Drug Information

Common brand names:

Fareston

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Magnesium and Potassium

    The chemotherapy drug cisplatin may cause excessive loss of magnesium and potassium in the urine. Preliminary reports suggest that both potassium and magnesium supplementation may be necessary to increase low potassium levels. Severe magnesium deficiency caused by cisplatin therapy has been reported to result in seizures. Severe magnesium deficiency is a potentially dangerous medical condition that should only be treated by a doctor. People receiving cisplatin chemotherapy should ask their prescribing doctor to closely monitor magnesium and potassium status.

  • Lactobacillus GG

    In a preliminary trial, supplementation with a probiotic (Lactobacillus GG) reduced the frequency of severe diarrhea and the incidence of abdominal discomfort related to the use of 5-FU. The amount of Lactobacillus GG used was 10-20 billion organisms per day during the 24 weeks of chemotherapy.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • N-Acetyl Cysteine

    A modified form of vitamin A has been reported to work synergistically with chemotherapy in test tube research. Vitamin C appears to increase the effectiveness of chemotherapy in animals and with human breast cancer cells in test tube research. In a double-blind study, Japanese researchers found that the combination of vitamin E, vitamin C, and N-acetyl cysteine (NAC)-all antioxidants-protected against chemotherapy-induced heart damage without interfering with the action of the chemotherapy.

    A comprehensive review of antioxidants and chemotherapy leaves open the question of whether supplemental antioxidants definitely help people with chemotherapy side effects, but it clearly shows that antioxidants need not be avoided for fear that the actions of chemotherapy are interfered with. Although research remains incomplete, the idea that people taking chemotherapy should avoid antioxidants is not supported by scientific research.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Spleen Peptide Extract

    Patients with inoperable head and neck cancer were treated with a spleen peptide preparation (Polyerga) in a double-blind trial during chemotherapy with cisplatin and 5-FU. The spleen preparation had a significant stabilizing effect on certain white blood cells. People taking it also experienced stabilized body weight and a reduction in the fatigue and inertia that usually accompany this combination of chemotherapy agents.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Taurine

    Taurine has been shown to be depleted in people taking chemotherapy. It remains unclear how important this effect is or if people taking chemotherapy should take taurine supplements.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

  • Acetyl-L-Carnitine

    Acetyl-L-carnitine in the amount of 1,000 mg three times per day for eight weeks has been shown to improve nerve damage (neuropathy) caused by the chemotherapy drug cisplatin.

  • Calcium and Magnesium
    In a double-blind trial, intravenous administration of calcium and magnesium before and after administration of oxaliplatin prevented the development of oxaliplatin-induced nerve damage. However, in another double-blind trial, the same treatment regimen as in the other study did not prevent oxaliplatin-induced nerve damage. It is not known whether oral administration of these minerals would also be beneficial.
  • Ginger

    Ginger (Zingiber officinale) can be helpful in alleviating nausea and vomiting caused by chemotherapy. Ginger, as tablets, capsules, or liquid herbal extracts, can be taken in 500 mg amounts every two or three hours, for a total of 1 gram per day.

  • Glutamine

    Though cancer cells use glutamine as a fuel source, studies in humans have not found that glutamine stimulates growth of cancers in people taking chemotherapy. In fact, animal studies show that glutamine may actually decrease tumor growth while increasing susceptibility of cancer cells to radiation and chemotherapy, though such effects have not yet been studied in humans.

    Glutamine has successfully reduced chemotherapy-induced mouth sores. In one trial, people were given 4 grams of glutamine in an oral rinse, which was swished around the mouth and then swallowed twice per day. Thirteen of fourteen people in the study had fewer days with mouth sores as a result. These excellent results have been duplicated in some, but not all double-blind research. In another study, patients receiving high-dose paclitaxel and melphalan had significantly fewer episodes of oral ulcers and bleeding when they took 6 grams of glutamine four times daily along with the chemotherapy.

