Lentinan Drug Interactions, Uses, Effectiveness, Safety & More
What is this page for?
First and foremost: how Lentinan interacts with medications. The heart of this page is the interaction list — every drug Lentinan is known to interact with, and how serious each one is.
But these pages have grown well beyond that into a full monograph — what Lentinan 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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Add one medicationLentinan Drug Interactions: The Bottom Line
From the HelloPharmacist Editorial Team · Updated August 2026Based on the available evidence, the overall risk of a clinically significant Lentinan drug interaction appears low for most people, since every reported interaction comes from lab or animal research rather than human studies. None of the listed interactions are rated major, and none have actually been documented in people so far.
The main theme is that lentinan may speed up several enzymes the body uses to clear medications, which could lower drug levels and make some medicines less effective. Animal studies showed reduced blood levels of metoprolol, a blood pressure and heart medication, as well as midazolam and omeprazole. Because the concern is a weaker drug effect rather than toxicity, it matters most for medicines where steady levels are important, such as heart, blood pressure, and mood medications.
The long list of medications reflects one shared mechanism, not hundreds of separate proven problems. Almost any drug cleared by these enzymes gets counted, even though the effect has only been seen in lab and animal research. Whether it causes meaningful changes in people has not been shown.
Based on HelloPharmacist’s Lentinan interaction data and reviewed under our editorial standards.
Drugs that interact with Lentinan
816 medications have a known interaction with Lentinan, graded by severity. Select any drug for the full evidence-based detail.
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Tell us the medications you take and we’ll check each one against Lentinan using our pharmacist-reviewed interaction data.
AI summaries are generated from our Lentinan interaction data for education only — always confirm with your pharmacist. How we use AI
No drugs match “”.
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 Lentinan combination — clinical detail, likelihood, evidence level, and citations.
- Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The kinds of drugs Lentinan affects
Every type of medication (drug category) Lentinan is known to interact with. Open any category for the detail — or search your exact drug in the checker above.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Laboratory evidence suggests that lentinan might increase the activity of cytochrome P450 1A2 (CYP1A2). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP1A2 in patients taking lentinan.
Some drugs metabolized by CYP1A2 include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), and others.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Laboratory research suggests that lentinan might increase the activity of cytochrome P450 2C19 (CYP2C19). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP2C19 in patients taking lentinan.
Some drugs metabolized by CYP2C19 include proton pump inhibitors including omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Laboratory research suggests that lentinan might increase the activity of cytochrome P450 2D6 (CYP2D6). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP2D6 in patients taking lentinan.
Some drugs metabolized by CYP2D6 include tricyclic antidepressants such as imipramine (Tofranil) and amitriptyline (Elavil); antipsychotics such as haloperidol (Haldol), risperidone (Risperdal), and chlorpromazine (Thorazine); beta-blockers such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), and carvedilol (Coreg); tamoxifen (Nolvadex); and others.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Laboratory research suggests that lentinan might increase the activity of cytochrome P450 3A4 (CYP3A4). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP3A4 in patients taking lentinan.
Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others.
Metoprolol (Toprol)
In animal research, lentinan decreases plasma levels of metoprolol. This may be due to induction of cytochrome P450 2D6 (CYP2D6) metabolism.
Midazolam (Versed)
In animal research, lentinan decreases plasma levels of midazolam. This may be due to induction of cytochrome P450 3A4 (CYP3A4) metabolism.
Omeprazole (Prilosec)
In animal research, lentinan decreases plasma levels of omeprazole. This may be due to induction of cytochrome P450 2C19 (CYP2C19) metabolism.
Phenacetin
In animal research, lentinan decreases plasma levels of phenacetin. This may be due to induction of cytochrome P450 1A2 (CYP1A2) metabolism.
Lentinan: Uses, Safety & Side Effects
Lentinan is a beta-glucan polysaccharide from shiitake mushrooms that is studied mainly as an immune-modulating add-on to cancer chemotherapy, where it is given by injection in a few countries. Evidence for oral supplements is limited, and quality varies widely between products. Talk with your pharmacist or doctor before using it, especially if you have a health condition or are pregnant or breastfeeding.

