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Dietary supplement

Alfalfa Ingredients & Drug Interactions

by Hawaii Pharm

Alfalfa label
See full label image
Liquid Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Alfalfa against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Alfalfa is a dietary supplement by Hawaii Pharm with 1 active ingredient. Its ingredients are commonly taken for high cholesterol, digestive complaints, menopausal symptoms.Based on those ingredients, 583 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are certified organic Alfalfa extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Alfalfa by Hawaii Pharm

Ask about any prescription or over-the-counter medication and we check it for interactions with Alfalfa by Hawaii Pharm — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Alfalfa by Hawaii Pharm

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 16, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 1 of its 1 active ingredient.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains one active ingredient: certified organic alfalfa extract in liquid form. The extract is prepared with vegetable palm glycerin, pharmaceutical-grade alcohol, and purified Hawaiian water as inactive carriers.

Does it work?

Couldn't assess
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Not assessable

This is a single-ingredient Alfalfa product and its label doesn't state a use — see Alfalfa's own graded uses on its monograph.

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.

The evidence for alfalfa's effectiveness hasn't been firmly established in our data. The conditions it's studied for — diabetes, indigestion, high cholesterol, and menopausal symptoms — all show insufficient reliable evidence to rate.

That doesn't mean it doesn't work; it means the research isn't conclusive yet. Your doctor or pharmacist can discuss what the emerging literature suggests for your specific interest.

The evidence, ingredient by ingredient Alfalfa

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Alfalfa leaf is generally well tolerated in food amounts, but supplements carry real risks for some people. The most common side effects are digestive: abdominal discomfort, diarrhea, flatulence, and bulkier stools — especially during the first week of use.

A rare but serious side effect is a lupus-like syndrome after long-term use, and dermatitis (skin inflammation) has been reported with heavy consumption. Alfalfa has estrogen-like activity, so the safety data advises against it in supplement amounts during pregnancy.

There isn't enough reliable safety data to know if it's safe while breastfeeding — talk with your doctor or pharmacist before using it if you're nursing.

Side effects, ingredient by ingredient Alfalfa

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Alfalfa.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 583 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this alfalfa extract, double-check these medication types with your doctor or pharmacist: blood thinners like warfarin (Major severity) — alfalfa's high vitamin K content can reduce their effect; birth control pills and hormone therapy (Moderate); photosensitizing drugs (Moderate); immunosuppressants (Moderate); and diabetes medications (Moderate) — there's a risk of low blood sugar.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.

Alfalfa extract is generally well tolerated as a food, but as a supplement it interacts with blood thinners, birth control, hormone therapy, and diabetes and immunosuppressant drugs. If you're on any of these medications, or if you're pregnant or breastfeeding, check with your doctor or pharmacist before starting.

The evidence for what it treats isn't yet conclusive, so weigh that against the risks in your own situation.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Nov 21, 2020.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Alfalfa, straight from the product label.

Brand Hawaii Pharm
Barcode (UPC) 0787699225746
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Nov 21, 2020
DSLD ID 237632
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Organic, Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Alfalfa by Hawaii Pharm, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
0.7 mL
Maximum serving Sizes:
1 mL
Servings per container
120
UPC/BARCODE
0787699225746
IngredientAmount% DV
certified organic Alfalfa extract970 mg--

Other ingredients: Vegetable Palm Glycerin, pharmaceutical grade Alcohol, artesian Hawaiian purified Water

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

Hawaii Pharm Herbal Extract Highest quality since 2008

Made with Aloha!

Formulation

Contains no GMO, gluten, artificial colors, heavy metals, preservatives, pesticides, fertilizers.

Super concentrated liquid herbal extract. Dry herb/menstruum ratio: 1:3.

Manufactured in an FDA registered facility.

Non GMO Gluten free

Made in USA, Hawaii

Suggested/Recommended/Usage/Directions

Directions for use: Shake well before using. Take about 20-30 drops (0.7-1 ml, one full squeeze of the dropper bulb) to 2-4 oz of juice or water up to 4 times per day.

Precautions

Warning: Keep out of the reach of children.

May have contraindications. We recommend to seek expert medical advice before taking.

Do not use if you are allergic to any ingredients.

Consult a physician before using during pregnancy, if nursing or taking any medications.

Do not use if seal is broken or missing.

Storage

Store in a cool dry place.

Formula

(Medicago sativa)

FDA Statement of Identity

Herbal Dietary Supplement

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Seals/Symbols

FDA Registered Facility Made in United States of America USA

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Alfalfa by Hawaii Pharm label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Alfalfa label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Alfalfa by Hawaii Pharm

This is the 1 active ingredient this product is made of. Select it to open its full monograph.

Serving size0.7 mL Dosage formLiquid Servings per container120 Amounts shown are per serving.

Certified organic Alfalfa extract

Interacts with
583 drugs
970 mg per serving

Alfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of...

