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Dietary supplement

Viscum Ingredients & Drug Interactions

by Nestmann

Viscum label
See full label image
Liquid Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Viscum 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

Viscum is a dietary supplement by Nestmann with 8 active ingredients. Its ingredients are commonly taken for insomnia and poor sleep, anxiety and stress, restlessness.Based on those ingredients, 1,328 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Valerian, Bladderwrack algae, European Mistletoe. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Viscum by Nestmann

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

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HelloPharmacist Scorecard of Viscum by Nestmann

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 11, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 8 active ingredients.

Viscum Liquid contains eight active ingredients: valerian, lovage, horsetail, restharrow, bladderwrack algae, European mistletoe, mugwort, and arnica montana. The product also contains water and ethyl alcohol as inactive ingredients.

Does it work?

Moderate evidence
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

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Moderate

Some clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Osteoarthritis — rated "Possibly Effective" (Arnica) (Natural Medicines).
  • On file: Insomnia — rated "Possibly Effective" (Valerian) (Natural Medicines).

The evidence for these ingredients is limited. Valerian is possibly effective for insomnia, but evidence for the other conditions tracked—restless legs syndrome, pre-procedural anxiety, stress, and dysmenorrhea—is insufficient to rate.

Horsetail, restharrow, mugwort, and lovage have insufficient evidence for their tracked uses. Arnica is possibly effective for osteoarthritis, but evidence for acne, hot flashes, postoperative pain, and dry eye is insufficient.

European mistletoe appears possibly ineffective for melanoma and head and neck cancer, with insufficient evidence for breast cancer, gastric cancer, and chemotherapy-induced diarrhea.

The evidence, ingredient by ingredient Valerian Lovage Horsetail Spiny Restharrow Fucus Vesiculosus European Mistletoe Mugwort Arnica

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 7 of the 8 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 8 of 8.
  • General safety write-ups exist for 8 of 8.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Valerian is generally well tolerated short-term, but long-term safety is not well studied. Common side effects include dizziness, drowsiness, mental slowness, headache, gastrointestinal upset, and vivid dreams.

When you stop valerian after prolonged use, withdraw slowly to avoid symptoms like rapid heartbeat, anxiety, and insomnia. Rare cases of liver damage have been reported with multi-ingredient products containing valerian.

Lovage may increase the risk of sun sensitivity (photosensitivity) with long-term use and should not be used if you're sensitive to ragweed. Horsetail contains a substance that can cause thiamine (vitamin B1) deficiency with prolonged use; Canadian products are required to be free of this concern.

European mistletoe is potentially toxic if swallowed in large amounts and should be used only under medical supervision. Arnica taken by mouth is unsafe and can cause serious toxicity; homeopathic and topical forms are better tolerated.

Mugwort may trigger allergic reactions in people sensitive to ragweed. Safety data during pregnancy and breastfeeding are not established for these ingredients.

Side effects, ingredient by ingredient Valerian Lovage Horsetail Spiny Restharrow Fucus Vesiculosus European Mistletoe Mugwort Arnica

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?
  • 7 of the 8 matched ingredients can interact with medications — Spiny Restharrow, Arnica, Lovage, Fucus Vesiculosus, Horsetail, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,329 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 Viscum, check if you use CNS depressants (sleeping pills, anxiety medications, opioids), blood pressure medications, blood thinners or antiplatelet drugs, diuretics (water pills), lithium, HIV medications, antidiabetes drugs, or immunosuppressants. Valerian and alcohol together can cause excessive sedation.

These are the medication types with documented interactions in this product.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

This product is a multi-ingredient herbal blend with documented interactions affecting over 1,200 medications. If you take any prescription medications—especially for sleep, anxiety, blood pressure, blood thinning, diabetes, or mood—or if you're pregnant or breastfeeding, talk with your pharmacist before starting.

Check your exact medications using the interaction tool on this page.

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

Assessment coverage: 8 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2013.

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 Viscum, straight from the product label.

Brand Nestmann
Net contents 1.69 fl. Oz.; 50 mL
Market status On market
Date entered into DSLD Sep 25, 2013
DSLD ID 25515
Product type Other Combinations
Supplement form Liquid
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years)
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 Viscum by Nestmann, 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:
0.9 mL
Maximum serving Sizes:
0.9 mL
Servings per container
55
IngredientAmount% DV
Valerian0 NP--
Lovage0 NP--
Horsetail0 NP--
Restharrow0 NP--
Bladderwrack algae0 NP--
European Mistletoe0 NP--
Mugwort0 NP--
Arnica Montana0 NP--

Other ingredients: Water, ethyl alcohol

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.
FDA Statement of Identity

Herbal Liquid Extract Supplement

General Statements

Cloudiness or sediment can occur in herbal products and will not alter the effectiveness.

>>NESTMANN<<

Made in Germany Nestmann Pharma Zapfendorf/Bamberg

1291

3

Seals/Symbols

MPI

Suggested/Recommended/Usage/Directions

Suggested Use: Adults take 30 drops two to three times daily in tepid water.

Precautions

Not intended for children.

Warnings: If pregnant or breast-feeding, consult a health professional before use.

Keep out of the reach of children.

Tamper Evident: Use this product only if tamper evident ring has not been broken away from base of cap.

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

See for yourself

Viscum by Nestmann label

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

Viscum 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 Viscum by Nestmann

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size0.9 mL Dosage formLiquid Servings per container55 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Valerian

Interacts with
902 drugs
0 NP per serving

Valerian is an herb whose root is widely used as a natural sleep aid and for calming nerves. The evidence is mixed and often weak, so it may help some...

Valerian monograph & interactions

Lovage

Interacts with
75 drugs
0 NP per serving

Lovage is a celery-like herb traditionally used for digestion, bloating, and as a mild diuretic to flush the urinary tract. Human evidence for these u...

