| HerbalDrugs | Compounds | Mechanismofinteraction | Comments |
| Chia seeds (Salvia hispanica, seeds) | Dietary fiber | Reduction of absorption of organic molecules[17] | * Tamoxifen has very low oral absorption and biotransformation in CYP 3A4 and 2C9. The inhibition of these enzymes decreases the production of the bioactive metabolite what could result in a therapeutic failure. Other chemotherapy drugs that are metabolized or activated in these isoforms of Cytochrome P450 could also be affected[18]. |
| Phenolic Compounds | Inhibition of CYP 3A4 and CYP 2C9[17,19] | ||
| Flaxseed (Linunusitatissimum, seeds) | Mucilage and pulp | Reduction of absorption of organic molecules[20,21] | * In breast cancer, it can promote hormone-dependent tumor growth (data not conclusive, but important alert) due to its estrogen-like effect . It also interferes with metabolizing of testosterone [22]. |
| Phytoestrogens | Inhibition of CYP 3A4[23] Estrogen-like activity[24] | ||
| Plantains (Plantago sp., seeds) | Mucilage | Reduction of absorption of organic molecules[20] | * |
| Chlorella (Chlorella ellipsoides) | Mucilage | Reduction of absorption of organic molecules[20,21] | * These products could be contaminated with other algae that produce toxins. (we had a unique event, that occurred with an oncological patient that suffered toxic hepatitis associated to chemotherapy and a microcystin that was in a contaminateda Chlorella supplement - case report submitted to publication)[25]. |
| Rhubarb (Rheum officinale, root) | Anthraquinone derivatives and tannins | Reduction of absorption and inhibition of CYP 1A1[26] | * ** |
| Rhamnusfrangula and Rhamnuspurshiana (bark) | Anthraquinone derivatives | Reduction of absorption[23,27] | * ** |
| Aloe barbadensis (concentrated juice of leaves) | Anthraquinone derivatives | Inhibition CYP 3A4[16] and reduction of absorption[27] | * ** Inhibition of CYP3A4 is irreversible[16]. |
| β-sitosterol | Promotion of angiogenesis[15] | Inhibition of angiogenesis it is a strategy of some chemotherapy schemes[28]. The intake of product that do the inverse effect could be problematic. | |
| Sene (Cassia acutifolia, leaves and fruits) | Anthraquinonederivatives | Reduction of absorption[21] | * ** |
| Konjac (Amorphophalluskonjac) | Glucomannan, mucilage and pulp | Reduction of absorption[20,21] | * |
| Guar gumming (Cyamopsistetragonolobus) | Mucilage and pulp | Reduction of absorption[20] | * |