Drug & supplement interaction

Zizyphus + Bendamustine

Bendamustine brand names: Treanda, Belrapzo, Vivimusta.

Moderate Interaction
The bottom line Moderate

Zizyphus has a moderate interaction with Bendamustine. Theoretically, zizyphus might decrease the levels and clinical effects of drugs metabolized by CYP1A2.

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

Zizyphus and Bendamustine

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

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Bendamustine

Bendamustine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Zizyphus interacts with.

Theoretically, zizyphus might decrease the levels and clinical effects of drugs metabolized by CYP1A2.
Animal research shows that zizyphus induces CYP1A2 enzymes. However, this effect has not been reported in humans.
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 gist: your body uses an enzyme called CYP1A2 to help process bendamustine. In animal studies, zizyphus appears to speed up that enzyme. If that held true in people, it could clear bendamustine out a little faster and potentially make it work less well against your CLL or lymphoma. Since bendamustine is an active cancer drug (not a prodrug that needs switching on), faster breakdown leans toward less effect, not more.

I want to be honest about how thin this evidence is. It's only lab and animal data, and this effect has never actually been shown in humans. Still, with a chemotherapy drug, I don't take chances. Please run any zizyphus supplement past your oncology team before adding it. Eating jujube fruit as food is far less likely to matter than concentrated supplement doses.

References
  1. Jing XY, Peng YR, Wang XM, Duan JA. Effects of Ziziphus jujuba fruit extracts on cytochrome P450 (CYP1A2) activity in rats. Chin J Nat Med. 2015 Aug;13(8):588-94. 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

Zizyphus Also Interacts With Other Medications

Zizyphus has 468 moderate known drug interactions in our database — the Bendamustine 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 Zizyphus

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

Everything else you take

See Every Supplement That Interacts With Bendamustine

This page covers Zizyphus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bendamustine page lists 87 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Acerola (moderate), Adrafinil (moderate), African Wild Potato (moderate), Alpha-lipoic Acid (moderate) and Ashitaba (moderate).

By severity: 62 moderate · 25 minor.

From our pharmacist’s overview on the Bendamustine page

“Bendamustine (Treanda, Belrapzo, Vivimusta) is IV chemotherapy for chronic lymphocytic leukemia and certain lymphomas, and the liver clears it through an enzyme called CYP1A2. That enzyme is why nearly all 87 supplements on this page appear here, since about 80 of them can push CYP1A2 up or down, which could either raise side effects o…”

Reviewed by 2 · Jul 18, 2026

Open the Bendamustine interaction page

How much people look this up

Where Zizyphus and Bendamustine 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 Zizyphus
Steady interest

#1,298 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Bendamustine
Top 5%

#55 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 Zizyphus

What is Zizyphus?

Zizyphus
  • Sleep problems and insomnia
  • Anxiety and stress
  • Digestive support
  • General nutrition (vitamin C and fiber)
  • Constipation

Zizyphus (jujube) is an edible fruit and traditional remedy used mainly for sleep, anxiety, and digestion. The fruit is a nutritious food, but human evidence for its medicinal benefits is limited and mostly preliminary. If you want to try a supplement form, talk with your pharmacist or doctor first, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Zizyphus monograph & all interactions
Medication

About Bendamustine Injection

What Is Bendamustine Injection Used For?

Brand names: Treanda, Belrapzo, Vivimusta

Bendamustine hydrochloride injection is used to treat adults with chronic lymphocytic leukemia (CLL). It is also used for adults with indolent B-cell non-Hodgkin lymphoma (NHL) — a slow-growing type of blood cancer — when the disease has continued to progress during or within six months of treatment with rituximab or a rituximab-containing regimen.

For CLL, how well bendamustine works compared to other first-line treatments (aside from chlorambucil) has not been fully established.

See full Bendamustine Injection drug information
Keep checking

Other Drugs & Zizyphus

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

0Major
468Moderate
0Minor
2,361No known interaction
Moderate

468 interactions

Showing 60 of 468 moderate interactions — see all 468 on the Zizyphus page.

No interaction 2,361 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 Zizyphus and Bendamustine Together: Common Questions

Can you take Zizyphus with Bendamustine?
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 Zizyphus and Bendamustine 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 Bendamustine and Zizyphus?

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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.