Drug & supplement interaction

Maral Root + Lepirudin

Lepirudin brand name: Refludan.

Moderate Interaction
The bottom line Moderate

Maral Root has a moderate interaction with Lepirudin. In vitro research shows that maral root tincture can reduce platelet aggregation.

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

Maral Root and Lepirudin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Lepirudin

Lepirudin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Maral Root interacts with.

In vitro research shows that maral root tincture can reduce platelet aggregation. Theoretically, maral root might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs. Some of these drugs include aspirin, clopidogrel (Plavix), nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, 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 these two together. Lepirudin (Refludan) is a powerful injectable blood thinner given in the hospital, often to folks who can't use heparin. Maral Root, in lab studies, appears to make platelets a little less sticky, which is the part of your blood that helps form clots. So pairing it with an already strong anticoagulant could, in theory, tip you toward easier bleeding.

I want to be honest about the evidence: this concern comes from test-tube research only, not real patient data, so it's theoretical. Still, since Lepirudin is a serious clot-blocker used under close monitoring, watch for things like easy bruising, nosebleeds, or bleeding gums, and loop in your care team before combining them.

References
  1. Koleckar V, Brojerova E, Rehakova Z, et al. In vitro antiplatelet activity of flavonoids from Leuzea carthamoides. Drug Chem Toxicol 2008;31(1):27-35.

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

Maral Root Also Interacts With Other Medications

Maral Root has 121 moderate known drug interactions in our database — the Lepirudin one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Maral Root

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

Everything else you take

See Every Supplement That Interacts With Lepirudin

This page covers Maral Root only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lepirudin page lists 218 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Aconite (moderate) and Allspice (moderate).

By severity: 3 major · 190 moderate · 25 minor.

From our pharmacist’s overview on the Lepirudin page

“Lepirudin (Refludan) is a potent injectable blood thinner, typically given when heparin has caused a dangerous platelet reaction, and that makes this a list to read with real care. Of the 218 supplements and herbs with interactions on file, 202 can slow clotting on their own, piling extra bleeding risk onto a drug whose chief hazard is…”

Reviewed by 2 · Jul 18, 2026

Open the Lepirudin interaction page

One more smart check

Taking Maral Root as Part of a Dietary Supplement Product? Check It for Interactions

We hold 82 real supplement products containing Maral Root, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Maral Root. Your product may carry other ingredients that interact with Lepirudin too, on top of Maral Root — 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 Maral Root and Lepirudin 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 Maral Root
Top half

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

29 days ago today
Medication Lepirudin
Steady interest

#2,661 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 Maral Root

What is Maral Root?

  • Physical performance and stamina
  • Muscle building
  • Fatigue and recovery
  • Stress and adaptation
  • General energy and vitality

Maral Root (Rhaponticum carthamoides) is a Siberian herb used as an 'adaptogen' and is popular among athletes for stamina and muscle building, largely because it contains plant compounds called ecdysteroids. Human evidence is very limited, so its benefits remain mostly unproven. Talk with a pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or have a health condition.

Read the full Maral Root monograph & all interactions
Keep checking

Other Drugs & Maral Root

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

0Major
121Moderate
0Minor
2,708No known interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Maral Root page.

No interaction 2,708 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 Maral Root and Lepirudin Together: Common Questions

Can you take Maral Root with Lepirudin?
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.
How serious is the Maral Root and Lepirudin 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.