Drug & supplement interaction

Baikal Skullcap + Ketoconazole

Ketoconazole brand name: Nizoral.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Baikal Skullcap and Ketoconazole in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Baikal Skullcap and Ketoconazole

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Ketoconazole and Baikal Skullcap in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Baikal Skullcap safety at a glance

Baikal Skullcap overall Use caution Often used in traditional medicine, but human safety data are limited and quality of products varies.
Pregnancy Avoid Not enough safety information; avoid use during pregnancy.
Breastfeeding Avoid Not enough safety information; avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Ketoconazole and Baikal Skullcap? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ketoconazole

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ketoconazole is filed under 8 classifications — including antifungals, cytochrome p450 2c19 (cyp2c19) inhibitors, cytochrome p450 2c9 (cyp2c9) inhibitors. Baikal Skullcap has documented interactions with 12 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), antidiabetes drugs (moderate) and antihypertensive drugs (moderate) — and none of Ketoconazole’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Baikal Skullcap Does Interact With Other Medications

Baikal Skullcap has 594 moderate, 352 minor known drug interactions in our database — Ketoconazole isn’t one of them. If you take anything else, check it against the full list below.

Moderate 594 Minor 352 No known interaction 1,884 (incl. Ketoconazole)
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.

What to actually watch for

No Interaction Found — But Data Suggests Baikal Skullcap and Ketoconazole May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Yellowing of the skin or eyes Worth acting on Additional detail

    Baikal Skullcap

    “A specific combination product (Limbrel, Primus Pharmaceuticals) containing flavocoxid, a mixture of Baikal skullcap flavonoid extract and catechu extract, has been linked to several reports of acute liver damage. There have been at least five published reports of liver damage associated with this product. In all cases, the patients were females aged 54-68 years taking doses of 250-500 mg twice daily for 1-3 months.”

    Baikal Skullcap · Natural Medicines adverse-effect record, reported in myasthenia gravis.

    6 sources cited
    1. 18009. Chalasani N, Vuppalanchi R, Navarro V, et al. Acute liver injury due to flavocoxid (Limbrel), a medical food for osteoarthritis: a case series. Ann Intern Med 2012;156:857-60. PubMed
    2. 96282. Papafragkakis C, Ona MA, Reddy M, Anand S. Acute hepatitis after ingestion of a preparation of Chinese skullcap and black catechu for joint pain. Case Reports Heptal 2016;2016:4356749. PubMed
    3. 18010. Reichenbach S, Juni P. Medical food and food supplements: not always as safe as generally assumed. Ann Intern Med 2012;156:894-5. PubMed
    4. 106042. US Food and Drug Administration (FDA). FDA Alerts Consumers About Potentially Life-Threatening Health Problems Linked to Limbrel. December 19, 2017. Available at: https://www.fda.gov/food/alerts-advisories-safety-information/fda-alerts-consumers-about-pot
    5. 33460. Linnebur, S. A., Rapacchietta, O. C., and Vejar, M. Hepatotoxicity associated with chinese skullcap contained in Move Free Advanced dietary supplement: two case reports and review of the literature. Pharmacotherapy 2010;30(7):750, 258e-750, 262e. PubMed
    6. 101737. Braude MR, Bassily R. Drug-induced liver injury secondary to Scutellaria baicalensis (Chinese skullcap). Intern Med J. 2019;49(4):544-546. PubMed

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Liver problems Worth acting on Additional detail

    Baikal Skullcap

    “Orally, Baikal skullcap seems to be well-tolerated. There is currently a limited amount of information on the adverse effects of intravenous and topical Baikal skullcap.

    Most Common Adverse Effects:

    Orally: Abdominal pain, constipation, diarrhea, erythema, nausea, pruritus, and vomiting.

    Intravenously: Skin reactions.

    Topically: Dermatitis.

    Serious Adverse Effects (Rare):

    Orally: Hepatotoxicity and hypersensitivity p…”

    Baikal Skullcap · Natural Medicines adverse-effect record, reported in constipation.

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Chills / Tiredness Additional detail

    Baikal Skullcap

    “A specific combination product (Limbrel, Primus Pharmaceuticals) containing flavocoxid, a mixture of Baikal skullcap flavonoid extract and catechu extract, has been linked to several reports of hypersensitivity pneumonitis. Symptoms include fever, chills, headache, cough, chronic bronchitis, shortness of breath, weight loss, and fatigue.”

    Baikal Skullcap · Natural Medicines adverse-effect record, reported in acute bronchitis.

    1 source cited
    1. 106042. US Food and Drug Administration (FDA). FDA Alerts Consumers About Potentially Life-Threatening Health Problems Linked to Limbrel. December 19, 2017. Available at: https://www.fda.gov/food/alerts-advisories-safety-information/fda-alerts-consumers-about-pot

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Fever Additional detail

    Baikal Skullcap

    Recorded for Baikal Skullcap in the same Natural Medicines adverse-effect record shown under Chills / Tiredness above.

