Drug & supplement interaction

Codonopsis + Palifermin

Palifermin brand name: Kepivance.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Codonopsis and Palifermin in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

Know someone taking this? Share
Interaction report

Codonopsis and Palifermin

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Palifermin and Codonopsis in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Codonopsis safety at a glance

Codonopsis overall Use caution Generally considered well tolerated in traditional food-like amounts, but high-quality safety data are limited.
Pregnancy Avoid Not enough reliable safety information, so it is best avoided during pregnancy.
Breastfeeding Avoid Safety while breastfeeding is unknown, so avoid it unless your doctor advises otherwise.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Palifermin and Codonopsis? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Palifermin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Palifermin is filed under a single classification — oral drugs. Codonopsis has documented interactions with 3 drug classes — the most serious being abiraterone (zytiga) (moderate), anticoagulant/antiplatelet drugs (moderate) and antidiabetes drugs (moderate) — and none of Palifermin’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Codonopsis Does Interact With Other Medications

Codonopsis has 211 moderate known drug interactions in our database — Palifermin isn’t one of them. If you take anything else, check it against the full list below.

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.

What to actually watch for

What Codonopsis Itself Has Been Linked To

This is not an interaction — nothing below involves Palifermin. It is the side-effect record for Codonopsis on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Codonopsis, this list is the first place to look. 3 entries are worth acting on rather than waiting out — marked below.

  • Unsteadiness / Confusion Worth acting on Additional detail

    “Orally, very large doses of codonopsis (30-60 grams) may cause vision problems, dizziness, loss of balance, leg spasms, and confusion (12).”

    Codonopsis · Natural Medicines adverse-effect record, reported in vertigo.

    1 source cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  • An irregular heartbeat / Chest pain Worth acting on Additional detail

    “Orally, very large doses of codonopsis (30-60 grams) may cause chest pain or arrhythmia (12).”

    Codonopsis · Natural Medicines adverse-effect record, reported in arrhythmia.

    1 source cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  • A severe allergic reaction / Hives / An allergic reaction Worth acting on Additional detail

    “Orally, codonopsis can cause allergic reactions including anaphylaxis and urticaria. In one case report, an 18-year-old male developed anaphylaxis after ingesting codonopsis roots. In an oral re-challenge test, he developed anaphylaxis and urticaria again 30 minutes after consuming 20 grams of codonopsis root.”

    Codonopsis · Natural Medicines adverse-effect record, reported in urticaria.

    1 source cited
    1. 100060. Hur GY, Choi GS, Park HJ, Ye YM, Park HS. Anaphylactic shock induced by Codonopsis lanceolata, traditional Chinese medicine in a patient with allergic rhinitis. Allergy. 2008;63(10):1406-7.
  • Dizziness Additional detail

    Recorded for Codonopsis in the same Natural Medicines adverse-effect record shown under Unsteadiness / Confusion above.

Everything above comes from the Natural Medicines adverse-effect record for Codonopsis — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Palifermin’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Palifermin column appears here.

Overlapping uses

What Palifermin Is Prescribed For, and What Codonopsis Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Palifermin is a prescription medicine with approved uses on its FDA label. Codonopsis is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Palifermin is prescribed for: Kepivance (palifermin) is used to decrease how often and how long severe oral mucositis — painful sores in the mouth and throat — occurs in patients with hematologic malignancies (blood cancers such as lymphoma, leukemia, or multiple myeloma) who are receiving high-dose, cell-damaging (myelotoxic) therapy before an autologous hematopoietic stem cell transplant (a transplant using the patient's own stem cells). Kepivance is specifically indicated when the preparative chemotherapy or radiation regimen is expected to cause severe mucositis in most patients. It is not recommended for use with a high-dose melphalan conditioning regimen, and it was not found to be effective in the setting of allogeneic stem cell transplant (using a donor's cells). Its safety and effectiveness have not been established for patients with non-blood cancers (non-hematologic malignancies).

