Drug & supplement interaction

Chinese Prickly Ash + Bivalirudin

Bivalirudin brand names: Angiomax, Angiox, Angiomax Rtu.

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

Chinese Prickly Ash has a moderate interaction with Bivalirudin. Chinese prickly ash might inhibit platelet aggregation.

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

Chinese Prickly Ash and Bivalirudin

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Bivalirudin

Bivalirudin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Chinese Prickly Ash interacts with.

Chinese prickly ash might inhibit platelet aggregation. Theoretically, combining Chinese prickly ash with anticoagulant or antiplatelet drugs might increase the risk of bleeding; avoid concomitant use. Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Severity Moderate Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the short version: Bivalirudin (Angiomax) is a powerful blood thinner given through an IV, usually in the hospital during heart procedures like an angioplasty. It works by blocking thrombin, a key clotting protein. On its own, it already raises your bleeding risk, which is exactly what it's meant to do.

Chinese prickly ash, the Sichuan pepper, may slightly interfere with how platelets clump together. In theory, stacking it on top of bivalirudin could add to your bleeding risk, meaning more bruising, oozing, or harder-to-stop bleeding. But honestly, this concern rests only on lab and animal data, and the culinary amounts in food are very unlikely to matter. Since bivalirudin is given in a closely monitored hospital setting, just let your care team know about any supplements you take.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Yang YP, Cheng MJ, Teng CM, et al. Chemical and anti-platelet constituents from Formosan Zanthoxylum simulans. Phytochemistry 2002;61:567-72.. PubMed

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

Chinese Prickly Ash Also Interacts With Other Medications

Chinese Prickly Ash has 121 moderate known drug interactions in our database — the Bivalirudin one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 No known interaction 2,709 (incl. Bivalirudin)
Taking anything else?

Check Another of Your Medications Against Chinese Prickly Ash

Covers the 2,830 medications we’ve checked against Chinese Prickly Ash. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Bivalirudin

This page covers Chinese Prickly Ash only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bivalirudin page lists 202 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Danshen (major), Piracetam (major), Aconite (moderate), Allspice (moderate) and Aloe (moderate).

By severity: 2 major · 183 moderate · 17 minor.

From our pharmacist’s overview on the Bivalirudin page

“Bivalirudin (Angiomax) is a strong intravenous blood thinner used during heart procedures like angioplasty, and because bleeding is already its main built-in danger, this list deserves genuine care. All 202 supplements on it interact the same basic way: they thin the blood or blunt platelets themselves, stacking bleeding risk on top of…”

Reviewed by 2 · Jul 18, 2026

Open the Bivalirudin interaction page

How much people look this up

Where Chinese Prickly Ash and Bivalirudin 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 Chinese Prickly Ash
Steady interest

#1,437 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Bivalirudin
Top half

#763 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 Chinese Prickly Ash

What is Chinese Prickly Ash?

  • Digestive upset and stomach pain
  • Toothache and oral numbing
  • Antimicrobial and antiparasitic use
  • Cooking spice (Sichuan pepper)
  • Mild pain relief

Chinese Prickly Ash is the fruit husk of Zanthoxylum bungeanum, best known as the Sichuan pepper that creates a tingling, numbing sensation on the tongue. It is widely used in cooking and traditional Chinese medicine for digestive complaints and pain, but strong human evidence for medicinal benefits is limited. Use culinary amounts safely, but talk to a pharmacist or doctor before using concentrated extracts.

Read the full Chinese Prickly Ash monograph & all interactions
Keep checking

Other Drugs & Chinese Prickly Ash

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

0Major
121Moderate
0Minor
2,708No known interaction
121 Moderate 2,708 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Chinese Prickly Ash page.

No interaction 2,708 drugs checked — show the list

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Chinese Prickly Ash list.

See the full Chinese Prickly Ash interactions page
See every supplement checked against Bivalirudin, 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
Chinese Prickly Ash monograph › Uses, safety, and every drug interaction in one place Bivalirudin supplement interactions › Every supplement checked against Bivalirudin, 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Chinese Prickly Ash and Bivalirudin Together: Common Questions

Can you take Chinese Prickly Ash with Bivalirudin?
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 Chinese Prickly Ash and Bivalirudin 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 Bivalirudin and Chinese Prickly Ash?

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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.