Drug & supplement interaction

Tolu Balsam + Nelarabine

Nelarabine brand name: Atriance.

No Known Interaction
Medically reviewed by · Updated June 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Tolu Balsam and Nelarabine 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.

Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Tolu Balsam and Nelarabine

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 Nelarabine and Tolu Balsam 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.

Worth understanding: our licensed dataset holds no drug-interaction record for Tolu Balsam at all — not against Nelarabine, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

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.

Tolu Balsam safety at a glance

Tolu Balsam overall Use caution Generally used in small amounts in foods and cough products, but it can cause allergic reactions and lacks strong safety data.
Pregnancy Avoid Not enough safety information, so it is best avoided during pregnancy.
Breastfeeding Avoid Safety during breastfeeding is unknown, so avoid medicinal use.

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

Still wondering about combining Nelarabine and Tolu Balsam? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Nelarabine’s Own FDA Label Lists

This is not an interaction — none of it involves Tolu Balsam. These are the most notable effects listed in the ADVERSE REACTIONS section of Nelarabine’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 10 of them are worth acting on rather than waiting out — marked below.

  • Muscle weakness Worth acting on mentioned in 5.8% of FDA reports for Nelarabine
  • Low magnesium Worth acting on
  • Severe muscle breakdown Worth acting on
  • Memory problems Worth acting on
  • Dehydration Worth acting on
  • Unsteadiness Worth acting on
  • Low blood sugar Worth acting on
  • Low potassium Worth acting on
  • Yellowing of the skin or eyes Worth acting on
  • High blood sugar Worth acting on

Showing the 10 most notable of 51 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Nelarabine. Read the label on DailyMed › Where a percentage is shown, it is the share of 956 voluntary FDA FAERS reports for Nelarabine that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Tolu Balsam’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Tolu Balsam side to compare — that is a limit of the record, not a statement that Tolu Balsam has no side effects.

Everything else you take

See Every Supplement That Interacts With Nelarabine

This page covers Tolu Balsam only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nelarabine page lists 130 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Kava (major) and L-tryptophan (major).

By severity: 6 major · 118 moderate · 6 minor.

From our pharmacist’s overview on the Nelarabine page

“Nelarabine (Atriance) is chemotherapy for a rare T-cell leukemia and lymphoma, and its most feared side effect is damage to the nervous system, from heavy drowsiness up to seizures. Most of the 130 supplement and herbal ingredients on this list press on exactly that weak point.”

Reviewed by 2 · Jul 18, 2026

Open the Nelarabine interaction page

One more smart check

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

We hold 3 real supplement products containing Tolu Balsam, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tolu Balsam. Even though Tolu Balsam itself has no known interaction with Nelarabine, 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 Tolu Balsam and Nelarabine 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 Tolu Balsam
Steady interest

#1,183 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Nelarabine
Steady interest

#2,153 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.
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Tolu Balsam and Nelarabine records this page draws on were last updated June 22, 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 Tolu Balsam

What is Tolu Balsam?

  • Cough and sore throat
  • Chest congestion
  • Wound and skin care (topical)
  • Flavoring and fragrance
  • Mild expectorant

Tolu balsam is a fragrant resin from a South American tree that has long been used as a flavoring and as an ingredient in cough syrups and throat lozenges. Good-quality human studies are lacking, so its real effectiveness is uncertain, and it can cause allergic skin reactions in some people. Talk to a pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or have allergies.

Myroxylon balsamum · Fabaceae · Resinous balsam (oleoresin) collected from the tree trunk · Syrups, cough lozenges, throat preparations, tinctures, and as a flavoring or fragrance ingredient

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

Tolu Balsam: dosing

There is no well-established standardized dose for tolu balsam. It is most often found as a minor ingredient in cough syrups, lozenges, and tinctures rather than taken on its own.If you use a product that contains tolu balsam, follow the directions on the label and do not exceed the recommended amount.

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

Read the full Tolu Balsam monograph & all interactions
Medication

About Nelarabine Injection

What Is Nelarabine Injection Used For?

Brand name: Atriance

Nelarabine injection (brand name Arranon) is used to treat two aggressive blood cancers: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL). It is approved for adult and pediatric patients age 1 year and older whose disease has not responded to — or has come back after — at least two prior chemotherapy regimens.

Nelarabine injection may also be given in combination with multi-agent chemotherapy as part of treatment for newly diagnosed T-ALL and T-LBL in certain settings, as studied in clinical trials.

Most-Reported Side Effects for Nelarabine

From FAERS, the FDA’s public side-effect reporting system (956 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Febrile neutropenia 75 reports
Neuropathy peripheral 60 reports
Neurotoxicity 60 reports
Sepsis 56 reports
Muscular weakness 55 reports
See full Nelarabine Injection drug information
Keep checking

Other Drugs & Tolu Balsam

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Tolu Balsam list.

See the full Tolu Balsam interactions page
See every supplement checked against Nelarabine, ranked by severity
Sources

Sources & How We Checked

We checked Tolu Balsam against Nelarabine in the Natural Medicines interaction database and found no documented interaction on file. The medication overview comes from MedlinePlus, and supplement label details from the NIH Dietary Supplement Label Database.

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
Tolu Balsam monograph › Uses, safety, and every drug interaction in one place Nelarabine supplement interactions › Every supplement checked against Nelarabine, ranked by severity Nelarabine Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Tolu Balsam and Nelarabine Together: Common Questions

Is it safe to take Tolu Balsam with Nelarabine?
We do not list a known interaction between Tolu Balsam and Nelarabine. 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.
Does Nelarabine interact with any supplements?
Yes. Nelarabine has documented interactions with 130 supplements in our database — Tolu Balsam is not one of them. The Nelarabine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Nelarabine and Tolu Balsam?

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.