Drug & supplement interaction

Baikal Skullcap + Vorapaxar

Vorapaxar brand name: Zontivity.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Baikal Skullcap has a moderate interaction with Vorapaxar. Theoretically, Baikal skullcap might increase the risk of bleeding when used concomitantly with anticoagulant and antiplatelet drugs.

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

Baikal Skullcap and Vorapaxar

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Vorapaxar

Vorapaxar falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Baikal Skullcap interacts with.

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 gist: vorapaxar (Zontivity) is already a potent platelet blocker that you're likely taking alongside aspirin and clopidogrel. Baikal skullcap has shown, mostly in lab studies and one small human trial, that it may also slow platelets down a bit. Stack a mild platelet effect on top of a strong one, and the theoretical concern is extra bleeding.

What that could look like with vorapaxar: easy bruising, nosebleeds, bleeding gums, or rarely something more serious. To be fair, the evidence here is weak and indirect, so I'm not raising alarm bells. Still, because vorapaxar carries real bleeding risk on its own, I'd run any skullcap supplement past your pharmacist or doctor first rather than starting it on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Vorapaxar one above is one of them. If you take anything else, check it against the full list below.

Moderate 593 Minor 352 No known interaction 1,885 (incl. Vorapaxar)
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 Vorapaxar

This page covers Baikal Skullcap only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Vorapaxar page lists 282 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 5 major · 236 moderate · 41 minor.

From our pharmacist’s overview on the Vorapaxar page

“Vorapaxar (Zontivity) keeps platelets from clumping after a heart attack or clogged leg arteries, so it raises bleeding risk by design, and adding supplements calls for real caution. Of the 282 ingredients on file, 202 can thin the blood further, stacking their antiplatelet effects on the drug's.”

Reviewed by 2 · Jul 18, 2026

Open the Vorapaxar 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 Vorapaxar 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 Vorapaxar 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 Vorapaxar
Steady interest

#2,656 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 Vorapaxar

What Is Vorapaxar Used For?

Brand name: Zontivity

Zontivity (vorapaxar) is used to lower the risk of heart attack, stroke, cardiovascular death, and the need for urgent procedures to open blocked arteries. It is prescribed for people who have already had a heart attack or who have peripheral arterial disease (PAD) — a condition where arteries outside the heart become narrowed or blocked.

Zontivity is not used alone. It is given alongside aspirin and/or clopidogrel as part of a broader antiplatelet treatment plan.

See full Vorapaxar 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
593 Moderate 352 Minor 1,884 No 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

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 1,884 medications checked with no known interaction — see the full Baikal Skullcap list.

See the full Baikal Skullcap interactions page
See every supplement checked against Vorapaxar, ranked by severity
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

Keep exploring
Baikal Skullcap monograph › Uses, safety, and every drug interaction in one place Vorapaxar supplement interactions › Every supplement checked against Vorapaxar, ranked by severity Vorapaxar drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Baikal Skullcap and Vorapaxar Together: Common Questions

Can you take Baikal Skullcap with Vorapaxar?
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.
How serious is the Baikal Skullcap and Vorapaxar 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

Still Have a Question About Vorapaxar 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.