Drug & supplement interaction

Baikal Skullcap + Anagrelide

Anagrelide brand name: Agrylin.

Moderate Interaction
The bottom line Moderate

Anagrelide falls into 2 drug categories that Baikal Skullcap can interact with; the most serious is rated moderate. Theoretically, Baikal skullcap may increase levels of drugs metabolized by CYP1A2 enzymes.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Baikal Skullcap and Anagrelide

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Baikal Skullcap interacts with whole categories of medication. Anagrelide falls into 2 of those categories, so it can interact with Baikal Skullcap in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Anagrelide

Anagrelide falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Baikal Skullcap interacts with.

Theoretically, Baikal skullcap may increase levels of drugs metabolized by CYP1A2 enzymes.
In vitro evidence suggests that constituents of Baikal skullcap inhibit the activity of CYP1A2. This effect has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for these two together. Your body relies on a liver enzyme called CYP1A2 to break down anagrelide. Baikal skullcap, in lab studies, appears to slow that same enzyme down. If that happened in a real person, anagrelide could clear more slowly and build up a bit, which might mean stronger effects and more side effects like headache, a pounding or fast heartbeat, dizziness, fluid retention, or diarrhea.

Now the important part: this is based only on test-tube research, and it has not been seen in actual people. So I wouldn't lose sleep over it, but I also wouldn't pair them on your own. Please run it by your pharmacist or doctor first before adding this herb.

References
  1. Kim, B. R., Kim, D. H., Park, R., Kwon, K. B., Ryu, D. G., Kim, Y. C., Kim, N. Y., Jeong, S., Kang, B. K., and Kim, K. S. Effect of an extract of the root of Scutellaria baicalensis and its flavonoids on aflatoxin B1 oxidizing cytochrome P450 enzymes. Pl PubMed
  2. Li, T., Li, N., Guo, Q., Ji, H., Zhao, D., Xie, S., Li, X., Qiu, Z., Han, D., Chen, X., and You, Q. Inhibitory effects of wogonin on catalytic activity of cytochrome P450 enzyme in human liver microsomes. Eur J Drug Metab Pharmacokinet. 6-29-2011; PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Anagrelide also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, Baikal skullcap might increase the risk of bleeding when used concomitantly with anticoagulant and antiplatelet drugs.
Preliminary clinical research suggests that taking capsules containing a combination of astragalus, goldthread, and Baikal skullcap daily for 4 weeks inhibits platelet aggregation; the effect seems to be similar to that of aspirin 50 mg daily. It is unclear if this effect is due to Baikal skullcap, other ingredients, or the combination.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: anagrelide already lowers your platelets and gently reduces how well they clump together, which helps prevent clots in conditions like essential thrombocythemia. Baikal skullcap has shown, mostly in lab work and one small human study (where it was mixed with other herbs), a possible mild platelet-slowing effect of its own. Stack the two and you could, in theory, tip toward easier bleeding or bruising.

To be clear, this is theoretical and based on weak evidence, so I don't want you to panic. Just keep an eye out for things like nosebleeds, bleeding gums, unusual bruising, or blood in urine or stool. Before adding this herb, check with your pharmacist or doctor, and don't change your anagrelide on your own.

References
  1. Huang, W. M., Yan, J., and Xu, J. [Clinical and experimental study on inhibitory effect of sanhuang mixture on platelet aggregation]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 1995;15(8):465-467.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Baikal Skullcap Also Interacts With Other Medications

Baikal Skullcap has 593 moderate, 352 minor known drug interactions in our database — the Anagrelide one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Baikal Skullcap

Covers the 2,830 medications we’ve checked against Baikal Skullcap. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Anagrelide

This page covers Baikal Skullcap only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Anagrelide page lists 265 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Aconite (moderate) and Adrafinil (moderate).

By severity: 3 major · 223 moderate · 39 minor.

From our pharmacist’s overview on the Anagrelide page

“Anagrelide (Agrylin) lowers platelet counts in people whose bone marrow makes too many, so bleeding risk is already the thing being managed, and most of this list pushes on exactly that. The bulk of these ingredients have some blood-thinning or antiplatelet activity of their own, from danshen and piracetam at the serious end down to fa…”

Reviewed by 2 · Jul 18, 2026

Open the Anagrelide interaction page

One more smart check

Taking Baikal Skullcap as Part of a Dietary Supplement Product? Check It for Interactions

We hold 737 real supplement products containing Baikal Skullcap, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Baikal Skullcap. Your product may carry other ingredients that interact with Anagrelide too, on top of Baikal Skullcap — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Baikal Skullcap and Anagrelide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Baikal Skullcap
Top 25%

#204 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Anagrelide
Top 25%

#417 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Baikal Skullcap

What is Baikal Skullcap?

Baikal Skullcap
  • Inflammation
  • Allergies
  • Anxiety and sleep
  • Immune support
  • Respiratory infections

Baikal skullcap is a traditional Chinese herb (Huang Qin) used for inflammation, allergies, and infections, with active compounds like baicalin and baicalein studied mostly in the lab. Human evidence remains limited, so it should not replace proven treatments. Talk to your pharmacist or doctor before using it, and avoid it in pregnancy and breastfeeding.

Read the full Baikal Skullcap monograph & all interactions
Medication

About Anagrelide

What Is Anagrelide Used For?

Brand name: Agrylin

Anagrelide — sold as Agrylin and as generic anagrelide capsules — is used to treat thrombocythemia secondary to myeloproliferative neoplasms. That means it's prescribed when a bone marrow disorder causes the body to produce too many platelets, raising the risk of dangerous blood clots.

By bringing platelet counts down to a safer range, anagrelide also helps reduce related symptoms, including bleeding and clotting events (thrombo-hemorrhagic events).

See full Anagrelide drug information
Keep checking

Other Drugs & Baikal Skullcap

Browse every other medication we’ve checked against Baikal Skullcap — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
593Moderate
352Minor
1,884No known interaction
Moderate

593 interactions

Showing 60 of 593 moderate interactions — see all 593 on the Baikal Skullcap page.

Minor

352 interactions

Showing 60 of 352 minor interactions — see all 352 on the Baikal Skullcap page.

No interaction 1,884 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Baikal Skullcap and Anagrelide Together: Common Questions

Can you take Baikal Skullcap with Anagrelide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Baikal Skullcap and Anagrelide?
Anagrelide belongs to more than one drug category, and Baikal Skullcap interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Baikal Skullcap and Anagrelide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.