Drug & supplement interaction

Witch Hazel + Tocilizumab

Tocilizumab brand name: Actemra.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Witch Hazel and Tocilizumab 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

Witch Hazel and Tocilizumab

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 Tocilizumab and Witch Hazel 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 Witch Hazel at all — not against Tocilizumab, 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.

Witch Hazel safety at a glance

Witch Hazel overall Use caution Generally well tolerated on the skin short-term, but not meant to be taken by mouth.
Pregnancy Use caution Topical use is likely low risk, but data are limited; avoid oral use and ask your doctor first.
Breastfeeding Use caution Limited safety data; topical use is likely low risk but check with your doctor, and avoid applying to the nipple area.

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

Still wondering about combining Tocilizumab and Witch Hazel? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Witch Hazel and Tocilizumab 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.

  • Liver problems Worth acting on Additional detail

    Witch Hazel

    “Topically, witch hazel is generally well tolerated. Orally, witch hazel seems to be well tolerated at appropriate doses, but high doses may be associated with more adverse effects due to the tannin content in witch hazel.

    Most Common Adverse Effects:

    Topically: Contact dermatitis.

    Serious Adverse Effects (Rare):

    Orally: Kidney and liver damage when preparations containing at least 10% tannins are used in high doses.”

    Witch Hazel · Natural Medicines adverse-effect record, reported in dermatitis.

    Tocilizumab

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

  • A skin rash reported in 12.1% of FDA reports for Tocilizumab Additional detail

    Witch Hazel

    “Topically, witch hazel can cause contact dermatitis (6,86505). A small number of people develop redness or burning.”

    Witch Hazel · Natural Medicines adverse-effect record, reported in dermatitis.

    3 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 86505. Khanna, N. and Datta, Gupta S. Rejuvenating facial massage--a bane or boon? Int J Dermatol. 2002;41(7):407-410. PubMed
    3. 67795. Wolff, H. H. and Kieser, M. Hamamelis in children with skin disorders and skin injuries: results of an observational study. Eur.J.Pediatr. 2007;166(9):943-948. PubMed

    Tocilizumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Tocilizumab, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Effects for Tocilizumab come from the ADVERSE REACTIONS section of its FDA label; effects for Witch Hazel come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 112,048 voluntary FDA FAERS reports for Tocilizumab 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.

Everything else you take

See Every Supplement That Interacts With Tocilizumab

This page covers Witch Hazel only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tocilizumab page lists 89 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Beer (major), Siberian Cocklebur (major), Wine (major), Active Hexose Correlated Compound (ahcc) (moderate) and Alfalfa (moderate).

By severity: 3 major · 85 moderate · 1 minor.

From our pharmacist’s overview on the Tocilizumab page

“Tocilizumab (Actemra) calms an overactive immune system in conditions like rheumatoid arthritis, and it is also known to strain the liver, which is exactly where its supplement interactions concentrate. This page deserves genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Tocilizumab interaction page

One more smart check

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

We hold 150 real supplement products containing Witch Hazel, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Witch Hazel. Even though Witch Hazel itself has no known interaction with Tocilizumab, 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 Witch Hazel and Tocilizumab 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 Witch Hazel
Top half

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

29 days ago today
Medication Tocilizumab
Steady interest

#2,553 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 Witch Hazel reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Witch Hazel and Tocilizumab 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 Witch Hazel

What is Witch Hazel?

  • Skin irritation and inflammation
  • Hemorrhoids
  • Minor cuts and bruises
  • Oily or acne-prone skin
  • Itching and minor swelling
  • Soothing after shaving or sun exposure

Witch hazel is a plant-based astringent used mostly on the skin for minor irritation, hemorrhoids, and oily skin. It is generally well tolerated as a topical product for short-term use, but evidence for most uses is limited, and it should not be swallowed. Check with your pharmacist or doctor before using it, especially during pregnancy or breastfeeding.

Hamamelis virginiana · Hamamelidaceae · Bark, leaves, and twigs · Liquid astringent (distilled water), gels, ointments, creams, wipes/pads, suppositories, soaps

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

Witch Hazel: dosing

There is no official standardized dose for witch hazel. The right amount depends on the product and the form, such as a liquid, gel, pad, or ointment.The safest approach is to follow the directions on the product label and use it only on the skin as directed. For hemorrhoid pads or creams, follow the package instructions. Do not take witch hazel by mouth unless a healthcare professional specifically advises it.

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

Read the full Witch Hazel monograph & all interactions
Medication

About Tocilizumab Injection

What Is Tocilizumab Injection Used For?

Brand name: Actemra

Tocilizumab injection is used to treat several serious inflammatory and immune-related conditions. Actemra (tocilizumab) is indicated for moderately to severely active rheumatoid arthritis in adults who haven't responded well to other disease-modifying drugs, giant cell arteritis in adults, systemic sclerosis-associated interstitial lung disease (SSc-ILD) to slow lung function decline, polyarticular and systemic juvenile idiopathic arthritis in patients 2 years and older, and severe or life-threatening cytokine release syndrome (CRS) caused by CAR T-cell therapy in adults and children 2 and older.

Actemra is also approved for hospitalized adults and children aged 2 and older with COVID-19 who are on corticosteroids and need supplemental oxygen or mechanical breathing support. Not every brand or route is approved for every use — your prescriber will choose the right form for your specific condition.

Most-Reported Side Effects for Tocilizumab

From FAERS, the FDA’s public side-effect reporting system (113,819 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Rheumatoid arthritis 22,747 reports
Arthralgia 17,322 reports
Joint swelling 16,327 reports
Fatigue 15,391 reports
Rash 13,781 reports
See full Tocilizumab Injection drug information
Keep checking

Other Drugs & Witch Hazel

Browse every other medication we’ve checked against Witch Hazel — 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
No interaction 2,829 drugs checked — show the list
Evidence & sources

Witch Hazel References

The 7 references that drive our Witch Hazel 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. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.
  4. Hormann HP, Korting HC. Evidence for the efficacy and safety of topical herbal drugs in dermatology: part I: anti-inflammatory agents. Phytomedicine 1994;1:161-71. PubMed
  5. Wolff, H. H. and Kieser, M. Hamamelis in children with skin disorders and skin injuries: results of an observational study. Eur.J.Pediatr. 2007;166(9):943-948. PubMed
  6. Khanna, N. and Datta, Gupta S. Rejuvenating facial massage--a bane or boon? Int J Dermatol. 2002;41(7):407-410. PubMed
  7. Theisen LL, Erdelmeier CA, Spoden GA, Boukhallouk F, Sausy A, Florin L, Muller CP. Tannins from Hamamelis virginiana bark extract: characterization and improvement of the antiviral efficacy against influenza A virus and human papillomavirus. PLoS One. 201 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 Witch Hazel and Tocilizumab Together: Common Questions

Is it safe to take Witch Hazel with Tocilizumab?
We do not list a known interaction between Witch Hazel and Tocilizumab. 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 Witch Hazel and Tocilizumab have any of the same side effects?
Yes — our sources link each of them separately to 2 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.
Does Tocilizumab interact with any supplements?
Yes. Tocilizumab has documented interactions with 89 supplements in our database — Witch Hazel is not one of them. The Tocilizumab 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 Tocilizumab and Witch Hazel?

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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.