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Dietary supplement

Comfrey Alcohol Free Ingredients & Drug Interactions

by Hawaii Pharm

Comfrey Alcohol Free label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Comfrey Alcohol Free 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: Moderate

Comfrey Alcohol Free is a dietary supplement by Hawaii Pharm with 1 active ingredient. Its ingredients are commonly taken for bruises and sprains, muscle and joint pain, minor wounds and skin irritation.Based on those ingredients, 438 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Comfrey. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Comfrey Alcohol Free by Hawaii Pharm

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

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HelloPharmacist Scorecard of Comfrey Alcohol Free 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 is a straightforward single-ingredient product: comfrey extract in a liquid form. The inactive ingredients are glycerin and water, which keep it in suspension.

Does it work?

Not established
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 established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use — see Comfrey's own graded uses on its monograph.

Why this rating?
  • The label markets this product for: muscle and joint pain relief support.
  • We looked for evidence on: Back pain, Bruises, Osteoarthritis, Sprains, Inflammation, Muscle strain.
  • The closest evidence on file: Comfrey is rated "Insufficient Reliable Evidence To Rate" for Back pain (Natural Medicines).
  • Also on file: Comfrey is rated "Insufficient Reliable Evidence To Rate" for Osteoarthritis, Bruises, Sprains.

The evidence we have doesn't establish whether comfrey works for any of the conditions listed on the label—including bronchitis, angina, back pain, cancer, or cough. The data shows insufficient reliable evidence to rate its effectiveness for these uses.

The evidence, ingredient by ingredient Comfrey

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.

Here's the critical point: comfrey taken by mouth is considered unsafe due to liver toxicity. The pyrrolizidine alkaloids in comfrey can cause serious liver damage including fibrosis, cirrhosis, scarring, and even liver failure—sometimes appearing months or years after use.

You may also develop lung damage and high blood pressure in the lungs. When applied to intact skin for short periods, it's generally well tolerated, though some people report mild skin irritation, rash, or itching.

Avoid this product if you're pregnant or breastfeeding. The safety data advises against it because of liver toxicity risk to you and possible harm to your baby or infant.

Side effects, ingredient by ingredient Comfrey

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Comfrey.
  • The most serious interaction on file is rated Moderate.
  • For scale: 439 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 product, check with your doctor or pharmacist if you take any medications that damage the liver or any drugs that speed up CYP3A4 enzyme activity (such as phenobarbital). Both types of medications significantly increase the risk of serious harm from comfrey's toxic alkaloids.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

This product carries serious safety and interaction concerns, especially for oral use. If you're considering comfrey for any condition, talk with your doctor or pharmacist first—especially if you take medications that affect your liver or any CYP3A4 inducers.

Your healthcare provider can help you weigh whether the unproven benefits outweigh the documented risks.

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 Sep 25, 2023.

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 Comfrey Alcohol Free, straight from the product label.

Brand Hawaii Pharm
Barcode (UPC) 840253615886
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Sep 25, 2023
DSLD ID 300557
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), 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 Comfrey Alcohol Free 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
840253615886
IngredientAmount% DV
Comfrey1156 mg--

Other ingredients: Glycerin, 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.
Brand IP Statement(s)

Hawaii Pharm Herbal Extract Highest quality since 2008

Suggested/Recommended/Usage/Directions

Suggested use: Shake well before using. For adults add about 20-30 drops (0.7-1 mL, one full squeeze of the dropper bulb) to some juice or water, up to 4 times a day.

Precautions

Warning: We recommend to seek expert medical advice before taking.

Do not use if you are allergic to any ingredients.

Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.

Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.

May affect the ability to drive and operate machinery. May have contraindications, can cause side effects and adverse reactions. Do not use if seal is broken or missing.

Keep out of the reach of children!

Storage

Store in a cool dry place.

Seals/Symbols

cGMP Made in compliance with cGMP 21 CFR 111 in an FDA registered and inspected facility.

C2H5OH Alcohol free USA Made in United States of America

FDA Disclaimer Statement

This product has not been evaluated by the FDA and is not intended to diagnose, treat, cure or prevent any disease.

General Statements

Scan this QR-code to get 15% discount on your next purchase. Limited time deal.

Formula

Symphytum officinale

Formulation

Only natural ingredients Purity is laboratory tested and verified

All the raw materials are gluten-free by their nature No artificial colors, flavors, or preservatives

Not tested on animals

C2H5OH Alcohol free

Made in USA, Hawaii

FDA Statement of Identity

Herbal Supplement

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

See for yourself

Comfrey Alcohol Free by Hawaii Pharm label

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

Comfrey Alcohol Free 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 Comfrey Alcohol Free 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.

Comfrey

Interacts with
438 drugs
1156 mg per serving Form: Symphytum officinale Leaf Extract, Dry

Comfrey is a traditional herb used mainly on the skin for bruises, sprains, and joint pain, and some topical products show modest benefit for these us...

Comfrey monograph & interactions

Other (inactive) ingredients: Glycerin, Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Comfrey Alcohol Free by Hawaii Pharm Drug Interactions

Want to check YOUR meds against Comfrey Alcohol Free?

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
438Drugs
438 Moderate

Ingredients driving the most interactions

Comfrey 438

Individual Drug Interactions

The ingredients in Comfrey Alcohol Free interact with 438 drugs. Click any drug to see the details.

1 of the 1 ingredient in Comfrey Alcohol Free interact with drugs. Each result below shows which ingredient is responsible. Comfrey

Each ingredient & the kinds of drugs it affects

For each ingredient in Comfrey Alcohol Free 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.

