Drug & supplement interaction

Chinese Prickly Ash + Diclofenac Sodium

Diclofenac Sodium brand names: Voltaren XR, Voltaren, Voltaren SR, Diclo, Difenac, and others.

Moderate Interaction
The bottom line Moderate

Chinese Prickly Ash has a moderate interaction with Diclofenac Sodium. 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 Diclofenac Sodium

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Diclofenac Sodium

Diclofenac Sodium 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 thing to know about pairing Sichuan pepper supplements with diclofenac. Diclofenac is an NSAID, and on its own it can already nudge up your bleeding risk because it affects platelets and can irritate the stomach lining. Lab studies hint that Chinese Prickly Ash may also make platelets a little less sticky, so stacking the two could in theory add up to easier bruising, nosebleeds, or stomach bleeding.

I'll be honest though: this is based only on test-tube and animal work, and a real problem is considered unlikely. The pinch you use in cooking is very unlikely to matter. Concentrated extracts are the bigger question mark, so check with your pharmacist or doctor before using those alongside diclofenac, especially if you notice unusual bruising.

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 Diclofenac Sodium one above is one of them. If you take anything else, check it against the full list below.

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.

From our Q&A

Questions About Chinese Prickly Ash or Diclofenac Sodium

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Chinese Prickly Ash or Diclofenac Sodium, 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 Diclofenac Sodium

This page covers Chinese Prickly Ash only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diclofenac Sodium page lists 308 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Piracetam (major).

By severity: 7 major · 266 moderate · 35 minor.

From our pharmacist’s overview on the Diclofenac Sodium page

“Diclofenac (Voltaren), a daily mainstay for arthritis and joint pain, comes with a supplement list that calls for real vigilance. Of the 308 ingredients on file, 7 rate major, and roughly two hundred entries share a single theme: anything with blood-thinning activity adds to diclofenac's own bleeding risk, especially in the stomach.”

Reviewed by 2 · Jul 18, 2026

Open the Diclofenac Sodium interaction page

How much people look this up

Where Chinese Prickly Ash and Diclofenac Sodium 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

#1,353 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Diclofenac Sodium
Top 10%

#221 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
Medication

About Diclofenac

What Is Diclofenac Used For?

Brand names: Voltaren XR, Voltaren, Voltaren SR, Diclo, Difenac, Diclo SR, Voltarol, Acoflam, Defenac, Dicloflex, Diclovol, Diclozip, Fenactol, Flamrase, Volraman, Diclomax SR, Diclomax Retard, Motifene 75 mg, Voltarol 75 mg SR, Acoflam 75 SR, Defenac SR, Dexomon 75 SR, Dicloflex 75 SR, Diclovol SR, Fenactol 75 mg SR, Flamatak 75 MR, Flamrase SR, Flexotard MR 75, Rheumatac Retard 75, Rhumalgan CR, Slofenac SR, Volsaid Retard 75, Voltarol Retard, Acoflam Retard, Defenac Retard, Dexomon Retard 100, Dicloflex Retard, Diclovol Retard, Fenactol Retard 100 mg, Flamatak 100 MR, Volsaid Retard 100, Voltarol Ophtha Multidose, Voltarol Ophtha, Pennsaid, Voltaren Emulgel, Dyloject

Diclofenac sodium topical gel is used to treat actinic keratoses (AK) — rough, scaly skin patches that form after years of sun exposure. These patches are considered precancerous, meaning they can develop into skin cancer if left untreated.

This is a topical gel, meaning it is applied directly to the skin over the affected area rather than taken by mouth. It belongs to the NSAID (nonsteroidal anti-inflammatory drug) family.

See full Diclofenac drug information
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
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
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 Chinese Prickly Ash and Diclofenac Sodium Together: Common Questions

Can you take Chinese Prickly Ash with Diclofenac Sodium?
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 Diclofenac Sodium 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.