Certified organic Alfalfa extract monograph & interactions

Other (inactive) ingredients: Vegetable Palm Glycerin, Pharmaceutical grade Alcohol, Artesian Hawaiian purified Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Alfalfa by Hawaii Pharm Drug Interactions

Want to check YOUR meds against Alfalfa?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
583Drugs
2 Major 581 Moderate

Ingredients driving the most interactions

certified organic Alfalfa extract 583

Individual Drug Interactions

The ingredients in Alfalfa interact with 583 drugs. Click any drug to see the details.

1 of the 1 ingredient in Alfalfa interact with drugs. Each result below shows which ingredient is responsible. certified organic Alfalfa extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Alfalfa with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

certified organic Alfalfa extract6 drug types · 583 drugs

Warfarin (Coumadin)

Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Alfalfa contains a large amount of vitamin K. This could theoretically interfere with the activity of warfarin.

Likelihood Probable Evidence D
Antidiabetes Drugs

Theoretically, alfalfa might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that alfalfa decreases blood sugar in diabetic mice. Also, in one case report, a diabetic patient experienced hypoglycemia after consuming alfalfa extract. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, alfalfa might interfere with the activity of contraceptive drugs.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.

Likelihood Possible Evidence D
Estrogens

Theoretically, alfalfa might interfere with hormone therapy.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, alfalfa might decrease the efficacy of immunosuppressive therapy.
In vitro research and human case reports suggest that alfalfa may have immunostimulant effects.

Likelihood Possible Evidence D
Photosensitizing Drugs

Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Animal research suggests that excessive doses of alfalfa may increase photosensitivity, possibly due to its chlorophyll content. It is unclear if this effect would be clinically relevant in humans.

Likelihood Possible Evidence D
certified organic Alfalfa extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Alfalfa, from the product label.

Hawaii Pharm

See all Hawaii Pharm products
Name
Hawaii Pharm LLC
City
Honolulu
State
HI
ZipCode
96815
Web Address
www.hawaiipharm.com
Pharmacist Counseling Corner

Alfalfa by Hawaii Pharm: Common Questions

Does Alfalfa by Hawaii Pharm interact with any medications?
Yes. Based on its ingredients, Alfalfa has a known interaction with 583 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Alfalfa contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take alfalfa if I'm on warfarin or another blood thinner?
Not without checking with your doctor first. Alfalfa is high in vitamin K, which can interfere with how warfarin works and raise your risk of blood clots. This is a Major interaction, so it's critical to confirm it's safe for you before you start.
Will alfalfa affect my birth control?
Possibly. Alfalfa contains compounds with estrogenic (hormone-like) activity that theoretically could reduce birth control effectiveness. Talk with your doctor or pharmacist about whether this product is right for you if you rely on hormonal contraception.
What are the most common side effects?
Digestive complaints — abdominal discomfort, diarrhea, gas, and bulkier stools — are typical, especially in the first week. Most people tolerate it well overall, but a full safety evaluation hasn't been done, so new effects could emerge with long-term use.
Is alfalfa safe during pregnancy?
The safety data advises against supplement amounts of alfalfa during pregnancy because it has estrogen-like activity. Talk with your doctor or pharmacist before considering it if you're pregnant or planning to become pregnant.
Can I take alfalfa if I have diabetes and take blood sugar medication?
Check with your doctor first. Animal research and one case report suggest alfalfa may lower blood sugar, which could cause low blood sugar (hypoglycemia) if you're already on diabetes drugs. Your doctor may need to monitor your blood glucose closely.
Does alfalfa really work for high cholesterol or menopausal symptoms?
The evidence we have isn't conclusive yet — both uses show insufficient reliable evidence to rate. That means more research is needed before we can say whether it works for these conditions.

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

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Alfalfa label
Go deeper

The Full Monographs Behind Alfalfa’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Alfalfa

Interacts with 583 drugs

Alfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of these uses is limited. It is best avoid...