Lovage monograph & interactions

Horsetail

Interacts with
188 drugs
0 NP per serving

Horsetail is a traditional herb most often used as a mild diuretic and for hair, nail, and bone support, but high-quality human evidence is limited. I...

Horsetail monograph & interactions

Restharrow

Interacts with
1 drug
0 NP per serving

Spiny Restharrow is a traditional European herb whose root has long been used as a mild diuretic to help flush the urinary tract. Solid human evidence...

Restharrow monograph & interactions

Bladderwrack algae

Interacts with
891 drugs
0 NP per serving

Fucus vesiculosus (bladderwrack) is a brown seaweed rich in iodine that has been used traditionally for thyroid concerns, weight, and skin. There is l...

Bladderwrack algae monograph & interactions

European Mistletoe

Interacts with
293 drugs
0 NP per serving

European mistletoe is a parasitic plant most studied as an injectable extract used alongside conventional cancer care in some European countries, main...

European Mistletoe monograph & interactions

Mugwort

No known
interactions
0 NP per serving

Mugwort is a traditional herb used for digestion, menstrual issues, and sleep, but there is very little high-quality human research to confirm these u...

Mugwort monograph & interactions

Arnica Montana

Interacts with
122 drugs
0 NP per serving

Arnica is a daisy-family plant used mainly in topical and homeopathic products for bruising, muscle soreness, and pain. The evidence is mixed and most...

Arnica Montana monograph & interactions

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

Interaction report

Viscum by Nestmann Drug Interactions

Want to check YOUR meds against Viscum?

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
1,328Drugs
851 Moderate 477 Minor

Ingredients driving the most interactions

Valerian 902
Bladderwrack algae 891
European Mistletoe 293
Horsetail 188
Arnica Montana 122

Individual Drug Interactions

The ingredients in Viscum interact with 1,328 drugs. Click any drug to see the details.

7 of the 8 ingredients in Viscum interact with drugs. Each result below shows which ingredient is responsible. Valerian Bladderwrack algae European Mistletoe Horsetail Arnica Montana Lovage Restharrow

Each ingredient & the kinds of drugs it affects

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

Valerian6 drug types · 902 drugs

Alcohol (Ethanol)

Valerian can have additive sedative effects when used concomitantly with alcohol.
Valerian has sedative effects. Theoretically, valerian might have an additive sedative effect when combined with alcohol. Excessive sedation has been reported in an alcohol-abusing individual who took valerian and Gingko biloba. However, the potential interaction between valerian and alcohol has been disputed in other research. Limited evidence suggests that a combination of valerian 160 mg and lemon balm 80 mg (Euvegal) does not cause further deterioration in reaction ability and reaction rate when taken with alcohol as compared to the effects of alcohol alone.

Likelihood Possible Evidence B
Alprazolam (Xanax)

Valerian can have additive sedative effects when used with alprazolam. Also, valerian in high doses might modestly increase alprazolam levels, though this is not likely to be clinically significant.
Valerian has sedative effects. Theoretically, valerian might cause additive sedation when combined with alprazolam. Also, a small pharmacokinetic study shows that taking valerian extract 1000 mg daily (providing 11 mg valerenic acid) might increase alprazolam levels by about 19%. This might be due to valerian's mild inhibition of cytochrome P450 3A4 (CYP3A4). Despite being statistically significant, this increase is not likely to be clinically significant.

Likelihood Possible Evidence B
Cns Depressants

Valerian can have additive sedative effects when used concomitantly with CNS depressant drugs.
Theoretically, concomitant use of valerian and drugs with sedative and anesthetic properties may cause additive therapeutic and adverse effects.

Likelihood Possible Evidence D
Glucuronidated Drugs

Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
In vitro research shows that methanolic valerian extract and valerenic acid might competitively inhibit UDP-glucuronosyltransferase (UGT) 1A1 (UGT1A1) and UGT2B7.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP2D6.
Although some in vitro evidence suggests that valerian affects CYP2D6, clinical pharmacokinetic (PK) studies show that valerian is unlikely to affect the CYP2D6 enzyme. In one PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days did not affect the metabolism of dextromethorphan, a CYP2D6 substrate. In another PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of debrisoquine, an accepted CYP2D6 probe-substrate.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Although some in vitro evidence suggests that valerian extract might inhibit or induce CYP3A4, clinical pharmacokinetic (PK) studies show that valerian does not have a clinically significant effect on the CYP3A4 enzyme. In one PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of midazolam, an accepted CYP3A4 probe-substrate. In another PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days modestly increases levels of alprazolam, a CYP3A4 substrate, suggesting mild inhibition of CYP3A4. However, this mild inhibition is unlikely to be clinically relevant.

Likelihood Possible Evidence B
Valerian full monograph & interactions

Bladderwrack algae9 drug types · 891 drugs

Amiodarone (Cordarone)

Theoretically, combining Fucus vesiculosus with amiodarone might cause excessively high iodine levels.
Fucus vesiculosus contains high concentrations of iodine. Amiodarone contains 37.3% iodine and can increase iodine levels. Concomitant use might increase the risk of having excessive iodine levels and adversely affecting thyroid function. Monitor thyroid function.

Likelihood Probable Evidence D
Antithyroid Drugs

Due to its iodine content, Fucus vesiculosus might alter the effects of antithyroid drugs.
Fucus vesiculosus contains high concentrations of iodine. Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Fucus vesiculosus while using antithyroid drugs could alter the effects of the antithyroid drugs.

