Drug & supplement interaction

Chinese Prickly Ash + Selexipag

Selexipag brand name: Uptravi.

Moderate Interaction
The bottom line Moderate

Chinese Prickly Ash has a moderate interaction with Selexipag. 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 Selexipag

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Selexipag

Selexipag 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 about pairing Sichuan pepper (Chinese Prickly Ash) with Selexipag (Uptravi): the concern on file is really about bleeding. Lab and animal studies hint that this supplement may make platelets (the cells that help your blood clot) a little less sticky. Selexipag relaxes the blood vessels in your lungs, and it can also nudge platelets toward being less sticky on its own. So in theory, stacking the two could slightly raise your bleeding risk, things like easier bruising, nosebleeds, or bleeding gums.

I want to keep this in perspective, though. The evidence here is weak and only from lab and animal testing, and an actual problem is considered unlikely. The Sichuan pepper you sprinkle on food is very different from a concentrated extract. If you're thinking about supplement-strength doses, please run it by your pharmacist or doctor first.

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 Selexipag 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.

Everything else you take

See Every Supplement That Interacts With Selexipag

This page covers Chinese Prickly Ash only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Selexipag page lists 291 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Danshen (major) and Piracetam (major).

By severity: 6 major · 258 moderate · 27 minor.

From our pharmacist’s overview on the Selexipag page

“People take selexipag (Uptravi) for pulmonary arterial hypertension, dangerously high pressure in the arteries of the lungs, and that diagnosis raises the stakes on this list of 291 interacting supplements. I would treat it with real vigilance.”

Reviewed by 2 · Jul 18, 2026

Open the Selexipag interaction page

How much people look this up

Where Chinese Prickly Ash and Selexipag 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

#1,432 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Selexipag
Top 25%

#307 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 Selexipag

What Is Selexipag Used For?

Brand name: Uptravi

Selexipag tablets are used to treat pulmonary arterial hypertension (PAH, WHO Group I) — a type of high blood pressure in the arteries of the lungs. The goal is to slow the disease from getting worse and to reduce the chances of being hospitalized because of PAH.

Uptravi (selexipag) tablets are approved for both adults and children aged 2 years and older. Uptravi for injection (intravenous) is also available for adult patients who are already on Uptravi tablets but temporarily cannot take medicine by mouth.

See full Selexipag 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 Selexipag Together: Common Questions

Can you take Chinese Prickly Ash with Selexipag?
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 Selexipag 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 Selexipag 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.