Codonopsis has been studied for:

  • Cancer studied, not established Codonopsis has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Codonopsis for cancer

    Although there is interest in using oral Codonopsis lanceolata for cancer, there is insufficient reliable information about the clinical effects of codonopsis for this condition.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Palifermin on your own; if you are taking Codonopsis for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Palifermin

This page covers Codonopsis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Palifermin page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Palifermin page

“Palifermin (Kepivance) is given by IV to prevent the severe mouth sores that intensive chemotherapy can cause, most often in patients heading into a stem cell transplant, and I read its interaction list with genuine caution because of how fragile those patients already are. All 17 supplements on file act on absorption through the gut,…”

Reviewed by 2 · Jul 18, 2026

Open the Palifermin 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. Even though Codonopsis itself has no known interaction with Palifermin, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Codonopsis and Palifermin 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 25%

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

29 days ago today
Medication Palifermin
Steady interest

#2,659 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Codonopsis reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Codonopsis and Palifermin records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Codonopsis pilosula · Campanulaceae · Dried root · Dried root, slices, decoctions (teas/soups), powders, capsules, tinctures, and herbal formulas

An interaction check asks whether these two react with each other — it does not ask whether Codonopsis is a good idea for someone in your situation. Here is what our Codonopsis record says about it on its own.

Codonopsis: dosing

There is no official, standardized dose of Codonopsis. Traditional preparations often use the dried root in soups or decoctions, while commercial products come as capsules, powders, and tinctures in widely varying strengths.Follow the directions on your specific product label, and do not assume more is better. A pharmacist or doctor can help you decide whether it is appropriate for you and what amount may be reasonable.

From our Codonopsis monograph — the full record covers uses, side effects and every documented interaction.

Read the full Codonopsis monograph & all interactions
Medication

About Palifermin

What Is Palifermin Used For?

Brand name: Kepivance

Kepivance (palifermin) is used to decrease how often and how long severe oral mucositis — painful sores in the mouth and throat — occurs in patients with hematologic malignancies (blood cancers such as lymphoma, leukemia, or multiple myeloma) who are receiving high-dose, cell-damaging (myelotoxic) therapy before an autologous hematopoietic stem cell transplant (a transplant using the patient's own stem cells).

Kepivance is specifically indicated when the preparative chemotherapy or radiation regimen is expected to cause severe mucositis in most patients. It is not recommended for use with a high-dose melphalan conditioning regimen, and it was not found to be effective in the setting of allogeneic stem cell transplant (using a donor's cells). Its safety and effectiveness have not been established for patients with non-blood cancers (non-hematologic malignancies).

Most-Reported Side Effects for Palifermin

From FAERS, the FDA’s public side-effect reporting system (388 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Mucosal inflammation 56 reports
Febrile neutropenia 39 reports
Rash 39 reports
Stomatitis 34 reports
Erythema 28 reports
See full Palifermin 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
211Moderate
0Minor
2,618No known interaction
Moderate

211 interactions

Showing 60 of 211 moderate interactions — see all 211 on the Codonopsis page.

No interaction 2,618 drugs checked — show the list
Evidence & sources

Codonopsis References

The 5 references that drive our Codonopsis monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. 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.
  3. Hur GY, Choi GS, Park HJ, Ye YM, Park HS. Anaphylactic shock induced by Codonopsis lanceolata, traditional Chinese medicine in a patient with allergic rhinitis. Allergy. 2008;63(10):1406-7.
  4. Zhang ZB, Ip SP, Cho WCS, et al. Herb-drug interactions between androgenic Chinese herbal medicines and androgen receptor antagonist on tumor growth: Studies on two xenograft prostate cancer animal models. Phytother Res. 2021.
  5. Jia W, Bi Q, Jiang S, et al. Hypoglycemic activity of Codonopsis pilosula (Franch.) Nannf. in vitro and in vivo and its chemical composition identification by UPLC-Triple-TOF-MS/MS. Food Funct 2022;13(5):2456-2464.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Codonopsis and Palifermin Together: Common Questions

Is it safe to take Codonopsis with Palifermin?
We do not list a known interaction between Codonopsis and Palifermin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Are Codonopsis and Palifermin used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Codonopsis in each. That is a conversation for your prescriber, especially if Palifermin is being adjusted to a target.
How was the Codonopsis and Palifermin combination checked?
Interactions in our licensed database are recorded against drug classes. Palifermin is filed under 1 classification, and Codonopsis has documented interactions with 3 drug classes — none of Palifermin's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Codonopsis interact with any other medications?
Yes. Codonopsis has 211 documented drug interactions in our database — Palifermin is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Palifermin interact with any supplements?
Yes. Palifermin has documented interactions with 17 supplements in our database — Codonopsis is not one of them. The Palifermin interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Palifermin and Codonopsis?

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.