Likelihood Possible Evidence D
Lithium

Concomitant use of Fucus vesiculosus and lithium has resulted in hyperthyroidism.
There is a case of hyperthyroidism occurring in a patient taking Fucus vesiculosus and lithium. Monitor thyroid hormones closely in patients taking lithium and Fucus vesiculosus concomitantly.

Likelihood Possible Evidence D
Thyroid Hormone

Due to its iodine content, Fucus vesiculosus might alter the effects of thyroid hormone.
Fucus vesiculosus contains high concentrations of iodine. Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Fucus vesiculosus while using thyroid hormone could alter the effects of thyroid hormone.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, taking Fucus vesiculosus with antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
In vitro evidence suggests that a constituent of Fucus vesiculosus, known as fucoidan, has anticoagulant effects. However, in clinical research, fucoidan does not seem to have significant anticoagulant activity when taken orally, possibly due to poor absorption.

Likelihood Unlikely Evidence D
Cytochrome P450 2C8 (Cyp2C8) Substrates

Theoretically, concomitant use of Fucus vesiculosus with CYP2C8 substrates might increase the risk for adverse effects.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP2C8. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, concomitant use of Fucus vesiculosus with CYP2C9 substrates might increase the risk for adverse effects.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP2C9. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, concomitant use of Fucus vesiculosus with CYP2D6 substrates might alter the effects of these substrates.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, both inhibits and induces CYP2D6. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.
In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP3A4. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Bladderwrack algae full monograph & interactions

European Mistletoe2 drug types · 293 drugs

Antihypertensive Drugs

Theoretically, European mistletoe might increase the risk of hypotension when taken with antihypertensive drugs.
Animal research suggests that European mistletoe extracts have hypotensive effects.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, European mistletoe might decrease the effectiveness of immunosuppressants.
Clinical and in vitro studies suggest that European mistletoe might have immunostimulant effects.

Likelihood Possible Evidence D
European Mistletoe full monograph & interactions

Horsetail5 drug types · 188 drugs

Antidiabetes Drugs

Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Equisetum myriochaetum has demonstrated hypoglycemic activity in clinical research. In an animal diabetic model, Equisetum giganteum had hypoglycemic effects. It is unclear whether other horsetail species have hypoglycemic effects.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, taking horsetail with diuretic drugs might increase potassium loss and the risk of hypokalemia.
Laboratory research shows that various species of horsetail have diuretic properties. Due to its diuretic effects, there has been concern that taking horsetail along with potassium-depleting diuretics might increase the risk for hypokalemia. However, pharmacokinetic research in humans shows that taking horsetail 900 mg daily for 4 days does not affect urinary excretion of electrolytes, including potassium and sodium, despite having a diuretic effect similar to taking hydrochlorothiazide 25 mg daily. It is unclear if taking horsetail for a longer duration would affect electrolyte levels. Until more is known, use with caution.

Likelihood Possible Evidence D
Efavirenz (Sustiva)

Theoretically, horsetail might decrease the levels and clinical effects of efavirenz.
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral regimen that included efavirenz. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing horsetail, the viral loads became undetectable in both cases. The exact mechanism of this interaction is unknown. It is also unclear if this interaction is specific to efavirenz or if it is related to various components of antiretroviral therapy.

Likelihood Possible Evidence D
Lithium

Theoretically, horsetail might increase the levels and adverse effects of lithium.
Animal research suggests that horsetail has diuretic properties. Theoretically, due to these potential diuretic effects, horsetail might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Possible Evidence D
Nucleoside Reverse Transcriptase Inhibitors (Nrtis)

Theoretically, horsetail might decrease the levels and clinical effects of NRTIs.
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral therapy. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing the supplement, the viral loads became undetectable in both cases. The exact mechanism of these interactions is unknown. It is also unclear if these interactions are specific to NRTIs or if they are related to various components of antiretroviral therapy.

Likelihood Possible Evidence D
Horsetail full monograph & interactions

Arnica Montana1 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, arnica might have additive effects with anticoagulant and antiplatelet drugs. Homeopathic arnica preparations are unlikely to have this interaction.
In vitro evidence shows that sesquiterpene lactones in arnica flowers can decrease platelet aggregation. However, this effect has not been reported in humans.

Likelihood Unlikely Evidence D
Arnica Montana full monograph & interactions

Lovage1 drug type · 75 drugs

Diuretic Drugs

Theoretically, lovage root might interfere with diuretic therapy due to its aquaretic effects.
Some diuretics include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.

Likelihood Possible Evidence D
Lovage full monograph & interactions

Restharrow1 drug type · 1 drug

Lithium

Theoretically, spiny restharrow might increase the levels and clinical effects of lithium.
Spiny restharrow is thought to have diuretic properties. Although animal studies suggest that spiny restharrow reduces edema, diuretic activity has not been reported or evaluated in humans. Theoretically, due to these potential diuretic effects, spiny restharrow might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Possible Evidence D
Restharrow full monograph & interactions
The maker

Brand information

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

Nestmann

See all Nestmann products
Name
Marco Pharma Int'l
City
Roseburg
State
OR
ZipCode
97470
Pharmacist Counseling Corner

