Drug & supplement interaction

Fo-ti + Rosiglitazone Maleate

Rosiglitazone Maleate brand name: Avandia.

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

Rosiglitazone Maleate falls into 4 drug categories that Fo-ti can interact with; the most serious is rated moderate. Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fo-ti and Rosiglitazone Maleate

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. Rosiglitazone Maleate 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

HEPATOTOXIC DRUGS

1 of 4

Why this applies to Rosiglitazone Maleate

Rosiglitazone Maleate falls under HEPATOTOXIC DRUGS — the group Fo-ti interacts with.

Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Fo-ti has been linked to liver damage in many reports.
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 concern with pairing Fo-ti and rosiglitazone (Avandia). This isn't about Fo-ti changing how your diabetes medicine works or your blood sugar control. Instead, it's about your liver. Rosiglitazone is one of those medications that can occasionally stress the liver, and Fo-ti (especially the processed root in supplement doses) has been linked to liver injury in a number of case reports. Stacking two things that each can burden the liver may add up.

To be fair, this is a theoretical concern based mostly on anecdotal reports, not strong studies, so I don't want to alarm you. Still, watch for signs like yellowing skin or eyes, dark urine, belly pain, or unusual tiredness. Please check with your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Park GJ, Mann SP, Ngu MC. Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum. J Gastroenterol Hepatol 2001;16:115-7.
  2. But PP, Tomlinson B, Lee KL. Hepatitis related to the Chinese medicine Shou-wu-pian manufactured from Polygonum multiflorum. Vet Hum Toxicol 1996;38:280-2.
  3. UK Medicines and Healthcare Products Regulatory Agency. Polygonum multiflorum and liver reactions. April 2006. Available at: www.mhra.gov.uk/home/idcplg?IdcService= SS_GET_PAGE&useSecondary=true&ssDocName= CON2023590&ssTargetNodeId= 833 (Accessed 10 May 2
  4. Panis B, Wong DR, Hooymans PM, De Smet PA, Rosias PP. Recurrent toxic hepatitis in a Caucasian girl related to the use of Shou-Wu-Pian, a Chinese herbal preparation. J Pediatr Gastroenterol Nutr 2005;41:256-8. PubMed
  5. Mazzanti G, Battinelli L, Daniele C, et al. New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese herbal product derived from Polygonum multiflorum. Ann Intern Med 2004;140:E589-90.
  6. Cardenas A, Restrepo JC, Sierra F, Correa G. Acute hepatitis due to shen-min: a herbal product derived from Polygonum multiflorum. J Clin Gastroenterol 2006;40:629-32. PubMed
  7. Laird AR, Ramchandani N, deGoma EM, et al. Acute hepatitis associated with the use of an herbal supplement (Polygonum multiflorum) mimicking iron-overload syndrome. J Clin Gastroenterol 2008;42:861-2. PubMed
  8. 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
  9. Yuen, M. F., Tam, S., Fung, J., Wong, D. K., Wong, B. C., and Lai, C. L. Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1-year prospective study. Aliment.Pharmacol.Ther 10-15-2006;24(8):1179-1186. PubMed
  10. Bae, S. H., Kim, D. H., Bae, Y. S., Lee, K. J., Kim, D. W., Yoon, J. B., Hong, J. H., and Kim, S. H. [Toxic hepatitis associated with Polygoni multiflori]. Korean J.Hepatol. 2010;16(2):182-186. PubMed
  11. Furukawa, M., Kasajima, S., Nakamura, Y., Shouzushima, M., Nagatani, N., Takinishi, A., Taguchi, A., Fujita, M., Niimi, A., Misaka, R., and Nagahara, H. Toxic hepatitis induced by show-wu-pian, a Chinese herbal preparation. Intern.Med. 2010;49(15):1537-1 PubMed
  12. Dong H, Slain D, Cheng J, Ma W, Liang W. Eighteen cases of liver injury following ingestion of Polygonum multiflorum. Complement Ther Med 2014;22(1):70-4. PubMed
  13. Lei X, Chen J, Ren J, et al. Liver damage associated with Polygonum multiflorum Thunb.: a systematic review of case reports and case series. Evid Based Complement Alternat Med 2015;2015:459749.
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 4

Rosiglitazone Maleate 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 simple version: your body clears rosiglitazone (Avandia) largely through a liver enzyme called CYP2C9. Lab and animal studies hint that Fo-ti may slow that enzyme down. If it did the same in people, more rosiglitazone could linger in your system, which might nudge its effects stronger. For this medication that could mean blood sugar dropping a bit lower than expected, or more of its usual side effects like fluid retention, swelling in the legs, or weight gain.

