Herb & supplement monograph

Alkanna Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Alkanna interacts with medications. The heart of this page is the interaction list — every drug Alkanna is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Alkanna is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Alkanna Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Alkanna drug interaction appears low for most people, because every listed interaction is theoretical rather than documented in humans. None of the interactions are rated major, and all of them trace back to a single lab-based concern rather than reported human harm.

Interactions deserving the most attention

The one concern worth understanding runs in an unusual direction: certain drugs may make Alkanna more harmful, not the other way around. Alkanna contains pyrrolizidine alkaloids, plant chemicals that can injure the liver, and medications that speed up the enzyme the body uses to process them, including carbamazepine, phenytoin, and rifampin, might in theory increase the amount converted into toxic byproducts. This has only been suggested by lab research, but because the potential harm involves the liver, it is the part of the profile we take most seriously.

What the rest of the list means

The long list of interacting medications reflects this one shared mechanism applied across many drugs, not dozens of separate problems. Since the evidence comes from lab reasoning rather than human studies, none of these predicted effects have been confirmed to cause meaningful harm in people.

Check your medications against Alkanna

Based on HelloPharmacist’s Alkanna interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Alkanna

87 medications have a known interaction with Alkanna, graded by severity. Select any drug for the full evidence-based detail.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Alkanna using our pharmacist-reviewed interaction data.

AI summaries are generated from our Alkanna interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. Interaction 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.
Possible. 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
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Alkanna combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Alkanna affects

Every type of medication (drug category) Alkanna is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 1 drug category Alkanna interacts with

Cytochrome P450 3a4 (cyp3a4) Inducers

Cytochrome P450 3A4 (Cyp3A4) Inducers

Hepatotoxic pyrrolizidine alkaloids (PAs) are substrates of cytochrome P450 3A4 (CYP3A4). Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites. Some drugs that induce CYP3A4 include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.

Likelihood Possible Evidence D

Monograph

Alkanna: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Alkanna is a Mediterranean plant whose red root has long been used as a dye and as a folk skin remedy for wounds and burns. Human evidence for any health benefit is very limited, and because the plant can contain liver-toxic pyrrolizidine alkaloids, oral use is not recommended. If you use it at all, use it externally and check with a pharmacist or doctor first.

Scientific name: Alkanna tinctoria
Family: Boraginaceae
Part used: Roots (mainly); occasionally leaves
Common forms: Topical creams, ointments, salves, oils, and natural dye; rarely oral preparations

People commonly use it for

Wound healing
Burns and skin ulcers
Natural red dye for foods and cosmetics
Skin irritation
Traditional remedy for diarrhea

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallUse caution

Topical use is more common, but the plant may contain liver-toxic pyrrolizidine alkaloids, so oral use should be avoided.

PregnancyLikely Unsafe

When alkanna preparations containing hepatotoxic pyrrolizidine alkaloids (PAs) are used orally. PAs might be teratogenic and hepatotoxic. There is ins...

Read the full pregnancy detail

BreastfeedingLikely Unsafe

When alkanna preparations containing hepatotoxic pyrrolizidine alkaloids (PAs) are used orally. PAs might be teratogenic and hepatotoxic. There is ins...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Alkanna (Alkanna tinctoria), also called alkanet or dyer's bugloss, is a flowering plant in the borage family. It is native to Europe, the Mediterranean region, and Western Asia. The plant's most prized part is its root, which contains a deep red pigment.

For centuries, alkanna root has been used as a natural dye for fabrics, foods, cosmetics, and even some alcoholic beverages and pharmaceutical products. In traditional medicine, root preparations have been applied to the skin to help with wounds, burns, and other skin problems.

It is worth noting that the name "henna" is sometimes listed as an alternate name, but true henna comes from a different plant (Lawsonia inermis). The two should not be confused.

How it works

Alkanna root contains red pigment compounds called naphthoquinones, most notably alkannin and its derivatives. In laboratory studies, these compounds have shown antioxidant, anti-inflammatory, antimicrobial, and wound-healing activity.

Researchers think these effects may help explain its traditional use on the skin. However, most of this work has been done in test tubes or animals, so it is not clear how well these effects apply to people.

The plant may also contain pyrrolizidine alkaloids, a group of compounds that can damage the liver. These are a safety concern rather than a benefit.

Effectiveness

Does Alkanna work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 2 uses evaluated

2 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

For Alkanna, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 2 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Burns

Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research in adults and children with second degree burns shows that applying a dressing containing olive oil, natural beeswax, and alkanna root extract to burn wounds once daily, usually starting within 24 hours of injury, improves healing compared with applying a dressing containing nitrofurazone and rifamycin every two days. Skin epithelization was initiated approximately 4 days earlier and mean hospital stay was about 6 days shorter for patients treated with the alkanna dressing compared with the control dressing. Pain was also reduced by approximately 14%. The validity of these results is limited by a lack of appropriate randomization and blinding, which introduces the potential for bias.

Sources Ref 96328

Insufficient Reliable Evidence To Rate Wound healing

Rating & evidence shown verbatim from Natural Medicines

Clinical research shows that applying alkanna root extract 20% ointment to the donor site after removal of a skin graft improves wound healing compared with applying base ointment alone. At 4 weeks, approximately 97% of patents using the alkanna ointment had complete healing compared with about 23% of patients using base ointment alone. It is unclear if the alkanna ointment reduces pain or scarring at the site of skin graft removal compared to base ointment alone.