Viscum by Nestmann: Common Questions

Does Viscum by Nestmann interact with any medications?
Yes. Based on its ingredients, Viscum has a known interaction with 1,328 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Viscum contains 8 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is 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 valerian safe to take long-term?
Valerian is generally well tolerated in the short term, but long-term safety hasn't been well studied. If you've been taking it for a while, don't stop abruptly—taper your dose slowly to avoid withdrawal symptoms like rapid heartbeat and anxiety.
Can I take this product if I'm trying to get pregnant or am pregnant?
No. Valerian, lovage, restharrow, European mistletoe, and mugwort should all be avoided during pregnancy. The safety data advise against their use. Talk with your doctor or pharmacist about whether this product is right for you.
What are the most common side effects of valerian?
Dizziness, drowsiness, mental slowness, headache, and vivid dreams are the most commonly reported. Some people also experience gastrointestinal upset. If you notice any of these, your dose may need adjustment.
Can lovage cause sun sensitivity?
Yes. Long-term use of lovage may increase your risk of photosensitive reactions, so avoid excessive sun or UV light exposure if you're taking this product.
Is this product safe while breastfeeding?
No. Safety data for breastfeeding are not established for valerian, lovage, horsetail, restharrow, European mistletoe, and mugwort. Talk with your doctor or pharmacist about safer alternatives if you're nursing.
What should I do if I suddenly stop taking this product?
If you've been using it for a while, especially valerian, taper your dose slowly over time rather than stopping all at once. Abruptly stopping can cause withdrawal symptoms like anxiety, irritability, and insomnia.

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.

Viscum label
Go deeper

The Full Monographs Behind Viscum’s Ingredients

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

Herb & supplement monograph

Valerian

Interacts with 902 drugs

Valerian is an herb whose root is widely used as a natural sleep aid and for calming nerves. The evidence is mixed and often weak, so it may help some people sleep but does not work reliably...

Read the full Valerian monograph → Herb & supplement monograph

Lovage

Interacts with 75 drugs

Lovage is a celery-like herb traditionally used for digestion, bloating, and as a mild diuretic to flush the urinary tract. Human evidence for these uses is very limited, and while culinary...

Read the full Lovage monograph → Herb & supplement monograph

Horsetail

Interacts with 188 drugs

Horsetail is a traditional herb most often used as a mild diuretic and for hair, nail, and bone support, but high-quality human evidence is limited. It can cause thiamine (vitamin B1) loss w...

Read the full Horsetail monograph → Herb & supplement monograph

Spiny Restharrow

Interacts with 1 drug

Spiny Restharrow is a traditional European herb whose root has long been used as a mild diuretic to help flush the urinary tract. Solid human evidence for its benefits is very limited, so an...

Read the full Spiny Restharrow monograph → Herb & supplement monograph

Fucus Vesiculosus

Interacts with 891 drugs

Fucus vesiculosus (bladderwrack) is a brown seaweed rich in iodine that has been used traditionally for thyroid concerns, weight, and skin. There is little solid human evidence to support mo...

Read the full Fucus Vesiculosus monograph → Herb & supplement monograph

European Mistletoe

Interacts with 293 drugs

European mistletoe is a parasitic plant most studied as an injectable extract used alongside conventional cancer care in some European countries, mainly to improve quality of life rather tha...

Read the full European Mistletoe monograph → Herb & supplement monograph

Mugwort

Mugwort is a traditional herb used for digestion, menstrual issues, and sleep, but there is very little high-quality human research to confirm these uses. It is closely related to ragweed an...

Read the full Mugwort monograph → Herb & supplement monograph

Arnica

Interacts with 122 drugs

Arnica is a daisy-family plant used mainly in topical and homeopathic products for bruising, muscle soreness, and pain. The evidence is mixed and mostly weak, and undiluted arnica taken by m...

Read the full Arnica monograph →
Sources

Sources & How We Checked

Viscum'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 130 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.