Read the full Alfalfa monograph →
Sources

Sources & How We Checked

Alfalfa's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 32 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Alfalfa 32 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  4. Kurzer MS, Xu X. Dietary phytoestrogens. Annu Rev Nutr 1997;17:353-81. PubMed
  5. Farber JM, Carter AO, Varughese PV, et al. Listeriosis traced to the consumption of alfalfa tablets and soft cheese [Letter to the Editor]. N Engl J Med 1990;322:338. PubMed
  6. Molgaard J, von Schenck H, Olsson AG. Alfalfa seeds lower low density lipoprotein cholesterol and apolipoprotein B concentrations in patients with type II hyperlipoproteinemia. Atherosclerosis 1987;65:173-9. PubMed
  7. Light TD, Light JA. Acute renal transplant rejection possibly related to herbal medications. Am J Transplant 2003;3:1608-9. PubMed
  8. Prete PE. The mechanism of action of L-canavanine in inducing autoimmune phenomena. Arthritis Rheum 1985;28:1198-200. PubMed
  9. Alcocer-Varela J, Iglesias A, Llorente L, Alarcon-Segovia D. Effects of L-canavanine on T cells may explain the induction of systemic lupus erythematosus by alfalfa. Arthritis Rheum 1985;28:52-7. PubMed
  10. Roberts JL, Hayashi JA. Exacerbation of SLE associated with alfalfa ingestion. N Engl J Med 1983;308:1361. DOI
  11. Feingold, R. M. Should we fear "health foods"? Arch Intern Med 7-12-1999;159(13):1502. PubMed
  12. Taormina, P. J., Beuchat, L. R., and Slutsker, L. Infections associated with eating seed sprouts: an international concern. Emerg.Infect.Dis 1999;5(5):626-634. PubMed
  13. Backer, H. D., Mohle-Boetani, J. C., Werner, S. B., Abbott, S. L., Farrar, J., and Vugia, D. J. High incidence of extra-intestinal infections in a Salmonella Havana outbreak associated with alfalfa sprouts. Public Health Rep. 2000;115(4):339-345. PubMed
  14. Mohle-Boetani J, Werner B, Polumbo M, and et al. From the Centers for Disease Control and Prevention. Alfalfa sprouts-- Arizona, California, Colorado, and New Mexico, February-April, 2001. JAMA 2-6-2002;287(5):581-582.
  15. Howard, M. B. and Hutcheson, S. W. Growth dynamics of Salmonella enterica strains on alfalfa sprouts and in waste seed irrigation water. Appl.Environ.Microbiol. 2003;69(1):548-553.
  16. Winthrop, K. L., Palumbo, M. S., Farrar, J. A., Mohle-Boetani, J. C., Abbott, S., Beatty, M. E., Inami, G., and Werner, S. B. Alfalfa sprouts and Salmonella Kottbus infection: a multistate outbreak following inadequate seed disinfection with heat and chl
  17. Strapp, C. M., Shearer, A. E., and Joerger, R. D. Survey of retail alfalfa sprouts and mushrooms for the presence of Escherichia coil O157:H7, Salmonella, and Listeria with BAX, and evaluation of this polymerase chain reaction-based system with experimen
  18. Akaogi, J., Barker, T., Kuroda, Y., Nacionales, D. C., Yamasaki, Y., Stevens, B. R., Reeves, W. H., and Satoh, M. Role of non-protein amino acid L-canavanine in autoimmunity. Autoimmun.Rev 2006;5(6):429-435. PubMed
  19. Burden and causes of foodborne disease in Australia: Annual report of the OzFoodNet network, 2005. Commun.Dis Intell. 2006;30(3):278-300.
  20. Shemesh, M., Lindner, H. R., and Ayalon, N. Affinity of rabbit uterine oestradiol receptor for phyto-oestrogens and its use in a competitive protein-binding radioassay for plasma coumestrol. J Reprod.Fertil. 1972;29(1):1-9. PubMed
  21. Elakovich, S. D. and Hampton, J. M. Analysis of coumestrol, a phytoestrogen, in alfalfa tablets sold for human consumption. J Agric.Food Chem. 1984;32(1):173-175. PubMed
  22. Malinow, M. R., Bardana, E. J., Jr., Pirofsky, B., Craig, S., and McLaughlin, P. Systemic lupus erythematosus-like syndrome in monkeys fed alfalfa sprouts: role of a nonprotein amino acid. Science 4-23-1982;216(4544):415-417. PubMed
  23. Malinow, M. R., McLaughlin, P., and Stafford, C. Alfalfa seeds: effects on cholesterol metabolism. Experientia 5-15-1980;36(5):562-564. PubMed
  24. Farnsworth, N. R. Alfalfa pills and autoimmune diseases. Am J Clin Nutr. 1995;62(5):1026-1028. DOI
  25. Herbert, V. and Kasdan, T. S. Alfalfa, vitamin E, and autoimmune disorders. Am J Clin Nutr 1994;60(4):639-640.
  26. Mahon, B. E., Ponka, A., Hall, W. N., Komatsu, K., Dietrich, S. E., Siitonen, A., Cage, G., Hayes, P. S., Lambert-Fair, M. A., Bean, N. H., Griffin, P. M., and Slutsker, L. An international outbreak of Salmonella infections caused by alfalfa sprouts grow
  27. Gray, A. M. and Flatt, P. R. Pancreatic and extra-pancreatic effects of the traditional anti- diabetic plant, Medicago sativa (lucerne). Br J Nutr. 1997;78(2):325-334.
  28. Van Beneden, C. A., Keene, W. E., Strang, R. A., Werker, D. H., King, A. S., Mahon, B., Hedberg, K., Bell, A., Kelly, M. T., Balan, V. K., Mac Kenzie, W. R., and Fleming, D. Multinational outbreak of Salmonella enterica serotype Newport infections due to
  29. Rubenstein AH, Levin NW, and Elliott GA. Manganese-induced hypoglycemia. Lancet 1962;1348-1351.
  30. Kaufman W. Alfalfa seed dermatitis. JAMA 1954;155(12):1058-1059. PubMed
  31. Ponka A, Andersson Y, Siitonen A, and et al. Salmonella in alfalfa sprouts. Lancet 1995;345:462-463. PubMed
  32. Puschner B, Chen X, Read D, Affolter VK. Alfalfa hay induced primary photosensitization in horses. Vet J. 2016 May;211:32-8. PubMed

See these in context on the Alfalfa monograph →

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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