Drug & supplement interaction

Codonopsis + Bivalirudin

Bivalirudin brand names: Angiomax, Angiox, Angiomax Rtu.

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

Codonopsis has a moderate interaction with Bivalirudin. Theoretically, codonopsis liquor might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.

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

Codonopsis 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 Codonopsis interacts with.

Theoretically, codonopsis liquor might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
A small clinical study in adults with coronary heart disease shows that consuming Codonopsis pilosula liquor for 4 weeks inhibits platelet aggregation but does not affect tissue-type plasminogen activator (t-PA) or plasminogen activator inhibitor (PAI).
Severity Moderate Likelihood Possible Evidence B

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

Bivalirudin is a powerful blood thinner given by IV in the hospital, usually during heart procedures like angioplasty or stent placement. It works by directly blocking thrombin, a key part of how your blood clots. Here's the thing: codonopsis isn't broken down the same way most pills are, so this isn't really about enzymes. Instead, a small study found that codonopsis liquor can make platelets (the cells that help form clots) stickier and slower to clump together on their own.

Stack that mild blood-thinning tendency on top of bivalirudin, and you could theoretically nudge up the bleeding risk, things like easy bruising, oozing, or bleeding that's harder to stop. The evidence here is limited, but since bivalirudin is given in tightly controlled hospital settings, always tell your care team about any supplement like this.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Xu, X., Wang, S. R., and Lin, Q. [Clinical and experimental study on codonopsis pilosula oral liquor in treating coronary heart disease with blood stasis]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 1995;15(7):398-400.

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

Codonopsis Also Interacts With Other Medications

Codonopsis has 210 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 210 No known interaction 2,620 (incl. Bivalirudin)
Taking anything else?

Check Another of Your Medications Against Codonopsis

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

Everything else you take

See Every Supplement That Interacts With Bivalirudin

This page covers Codonopsis 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

One more smart check

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

We hold 493 real supplement products containing Codonopsis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Codonopsis. Your product may carry other ingredients that interact with Bivalirudin too, on top of Codonopsis — 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 Codonopsis 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 Codonopsis
Top half

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

29 days ago today
Medication Bivalirudin
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 Codonopsis

What is Codonopsis?

  • Fatigue and low energy
  • Digestive support and poor appetite
  • Immune support
  • General tonic ('qi' tonic in Traditional Chinese Medicine)
  • Cough and weakness during recovery from illness

Codonopsis (often called 'dang shen') is a root long used in Traditional Chinese Medicine as a gentle energy and digestive tonic, frequently as a milder substitute for ginseng. Human research is very limited, so its benefits are not well proven. It appears reasonably well tolerated in food-like amounts, but you should talk with a pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or have a health condition.

Read the full Codonopsis monograph & all interactions
Keep checking

Other Drugs & Codonopsis

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

0Major
210Moderate
0Minor
2,619No known interaction
210 Moderate 2,619 No interaction
Moderate

210 interactions

Showing 60 of 210 moderate interactions — see all 210 on the Codonopsis page.

No interaction 2,619 drugs checked — show the list

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

Showing the 60 most looked-up of 2,619 medications checked with no known interaction — see the full Codonopsis list.

See the full Codonopsis 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
Codonopsis 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 Codonopsis and Bivalirudin Together: Common Questions

Can you take Codonopsis 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 Codonopsis 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 Codonopsis?

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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.