    One double-blind trial suggested that 6 grams of glutamine taken three times per day can decrease diarrhea caused by chemotherapy. However, other studies using higher amounts or intravenous glutamine have not reported this effect.

    Intravenous use of glutamine in people undergoing bone marrow transplants, a procedure sometimes used to allow very high amounts of chemotherapy to be used, has led to reduced hospital stays, leading to a savings of over $21,000 for each patient given glutamine.

    In a double-blind study, supplementation with 18 grams of glutamine per day for 15 days, starting five days before the beginning of 5-FU therapy, significantly reduced the severity of drug-induced intestinal toxicity.

    Intravenous use of glutamine in people undergoing bone marrow transplants, a procedure sometimes used to allow very high amounts of chemotherapy to be used, has led to reduced hospital stays, leading to a savings of over $21,000 for each patient given glutamine.

  • Glutathione

    High-dose cisplatin chemotherapy is associated with kidney toxicity and damage, which may be reduced by glutathione administration. Nerve damage is another frequent complication of high amounts of cisplatin. Preliminary evidence has shown that glutathione injections may protect nerve tissue during cisplatin therapy without reducing cisplatin's anti-tumor activity. There is no evidence that glutathione taken by mouth has the same benefits.

  • Melatonin

    Melatonin supplementation (20 mg per day) has decreased toxicity and improved effectiveness of chemotherapy with cisplatin plus etoposide and cisplatin plus 5-FU.

  • Probiotics

    In a preliminary trial, supplementation with a probiotic (Lactobacillus GG) reduced the frequency of severe diarrhea and the incidence of abdominal discomfort related to the use of 5-FU. The amount of Lactobacillus GG used was 10-20 billion organisms per day during the 24 weeks of chemotherapy.

  • Selenium

    In one human study, administration of 4,000 mcg per day of a selenium product, Seleno-Kappacarrageenan, reduced the kidney damage and white blood cell-lowering effects of the chemotherapy drug cisplatin. The amount of selenium used in this study is potentially toxic and should only be used under the supervision of a doctor. In another study, patients being treated with cisplatin and cyclophosphamide for ovarian cancer were given a multivitamin preparation, with or without 200 mcg of selenium per day. Compared with the group not receiving selenium, those receiving selenium had a smaller reduction in white blood cell count and fewer chemotherapy side effects such as nausea, hair loss, weakness, and loss of appetite.

  • Spleen Peptide Extract

    Patients with inoperable head and neck cancer were treated with a spleen peptide preparation (Polyerga) in a double-blind trial during chemotherapy with cisplatin and 5-FU. The spleen preparation had a significant stabilizing effect on certain white blood cells. People taking it also experienced stabilized body weight and a reduction in the fatigue and inertia that usually accompany this combination of chemotherapy agents.

  • Wheat Grass

    In a preliminary trial, taking wheat grass in the amount of 60 ml (about 2 ounces) per day during chemotherapy reduced the incidence of certain chemotherapy-related side effects (including anemia and a decline in white blood cell counts) in women with breast cancer. Taking wheat grass did not appear to interfere with the anticancer effect of the chemotherapy. The chemotherapy used in this study was a combination of 5-fluorouracil, doxorubicin, and cyclophosphamide.

Support Medicine

  • Milk Thistle

    Milk thistle's (Silybum marianum) major flavonoids, known collectively as silymarin, have shown synergistic actions with the chemotherapy drugs cisplatin and doxorubicin (Adriamycin) in test tubes. Silymarin also offsets the kidney toxicity of cisplatin in animals. Silymarin has not yet been studied in humans treated with cisplatin. There is some evidence that silymarin may not interfere with some chemotherapy in humans with cancer.

  • Thymus Extracts

    Peptides or short proteins derived from the thymus gland, an important immune organ, have been used in conjunction with chemotherapy drugs for people with cancer. One study using thymosin fraction V in combination with chemotherapy, compared with chemotherapy alone, found significantly longer survival times in the thymosin fraction V group. A related substance, thymostimulin, decreased some side effects of chemotherapy and increased survival time compared with chemotherapy alone. A third product, thymic extract TP1, was shown to improve immune function in people treated with chemotherapy compared with effects of chemotherapy alone. Thymic peptides need to be administered by injection. People interested in their combined use with chemotherapy should consult a doctor.

