Drug & supplement interaction

Fo-ti + Clopidogrel

Clopidogrel brand name: Plavix.

Moderate Interaction
The bottom line Moderate

Clopidogrel falls into 4 drug categories that Fo-ti can interact with; the most serious is rated moderate. Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Fo-ti and Clopidogrel

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Fo-ti interacts with whole categories of medication. Clopidogrel falls into 4 of those categories, so it can interact with Fo-ti in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 4

Why this applies to Clopidogrel

Clopidogrel falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Fo-ti interacts with.

Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.
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 honest picture with Plavix and Fo-ti. Plavix is a prodrug, meaning your body has to switch it on before it can thin your blood and prevent clots. That activation mostly relies on a liver enzyme called CYP2C19, not the CYP1A2 enzyme this particular interaction is built around. So the lab-based concern about Fo-ti nudging CYP1A2 up or down doesn't line up neatly with how clopidogrel actually works.

On top of that, this flag comes only from test-tube and animal studies, and the results even disagreed with each other. Nothing has been shown in real people. I wouldn't lose sleep over it, but since Plavix protects you from heart attacks and strokes, please run any Fo-ti use past your pharmacist or doctor first, especially because Fo-ti has been linked to liver injury.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  2. Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
  3. Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 4

Clopidogrel also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C9.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C9. However, this interaction has not been reported in humans.
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 about Plavix (clopidogrel): it's a prodrug, meaning it's inactive until your liver enzymes switch it on. So when a supplement slows down those enzymes, it can actually leave you with less active clopidogrel, not more, even though the drug level on paper might look higher. Since clopidogrel is the medicine keeping clots from forming in your heart, stents, or arteries, weaker activation could mean less protection.

That said, this is very theoretical for Fo-ti. The enzyme-slowing effect only showed up in lab and animal studies, and it was never confirmed in people. I wouldn't lose sleep over it, but because clopidogrel does such important work, please run it past your pharmacist or doctor before adding Fo-ti, and remember Fo-ti has its own liver-injury reports too.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  2. Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
  3. Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 4

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

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction has not been reported in humans.
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 an important wrinkle with Plavix (clopidogrel): it's a prodrug, meaning it arrives in your body inactive and your liver enzymes have to switch it on. The main enzyme for that activation is CYP2C19, not CYP3A4, though CYP3A4 plays a smaller supporting role. Since Fo-ti's lab signal is about slowing CYP3A4, the theoretical concern is slightly less clopidogrel getting activated, which could mean a touch weaker clot protection rather than more bleeding.

That said, this is very weak evidence, just test-tube and animal studies that even conflict with each other, and it has never been seen in real people. Because Plavix protects against strokes and heart attacks, don't change anything on your own. Just give your pharmacist or doctor a heads-up before starting Fo-ti.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  2. Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
  3. Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

4 of 4

Clopidogrel also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery. Theoretically, concomitant use of fo-ti with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients. Until more is known, monitor patients taking fo-ti and drugs that affect bleeding.
Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), 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 gist with Plavix and Fo-ti. Plavix is a blood thinner that keeps your platelets from clumping, so the real-world concern is bleeding. The worry on file isn't really about how Plavix is broken down. It's that Fo-ti has been tied to rare cases of liver injury, and your liver makes the clotting factors your blood needs. If the liver gets hurt, your clotting can drop and Plavix's effect can stack on top of that, nudging your bleeding risk up.

Keep in mind this is anecdotal, mostly one warfarin case, so it's a caution and not a sure thing. Still, watch for easy bruising, nosebleeds, blood in urine or stool, or any unusual fatigue or yellowing of the skin. Please check with your pharmacist or doctor before pairing these.

References
  1. Jung KA, Min HJ, Yoo SS, et al. Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb. Gut Liver 2011;5(4):493-9. 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

Fo-ti Also Interacts With Other Medications

Fo-ti has 1,256 moderate known drug interactions in our database — the Clopidogrel 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 Fo-ti

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

From our Q&A

Questions About Fo-ti or Clopidogrel

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Fo-ti or Clopidogrel, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Clopidogrel

This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Clopidogrel page lists 309 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 · 258 moderate · 46 minor.

From our pharmacist’s overview on the Clopidogrel page

“Clopidogrel (Plavix) keeps platelets from sticking together after a stent, heart attack, or stroke, which makes this a list to take carefully. Of the 309 supplements and herbs on file, 202 carry blood-thinning or antiplatelet activity of their own and can stack bleeding risk on top of the drug's, while most of the rest change how the l…”

Reviewed by 2 · Jul 18, 2026

Open the Clopidogrel interaction page

One more smart check

Taking Fo-ti as Part of a Dietary Supplement Product? Check It for Interactions

We hold 976 real supplement products containing Fo-ti, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fo-ti. Your product may carry other ingredients that interact with Clopidogrel too, on top of Fo-ti — 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 Fo-ti and Clopidogrel 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 Fo-ti
Top 25%

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

29 days ago today
Medication Clopidogrel
Top 1%

#13 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 Fo-ti

What is Fo-ti?

  • Anti-aging and longevity
  • Hair graying and hair loss
  • General tonic for vitality
  • Constipation
  • High cholesterol

Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these benefits is limited, and processed Fo-ti has been linked to reports of liver injury, so caution and professional guidance are important.

Read the full Fo-ti monograph & all interactions
Medication

About Clopidogrel

What Is Clopidogrel Used For?

Brand name: Plavix

Clopidogrel tablets are used to reduce the risk of heart attack and stroke in people with acute coronary syndrome (ACS) — including unstable angina and non-ST-elevation or ST-elevation heart attacks — and in people with a history of recent heart attack, recent stroke, or established peripheral arterial disease. For ACS, it is typically given alongside aspirin.

It works by preventing platelets (blood cells that trigger clotting) from clumping together, which helps keep arteries open and lowers the chance of a dangerous clot forming.

See full Clopidogrel drug information
Keep checking

Other Drugs & Fo-ti

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

0Major
1,256Moderate
0Minor
1,573No known interaction
Moderate

1,256 interactions

Showing 60 of 1,256 moderate interactions — see all 1,256 on the Fo-ti page.

No interaction 1,573 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 Fo-ti and Clopidogrel Together: Common Questions

Can you take Fo-ti with Clopidogrel?
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 4 interactions listed for Fo-ti and Clopidogrel?
Clopidogrel belongs to more than one drug category, and Fo-ti 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 Fo-ti and Clopidogrel 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 Clopidogrel and Fo-ti?

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.