Drug & supplement interaction

Thuja + Epoetin Beta

Epoetin Beta brand names: Recormon, Mircera.

Moderate Interaction
The bottom line Moderate

Thuja has a moderate interaction with Epoetin Beta. Thuja products can contains significant amounts of thujone, a neurotoxin.

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

Thuja and Epoetin Beta

Here is the interaction we found between these two, with the evidence behind it.

Moderate

SEIZURE THRESHOLD LOWERING DRUGS

Why this applies to Epoetin Beta

Epoetin Beta falls under SEIZURE THRESHOLD LOWERING DRUGS — the group Thuja interacts with.

Thuja products can contains significant amounts of thujone, a neurotoxin. Theoretically, patients taking drugs that lower the seizure threshold might be at greater risk of seizure if they also take thuja. Advise patients taking these drugs to avoid thuja products. Some drugs that lower the seizure threshold include anesthetics (propofol, others), antiarrhythmics (mexiletine), antibiotics (amphotericin, penicillin, cephalosporins, imipenem), antidepressants (bupropion, others), antihistamines (cyproheptadine, others), immunosuppressants (cyclosporine), narcotics (fentanyl, others), stimulants (methylphenidate), theophylline, 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 connection in plain terms. Thuja, especially its undiluted oil, can contain thujone, a compound that may irritate the nervous system and, in theory, make seizures more likely. Epoetin beta (Recormon, Mircera) is grouped with medicines that can slightly lower the seizure threshold, partly because raising your red blood cell count and blood pressure can rarely trigger seizures. Stacking thuja on top of that could, in theory, nudge that risk a little higher.

I want to be honest about the evidence though. This is theoretical and based only on anecdotal reports, not strong studies, so don't panic. Still, because thujone can be genuinely toxic, I'd skip concentrated thuja supplements and oil while you're on epoetin beta. Please run it by your kidney doctor or pharmacist first.

References
  1. Millet Y, Jouglard J, Steinmetz MD, et al. Toxicity of some essential plant oils. Clinical and experimental study. Clin Toxicol 1981;18:1485-98. 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

Thuja Also Interacts With Other Medications

Thuja has 575 moderate known drug interactions in our database — the Epoetin Beta one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Thuja

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

Everything else you take

See Every Supplement That Interacts With Epoetin Beta

This page covers Thuja only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Epoetin Beta page lists 23 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Biofeedback (moderate), Coffee Charcoal (moderate), Dendrobium (moderate) and European Mandrake (moderate).

By severity: 1 major · 13 moderate · 9 minor.

From our pharmacist’s overview on the Epoetin Beta page

“Epoetin Beta (Recormon, Mircera) prompts the body to make more red blood cells, usually for anemia from kidney disease or chemotherapy, and its 23 supplement interactions warrant genuine care, starting with the single major one. Activated charcoal can cut exposure to many drugs regardless of how they are given, which could undercut a t…”

Reviewed by 2 · Jul 18, 2026

Open the Epoetin Beta interaction page

One more smart check

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

We hold 84 real supplement products containing Thuja, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Thuja. Your product may carry other ingredients that interact with Epoetin Beta too, on top of Thuja — 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 Thuja and Epoetin Beta 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 Thuja
Top half

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

29 days ago today
Medication Epoetin Beta
Steady interest

#2,214 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 Thuja

What is Thuja?

  • Warts and skin growths
  • Respiratory and immune support
  • Cold and upper respiratory symptoms
  • Topical skin conditions
  • Traditional use as a diuretic or to bring on menstruation

Thuja, also called northern white cedar or arborvitae, is a tree whose leaf and oil have a long history in folk and homeopathic medicine, especially for warts and immune support. Solid human evidence for these uses is very limited, and the undiluted oil contains thujone, which can be toxic. Talk with a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Thuja monograph & all interactions
Medication

About Methoxy Polyethylene Glycol-Epoetin Beta Injection

What Is Methoxy Polyethylene Glycol-Epoetin Beta Injection Used For?

Brand names: Recormon, Mircera

Mircera is used to treat anemia associated with chronic kidney disease (CKD) in adult patients, whether or not they are on dialysis. It is also approved for pediatric patients aged 3 months to 17 years who are on dialysis or not on dialysis, but only when they are converting from another ESA after their hemoglobin level has already been stabilized.

Mircera is not indicated for anemia caused by cancer chemotherapy, and it is not a substitute for red blood cell (RBC) transfusions when anemia needs to be corrected immediately. It has not been shown to improve symptoms, fatigue, or quality of life.

See full Methoxy Polyethylene Glycol-Epoetin Beta Injection drug information
Keep checking

Other Drugs & Thuja

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

0Major
575Moderate
0Minor
2,254No known interaction
Moderate

575 interactions

Showing 60 of 575 moderate interactions — see all 575 on the Thuja page.

No interaction 2,254 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

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Pharmacist Counseling Corner

Taking Thuja and Epoetin Beta Together: Common Questions

Can you take Thuja with Epoetin Beta?
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.
How serious is the Thuja and Epoetin Beta 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 Epoetin Beta and Thuja?

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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.