- Scientific name
- Lentinula edodes
- Family
- Marasmiaceae
- Part used
- Fruiting body of the shiitake mushroom (the polysaccharide is extracted from it)
- Common forms
- Injection (used in some countries under medical supervision), capsules, tablets, powdered mushroom extracts, oral liquid
- Immune support
- Used alongside cancer treatment
- Anti-inflammatory
- General wellness/tonic
- Antimicrobial support
Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.
Oral mushroom extracts are generally well tolerated, but the injectable medical form should only be used under a doctor's care.
Insufficient reliable information available; avoid using.
Read the full pregnancy detailInsufficient reliable information available; avoid using.
Read the full breastfeeding detailPregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.
Overview
Lentinan is a natural sugar-based compound (a polysaccharide) found in the shiitake mushroom, Lentinula edodes. Its main building block is a type of fiber called beta-1,3-glucan, which is why supplements are sometimes labeled simply as "beta-glucan." Shiitake mushrooms are widely eaten in East Asia and grow on hardwood logs and sawdust.
Shiitake has a long history in traditional Asian medicine, where it was used as a general health tonic. In more recent decades, a purified form of lentinan has been studied and, in some countries such as Japan and China, used as an injectable medicine given together with cancer chemotherapy. Outside of that setting, lentinan and shiitake extracts are sold as oral dietary supplements marketed for "immune support."
How it works
Lentinan is a beta-glucan, a type of complex sugar that the immune system can recognize. In laboratory and animal studies, beta-glucans appear to stimulate certain immune cells, such as macrophages and natural killer cells, and to affect chemical messengers (cytokines) that the body uses to coordinate immune responses. Because of this, lentinan is described as an "immune modulator."
Researchers believe these immune effects are why lentinan has been studied alongside chemotherapy — the idea is to support the body's own defenses rather than to attack tumor cells directly. It is important to know that most of this mechanism research is from cells and animals, and effects seen in the lab do not always translate into benefits for people.
Does Lentinan work?
How to read these evidence grades
Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.
Possibly Effective Malignant pleural effusions
Two meta-analyses of low to moderate quality randomized controlled trials in patients with malignant pleural effusions show that combining lentinan intrapleural infusion therapy with cisplatin increases clinical response when compared with cisplatin alone. One meta-analysis of 54 studies shows that including lentinan treatment increases the likelihood of a complete response by 68%, based on the absence of pleural effusion for at least 4 weeks, when compared with cisplatin alone. Another meta-analysis of 17 studies including at least 60 patients each shows that including lentinan increases the likelihood of clinical response by approximately 47%, based on either a complete response or an improvement of at least 50% maintained for at least 4 weeks. Both analyses also show that there is a reduction in the risk of treatment failure and an improvement in quality of life when lentinan is added to cisplatin treatment. Although one meta-analysis shows that adding lentinan reduces some, but not all, adverse effects of cisplatin, the other shows that adding lentinan does not affect the incidence of adverse effects. Lentinan was used in doses of 1-10 mg, 1-3 times weekly, with 1-8 total doses.
Also studied for 7 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Chronic obstructive pulmonary disease (COPD)
In patients with acute exacerbation of COPD requiring ventilator support, clinical research shows that taking lentinan (Jinling Pharmaceutical Co., Ltd.) 0.5 grams twice daily orally in combination with budesonide 1 mg twice daily for 4 days reduces the time on mechanical ventilation by about 1 day, as well as the length of stay in the intensive care unit by about 2.5 days, when compared with budesonide alone.
Insufficient Reliable Evidence To Rate Esophageal cancer
One small clinical study in adults with esophageal cancer shows that adding intravenous lentinan to chemotherapy treatment with tegafur, a prodrug of 5-fluorouracil, improves quality of life when compared with chemotherapy alone. These improvements were greater in the second course of treatment, with approximately twice as many patients achieving partial remission or experiencing improvement.
