Drug & supplement interaction

Codonopsis + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

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

Codonopsis has a moderate interaction with Nintedanib Esylate. 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 Nintedanib Esylate

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Nintedanib Esylate

Nintedanib Esylate 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

Here's the thing to keep an eye on with Ofev (nintedanib) and codonopsis. Nintedanib already carries a known risk of bleeding on its own, things like nosebleeds, easy bruising, or bleeding in the gut. Codonopsis isn't changing how your body breaks nintedanib down. Instead, a small study suggests it may make platelets (the cells that help your blood clot) a little less sticky. Stack that mild blood-thinning tendency on top of nintedanib, and the worry is simply more bleeding overall.

I want to be honest that this is largely theoretical and based on limited research, mostly with a concentrated codonopsis liquor rather than a pinch in soup. Still, since nintedanib can already cause bleeding, please check with your doctor or pharmacist before adding this supplement.

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 Nintedanib Esylate 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. Nintedanib Esylate)
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 Nintedanib Esylate

This page covers Codonopsis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate 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 Nintedanib Esylate 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 Nintedanib Esylate 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

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

29 days ago today
Medication Nintedanib Esylate
Top half

#1,016 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
Medication

About Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib drug information
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 Nintedanib Esylate, 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 Nintedanib Esylate supplement interactions › Every supplement checked against Nintedanib Esylate, ranked by severity Nintedanib drug information › The full plain-English guide to this medication 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 Nintedanib Esylate Together: Common Questions

Can you take Codonopsis with Nintedanib Esylate?
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 Nintedanib Esylate 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 Nintedanib Esylate 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.