  • Wheat Grass

    In a preliminary trial, taking wheat grass in the amount of 60 ml (about 2 ounces) per day during chemotherapy reduced the incidence of certain chemotherapy-related side effects (including anemia and a decline in white blood cell counts) in women with breast cancer. Taking wheat grass did not appear to interfere with the anticancer effect of the chemotherapy. The chemotherapy used in this study was a combination of 5-fluorouracil, doxorubicin, and cyclophosphamide.

  • Gamma Linolenic Acid

    Gamma-linolenic acid (GLA), found in evening primrose and borage oils, may enhance the therapeutic effects of tamoxifen. A small group of breast cancer patients took 2.8 g of oral GLA per day in addition to tamoxifen, in a preliminary trial. Another group of breast cancer patients took tamoxifen alone. Those taking the GLA-tamoxifen combination appeared to have a better clinical response than did those taking tamoxifen alone. However, the results of this preliminary research are far from conclusive and need to be confirmed in a larger, more definitive trial.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Melatonin

    In preliminary research, large amounts of melatonin were used successfully in combination with tamoxifen in a few people with breast cancer for whom tamoxifen had previously failed. The amounts used in this study should be taken only under the supervision of a doctor.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Tocotrienols

    Tocotrienols are compounds similar to vitamin E that are found in palm oil. Test tube studies have shown that tocotrienols enhance the effects of tamoxifen. Controlled studies are needed to determine whether supplementing with tocotrienols might enhance the anticancer effects of tamoxifen.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduces Effectiveness

  • none

Potential Negative Interaction

  • Tangeretin

    Preliminary research in animals found that the citrus flavonoid tangeretin (found primarily in the peel of citrus fruits) interferes with the ability of tamoxifen to inhibit tumor growth. Although the evidence is far from conclusive, people taking tamoxifen should probably avoid citrus bioflavonoid supplements, as well as beverages and foods to which citrus peel oils have been added.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Explanation Required 

  • Vitamin A

    A controlled French trial reported that when postmenopausal late-stage breast cancer patients were given very large amounts of vitamin A (350,000-500,000 IU per day) along with chemotherapy, remission rates were significantly better than when the chemotherapy was not accompanied by vitamin A. Similar results were not found in premenopausal women. The large amounts of vitamin A used in the study are toxic and require clinical supervision.

  • Antioxidants

    Chemotherapy can injure cancer cells by creating oxidative damage. As a result, some oncologists recommend that patients avoid supplementing antioxidants if they are undergoing chemotherapy. Limited test tube research occasionally does support the idea that an antioxidant can interfere with oxidative damage to cancer cells. However, most scientific research does not support this supposition.

    A modified form of vitamin A has been reported to work synergistically with chemotherapy in test tube research. Vitamin C appears to increase the effectiveness of chemotherapy in animals and with human breast cancer cells in test tube research. In a double-blind study, Japanese researchers found that the combination of vitamin E, vitamin C, and N-acetyl cysteine (NAC)-all antioxidants-protected against chemotherapy-induced heart damage without interfering with the action of the chemotherapy.

    A comprehensive review of antioxidants and chemotherapy leaves open the question of whether supplemental antioxidants definitely help people with chemotherapy side effects, but neither does it show that antioxidants should be avoided for fear that the actions of chemotherapy are interfered with. Although research remains incomplete, the idea that people taking chemotherapy should avoid antioxidants is not supported by scientific research.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Echinacea

    Echinacea is a popular immune-boosting herb that has been investigated for use with chemotherapy. One study investigated the actions of cyclophosphamide, echinacea, and thymus gland extracts to treat advanced cancer patients. Although small and uncontrolled, this trial suggested that the combination modestly extended the life span of some patients with inoperable cancers. Signs of restoration of immune function were seen in these patients.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • N-Acetyl Cysteine

    NAC, an amino acid-like supplement that possesses antioxidant activity, has been used in four human studies to decrease the kidney and bladder toxicity of the chemotherapy drug ifosfamide. These studies used 1-2 grams NAC four times per day. Th+N110ere was no sign that NAC interfered with the efficacy of ifosfamide in any of these studies. Intakes of NAC over 4 grams per day may cause nausea and vomiting.

