Methotrexate

Drug Information

Methotrexate (MTX) is a chemotherapy drug that interferes with folic acid activation, preventing cell reproduction. Methotrexate is used to treat some forms of cancer; severe, disabling psoriasis; and severe, active rheumatoid arthritis.

Note: Many of the interactions described below, in the text and in the Summary of Interactions, have been reported only for specific chemotherapeutic drugs, and may not apply to other chemotherapeutic drugs. There are many unknowns concerning interactions of nutrients, herbs, and chemotherapy drugs. People receiving chemotherapy who wish to supplement with vitamins, minerals, herbs, or other natural substances should always consult a physician.

Common brand names:

Rheumatrex Dose Pack, Trexall

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions:BeneficialAdverseCheck

Replenish Depleted Nutrients

  • 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.

  • Calcium

    The chemotherapy drug cisplatin may cause kidney damage, resulting in depletion of calcium and phosphate.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Glutathione
    Glutathione, the main antioxidant found within cells, is frequently depleted in individuals on chemotherapy and/or radiation. Preliminary studies have found that intravenously injected glutathione may decrease some of the adverse effects of chemotherapy and radiation, such as diarrhea.
    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • 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.
  • The chemotherapy drug cisplatin may cause kidney damage, resulting in depletion of calcium and phosphate.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • A modified form of vitamin A has been reported to work synergistically with chemotherapy in test tube 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.
  • Vitamin C combined with Vitamin K3 appears to increase the effectiveness of chemotherapy in animals.
    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.

  • 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.
  • 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

    High amounts of melatonin have been combined with a variety of chemotherapy drugs to reduce their side effects or improve drug efficacy. One study gave melatonin at night in combination with the drug triptorelin to men with metastatic prostate cancer. All of these men had previously become unresponsive to triptorelin. The combination decreased PSA levels—a marker of prostate cancer progression—in eight of fourteen patients, decreased some side effects of triptorelin, and helped nine of fourteen to live longer than one year. The outcome of this preliminary study suggests that melatonin may improve the efficacy of triptorelin even after the drug has apparently lost effectiveness.

  • 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

    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 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.

    A new formulation of selenium (Seleno-Kappacarrageenan) was found to reduce kidney damage and white blood cell–lowering effects of cisplatin in one human study. However, the level used in this study (4,000 mcg per day) is potentially toxic and should only be used under the supervision of a doctor.

    Glutathione, the main antioxidant found within cells, is frequently depleted in individuals on chemotherapy and/or radiation. Preliminary studies have found that intravenously injected glutathione may decrease some of the adverse effects of chemotherapy and radiation, such as diarrhea.

  • Vitamin E

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity). A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.

  • 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.

  • Beta-Carotene

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks. Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo. Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores. Applying vitamin E only once per day was helpful to only some groups of patients in another trial, and not all studies have found vitamin E to be effective. Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

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

    A liquid preparation of German chamomile has been shown to reduce the incidence of mouth sores in people receiving radiation and systemic chemotherapy treatment in an uncontrolled study.

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

    Russian research has looked at using eleuthero with chemotherapy. One study of patients with melanoma found that chemotherapy was less toxic when eleuthero was given simultaneously. Similarly, women with inoperable breast cancer given eleuthero were reported to tolerate more chemotherapy. Eleuthero treatment was also associated with improved immune function in women with breast cancer treated with chemotherapy and radiation.

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

    Ginger 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.

    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.
  • Zinc

    Irradiation treatment, especially of head and neck cancers, frequently results in changes to normal taste sensation. Zinc supplementation may be protective against taste alterations caused or exacerbated by irradiation. A double-blind trial found that 45 mg of zinc sulfate three times daily reduced the alteration of taste sensation during radiation treatment and led to significantly greater recovery of taste sensation after treatment was concluded.

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

Support Medicine

  • 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.

  • 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.