Insufficient Reliable Evidence To Rate Gastric cancer
Preliminary clinical research shows that administering lentinan by injection as adjunctive treatment seems to improve response in patients being treated for gastric cancer. Also, a meta-analysis of preliminary clinical research shows that lentinan approximately doubles the odds of having improved clinical efficacy when added to the FOLFOX chemotherapy regimen in patients with gastric cancer. The odds of a favorable change in performance status improved 3.2-fold over FOLFOX alone. Lentinan also reduced the odds of developing leukopenia or having a gastrointestinal reaction to FOLFOX. However, clinical research suggests that lentinan reduces survival time when used in combination with tegafur, gimeracil, and oteracil for unresectable or recurrent gastric cancer. These disparate findings might be related to the chemotherapy regimen used or the stage of cancer being treated.
Insufficient Reliable Evidence To Rate HIV/AIDS
Preliminary clinical research shows that administering lentinan by injection once weekly for 56 weeks, in combination with didanosine by mouth, increases CD4 counts when compared with didanosine alone.
Insufficient Reliable Evidence To Rate Lung cancer
Meta-analyses of preliminary clinical research shows that lentinan injection increases the efficacy of chemotherapy in patients with lung cancer. In patients with non-small cell lung cancer, the objective response rate was improved by 31% over chemotherapy alone. However, lentinan did not improve the response to navelbine with cisplatin in a sub-group analysis. Lentinan also reduced serious chemotherapy-induced gastrointestinal reactions by 46% and granulocytopenia by 35%. In patients with advanced lung cancer, the overall response was increased by 33%. The validity of these findings is limited by the lack of a comparator group.
Insufficient Reliable Evidence To Rate Prostate cancer
One small clinical study in men with metastatic prostate cancer shows that administering lentinan by injection as 2 mg weekly or 4 mg every other week, in conjunction with hormonal therapy and chemotherapy with tegafur, a prodrug of 5-fluorouracil, improves 5-year survival rate when compared with Tegafur alone.
Insufficient Reliable Evidence To Rate Quality of life
Preliminary clinical research shows that taking lentinan (Lentinex, GlycaNova) 1-2 mg daily for 4 weeks improves quality of life by a small amount when compared with placebo in healthy adults. Adults with the lowest scores of well-being at baseline tended to show the largest improvements on individual questions.
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
Eating shiitake mushrooms as food is considered safe for most people. Oral shiitake and beta-glucan supplements are generally well tolerated in short-term use. The purified injectable form is a medicine and should only be used under the care of a doctor, since injections carry their own risks.
People with autoimmune conditions or those taking medicines that suppress the immune system should be especially cautious, because a product that may stimulate the immune system could in theory be a problem. People who are allergic to mushrooms should avoid it.
Pregnancy and breastfeeding: There is not enough reliable information to consider lentinan supplements safe during pregnancy or while breastfeeding. To be safe, avoid using it during these times. (Eating shiitake as a normal food is a separate matter from taking concentrated extracts.) Always check with your pharmacist or doctor before starting any new supplement.
Side effects
Oral shiitake products are usually well tolerated, but possible side effects include stomach upset, bloating, gas, or diarrhea. Some people who handle raw shiitake or take certain shiitake extracts have developed a skin rash sometimes called "shiitake dermatitis."
The injectable medical form has been linked to reactions such as fever, chills, and other infusion-related effects, which is one reason it is given in a medical setting. As with any natural product, allergic reactions are possible; stop use and seek medical help if you notice rash, swelling, or trouble breathing.
Lentinan: Reported Adverse Effects
Documented safety reports on Lentinan from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.