Valerian 37 references
  1. Willey LB, Mady SP, Cobaugh DJ, Wax PM. Valerian overdose: a case report. Vet Hum Toxicol 1995;37:364-5.
  2. Kuhlmann J, Berger W, Podzuweit H, Schmidt U. The influence of valerian treatment on "reaction time, alertness and concentration" in volunteers. Pharmacopsychiatry 1999;32:235-41. PubMed
  3. Klepser TB, Klepser ME. Unsafe and potentially safe herbal therapies. Am J Health Syst Pharm 1999;56:125-38. PubMed
  4. Houghton PJ. The scientific basis for the reputed activity of Valerian. J Pharm Pharmacol 1999;51:505-12. PubMed
  5. Garges HP, Varia I, Doraiswamy PM. Cardiac complications and delirium associated with Valerian root withdrawal. [Letter to the Editor]. JAMA 1998;280:1566-7. PubMed
  6. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  7. MacGregor FB, Abernethy VE, Dahabra S, et al. Hepatotoxicity of herbal remedies. BMJ 1989;299:1156-7. PubMed
  8. Leathwood PD, Chauffard F. Aqueous extract of valerian reduces latency to fall asleep in man. Planta Med 1985;2:144-8. PubMed
  9. Hadley S, Petry JJ. Valerian. Am Fam Physician 2003;67:1755-8..
  10. Glass JR, Sproule BA, Herrmann N, et al. Acute pharmacological effects of temazepam, diphenhydramine, and valerian in healthy elderly subjects. J Clin Psychopharmacol 2003;23:260-8. PubMed
  11. Lefebvre T, Foster BC, Drouin CE, et al. In vitro activity of commercial valerian root extracts against human cytochrome P450 3A4. J Pharm Pharmaceut Sci 2004;7:265-73.
  12. Yuan CS, Mehendale S, Xiao Y, et al. The gamma-aminobutyric acidergic effects of valerian and valerenic acid on rat brainstem neuronal activity. Anesth Analg 2004;98:353-8. PubMed
  13. Donovan JL, DeVane CL, Chavin KD, et al. Multiple night-time doses of valerian (Valeriana officinalis) had minimal effects on CYP3A4 activity and no effect on CYP2D6 activity in healthy volunteers. Drug Metab Dispos 2004;32:1333-6. PubMed
  14. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
  15. Gutierrez S, Ang-Lee MK, Walker DJ, Zacny JP. Assessing subjective and psychomotor effects of the herbal medication valerian in healthy volunteers. Pharmacol Biochem Behav 2004;78:57-64. PubMed
  16. Jacobs BP, Bent S, Tice JA, et al. An internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia. Medicine (Baltimore) 2005;84:197-207. PubMed
  17. National Toxicology Program, US Department of Health and Human Services. Chemical Information Review Document for Valerian (Valeriana officinalis L.) [CAS No. 8057-49-6] and Oils [CAS No. 8008-88-6]. Supporting Nomination for Toxicological Evaluation by t
  18. Fernández-San-Martín MI, Masa-Font R, Palacios-Soler L, et al. Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials. Sleep Med. 2010 Jun;11:505-11. PubMed
  19. Coxeter PD, Schluter PJ, Eastwood HL, et al. Valerian does not appear to reduce symptoms for patients with chronic insomnia in general practice using a series of randomised n-of-1 trials. Complement Ther Med. 2003 Dec;11:215-22. PubMed
  20. Diaper A, Hindmarch I. A double-blind, placebo-controlled investigation of the effects of two doses of a valerian preparation on the sleep, cognitive and psychomotor function of sleep-disturbed older adults. Phytother Res. 2004 Oct;18:831-6. PubMed
  21. Cuellar NG, Ratcliffe SJ. Does valerian improve sleepiness and symptom severity in people with restless legs syndrome? Altern Ther Health Med 2009;15:22-8.
  22. Chen D, Klesmer J, Giovanniello A, et al. Mental status changes in an alcohol abuser taking valerian and gingko biloba. Am J Addict. 2002 Winter;11:75-7. PubMed
  23. Albrecht M, Berger W, Laux P, Schmidt U, et al. Psychopharmaka und Verkehrssicherheit. Der Einfluß von Euvegal&reg; - Dragees forte auf die Fahrtüchtigkeit und Kombinationswirkungen mit Alkohol Z Allg Med 1995;71:1215-25.
  24. Carrasco MC, Vallejo JR, Pardo-de-Santayana M, et al. Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam. Phytother Res. 2009 Dec;23:1795-6.
  25. Hellum BH, Nilsen OG. The in vitro inhibitory potential of trade herbal products on human CYP2D6-mediated metabolism and the influence of ethanol. Basic Clin Pharmacol Toxicol. 2007 Nov;101:350-8.
  26. Hellum BH, Hu Z, Nilsen OG. The induction of CYP1A2, CYP2D6 and CYP3A4 by six trade herbal products in cultured primary human hepatocytes. Basic Clin Pharmacol Toxicol. 2007 Jan;100:23-30. PubMed
  27. Alkharfy, K. M. and Frye, R. F. Effect of valerian, valerian/hops extracts, and valerenic acid on glucuronidation in vitro. Xenobiotica 2007;37(2):113-123.
  28. Vassiliadis, T., Anagnostis, P., Patsiaoura, K., Giouleme, O., Katsinelos, P., Mpoumponaris, A., and Eugenidis, N. Valeriana hepatotoxicity. Sleep Med 2009;10(8):935. PubMed
  29. Muller, Z., Sarkany, A., Altorjay, A., Szilagyi, A., Tura, T., and Ozsvar, Z. [Liver failure a la Eastern Europe]. Orv.Hetil. 3-22-2009;150(12):555-557. PubMed
  30. National Toxicology Program, US Department of Health and Human Services. Chemical Information Review Document for Valerian (Valeriana officinalis L.) [CAS No. 8057-49-6] and Oils [CAS No. 8008-88-6]. 2009;
  31. Wells SR. International intravenous administration of a crude valerian root extract. NACCT 1995;33:542.
  32. Aydinoglu U, Özcan H, Yücel A, Yücel N, Mutlu M. Valerian induced hypomania: a case report. Bull Clin Psychopharma 2012;22(Suppl. 1):S63.
  33. Mirabi P, Mojab F. The effects of valerian root on hot flashes in menopausal women. Iran J Pharm Res 2013;12(1):217-22.
  34. Thomas K, Canedo J, Perry PJ, et al. Effects of valerian on subjective sedation, field sobriety testing and driving simulator performance. Accid Anal Prev. 2016 Jul;92:240-4. PubMed
  35. Kia YH, Alexander S, Dowling D, Standish R. A case of steroid-responsive valerian-associated hepatitis. Intern Med J. 2016 Jan;46(1):118-9. PubMed
  36. Burke H, Jiang S, Chatham P, Stern TA. Delirium After Withdrawal From Valerian Root: A Case Report. Psychosomatics. 2020;61(6):787-790. PubMed
  37. Hajizadeh I, Jamshidi M, Kazemi M, Kargar H, Sadeghi T. Comparison the effect of valerian and gabapentin on RLS and sleep quality in hemodialysis patients: A randomized clinical trial. Ther Apher Dial 2023.

See these in context on the Valerian monograph →

Lovage 10 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
  3. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  4. Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
  5. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  6. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  7. Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.
  8. Ashwood-Smith MJ, Ceska O, Yeoman A, et al. Photosensitivity from harvesting lovage (Levisticum officinale). Contact Dermatitis 1992;26(5):356-357.
  9. Martynyuk L, Martynyuk L, Ruzhitska O, Martynyuk O. Effect of the herbal combination Canephron N on diabetic nephropathy in patients with diabetes mellitus: results of a comparative cohort study. J Altern Complement Med. 2014;20(6):472-478. PubMed
  10. Lapeere H, Boone B, Verhaeghe E, Ongenae K, Lambert J. Contact dermatitis caused by lovage (Levisticum officinalis) essential oil. Contact Dermatitis 2013;69(3):181-2.

