Drug & supplement interaction

Hu Zhang + Ramelteon

Ramelteon brand name: Rozerem.

Moderate Interaction
The bottom line Moderate

Ramelteon falls into 2 drug categories that Hu Zhang can interact with; the most serious is rated moderate. Theoretically, hu zhang might increase levels of drugs metabolized by CYP1A2.

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

Hu Zhang and Ramelteon

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

Why Are There 2 Interactions?

Hu Zhang interacts with whole categories of medication. Ramelteon falls into 2 of those categories, so it can interact with Hu Zhang 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 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Ramelteon

Ramelteon falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Hu Zhang interacts with.

Theoretically, hu zhang might increase levels of drugs metabolized by CYP1A2.
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP1A2 enzyme. 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 situation with these two together. Your body clears Ramelteon (Rozerem) mostly through a liver enzyme called CYP1A2. The resveratrol in Hu Zhang has, in lab studies, slowed that same enzyme down. If that happened in a person, Ramelteon could clear out more slowly and build up a bit. Ramelteon is the active drug (not a prodrug), so higher levels would mean a stronger effect: think more next-morning drowsiness, grogginess, or feeling foggy.

I'll be straight with you, though. This is only a theoretical concern based on test-tube data, and it hasn't actually been reported in real people. So don't panic. It's still worth a quick chat with your pharmacist or doctor before pairing them.

References
  1. Chang, T. K., Chen, J., and Lee, W. B. Differential inhibition and inactivation of human CYP1 enzymes by trans-resveratrol: evidence for mechanism-based inactivation of CYP1A2. J.Pharmacol.Exp.Ther. 2001;299(3):874-882.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

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

Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP3A4 enzyme. However, a clinical study in adults with NAFLD found that adding resveratrol 3000 mg daily for 8 weeks did not necessitate dose adjustments to any established medications metabolized by 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 Ramelteon (Rozerem): your body relies on a liver enzyme called CYP3A4 to clear it. Hu Zhang contains resveratrol, which in test-tube studies appears to slow that same enzyme down. If that happened in real life, Ramelteon could linger a bit longer, which might leave you feeling groggier, drowsier, or dizzy the next morning.

That said, this is a theoretical concern. It's based on lab research, not on people actually taking the two together. In fact, one human study using a hefty dose of resveratrol didn't require any dose changes to CYP3A4 medications. So I wouldn't lose sleep over it, but since Ramelteon already makes you sleepy, run it past your pharmacist or doctor before combining the two.

References
  1. Piver B, Berthou F, Dreano Y, Lucas D. Inhibition of CYP3A, CYP1A and CYP2E1 activities by resveratrol and other non volatile red wine components. Toxicol Lett 2001;125:83-91. PubMed
  2. Yu, C., Shin, Y. G., Kosmeder, J. W., Pezzuto, J. M., and van Breemen, R. B. Liquid chromatography/tandem mass spectrometric determination of inhibition of human cytochrome P450 isozymes by resveratrol and resveratrol-3-sulfate. Rapid Commun.Mass Spectro PubMed
  3. Chachay VS, Macdonald GA, Martin JH, Whitehead JP, O'Moore-Sullivan TM, Lee P, Franklin M, Klein K, Taylor PJ, Ferguson M, Coombes JS, Thomas GP, Cowin GJ, Kirkpatrick CM, Prins JB, Hickman IJ. Resveratrol does not benefit patients with nonalcoholic fatty

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

Hu Zhang Also Interacts With Other Medications

Hu Zhang has 825 moderate known drug interactions in our database — the Ramelteon 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 Hu Zhang

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

From our Q&A

Questions About Hu Zhang or Ramelteon

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Hu Zhang or Ramelteon, 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 Ramelteon

This page covers Hu Zhang only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ramelteon page lists 228 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 9 major · 173 moderate · 46 minor.

From our pharmacist’s overview on the Ramelteon page

“Ramelteon (Rozerem) is a prescription sleep aid, and its 228 interacting supplements call for real care, starting with the nine rated major. The frustrating part is that the things sleepless people typically reach for, kava, CBD, a glass of wine before bed, sit at the heart of the problem.”

Reviewed by 2 · Jul 18, 2026

Open the Ramelteon interaction page

One more smart check

Taking Hu Zhang as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,014 real supplement products containing Hu Zhang, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hu Zhang. Your product may carry other ingredients that interact with Ramelteon too, on top of Hu Zhang — 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 Hu Zhang and Ramelteon 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 Hu Zhang
Top 25%

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

29 days ago today
Medication Ramelteon
Top half

#1,055 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 Hu Zhang

What is Hu Zhang?

  • Source of resveratrol
  • Heart and circulation support
  • Inflammation
  • Liver and digestive complaints (traditional)
  • Cough and respiratory symptoms (traditional)
  • Skin and joint conditions (traditional topical use)

Hu Zhang (Japanese knotweed root) is a traditional Chinese herb that is one of the richest natural sources of resveratrol and emodin. Some lab and early human research looks interesting for inflammation and heart health, but high-quality evidence in people is limited. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Hu Zhang monograph & all interactions
Medication

About Ramelteon

What Is Ramelteon Used For?

Brand name: Rozerem

Ramelteon tablets — sold as the brand Rozerem and as generic ramelteon — are used to treat insomnia when the main problem is trouble falling asleep at the start of the night. It is not indicated for difficulty staying asleep.

Clinical studies supporting its effectiveness ran up to six months in both adults and elderly patients.

See full Ramelteon drug information
Keep checking

Other Drugs & Hu Zhang

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

0Major
825Moderate
0Minor
2,004No known interaction
Moderate

825 interactions

Showing 60 of 825 moderate interactions — see all 825 on the Hu Zhang page.

No interaction 2,004 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 Hu Zhang and Ramelteon Together: Common Questions

Can you take Hu Zhang with Ramelteon?
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 Hu Zhang and Ramelteon?
Ramelteon belongs to more than one drug category, and Hu Zhang 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 Hu Zhang and Ramelteon 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 Ramelteon and Hu Zhang?

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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.