalia Chebula

Steady interest

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

29 days ago today

Medication Nintedanib Esylate

Top half

#1,142 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 Terminalia Chebula reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified October 4, 2026. The Terminalia Chebula and Nintedanib Esylate 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 Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Terminalia Chebula

What is Terminalia Chebula?

Digestive support and constipation
Antioxidant support
Oral and throat health
General immune support
Traditional tonic in Ayurvedic medicine

Terminalia chebula, often called haritaki, is a fruit widely used in Ayurvedic medicine, most commonly for digestion and as a key part of the Triphala blend. Early laboratory and small human studies suggest possible antioxidant and digestive effects, but high-quality evidence in people is limited. Talk with your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or take other medicines.

Terminalia chebula · Combretaceae · Dried fruit · Powder (churna), capsules, tablets, decoctions, and as part of herbal blends like Triphala

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

Terminalia Chebula: dosing

There is no official, standardized dose of Terminalia chebula. Traditional and commercial products vary widely in their strength and form.The safest approach is to follow the directions on the product label and not exceed the recommended amount.

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

Read the full Terminalia Chebula monograph & all interactions

Medication

About Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib treats certain scarring lung diseases in adults. All the supported products are indicated for idiopathic pulmonary fibrosis (IPF) and for chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype (scarring lung disease that keeps getting worse).

Ofev, nintedanib capsules (100 mg and 150 mg) and one other nintedanib capsule product are also indicated to slow the decline in lung function in systemic sclerosis-associated interstitial lung disease (SSc-ILD). The nintedanib esylate capsule label lists only IPF and progressive chronic fibrosing ILDs.

See full Nintedanib drug information

Keep checking

Other Drugs & Terminalia Chebula

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

0Major

93Moderate

0Minor

2,736No known interaction

93 Moderate 2,736 No interaction

Moderate

93 interactions

Showing 60 of 93 moderate interactions — see all 93 on the Terminalia Chebula page.

No interaction 2,736 drugs checked — show the list

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

Showing the 60 most looked-up of 2,736 medications checked with no known interaction — see the full Terminalia Chebula list.

See the full Terminalia Chebula interactions page

See every supplement checked against Nintedanib Esylate, ranked by severity

Evidence & sources

Terminalia Chebula References

The 9 references that drive our Terminalia Chebula 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.

Chevallier A. Encyclopedia of Medicinal Plants. New York, NY: DK Publishing, 1996.
Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
Murali, Y. K., Anand, P., Tandon, V., Singh, R., Chandra, R., and Murthy, P. S. Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced
Senthilkumar, G. P. and Subramanian, S. Evaluation of antioxidant potential of Terminalia chebula fruits studies in streptozotocin-induced diabetic rats. Pharmaceutical Biology (Netherlands) 2007;45:511-518.
Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.
Donato F, Raffetti E, Toninelli G, Festa A, Scarcella C, Castellano M; TRIGU Project Working Group. Guggulu and Triphala for the Treatment of Hypercholesterolaemia: A Placebo-Controlled, Double-Blind, Randomised Trial. Complement Med Res 2021;28(3):216-22 PubMed
Das A, Naveen J, Sreerama YN, Gnanesh Kumar BS, Baskaran V. Low-glycemic foods with wheat, barley and herbs (Terminalia chebula, Terminalia bellerica and Emblica officinalis) inhibit a-amylase, a-glucosidase and DPP-IV activity in high fat and low dose st
Eltimamy M, Elshamarka M, Aboelsaad M, Sayed M, Moawad H. Effects of alcoholic extract of Terminalia Chebula dried fruit on blood biochemical profile in diabetic rats. J Diabetes Metab Disord 2022;21(1):159-170. PubMed
Agrawal OD, Kulkarni YA. Treatment with Terminalia chebula extract reduces insulin resistance, hyperglycemia and improves SIRT1 expression in type 2 diabetic rats. Life (Basel) 2023;13(5):1168. 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 Terminalia Chebula and Nintedanib Esylate Together: Common Questions

Is it safe to take Terminalia Chebula with Nintedanib Esylate?

We do not list a known interaction between Terminalia Chebula and Nintedanib Esylate. 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 Terminalia Chebula and Nintedanib Esylate have any of the same side effects?

Yes — our sources link each of them separately to one 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 Terminalia Chebula and Nintedanib Esylate at the same time of day?

At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take Terminalia Chebula on an empty stomach out of habit, keep them separate and take Nintedanib Esylate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Nintedanib Esylate products can differ — so check the directions on your own box. This is about absorption, not an interaction.

How was the Terminalia Chebula and Nintedanib Esylate combination checked?

Interactions in our licensed database are recorded against drug classes. Nintedanib Esylate is filed under 5 classifications, and Terminalia Chebula has documented interactions with 3 drug classes — none of Nintedanib Esylate'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 Terminalia Chebula interact with any other medications?

Yes. Terminalia Chebula has 93 documented drug interactions in our database — Nintedanib Esylate 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 Nintedanib Esylate interact with any supplements?

Yes. Nintedanib Esylate has documented interactions with 285 supplements in our database — Terminalia Chebula is not one of them. The Nintedanib Esylate 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

Terminalia Chebula monograph Uses, safety profile, and every drug interaction in one place Nintedanib drug information The full plain-English guide to this medication Nintedanib Esylate supplement interactions Every supplement checked against Nintedanib Esylate, 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 9 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nintedanib Esylate and Terminalia Chebula?

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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.