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Constipation / Stomach pain / Diarrhea Additional detail

    Baikal Skullcap

    “Orally, use of Baikal skullcap has been associated with epigastric pain, abdominal pain, constipation, diarrhea, nausea, and vomiting.”

    Baikal Skullcap · Natural Medicines adverse-effect record, reported in constipation.

    2 sources cited
    1. 101738. Shin NR, Gu N, Choi HS, Kim H. Combined effects of Scutellaria baicalensis with metformin on glucose tolerance of patients with type 2 diabetes via gut microbiota modulation. Am J Physiol Endocrinol Metab. 2020;318(1):E52-E61.
    2. 105867. Li WJ, Bao J, Zheng DC, et al. Treatments of Peyronie's disease with Scutellaria baicalensis and surgery according to the disease course: a single-center retrospective study of 261 patients. Ann Palliat Med. 2021 Mar;10(3):2979-2989. PubMed

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

  • Itching / A skin rash Additional detail

    Baikal Skullcap

    “Orally, taking Baikal skullcap may cause erythema and pruritus. Intravenously, Baikal skullcap as part of a Tanreqing injection has been associated with reports of skin reactions in some pediatric patients.

    Topically, several cases of allergic contact dermatitis have been reported after applying sunscreen containing Baikal skullcap extract.”

    Baikal Skullcap · Natural Medicines adverse-effect record, reported in dermatitis.

    5 sources cited
    1. 105867. Li WJ, Bao J, Zheng DC, et al. Treatments of Peyronie's disease with Scutellaria baicalensis and surgery according to the disease course: a single-center retrospective study of 261 patients. Ann Palliat Med. 2021 Mar;10(3):2979-2989. PubMed
    2. 96281. Lin H, Zhou J, Lin K, et al. Efficacy of Scutellaria baicalensis for the treatment of hand, foot, and mouth disease associated with encephalitis in patients infected with EV71: a multicenter, retrospective analysis. Biomed Res Int 2016;2016:5697571.
    3. 105869. Adam T, Bursztejn AC, Schmutz JL. Facial eczema from a sunscreen: Scutellaria baicalensis, a novel allergen beginning to attract attention. Contact Dermatitis. 2020 Apr;82(4):253-254.
    4. 105870. Luna-Bastante L, Gatica-Ortega ME, Pastor-Nieto MA, et al. Allergic contact dermatitis to Tinosorb S, Scutellaria baicalensis, and other emerging allergens in cosmetics. Contact Dermatitis. 2020 May;82(5):307-309.
    5. 110024. Badaoui A. Allergic contact dermatitis to resveratrol and Scutellaria baicalensis root extract in a cosmetic product. Contact Dermatitis 2022.

    Ketoconazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Ketoconazole. Read the label on DailyMed ›

Showing the 10 most notable of 13 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Baikal Skullcap but not commonly for Ketoconazole: shortness of breath, an allergic reaction, weight loss and kidney problems.

Effects for Ketoconazole come from the ADVERSE REACTIONS section of its FDA label; effects for Baikal Skullcap come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About Baikal Skullcap or Ketoconazole

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Baikal Skullcap or Ketoconazole, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ketoconazole

This page covers Baikal Skullcap only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ketoconazole page lists 182 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 135 moderate · 41 minor.

From our pharmacist’s overview on the Ketoconazole page

“Ketoconazole (Nizoral) is already hard on the liver, so treat its 182 interacting supplements with genuine care, starting with the six rated major. Most of the list runs through CYP3A4, the liver enzyme ketoconazole strongly blocks, so it can raise levels of over a hundred herbal ingredients, while grapefruit pushes ketoconazole itself…”

Reviewed by 2 · Jul 18, 2026

Open the Ketoconazole 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. Even though Baikal Skullcap itself has no known interaction with Ketoconazole, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Baikal Skullcap and Ketoconazole 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%

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

29 days ago today
Medication Ketoconazole
Steady interest

#2,081 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Baikal Skullcap reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Baikal Skullcap and Ketoconazole records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Scutellaria baicalensis · Lamiaceae · Root · Capsules, tablets, tinctures, dried root, teas, and standardized extracts

An interaction check asks whether these two react with each other — it does not ask whether Baikal Skullcap is a good idea for someone in your situation. Here is what our Baikal Skullcap record says about it on its own.

Baikal Skullcap: dosing

There is no well-established standard dose of Baikal skullcap. Products differ widely in their strength and in how much baicalin or baicalein they contain.The best approach is to follow the directions on the product label and not exceed the recommended amount.

From our Baikal Skullcap monograph — the full record covers uses, side effects and every documented interaction.

Read the full Baikal Skullcap monograph & all interactions
Medication

About Ketoconazole

What Is Ketoconazole Used For?

Brand name: Nizoral

Ketoconazole 2% shampoo and foam are used to treat tinea versicolor (also called pityriasis versicolor) — a fungal infection caused by Pityrosporum orbiculare (also known as Malassezia furfur), a yeast that naturally lives on the skin.