Parenterally and orally, lentinan seems to be well tolerated. Orally, lentinan has been rarely reported to cause rash, diarrhea, and constipation. Parenterally, lentinan has been reported to cause gastrointestinal cramping, rash, myalgia, and fatigue. Mild thrombocytopenia has also been reported in clinical trials. Rapid intravenous infusion of lentinan is reported to cause chest tightness and dryness of the throat; these symptoms were not reported to occur with slow drip infusion.
- Wang H, Cai Y, Zheng Y, Bai Q, Xie D, Yu J. Efficacy of biological response modifier lentinan with chemotherapy for advanced cancer: a meta-analysis. Cancer Med. 2017;6(10):2222-2233.
- Hazama, S., Watanabe, S., Ohashi, M., Yagi, M., Suzuki, M., Matsuda, K., Yamamoto, T., Suga, Y., Suga, T., Nakazawa, S., and Oka, M. Efficacy of orally administered superfine dispersed lentinan (beta-1,3-glucan) for the treatment of advanced colorectal c
- Gordon M, Guralnik M, Kaneko Y, et al. A phase II controlled study of a combination of the immune modulator, lentinan, with didanosine (ddI) in HIV patients with CD4 cells of 200-500/mm3. J Med 1995;26:193-207.
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Wada T, Nishide T, Hatayama K, et al. [A comparative clinical trial with tegafur plus lentinan treatment at two different doses in advanced cancer]. Gan To Kagaku Ryoho 1987;14:2509-11.
Cluster headache Neurologic/CNS
Parenterally, lentinan has been reported to cause headache.
Constipation Gastrointestinal
Orally and parenterally, lentinan has been rarely reported to cause diarrhea, nausea, vomiting, and constipation.
- Gordon M, Bihari B, Goosby E, et al. A placebo-controlled trial of the immune modulator, lentinan, in HIV-positive patients: a phase I/II trial. J Med 1998;29:305-30.
- Hazama, S., Watanabe, S., Ohashi, M., Yagi, M., Suzuki, M., Matsuda, K., Yamamoto, T., Suga, Y., Suga, T., Nakazawa, S., and Oka, M. Efficacy of orally administered superfine dispersed lentinan (beta-1,3-glucan) for the treatment of advanced colorectal c
Fever Immunologic
Parenterally, lentinan has been reported to cause chills, fever, and lymph node swelling.
Myalgia Musculoskeletal
Parenterally, lentinan has been reported to cause joint pain and myalgia.
- Gordon M, Guralnik M, Kaneko Y, et al. A phase II controlled study of a combination of the immune modulator, lentinan, with didanosine (ddI) in HIV patients with CD4 cells of 200-500/mm3. J Med 1995;26:193-207.
- Gordon M, Bihari B, Goosby E, et al. A placebo-controlled trial of the immune modulator, lentinan, in HIV-positive patients: a phase I/II trial. J Med 1998;29:305-30.
Thrombocytopenia Hematologic
Parenterally, lentinan has been reported to cause mild thrombocytopenia.
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
Adverse-effects data: Natural Medicines, Therapeutic Research Center
Dosing
There is no well-established standard dose for oral lentinan or shiitake supplements. Products differ a lot in how much actual beta-glucan they contain, so amounts on labels are not always comparable.
If you choose to take an oral supplement, follow the directions on the product label and do not exceed them. The injectable medical form has its own dosing that is determined by a doctor as part of cancer treatment and is not something to manage at home. Because quality and strength vary, it is wise to choose products from reputable companies and to check with your pharmacist before starting.
Lentinan & Pregnancy
Lentinan & Breastfeeding
© 2026 Therapeutic Research Center
Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center
References & further reading
The 19 references that drive our Lentinan 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.
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Gordon M, Guralnik M, Kaneko Y, et al. A phase II controlled study of a combination of the immune modulator, lentinan, with didanosine (ddI) in HIV patients with CD4 cells of 200-500/mm3. J Med 1995;26:193-207.
- Yoshiyuki T, Onda M, Tokunaga A, et al. [Treatment for peritoneal dissemination of gastric cancer by intraperitoneal administration of CDDP through Infuse-a-Port]. Gan To Kagaku Ryoho 1994;21:2323-5.