  • Melatonin

    High amounts of melatonin have been combined with a variety of chemotherapy drugs to reduce their side effects or improve drug efficacy. One study gave melatonin at night in combination with the drug triptorelin to men with metastatic prostate cancer. All of these men had previously become unresponsive to triptorelin. The combination decreased PSA levels—a marker of prostate cancer progression—in eight of fourteen patients, decreased some side effects of triptorelin, and helped nine of fourteen to live longer than one year. The outcome of this preliminary study suggests that melatonin may improve the efficacy of triptorelin even after the drug has apparently lost effectiveness.

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

    Milk thistle’s 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.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • The mushroom Coriolus versicolor contains an immune-stimulating substance called polysaccharide krestin, or PSK. PSK has been shown in several studies to help cancer patients undergoing chemotherapy. One study involved women with estrogen receptor-negative breast cancer. PSK combined with chemotherapy significantly prolonged survival time compared with chemotherapy alone. Another study followed women with breast cancer who were given chemotherapy with or without PSK. The PSK-plus-chemotherapy group had a 25% better chance of survival after ten years compared with those taking chemotherapy without PSK. Another study investigated people who had surgically removed colon cancer. They were given chemotherapy with or without PSK. Those given PSK had a longer disease-free period and longer survival time. Three grams of PSK were taken orally each day in these studies.

    Although PSK is rarely available in the United States, hot-water extract products made from Coriolus versicolor mushrooms are available. These products may have activity related to that of PSK, but their use with chemotherapy has not been studied.

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

Reduces Effectiveness

  • none

Potential Negative Interaction

  • PABA

    PABA can increase methotrexate levels, activity, and side effects. The incidence and severity of this interaction remains unclear.

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

Explanation Required

  • Folic Acid

    In cancer treatment, methotrexate works by blocking activation of folic acid. Folic acid-containing supplements may interfere with methotrexate therapy in people with cancer. Methotrexate therapy can lead to folic acid deficiency. People using methotrexate for cancer treatment should ask their prescribing doctor before using any folic acid-containing supplements. There is no concern about folic acid supplementation for people with cancer using chemotherapy drugs other than methotrexate.

    Until recently, it was believed that methotrexate helped people with rheumatoid arthritis also by interfering with folic acid metabolism. However, this is not necessarily so, as some studies have shown that folic acid supplementation in amounts ranging from 5–50 mg per week did not alter the efficacy of methotrexate in the treatment of rheumatoid arthritis. Many doctors now believe that people with rheumatoid arthritis taking methotrexate should supplement large amounts of folic acid. In separate double-blind trials, 5 mg per week of folic acid and 2.5–5 mg per week of folinic acid (an activated form of folic acid) have substantially reduced side effects of methotrexate without interfering with the therapeutic action in rheumatoid patients. Folic or folinic acid was taken at a different time from methotrexate and sometimes only five days per week. Daily (as opposed to weekly) supplementation with folic acid (5 mg per day for 13 days) was found to reduce blood levels of methotrexate; however, the researchers in this study suggest that the reduction in blood methotrexate levels by folic acid does not necessarily mean that the folic acid is interfering with the therapeutic action of the drug. It is possible that the lower blood levels of methotrexate are simply an indication that the drug is being taken up more rapidly by the cells as a result of folic acid supplementation. In most of the studies cited here, folic acid supplementation was begun 24 hours after the administration of methotrexate. Because of the uncertainty regarding this interaction, persons taking methotrexate for rheumatoid arthritis who are considering supplementation with folic acid should first consult with their doctor.

    People who are prescribed methotrexate to treat severe psoriasis experience fewer side effects if they also supplement high amounts (5 mg per day) of folic acid. As is the case with methotrexate and rheumatoid arthritis, supplementing folic acid did not interfere with the activity of methotrexate. Such high levels of folic acid should not be taken without clinical supervision.

  • 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.
  • Many chemotherapy drugs can cause diarrhea, lack of appetite, vomiting, and damage to the gastrointestinal tract. Recent anti-nausea prescription medications are often effective. Nonetheless, nutritional deficiencies still occur. It makes sense for people undergoing chemotherapy to take a high-potency multivitamin-mineral to protect against deficiencies.

    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.
  • 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.

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