See these in context on the Lovage monograph →

Horsetail 14 references
  1. Sudan BJ. Seborrhoeic dermatitis induced by nicotine of horsetails (Equisetum arvense L.). Contact Dermatitis 1985;13:201-2.
  2. Perez Gutierrez RM, Laguna GY, Walkowski A. Diuretic activity of Mexican equisetum. J Ethnopharmacol 1985;14:269-72. PubMed
  3. Lemus I, Garcia R, Erazo S, et al. Diuretic activity of an Equisetum bogotense tea (Platero herb): evaluation in healthy volunteers. J Ethnopharmacol 1996;54:55-8. PubMed
  4. Revilla MC, Andrade-Cetto A, Islas S, Wiedenfeld H. Hypoglycemic effect of Equisetum myriochaetum aerial parts on type 2 diabetic patients. J Ethnopharmacol 2002;81:117-20. PubMed
  5. Tiktinskii, O. L. and Bablumian, I. A. [Therapeutic action of Java tea and field horsetail in uric acid diathesis]. Urol.Nefrol.(Mosk) 1983;3(1):47-50.
  6. Henderson JA, Evans EV, and McIntosh RA. The antithiamine action of Equisetum. J Amer Vet Med Assoc 1952;120:375-378.
  7. Carneiro DM, Freire RC, Honório TC, Zoghaib I, Cardoso FF, Tresvenzol LM, de Paula JR, Sousa AL, Jardim PC, da Cunha LC. Randomized, Double-Blind Clinical Trial to Assess the Acute Diuretic Effect of Equisetum arvense (Field Horsetail) in Healthy Voluntee
  8. Klnçalp S, Ekiz F, Basar Ö, Coban S, Yüksel O. Equisetum arvense (Field Horsetail)-induced liver injury. Eur J Gastroenterol Hepatol. 2012 Feb;24(2):213-4. PubMed
  9. Ortega García JA, Angulo MG, Sobrino-Najul EJ, Soldin OP, Mira AP, Martínez-Salcedo E, Claudio L. Prenatal exposure of a girl with autism spectrum disorder to 'horsetail' (Equisetum arvense) herbal remedy and alcohol: a case report. J Med Case Rep. 2011 M PubMed
  10. Cordova E, Morganti L, Rodriguez C. Possible Drug-Herb Interaction between Herbal Supplement Containing Horsetail (Equisetum arvense) and Antiretroviral Drugs. J Int Assoc Provid AIDS Care. 2017;16(1):11-13.
  11. García Gavilán MD, Moreno García AM, Rosales Zabal JM, Navarro Jarabo JM, Sánchez Cantos A. Case of drug-induced acute pancreatitis produced by horsetail infusions. Rev Esp Enferm Dig. 2017 Apr;109(4):301-304. PubMed
  12. Vieira GT, de Oliveira TT, Carneiro MAA, et al. Antidiabetic effect of Equisetum giganteum L. extract on alloxan-diabetic rabbit. J Ethnopharmacol. 2020;260:112898. PubMed
  13. Health Canada. Organism-Equisetum arvense. Available at: http://webprod.hc-sc.gc.ca/nhpid-bdipsn/ingredReq.do?id=6117&lang=eng. Accessed 21-July 2021.
  14. Bates D, Duong TB, Kheyson S, Moore K. Hyponatremia Secondary to Decreased Oral Intake and SIADH and Possibly Exacerbated by Horsetail (Equisetum arvense). Can J Hosp Pharm 2021;74(4):386-389. PubMed

See these in context on the Horsetail monograph →

Spiny Restharrow 2 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

See these in context on the Spiny Restharrow monograph →

Fucus Vesiculosus 15 references
  1. Goodman GA, Rall TW, Nies AS, Taylor P. The Pharmacological Basis of Therapeutics, 9th ed.
  2. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  3. Phaneuf D, Cote I, Dumas P, et al. Evaluation of the contamination of marine algae (Seaweed) from the St. Lawrence River and likely to be consumed by humans. Environ Res 1999;80:S175-S182. PubMed
  4. Durig J, Bruhn T, Zurborn KH, et al. Anticoagulant fucoidan fractions from Fucus vesiculosus induce platelet activation in vitro. Thromb Res 1997;85:479-91. PubMed
  5. Conz PA, La Greca G, Benedetti P, et al. Fucus vesiculosus: a nephrotoxic alga? Nephrol Dial Transplant 1998;13:526-7.
  6. Ohye H, Fukata S, Kanoh M, et al. Thyrotoxicosis caused by weight-reducing herbal medicines. Arch Intern Med 2005;165:831-4. PubMed
  7. Okamura K, Inoue K, Omae T. A case of Hashimoto's thyroiditis with thyroid immunological abnormality manifested after habitual ingestion of seaweed. Acta Endocrinol (Copenh) 1978;88:703-12. PubMed
  8. Agarwal SC, Crook JR, Pepper CB. Herbal remedies -- how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol 2006;106:260-1. PubMed
  9. Sterling JB, Heymann WR. Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications. J Am Acad Dermatol 2000;43:691-7. PubMed
  10. Catania, M. A., Oteri, A., Caiello, P., Russo, A., Salvo, F., Giustini, E. S., Caputi, A. P., and Polimeni, G. Hemorrhagic cystitis induced by an herbal mixture. South.Med.J. 2010;103(1):90-92. PubMed
  11. Cumashi, A., Ushakova, N. A., Preobrazhenskaya, M. E., D'Incecco, A., Piccoli, A., Totani, L., Tinari, N., Morozevich, G. E., Berman, A. E., Bilan, M. I., Usov, A. I., Ustyuzhanina, N. E., Grachev, A. A., Sanderson, C. J., Kelly, M., Rabinovich, G. A., I
  12. Irhimeh, M. R., Fitton, J. H., and Lowenthal, R. M. Pilot clinical study to evaluate the anticoagulant activity of fucoidan. Blood Coagul.Fibrinolysis 2009;20(7):607-610. PubMed
  13. Arbaizar, B. and Llorca, J. [Fucus vesiculosus induced hyperthyroidism in a patient undergoing concomitant treatment with lithium]. Actas Esp.Psiquiatr. 2011;39(6):401-403.
  14. Church FC, Meade JB, Treanor RE, and et al. Antithrombin activity of fucoidan. The interaction of fucoidan with heparin cofactor II, antithrombin III, and thrombin. J Biol Chem 2-25-1989;264(6):3618-3623. DOI
  15. Mathew L, Burney M, Gaikwad A, et al. Preclinical evaluation of safety of fucoidan extracts from Undaria pinnatifida and Fucus vesiculosus for use in cancer treatment. Integr Cancer Ther 2017;16(4):572-84.