The key word is theoretical. This hasn't actually been seen in humans, only in test tubes and animals, so I wouldn't lose sleep over it. Still, before adding a concentrated Fo-ti supplement, run it past your pharmacist or doctor, especially since Fo-ti itself has been linked to liver injury.

Contact Dr. Brian directly if you have additional questions on this interaction
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

ANTIDIABETES DRUGS

3 of 4

Rosiglitazone Maleate also falls under ANTIDIABETES DRUGS.

Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Fo-ti reportedly has hypoglycemic effects.
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 simple version: Rosiglitazone (Avandia) lowers your blood sugar by making your body more sensitive to insulin. Fo-ti has reportedly shown its own mild blood-sugar-lowering effect in some early reports. So the worry is that stacking them could push your sugar a little too low, which we call hypoglycemia.

I want to be honest about how strong this concern is. It's theoretical, based on how Fo-ti behaves in lab and animal studies, not on solid human proof. Still, if you do combine them, keep an eye out for signs of low sugar like shakiness, sweating, dizziness, or feeling foggy. Loop in your doctor or pharmacist before adding Fo-ti, and keep checking your numbers as usual. Also note Fo-ti has been tied to rare liver injury, so that's worth mentioning too.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Moderate

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

4 of 4

Rosiglitazone Maleate also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2C8.
In vitro research suggests that fo-ti might inhibit CYP2C8. 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 gist: your body clears rosiglitazone (Avandia) mainly through a liver enzyme called CYP2C8. Lab studies hint that Fo-ti may slow that enzyme down. If that happened in a person, rosiglitazone could build up a bit more than expected, which might nudge its blood-sugar-lowering effect and side effects upward. With this drug that can mean things like low blood sugar (shaky, sweaty, dizzy spells), fluid retention, swelling in the ankles, or weight gain.

I want to be honest about the strength of this, though. It's only been seen in test-tube research, never confirmed in real people, so it's theoretical. I wouldn't lose sleep over it, but please run it by your pharmacist or doctor before combining them, especially since Fo-ti has been tied to liver concerns.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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

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 Rosiglitazone Maleate one above is among them. If you take anything else, check it against the full list below.

Moderate 1,256 No known interaction 1,574 (incl. Rosiglitazone Maleate)
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.

Everything else you take

See Every Supplement That Interacts With Rosiglitazone Maleate

This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rosiglitazone Maleate page lists 314 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Acai (moderate).

By severity: 4 major · 266 moderate · 44 minor.

From our pharmacist’s overview on the Rosiglitazone Maleate page

“Rosiglitazone (Avandia) lowers blood sugar in type 2 diabetes, and most of the 314 supplements and herbs on this page pull on that same lever. Some 239 can move blood glucose on their own, so adding one risks hypoglycemia, the shakiness, sweating, and confusion of sugar falling too low.”

Reviewed by 2 · Jul 18, 2026

Open the Rosiglitazone Maleate 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 Rosiglitazone Maleate 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 Rosiglitazone Maleate 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%

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

29 days ago today
Medication Rosiglitazone Maleate
Top 5%

#128 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 Rosiglitazone

What Is Rosiglitazone Used For?

Brand name: Avandia

  • Rosiglitazone is used along with a diet and exercise program and sometimes with one or more other medications to treat type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood). Rosiglitazone is in a class of medications called thiazolidinediones. It works by increasing the body's sensitivity to insulin, a natural substance that helps control blood sugar levels. Rosiglitazone is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may occur if high blood sugar is not treated).

  • Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

See full Rosiglitazone 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
1,256 Moderate 1,573 No 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

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

Showing the 60 most looked-up of 1,573 medications checked with no known interaction — see the full Fo-ti list.

See the full Fo-ti interactions page
See every supplement checked against Rosiglitazone Maleate, 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
Fo-ti monograph › Uses, safety, and every drug interaction in one place Rosiglitazone Maleate supplement interactions › Every supplement checked against Rosiglitazone Maleate, ranked by severity Rosiglitazone 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 Fo-ti and Rosiglitazone Maleate Together: Common Questions

Can you take Fo-ti with Rosiglitazone Maleate?
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 Rosiglitazone Maleate?
Rosiglitazone Maleate 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 Rosiglitazone Maleate 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.