Sources Ref 99905

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

The biggest safety concern with alkanna is that some preparations may contain pyrrolizidine alkaloids (PAs). These compounds can be toxic to the liver and, with repeated exposure, have been linked to serious liver damage and other harms. For this reason, oral use is generally not recommended.

Topical (skin) use is more common and is considered lower risk, but PAs can still be absorbed through the skin, especially on broken or damaged skin. Use only on small areas and avoid prolonged use.

Pregnancy and breastfeeding: Avoid alkanna entirely. Pyrrolizidine alkaloids can be especially harmful, and there is no reliable safety information for these situations.

People with liver disease, children, and older adults should be especially cautious. Always talk to a pharmacist or doctor before using alkanna in any form.

Side effects

When used on the skin, alkanna may cause skin irritation or allergic reactions in some people. If you notice redness, itching, rash, or swelling, stop using it.

The most serious concern is liver toxicity from pyrrolizidine alkaloids, particularly with oral use or long-term use. Signs of liver problems can include stomach pain, nausea, unusual tiredness, dark urine, or yellowing of the skin or eyes. Seek medical care if these occur.

Because alkanna is a strong dye, it can also stain skin, clothing, and surfaces.

Alkanna: Reported Adverse Effects

Documented safety reports on Alkanna from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, the major concern with alkanna is its pyrrolizidine alkaloid (PA) content. These constituents are hepatotoxic, pneumotoxic, carcinogenic, and mutagenic. Chronic exposure to other plants containing hepatotoxic PA constituents is associated with veno-occlusive disease. Sub-acute veno-occlusive disease can cause vague symptoms, including colicky pains, vomiting, diarrhea, and ascites within several days; persistent liver enlargement occurs within a few weeks.

Topically, PAs can be absorbed through the broken skin. Absorption of PAs can lead to systemic toxicities.

There is currently a limited amount of information available about the adverse effects of PA-free alkanna.

Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.

Reports by condition

Diarrhea Hepatic

Orally and topically, alkanna might cause toxicity. The major concern with alkanna use is its hepatotoxic pyrrolizidine alkaloid (PA) content. Chronic exposure to other plants containing hepatotoxic PA constituents is associated with veno-occlusive disease. Sub-acute veno-occlusive disease can cause vague symptoms, including colicky pains, vomiting, diarrhea, and ascites within several days; persistent liver enlargement occurs within a few weeks.

Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.

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.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no established standard dose for alkanna. It has not been studied well enough in people to define a safe and effective amount, whether on the skin or by mouth.

If you use a product that contains alkanna, follow the directions on the label and use it only as intended. Oral use is best avoided because of the risk of liver-toxic alkaloids.

Before using alkanna for any reason, check with a pharmacist or doctor, especially if you are pregnant, breastfeeding, have liver problems, or take other medicines.

Pregnancy & Breastfeeding

Alkanna & Pregnancy

Likely Unsafe

When alkanna preparations containing hepatotoxic pyrrolizidine alkaloids (PAs) are used orally. PAs might be teratogenic and hepatotoxic. There is insufficient reliable information available about the safety of alkanna products that do not contain hepatotoxic PAs when used during pregnancy and lactation; avoid using.

Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.

Alkanna & Breastfeeding

Likely Unsafe

Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46.
Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 6 references that drive our Alkanna 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.

WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.
Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. PubMed
Gümüs K, Özlü ZK. The effect of a beeswax, olive oil and Alkanna tinctorial (L.) Tausch mixture on burn injuries: An experimental study with a control group. Complement Ther Med. 2017;34:66-73.
Kheiri A, Amini S, Javidan AN, Saghafi MM, Khorasani G. The effects of Alkanna tinctoria Tausch on split-thickness skin graft donor site management: a randomized, blinded placebo-controlled trial. BMC Complement Altern Med. 2017;17(1):253. PubMed

Keep reading

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.

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.

Brand directory

Brands that make products with Alkanna

1 brand in our database make a supplement containing Alkanna.

Bixa Botanical 106 products

Product directory

Supplement products with Alkanna

1 product in our database contain Alkanna. Open any to see its full ingredient list and every drug interaction we check.

Alkanet Root Powder by Bixa Botanical Powder 200 Gram(s) · 7 Ounce(s) View ingredients & interactions

Pharmacist Counseling Corner

Alkanna: Common Questions

What is Alkanna used for, and does it work?

People use Alkanna for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.

Does Alkanna interact with prescription medications?

Yes. We list 87 medications with a known interaction with Alkanna. Use the checker above to see how Alkanna interacts with a specific drug.

How are Alkanna interactions rated?

Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.

Is it safe to take Alkanna with my medications?

It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.

Where does this Alkanna interaction information come from?

Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.

What is Alkanna used for?

Alkanna is most commonly used as a natural red dye and as a traditional skin remedy for wounds and burns. Scientific evidence for any medical benefit is limited.

Is Alkanna safe to take by mouth?

Oral use is generally not recommended because some Alkanna products may contain pyrrolizidine alkaloids that can damage the liver. Topical use is more common and considered lower risk.

Is Alkanna the same as henna?

No. Although "henna" is sometimes listed as an alternate name, true henna comes from a different plant called Lawsonia inermis. Alkanna comes from Alkanna tinctoria.

Can I use Alkanna while pregnant or breastfeeding?

It is best to avoid Alkanna during pregnancy and breastfeeding because of possible liver-toxic alkaloids and a lack of safety data. Talk to your doctor or pharmacist first.

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

Keep exploring

Products that contain Alkanna

A rotating sample of real supplements in our database that list Alkanna — open any to see its full ingredients and every drug interaction we check.

Alkanet Root Powder by Bixa Botanical

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