See these in context on the Fucus Vesiculosus monograph →

European Mistletoe 35 references
  1. Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. Harvey J, Colin-Jones DG. Mistletoe hepatitis. Br Med J (Clin Res Ed) 1981;282:186-7.
  5. Natl Cancer Inst. Mistletoe (PDQ). CancerNet. www.cancernet.nci.nih.gov/cam/mistletoe.htm#7 (Accessed 30 March 2001).
  6. Kaegi E. Unconventional therapies for cancer: 3. Iscador. Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative. CMAJ 1998;158:1157-9.
  7. Grossarth-Matichek R, Kiene H, Baumgartner SM, Ziegler R. Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Altern Ther Health
  8. Huber R, Barth H, Schmitt-Graff A, Klein R. Hypereosinophilia induced by high-dose intratumoral and peritumoral mistletoe application to a patient with pancreatic carcinoma. J Altern Complement Med 2000;6:305-10. PubMed
  9. Timoshenko AV, Cherenkevich SN, Gabius HJ. Viscum album agglutinin-induced aggregation of blood cells and the lectin effects on neutrophil function. Biomed Pharmacother 1995;49:153-8.. PubMed
  10. Bussing A, Regnery A, Schweizer K. Effects of Viscum album L. on cyclophosphamide-treated peripheral blood mononuclear cells in vitro: sister chromatid exchanges and activation/proliferation marker expression. Cancer Lett 1995;94:199-205.. PubMed
  11. Deliorman D, Calis I, Ergun F. A new acyclic monoterpene glucoside from Viscum album ssp. album. Fitoterapia 2001;72:101-5. PubMed
  12. Finall AI, McIntosh SA, Thompson WD. Subcutaneous inflammation mimicking metastatic malignancy induced by injection of mistletoe extract. BMJ 2006;333:1293-4. PubMed
  13. Bauer C, Oppel T, Rueff F, Przybilla B. Anaphylaxis to viscotoxins of mistletoe (Viscum album) extracts. Ann Allergy Asthma Immunol 2005;94:86-9. PubMed
  14. Schoffski P, Breidenbach I, Krauter J, et al. Weekly 24 h infusion of aviscumine (rViscumin): A phase I study in patients with solid tumours. Eur J Cancer 2005;41:1431-8.
  15. Chernyshov VP, Omelchenko LI, Heusser P, and et al. Immunomodulatory actions of Viscum album (Iscador) in children with recurrent respiratory disease as a result of the Chernobyl nuclear accident. Complementary Therapies in Medicine 1997;5(3):141-146. DOI
  16. Chernyshov, V. P., Heusser, P., Omelchenko, L. I., Chernyshova, L. I., Vodyanik, M. A., Vykhovanets, E. V., Galazyuk, L. V., Pochinok, T. V., Gaiday, N. V., Gumenyuk, M. E., Zelinsky, G. M., Schaefermeyer, H., and Schaefermeyer, G. Immunomodulatory and cl
  17. Kim HJ, Kim H, Ahn JH, Suk JH. Liver injury induced by herbal extracts containing mistletoe and kudzu. J Altern Complement Med 2015;21(3):180-5. PubMed
  18. Kienle GS, Grugel R, Kiene H. Safety of higher dosages of Viscum album L. in animals and humans--systematic review of immune changes and safety parameters. BMC Complement Altern Med. 2011 Aug 28;11:72. PubMed
  19. Schad F, Atxner J, Buchwald D, Happe A, Popp S, Kröz M, Matthes H. Intratumoral Mistletoe (Viscum album L) Therapy in Patients With Unresectable Pancreas Carcinoma: A Retrospective Analysis. Integr Cancer Ther. 2014 Jul;13(4):332-40.
  20. Steele ML, Axtner J, Happe A, Kröz M, Matthes H, Schad F. Adverse Drug Reactions and Expected Effects to Therapy with Subcutaneous Mistletoe Extracts (Viscum album L.) in Cancer Patients. Evid Based Complement Alternat Med. 2014;2014:724258.
  21. Steele ML, Axtner J, Happe A, Kröz M, Matthes H, Schad F. Safety of Intravenous Application of Mistletoe (Viscum album L.) Preparations in Oncology: An Observational Study. Evid Based Complement Alternat Med. 2014;2014:236310.
  22. von Schoen-Angerer T, Wilkens J, Kienle GS, Kiene H, Vagedes J. High-Dose Viscum album Extract Treatment in the Prevention of Recurrent Bladder Cancer: A Retrospective Case Series. Perm J. 2015 Fall;19(4):76-83.
  23. Nazaruk J, Orlikowski P. Phytochemical profile and therapeutic potential of Viscum album L. Nat Prod Res. 2016;30(4):373-85.
  24. Bussing A, Stumpf C, Troger W, Schietzel M. Course of mitogen-stimulated T lymphocytes in cancer patients treated with Viscum album extracts. Anticancer Res. 2007 Jul-Aug;27(4C):2903-10.
  25. Noh D, Park JS, Lee DY. Acute respiratory distress syndrome after Viscum album pleurodesis for primary spontaneous pneumothorax. Koren J THorac Cariodvasc Surg. 2017 Feb;50(1):64-67.
  26. Schad F, Axtner J, Kroz M, Matthes H, Steele ML. Safety of combined treatment with monoclonal antibodies and Viscum album L preparations. Integr Cancer Ther. 2018 Mar;17(1):41-51.
  27. Thronicke A, Steele ML, Grah C, Matthes B, Schad F. Clinical safety of combined therapy of immune checkpoint inhibitors and Viscum album L. therapy in patients with advanced or metastatic cancer. BMC Complement Altern Med. 2017 Dec 13;17(1):534. PubMed
  28. Khan T, Ali S, Qayyum R, Hussain I, Wahid F, Shah AJ. Intestinal and vascular smooth muscle relaxant effect of Viscum album explains its medicinal use in hyperactive gut disorders and hypertension. BMC Complement Altern Med. 2016 Jul 27;16:251. PubMed
  29. Cho SJ, Kim SW, Chang JW. Acute pneumonitis consequent on pleurodesis with Viscum album extract: severe chest images but benign clinical course. Multidiscip Respir Med. 2014 Nov 27;9(1):61. PubMed
  30. Steele ML, Axtner J, Happe A, Kroz M, Matthes H, Schad F. Use and safety of intratumoral application of European mistletoe (Visum album L) preparations in oncology. Integr Cancer Ther. 2015 Mar;14(2):140-8.
  31. Zuzak TJ, Wasmuth A, Bernitzki S, Schwermer M, Längler A. Safety of high-dose intravenous mistletoe therapy in pediatric cancer patients: A case series. Complement Ther Med. 2018;40:198-202. PubMed
  32. Kim JD, Choi JW, Park HO, et al. Chemical pleurodesis with Viscum album L. extract for secondary spontaneous pneumothorax in elderly patients. J Thorac Dis 2020;12(10):5440-5445. PubMed
  33. Baek JH, Jeon Y, Han KW, Jung DH, Kim KO. Effect of mistletoe extract on tumor response in neoadjuvant chemoradiotherapy for rectal cancer: a cohort study. World J Surg Oncol 2021;19(1):178. PubMed
  34. Casetti F, Rafei-Shamsabadi D, Müller S. Grade II-anaphylaxis after subcutaneous injection of mistletoe extract. Contact Dermatitis 2021;85(4):462-5.
  35. Cogo E, Elsayed M, Bhardwaj S, et al. Mistletoe Extracts during the Oncological Perioperative Period: A Systematic Review and Meta-Analysis of Human Randomized Controlled Trials. Curr Oncol 2023;30(9):8196-8219. PubMed

