Drug & supplement interaction

Panax Notoginseng + Bendamustine

Bendamustine brand names: Treanda, Belrapzo, Vivimusta.

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

Panax Notoginseng has a moderate interaction with Bendamustine. Theoretically, taking Panax notoginseng might reduce the levels and clinical effects of CYP1A2 substrates.

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

Panax Notoginseng and Bendamustine

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

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Bendamustine

Bendamustine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Panax Notoginseng interacts with.

Theoretically, taking Panax notoginseng might reduce the levels and clinical effects of CYP1A2 substrates.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction was attributed to the ability of Panax notoginseng to increase the activity of CYP1A2.
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 basic idea with Panax notoginseng and bendamustine. Bendamustine is partly broken down by a liver enzyme called CYP1A2. This herb appears to speed that enzyme up, so in theory it could clear bendamustine a bit faster and leave less of it working against your cancer. Since bendamustine is the active drug (not a prodrug), faster breakdown could mean a weaker effect, which is a real concern with a chemotherapy you want working at full strength.

I want to be honest about how thin the evidence is here. This comes from a lab and animal study using caffeine, not from people taking bendamustine, so it's mostly theoretical. Still, with a cancer drug, I wouldn't risk it. Please check with your oncology team or pharmacist before using this supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Liu R, Qin M, Hang P, Liu Y, Zhang Z, Liu G. Effects of Panax notoginseng saponins on the activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in rats in vivo. Phytother Res. 2012 Aug;26(8):1113-8.

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

Panax Notoginseng Also Interacts With Other Medications

Panax Notoginseng has 206 moderate known drug interactions in our database — the Bendamustine one above is one of them. If you take anything else, check it against the full list below.

Moderate 206 No known interaction 2,624 (incl. Bendamustine)
Taking anything else?

Check Another of Your Medications Against Panax Notoginseng

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

Everything else you take

See Every Supplement That Interacts With Bendamustine

This page covers Panax Notoginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bendamustine page lists 87 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Acerola (moderate), Adrafinil (moderate), African Wild Potato (moderate), Alpha-lipoic Acid (moderate) and Ashitaba (moderate).

By severity: 62 moderate · 25 minor.

From our pharmacist’s overview on the Bendamustine page

“Bendamustine (Treanda, Belrapzo, Vivimusta) is IV chemotherapy for chronic lymphocytic leukemia and certain lymphomas, and the liver clears it through an enzyme called CYP1A2. That enzyme is why nearly all 87 supplements on this page appear here, since about 80 of them can push CYP1A2 up or down, which could either raise side effects o…”

Reviewed by 2 · Jul 18, 2026

Open the Bendamustine interaction page

One more smart check

Taking Panax Notoginseng as Part of a Dietary Supplement Product? Check It for Interactions

We hold 55 real supplement products containing Panax Notoginseng, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Panax Notoginseng. Your product may carry other ingredients that interact with Bendamustine too, on top of Panax Notoginseng — 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 Panax Notoginseng and Bendamustine 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 Panax Notoginseng
Top half

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

29 days ago today
Medication Bendamustine
Top 5%

#57 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 Panax Notoginseng

What is Panax Notoginseng?

Panax Notoginseng
  • Bleeding and bruising
  • Heart and circulation health
  • High blood pressure
  • Chest pain (angina)
  • Inflammation and swelling

Panax notoginseng (sanqi or tienchi ginseng) is a traditional Chinese herb most often used to help with bleeding, bruising, and circulation. Human evidence for these uses is limited and mostly early, so it should not replace proven treatments. Talk to a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Panax Notoginseng monograph & all interactions
Medication

About Bendamustine Injection

What Is Bendamustine Injection Used For?

Brand names: Treanda, Belrapzo, Vivimusta

Bendamustine hydrochloride injection is used to treat adults with chronic lymphocytic leukemia (CLL). It is also used for adults with indolent B-cell non-Hodgkin lymphoma (NHL) — a slow-growing type of blood cancer — when the disease has continued to progress during or within six months of treatment with rituximab or a rituximab-containing regimen.

For CLL, how well bendamustine works compared to other first-line treatments (aside from chlorambucil) has not been fully established.

See full Bendamustine Injection drug information
Keep checking

Other Drugs & Panax Notoginseng

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

0Major
206Moderate
0Minor
2,623No known interaction
206 Moderate 2,623 No interaction
Moderate

206 interactions

Showing 60 of 206 moderate interactions — see all 206 on the Panax Notoginseng page.

No interaction 2,623 drugs checked — show the list

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

Showing the 60 most looked-up of 2,623 medications checked with no known interaction — see the full Panax Notoginseng list.

See the full Panax Notoginseng interactions page
See every supplement checked against Bendamustine, 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
Panax Notoginseng monograph › Uses, safety, and every drug interaction in one place Bendamustine supplement interactions › Every supplement checked against Bendamustine, ranked by severity Bendamustine 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 Panax Notoginseng and Bendamustine Together: Common Questions

Can you take Panax Notoginseng with Bendamustine?
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 Panax Notoginseng and Bendamustine 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 Bendamustine and Panax Notoginseng?

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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.