Comfrey2 drug types · 438 drugs

Cytochrome P450 3A4 (Cyp3A4) Inducers

Theoretically, CYP3A4 inducers might increase the risk of adverse effects from the pyrrolizidine alkaloid constituents in comfrey.
CYP3A4 enzymes convert pyrrolizidine alkaloids, constituents of comfrey, to toxic metabolites. Some case reports show that enzyme inducers, such as phenobarbital, seem to enhance the toxicity of comfrey.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, comfrey might have additive adverse effects on the liver when used with hepatotoxic drugs.
Due to its pyrrolizidine alkaloid constituents, comfrey can cause hepatotoxic effects, including ascites, cirrhosis, hepatic fibrosis, hepatomegaly, and sinusoidal obstruction syndrome.

Likelihood Possible Evidence D
Comfrey full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Comfrey Alcohol Free, from the product label.

Hawaii Pharm

See all Hawaii Pharm products
Name
Hawaii Pharm LLC
Street Address
510 Sumner St. Ste. 613
City
Honolulu
State
HI
ZipCode
96817
Phone Number
888-854-2924
Web Address
www.hawaiipharm.com
Pharmacist Counseling Corner

Comfrey Alcohol Free by Hawaii Pharm: Common Questions

Does Comfrey Alcohol Free by Hawaii Pharm interact with any medications?
Yes. Based on its ingredients, Comfrey Alcohol Free has a known interaction with 438 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Comfrey Alcohol Free 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.
Is this safe to take by mouth?
No. Oral comfrey is considered unsafe because of liver toxicity. The compounds in it can cause serious liver damage, sometimes appearing months or even years after you stop using it. Talk with your doctor or pharmacist about safer alternatives.
Can I use this while pregnant or breastfeeding?
The safety data advises against it during both pregnancy and breastfeeding. The product carries liver toxicity risk to you and potential harm to your baby or infant. Discuss this with your doctor or pharmacist.
What are the most common side effects?
When applied to intact skin, comfrey is generally well tolerated, though some people experience mild reactions like skin irritation, rash, itching, or eczema. Serious effects—liver damage, cirrhosis, lung problems—are rare but possible, especially with oral use or long-term exposure.
Does comfrey actually work for back pain or cough?
The evidence we have doesn't establish whether it does. The data shows insufficient reliable evidence to rate its effectiveness for these or other listed uses, so we can't say whether it works.
What are pyrrolizidine alkaloids and why do they matter?
They're compounds naturally present in comfrey that can poison your liver and lungs. They're the reason comfrey is unsafe to take by mouth—your body can convert them into even more toxic forms, especially if you're on certain medications.

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

Not sure if Comfrey Alcohol Free is safe with your meds?

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Ask a pharmacist

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.

Comfrey Alcohol Free label
Go deeper

The Full Monographs Behind Comfrey Alcohol Free’s Ingredients

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

Herb & supplement monograph

Comfrey

Interacts with 438 drugs

Comfrey is a traditional herb used mainly on the skin for bruises, sprains, and joint pain, and some topical products show modest benefit for these uses. However, comfrey contains compounds...

Read the full Comfrey monograph →
Sources

Sources & How We Checked

Comfrey Alcohol Free'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 13 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.

Comfrey 13 references
  1. Stewart MJ, Steenkamp V. Pyrrolizidine poisoning: a neglected area in human toxicology. Ther Drug Monit 2001;23:698-708. PubMed
  2. Food and Drug Administration. FDA Advises Dietary Supplement Manufacturers to Remove Comfrey Products From the Market. July 6, 2001. Available at: http://www.cfsan.fda.gov/~dms/dspltr06.html.
  3. Stickel F, Seitz HK. The efficacy and safety of comfrey. Public Health Nutr 2000;3:501-8. PubMed
  4. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  5. 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
  6. Predel, H. G., Giannetti, B., Koll, R., Bulitta, M., and Staiger, C. Efficacy of a comfrey root extract ointment in comparison to a diclofenac gel in the treatment of ankle distortions: results of an observer-blind, randomized, multicenter study. Phytome
  7. Gyorik, S. and Stricker, H. Severe pulmonary hypertension possibly due to pyrrolizidine alkaloids in polyphytotherapy. Swiss.Med.Wkly. 4-4-2009;139(13-14):210-211.
  8. Giannetti, B. M., Staiger, C., Bulitta, M., and Predel, H. G. Efficacy and safety of comfrey root extract ointment in the treatment of acute upper or lower back pain: results of a double-blind, randomised, placebo controlled, multicentre trial. Br.J Spor PubMed
  9. Tanret, I. and Duh, D. [Pharmaceutical sheet. Symphytum officinale L., dermal use (Flexagile cream)]. J Pharm.Belg. 2012;(1):41-42.
  10. Laslett, L. L., Quinn, S. J., Darian-Smith, E., Kwok, M., Fedorova, T., Korner, H., Steels, E., March, L., and Jones, G. Treatment with 4Jointz reduces knee pain over 12 weeks of treatment in patients with clinical knee osteoarthritis: a randomised contr
  11. Frost R, Macpherson H, O'meara S. A critical scoping review of external uses of comfrey (Symphytum spp.). Complement Ther Med. 2013;21(6):724-45. PubMed
  12. Pabst H, Schaefer A, Staiger C, Junker-samek M, Predel HG. Combination of comfrey root extract plus methyl nicotinate in patients with conditions of acute upper or low back pain: a multicentre randomised controlled trial. Phytother Res. 2013;27(6):811-7. PubMed
  13. Smith DB, Jacobson BH. Effect of a blend of comfrey root extract (Symphytum officinale L.) and tannic acid creams in the treatment of osteoarthritis of the knee: randomized, placebo-controlled, double-blind, multiclinical trials. J Chiropr Med. 2011;10(3) PubMed

See these in context on the Comfrey 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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