    The newer anti-nausea drugs prescribed for people taking chemotherapy lead to greatly reduced nausea and vomiting for most people. Nonetheless, these drugs often do not totally eliminate all nausea. Natural substances used to reduce nausea should not be used instead of prescription anti-nausea drugs. Rather, under the guidance of a doctor, they should be added to those drugs if needed. At least one trial suggests that NAC at 1,800 mg per day may reduce nausea and vomiting caused by chemotherapy.

    A modified form of vitamin A has been reported to work synergistically with chemotherapy in test tube research. Vitamin C appears to increase the effectiveness of chemotherapy in animals and with human breast cancer cells in test tube research. In a double-blind study, Japanese researchers found that the combination of vitamin E, vitamin C, and N-acetyl cysteine (NAC)-all antioxidants-protected against chemotherapy-induced heart damage without interfering with the action of the chemotherapy.

    A comprehensive review of antioxidants and chemotherapy leaves open the question of whether supplemental antioxidants definitely help people with chemotherapy side effects, but neither does it show that antioxidants should be avoided for fear that the actions of chemotherapy are interfered with. Although research remains incomplete, the idea that people taking chemotherapy should avoid antioxidants is not supported by scientific research.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Vitamin A, Vitamin C, and N-Acetyl Cysteine

    Chemotherapy can injure cancer cells by creating oxidative damage. As a result, some oncologists recommend that patients avoid supplementing antioxidants if they are undergoing chemotherapy. Limited test tube research occasionally does support the idea that an antioxidant can interfere with oxidative damage to cancer cells. However, most scientific research does not support this supposition.

    A modified form of vitamin A has been reported to work synergistically with chemotherapy in test tube research. Vitamin C appears to increase the effectiveness of chemotherapy in animals and with human breast cancer cells in test tube research. In a double-blind study, Japanese researchers found that the combination of vitamin E, vitamin C, and N-acetyl cysteine (NAC)-all antioxidants-protected against chemotherapy-induced heart damage without interfering with the action of the chemotherapy.

    A comprehensive review of antioxidants and chemotherapy leaves open the question of whether supplemental antioxidants definitely help people with chemotherapy side effects, but neither does it show that antioxidants should be avoided for fear that the actions of chemotherapy are interfered with. Although research remains incomplete, the idea that people taking chemotherapy should avoid antioxidants is not supported by scientific research.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Vitamin C

    Chemotherapy can injure cancer cells by creating oxidative damage. As a result, some oncologists recommend that patients avoid supplementing antioxidants if they are undergoing chemotherapy. Limited test tube research occasionally does support the idea that an antioxidant can interfere with oxidative damage to cancer cells. However, most scientific research does not support this supposition.

    A modified form of vitamin A has been reported to work synergistically with chemotherapy in test tube research. Vitamin C combined with Vitamin K3 appears to increase the effectiveness of chemotherapy in animals and with human breast cancer cells in test tube research. In a double-blind study, Japanese researchers found that the combination of vitamin E, vitamin C, and N-acetyl cysteine (NAC)-all antioxidants-protected against chemotherapy-induced heart damage without interfering with the action of the chemotherapy.

    A comprehensive review of antioxidants and chemotherapy leaves open the question of whether supplemental antioxidants definitely help people with chemotherapy side effects, but it clearly shows that antioxidants need not be avoided for fear that the actions of chemotherapy are interfered with. Although research remains incomplete, the idea that people taking chemotherapy should avoid antioxidants is not supported by scientific research.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers' package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.