This infection creates light or dark patches, most often on the trunk, neck, arms, and upper thighs. Even after the fungus is cleared, those skin patches may take months to return to their normal color — that's normal, and depends on your skin type and sun exposure. Tinea versicolor can also come back, since the fungus lives on healthy skin even when there's no active infection.

Most-Reported Side Effects for Ketoconazole

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Pruritus 984 reports
Fatigue 975 reports
Nausea 873 reports
Rash 858 reports
Diarrhea 814 reports
See full Ketoconazole 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
594Moderate
352Minor
1,883No known interaction
594 Moderate 352 Minor 1,883 No interaction
Moderate

594 interactions

Showing 60 of 594 moderate interactions — see all 594 on the Baikal Skullcap page.

Minor

352 interactions

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

No interaction 1,883 drugs checked — show the list

We also checked Baikal Skullcap against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,883 medications checked with no known interaction — see the full Baikal Skullcap list.

See the full Baikal Skullcap interactions page
See every supplement checked against Ketoconazole, ranked by severity
Evidence & sources

Baikal Skullcap References

The 34 references that drive our Baikal Skullcap monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Huang KC. The pharmacology of Chinese herbs. 2nd ed. New York, NY: CRC Press LLC. 1999;385-6, 400-1.
  2. Hui KM, Wang XH, Xue H. Interaction of flavones from the roots of Scutellaria baicalensis with the benzodiazepine site. Planta Med 2000;66:91-3.
  3. Liao JF, Wang HH, Chen MC, et al. Benzodiazepine binding site-interactive flavones from Scutellaria baicalensis root. Planta Med 1998;64:571-2.
  4. Nishioka T, Kawabata J, Aoyama Y. Baicalein, an alpha-glucosidase inhibitor from Scutellaria baicalensis. J Nat Prod 1998;61:1413-5.
  5. Zhang CZ, Wang SX, Zhang Y, et al. In vitro estrogenic activities of Chinese medicinal plants traditionally used for the management of menopausal symptoms. J Ethnopharmacol 2005;98:295-300. PubMed
  6. Fan L, Zhang W, Guo D, et al. The effect of herbal medicine baicalin on pharmacokinetics of rosuvastatin, substrate of organic anion-transporting polypeptide 1B1. Clin Pharmacol Ther 2007;83:471-6. PubMed
  7. Chen C, Mireles RJ, Campbell SD, et al. Differential interaction of 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors with ABCB1, ABCC2, and OATP1B1. Drug Metab Dispos 2005;33:537-46. PubMed
  8. Pasanen MK, Fredrikson H, Neuvonen PJ, Niemi M. Different effects of SLCO1B1 polymorphism on the pharmacokinetics of atorvastatin and rosuvastatin. Clin Pharmacol Ther 2007;82:726-33. PubMed
  9. Konig J, Seithel A, Gradhand U, Fromm MF. Pharmacogenomics of human OATP transporters. Naunyn-Schmiedeberg Arch Pharmacol 2006;372:432-43. PubMed
  10. Chalasani N, Vuppalanchi R, Navarro V, et al. Acute liver injury due to flavocoxid (Limbrel), a medical food for osteoarthritis: a case series. Ann Intern Med 2012;156:857-60. PubMed
  11. Reichenbach S, Juni P. Medical food and food supplements: not always as safe as generally assumed. Ann Intern Med 2012;156:894-5. PubMed
  12. 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.
  13. 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
  14. Lee, Y., Yeo, H., Liu, S. H., Jiang, Z., Savizky, R. M., Austin, D. J., and Cheng, Y. C. Increased anti-P-glycoprotein activity of baicalein by alkylation on the A ring. J Med Chem 10-21-2004;47(22):5555-5566. PubMed
  15. Huang, Y., Tsang, S. Y., Yao, X., and Chen, Z. Y. Biological properties of baicalein in cardiovascular system. Curr Drug Targets.Cardiovasc.Haematol.Disord 2005;5(2):177-184. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Baikal Skullcap and Ketoconazole Together: Common Questions

Is it safe to take Baikal Skullcap with Ketoconazole?
We do not list a known interaction between Baikal Skullcap and Ketoconazole. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Baikal Skullcap and Ketoconazole have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Baikal Skullcap and Ketoconazole combination checked?
Interactions in our licensed database are recorded against drug classes. Ketoconazole is filed under 8 classifications, and Baikal Skullcap has documented interactions with 12 drug classes — none of Ketoconazole's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Baikal Skullcap interact with any other medications?
Yes. Baikal Skullcap has 946 documented drug interactions in our database — Ketoconazole is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Ketoconazole interact with any supplements?
Yes. Ketoconazole has documented interactions with 182 supplements in our database — Baikal Skullcap is not one of them. The Ketoconazole interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Baikal Skullcap monograph Uses, safety profile, and every drug interaction in one place Ketoconazole drug information The full plain-English guide to this medication Ketoconazole supplement interactions Every supplement checked against Ketoconazole, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 34 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Ketoconazole and Baikal Skullcap?

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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.