- Tari K, Satake I, Nakagomi K, et al. [Effect of lentinan for advanced prostate carcinoma]. Hinyokika Kiyo 1994;40:119-23.
- Nishihira T, Akimoto M, Mori S. [Anti-cancer effects of BRMs associated with nutrition in cancer patients]. Gan To Kagaku Ryoho,1988;15:1615-20.
- Wada T, Nishide T, Hatayama K, et al. [A comparative clinical trial with tegafur plus lentinan treatment at two different doses in advanced cancer]. Gan To Kagaku Ryoho 1987;14:2509-11.
- Taguchi T. Clinical efficacy of lentinan on patients with stomach cancer: end point results of a four-year follow-up survey. Cancer Detect Prev Suppl 1987;1:333-49.
- Gordon M, Bihari B, Goosby E, et al. A placebo-controlled trial of the immune modulator, lentinan, in HIV-positive patients: a phase I/II trial. J Med 1998;29:305-30.
- Hazama, S., Watanabe, S., Ohashi, M., Yagi, M., Suzuki, M., Matsuda, K., Yamamoto, T., Suga, Y., Suga, T., Nakazawa, S., and Oka, M. Efficacy of orally administered superfine dispersed lentinan (beta-1,3-glucan) for the treatment of advanced colorectal c
- Zhang D, Zheng J, Ni M, et al. Comparative efficacy and safety of Chinese herbal injections combined with the FOLFOX regimen for treating gastric cancer in China: a network meta-analysis. Oncotarget. 2017;8(40):68873-68889. PubMed
- Wang H, Cai Y, Zheng Y, Bai Q, Xie D, Yu J. Efficacy of biological response modifier lentinan with chemotherapy for advanced cancer: a meta-analysis. Cancer Med. 2017;6(10):2222-2233. PubMed
- Yoshino S, Nishikawa K, Morita S, et al. Randomised phase III study of S-1 alone versus S-1 plus lentinan for unresectable or recurrent gastric cancer (JFMC36-0701). Eur J Cancer. 2016;65:164-71. PubMed
- Yin X, Ying J, Li L, Zhang H, Wang H. A meta-analysis of lentinan injection combined with chemotherapy in the treatment of nonsmall cell lung cancer. Indian J Cancer. 2015;52 Suppl 1:e29-31. PubMed
- Wang JL, Bi Z, Zou JW, Gu XM. Combination therapy with lentinan improves outcomes in patients with esophageal carcinoma. Mol Med Rep. 2012;5(3):745-8. PubMed
- Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.
- Sun J, Zhao G. Clinical effects of lentinan combined with budesonide inhalation in treating acute exacerbation of chronic obstructive pulmonary disease under mechanical ventilation. Exp Ther Med. 2019;17(3):1503-1508. PubMed
- Congcong Q, Hengting Z, Shuhui L, Fang Y, Shan W. Evaluation of efficacy and safety for lentinan in the control of the malignant pleural effusions via intrapleural injection. Am J Med Sci. 2019;358(6):400-411. PubMed
- Xiao Z, Jiang Y, Chen XF, et al. Intrathoracic infusion therapy with lentinan and chemical irritants for malignant pleural effusion: a systematic review and meta-analysis of 65 randomized controlled trials. Phytomedicine. 2020;76:153260. PubMed
- Aldwinckle J, Kristiansen B. A quality-of-life study in healthy adults supplemented with Lentinex beta-glucan of shiitake culinary-medicinal mushroom, Lentinus edodes (Agaricomycetes). Int J Med Mushrooms. 2020;22(5):407-415. PubMed
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.
© 2021 Therapeutic Research Center, LLC
Brands that make products with Lentinan
1 brand in our database make a supplement containing Lentinan.
Supplement products with Lentinan
1 product in our database contain Lentinan. Open any to see its full ingredient list and every drug interaction we check.
Lentinan: Common Questions
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