Drug & supplement interaction

Cnidium + Acenocoumarol

Acenocoumarol brand name: Sintrom.

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

Cnidium has a moderate interaction with Acenocoumarol. Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets.

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

Cnidium and Acenocoumarol

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Acenocoumarol

Acenocoumarol falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Cnidium interacts with.

Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets. Theoretically, cnidium might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
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

Acenocoumarol (Sintrom) is a powerful blood thinner that already walks a fine line: too little and you risk clots, too much and you bleed too easily. That's why it gets such careful monitoring with INR blood tests. Here's the wrinkle with cnidium. Lab work suggests one of its compounds, osthole, can slow down clotting and calm platelets on its own. Stack that effect on top of Sintrom and, at least in theory, you could tip toward too much blood-thinning.

I want to be honest about the evidence though: this comes from test-tube and animal studies, not real patients, so it's more of a caution than a proven problem. Still, with a narrow-margin drug like this, even small shifts matter. Watch for things like easy bruising, nosebleeds, bleeding gums, or unusually dark stools, and please check with your pharmacist or doctor before adding cnidium.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sun Y, Yang AWH, Lenon GB. Phytochemistry, ethnopharmacology, pharmacokinetics and toxicology of Cnidium monnieri (L.) Cusson. Int J Mol Sci. 2020;21(3):1006. 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

Cnidium Also Interacts With Other Medications

Cnidium has 350 moderate known drug interactions in our database — the Acenocoumarol one above is one of them. If you take anything else, check it against the full list below.

Moderate 350 No known interaction 2,480 (incl. Acenocoumarol)
Taking anything else?

Check Another of Your Medications Against Cnidium

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

Everything else you take

See Every Supplement That Interacts With Acenocoumarol

This page covers Cnidium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acenocoumarol page lists 221 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Acetyl-l-carnitine (moderate) and Aconite (moderate).

By severity: 3 major · 193 moderate · 25 minor.

From our pharmacist’s overview on the Acenocoumarol page

“Acenocoumarol (Sintrom) is a blood thinner in the warfarin family, and it lives in a narrow zone where a little too much means bleeding and a little too little means clots. So treat its 221 supplement interactions as a real safety issue, not fine print.”

Reviewed by 2 · Jul 18, 2026

Open the Acenocoumarol interaction page

One more smart check

Taking Cnidium as Part of a Dietary Supplement Product? Check It for Interactions

We hold 175 real supplement products containing Cnidium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cnidium. Your product may carry other ingredients that interact with Acenocoumarol too, on top of Cnidium — 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 Cnidium and Acenocoumarol 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 Cnidium
Top half

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

29 days ago today
Medication Acenocoumarol
Top 25%

#538 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 Cnidium

What is Cnidium?

Cnidium
  • Skin conditions and itching
  • Erectile dysfunction and low libido
  • Eczema and dermatitis
  • Antifungal or antimicrobial washes
  • Athletic performance
  • General antioxidant support

Cnidium is the dried fruit of an Asian plant long used in traditional Chinese medicine, mostly for skin problems and sexual health. Modern human evidence for these uses is very limited, with most research coming from laboratory and animal studies. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Cnidium monograph & all interactions
Keep checking

Other Drugs & Cnidium

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

0Major
350Moderate
0Minor
2,479No known interaction
350 Moderate 2,479 No interaction
Moderate

350 interactions

Showing 60 of 350 moderate interactions — see all 350 on the Cnidium page.

No interaction 2,479 drugs checked — show the list

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

Showing the 60 most looked-up of 2,479 medications checked with no known interaction — see the full Cnidium list.

See the full Cnidium interactions page
See every supplement checked against Acenocoumarol, 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
Cnidium monograph › Uses, safety, and every drug interaction in one place Acenocoumarol supplement interactions › Every supplement checked against Acenocoumarol, 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 Cnidium and Acenocoumarol Together: Common Questions

Can you take Cnidium with Acenocoumarol?
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 Cnidium and Acenocoumarol 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 Acenocoumarol and Cnidium?

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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.