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Mugwort 7 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Borghesan F, Mistrello G, Amato S, Giuffrida MG, Villalta D, Asero R. Mugwort-fennel-allergy-syndrome associated with sensitization to an allergen homologous to Api g 5. Eur Ann Allergy Clin Immunol. 2013;45(4):130-7.
  4. Kim SH, Lee SM, Park HW, et al. Chinese bellflower root anaphylaxis: IgE-binding components and cross-reactivity with mugwort and birch. Korean J Intern Med. 2009;24(3):279-82. PubMed
  5. Silva R, Lopes C, Castro E, et al. Anaphylaxis to mango fruit and crossreactivity with Artemisia vulgaris pollen. J Investig Allergol Clin Immunol. 2009;19(5):420-2.
  6. Rodrigues-Alves R, Pregal A, Pereira-Santos MC, et al. Anaphylaxis to pine nut: cross-reactivity to Artemisia vulgaris? Allergol Immunopathol (Madr). 2008;36(2):113-6. PubMed
  7. Di Lorenzo C, Ferretti F, Moro E, et al. Identification and quantification of thujone in a case of poisoning due to repeated ingestion of an infusion of Artemisia vulgaris L. J Food Sci. 2018;83(8):2257-2264.

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Arnica 10 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Schroder H, Losche W, Strobach H, et al. Helenalin and 11 alpha, 13-dihydrohelenalin, two constituents from Arnica montana L., inhibit human platelet function via thiol-dependent pathways. Thromb Res 1990;57:839-45.
  4. Adkison JD, Bauer DW, Chang T. The effect of topical arnica on muscle pain. Ann Pharmacother 2010;44:1579-84. PubMed
  5. No authors listed. Final report on the safety assessment of Arnica montana extract and Arnica montana. Int.J.Toxicol. 2001;20:1-11. DOI
  6. Karow JH, Abt HP, Frohling M, and Ackermann H. Efficacy of Arnica montana D4 for healing of wounds after Hallux valgus surgery compared to diclofenac. J Altern Complement Med 2008;14:17-25.
  7. Venkatramani DV, Goel S, Ratra V, et al. Toxic optic neuropathy following ingestion of homeopathic medication Arnica-30. Cutan.Ocul.Toxicol. 2013;32:95-97. PubMed
  8. Moghadam BK, Gier R, and Thurlow T. Extensive oral mucosal ulcerations caused by misuse of a commercial mouthwash. Cutis 1999;64:131-134.
  9. Stevinson C, Devaraj VS, Fountain-Barber A, et al. Homeopathic arnica for prevention of pain and bruising: randomized placebo-controlled trial in hand surgery. J R Soc Med 2003;96:60-65. PubMed
  10. Canders CP, Stanford SR, Chiem AT. A dangerous cup of tea. Wilderness Environ Med. 2014 Mar;25(1):111-2. PubMed

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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.

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