Drug & supplement interaction

Maral Root + Nusinersen Sodium

Nusinersen Sodium brand name: Spinraza.

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

Maral Root has a moderate interaction with Nusinersen Sodium. 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 Nusinersen Sodium

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Nusinersen Sodium

Nusinersen Sodium 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 something worth knowing about Spinraza (nusinersen). It's given as an injection into the fluid around your spinal cord (a lumbar puncture), and that procedure itself carries a small bleeding risk. Maral Root may, in theory, make your platelets a little less sticky, which could mean slightly easier bleeding or bruising around the time of your spinal tap.

I want to be honest about the strength of this concern. It comes only from lab dish studies, not from people taking these two together, so it's theoretical. Still, because Spinraza involves a needle near your spine, it's smart to mention any Maral Root use to your care team before each dose. Don't change anything on your own. Let your doctor or pharmacist guide you.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Nusinersen Sodium one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 No known interaction 2,709 (incl. Nusinersen Sodium)
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 Nusinersen Sodium

This page covers Maral Root only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nusinersen Sodium page lists 208 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Asarabacca (major), Danshen (major), Piracetam (major), Siberian Cocklebur (major) and Aconite (moderate).

By severity: 4 major · 186 moderate · 18 minor.

From our pharmacist’s overview on the Nusinersen Sodium page

“Spinraza (nusinersen) is given by spinal injection to treat spinal muscular atrophy, and it carries its own warnings for low platelets and kidney stress, which makes the 208 supplements on this page worth real vigilance rather than a shrug. All but six of them, 202 ingredients, could raise bleeding risk by thinning the blood or dulling…”

Reviewed by 2 · Jul 18, 2026

Open the Nusinersen Sodium 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 Nusinersen Sodium 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 Nusinersen Sodium 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 Nusinersen Sodium
Top half

#1,203 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
Medication

About Nusinersen Injection

What Is Nusinersen Injection Used For?

Brand name: Spinraza

Spinraza (nusinersen) is used to treat spinal muscular atrophy (SMA) — a genetic disease that causes progressive muscle weakness by reducing the body's ability to make a protein called SMN (survival motor neuron). Spinraza is approved for pediatric and adult patients with SMA.

Spinraza is given by intrathecal injection — directly into the fluid surrounding the spinal cord — so the medicine can reach the central nervous system where it's needed most.

See full Nusinersen Injection drug information
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
121 Moderate 2,708 No 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

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Maral Root list.

See the full Maral Root interactions page
See every supplement checked against Nusinersen Sodium, 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
Maral Root monograph › Uses, safety, and every drug interaction in one place Nusinersen Sodium supplement interactions › Every supplement checked against Nusinersen Sodium, ranked by severity Nusinersen Injection 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 Maral Root and Nusinersen Sodium Together: Common Questions

Can you take Maral Root with Nusinersen Sodium?
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 Nusinersen Sodium 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 Nusinersen Sodium and Maral Root?

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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.