Drug & supplement interaction

Corydalis Yanhusuo + Siponimod

Siponimod brand name: Mayzent.

Moderate Interaction
The bottom line Moderate

Siponimod falls into 2 drug categories that Corydalis Yanhusuo can interact with; the most serious is rated moderate. Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP2C9.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Corydalis Yanhusuo and Siponimod

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Corydalis Yanhusuo interacts with whole categories of medication. Siponimod falls into 2 of those categories, so it can interact with Corydalis Yanhusuo in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Siponimod

Siponimod falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Corydalis Yanhusuo interacts with.

Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP2C9.
Corydalis yanhusuo contains berberine. Preliminary clinical research shows that berberine can inhibit CYP2C9. Theoretically, Corydalis yanhusuo might also inhibit CYP2C9.
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 situation with these two together. Your body relies on a liver enzyme called CYP2C9 to break down and clear siponimod. Corydalis contains berberine, which lab and early human research suggests can slow that same enzyme down. If that happens, siponimod could clear more slowly and build up in your blood, making its effects stronger than intended.

With siponimod, more drug in your system could mean a bigger drop in heart rate, more dizziness, or a deeper dip in your white blood cells (which raises infection risk). I'll be honest though: this is a theoretical concern based on how berberine behaves, not a proven problem in people taking siponimod. Still, since siponimod dosing is already tailored to your genetics, even small shifts matter. Please run this by your pharmacist or neurologist before combining them.

References
  1. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Siponimod also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP3A4.
Corydalis yanhusuo contains berberine. In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, Corydalis yanhusuo might also inhibit CYP3A4.
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 gist for Siponimod (Mayzent): your body relies on a liver enzyme called CYP3A4 to help clear this drug. Corydalis yanhusuo contains berberine, which lab and early human studies suggest can mildly slow CYP3A4 down. If that enzyme is working slower, Siponimod could build up more than expected, which may mean stronger effects and a higher chance of side effects like a slow heart rate, dizziness, headache, or more lowering of your immune cells.

I want to be honest though, this is a theoretical concern based on how these things work, not solid proof in people. Still, since Siponimod already needs careful dosing, it's worth a quick chat with your pharmacist or doctor before combining them.

References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  4. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. 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

Corydalis Yanhusuo Also Interacts With Other Medications

Corydalis Yanhusuo has 1,159 moderate known drug interactions in our database — the Siponimod one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Corydalis Yanhusuo

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

Everything else you take

See Every Supplement That Interacts With Siponimod

This page covers Corydalis Yanhusuo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Siponimod page lists 190 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 147 moderate · 40 minor.

From our pharmacist’s overview on the Siponimod page

“Siponimod (Mayzent) treats secondary progressive multiple sclerosis, and because its blood level depends heavily on two liver enzymes, this is a supplement list to respect. Most of these entries can nudge siponimod levels up or down; the three rated major are grapefruit, which raises them, St.”

Reviewed by 2 · Jul 18, 2026

Open the Siponimod interaction page

How much people look this up

Where Corydalis Yanhusuo and Siponimod 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 Corydalis Yanhusuo
Top half

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

29 days ago today
Medication Siponimod
Steady interest

#2,568 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 Corydalis Yanhusuo

What is Corydalis Yanhusuo?

  • Pain relief
  • Menstrual cramps
  • Headache
  • Stress and sleep support
  • Stomach and abdominal discomfort

Corydalis yanhusuo is a traditional Chinese herb used mainly for pain. Some early laboratory and animal research suggests its compounds may affect pain and the nervous system, but high-quality human studies are limited, so its true benefits and long-term safety are not well established. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Corydalis Yanhusuo monograph & all interactions
Medication

About Siponimod

What Is Siponimod Used For?

Brand name: Mayzent

Mayzent (siponimod) is approved for adults with relapsing forms of multiple sclerosis (MS). This includes three specific types: clinically isolated syndrome (a first episode of MS-like symptoms), relapsing-remitting MS (periods of attacks followed by recovery), and active secondary progressive MS (a phase where the disease gradually worsens but still has active relapses).

It is taken by mouth once daily and is intended as a long-term treatment to reduce relapses and slow disease progression.

See full Siponimod drug information
Keep checking

Other Drugs & Corydalis Yanhusuo

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

0Major
1,159Moderate
0Minor
1,670No known interaction
Moderate

1,159 interactions

Showing 60 of 1,159 moderate interactions — see all 1,159 on the Corydalis Yanhusuo page.

No interaction 1,670 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

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Pharmacist Counseling Corner

Taking Corydalis Yanhusuo and Siponimod Together: Common Questions

Can you take Corydalis Yanhusuo with Siponimod?
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.
Why are there 2 interactions listed for Corydalis Yanhusuo and Siponimod?
Siponimod belongs to more than one drug category, and Corydalis Yanhusuo interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Corydalis Yanhusuo and Siponimod 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

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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.