Drug & supplement interaction

Cnidium + Tivozanib Hydrochloride

Tivozanib Hydrochloride brand name: Fotivda.

Moderate Interaction
The bottom line Moderate

Cnidium has a moderate interaction with Tivozanib Hydrochloride. 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?
Know someone taking this? Share
Interaction report

Cnidium and Tivozanib Hydrochloride

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Tivozanib Hydrochloride

Tivozanib Hydrochloride 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

Here's the thing to know if you're on Fotivda (tivozanib) and thinking about cnidium. Tivozanib itself can raise your bleeding risk, since this type of kidney cancer drug can cause bleeding, easy bruising, nosebleeds, and sometimes more serious bleeds. Cnidium contains a compound called osthole that, in lab and animal studies, slows blood clotting and makes platelets less sticky. Stack the two together and you could, in theory, push that bleeding risk a little higher.

I want to be straight with you though: this concern comes only from laboratory and animal research, not from human studies, so it's more of a caution than a proven problem. Still, with a cancer drug like this, I'd play it safe. Please check with your oncologist or pharmacist before adding cnidium, and let them know right away about any unusual bruising or bleeding.

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 Tivozanib Hydrochloride 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 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 Tivozanib Hydrochloride

This page covers Cnidium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tivozanib Hydrochloride page lists 288 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 7 major · 239 moderate · 42 minor.

From our pharmacist’s overview on the Tivozanib Hydrochloride page

“Tivozanib (Fotivda), an oral targeted therapy for advanced kidney cancer, has a supplement list that calls for genuine vigilance. Seven of the 288 ingredients on file are rated major, and those seven deserve your attention first.”

Reviewed by 2 · Jul 18, 2026

Open the Tivozanib Hydrochloride 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 Tivozanib Hydrochloride 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 Tivozanib Hydrochloride 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

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

29 days ago today
Medication Tivozanib Hydrochloride
Steady interest

#1,835 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
Medication

About Tivozanib

What Is Tivozanib Used For?

Brand name: Fotivda

Fotivda (tivozanib) is used to treat adults with advanced renal cell carcinoma (RCC) — a type of kidney cancer — that is relapsed or refractory (has come back or stopped responding to treatment) after two or more prior systemic therapies (cancer treatments given throughout the body).

See full Tivozanib drug information
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
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
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
Pharmacist Counseling Corner

Taking Cnidium and Tivozanib Hydrochloride Together: Common Questions

Can you take Cnidium with Tivozanib Hydrochloride?
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 Tivozanib Hydrochloride 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 Tivozanib Hydrochloride and Cnidium?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.