Drug & supplement interaction

Panax Notoginseng + Levothyroxine

Levothyroxine brand names: Euthyrox, Levothroid, Unithroid, Synthroid, Levoxyl, and others.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Panax Notoginseng and Levothyroxine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Levothyroxine states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Panax Notoginseng and Levothyroxine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Levothyroxine and Panax Notoginseng in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Panax Notoginseng safety at a glance

Panax Notoginseng overall Use caution May be tolerated short-term by healthy adults, but quality human safety data are limited.
Pregnancy Likely Unsafe When used orally. Ginsenoside Rb1, an active constituent of Panax notoginseng, has teratogenic effects in animal models. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally. Ginsenoside Rb1, an active constituent of Panax notoginseng, has teratogenic effects in animal models. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Levothyroxine and Panax Notoginseng? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Levothyroxine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Levothyroxine is filed under 3 classifications — including thyroid hormone, oral drugs. Panax Notoginseng has documented interactions with 4 drug classes — the most serious being aspirin (moderate), caffeine (moderate) and cytochrome p450 1a2 (cyp1a2) substrates (moderate) — and none of Levothyroxine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Panax Notoginseng Does Interact With Other Medications

Panax Notoginseng has 207 moderate known drug interactions in our database — Levothyroxine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 207 No known interaction 2,623 (incl. Levothyroxine)
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.

What to actually watch for

No Interaction Found — But Data Suggests Panax Notoginseng and Levothyroxine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Anxiety or restlessness / Trouble sleeping / Headache Additional detail

    Panax Notoginseng

    “Orally, Panax notoginseng can cause nervousness and insomnia. Intravenously, Panax notoginseng has been reported to cause headache. In a retrospective review of hospital records of 30,884 patients, a specific Xueshuantong injection (XSTI) containing Panax notoginseng saponins was associated with a headache frequency of 0.3% and paresthesia frequency of 0.1%.”

    Panax Notoginseng · Natural Medicines adverse-effect record, reported in cluster headache.

    4 sources cited
    1. 5558. Huang KC. The Pharmacology of Chinese Herbs. 2nd ed. New York, NY: CRC Press, LLC 1999:101-102.
    2. 94326. Yang X, Xiong X, Wang J. Sanqi panax notoginseng injection for angina pectoris. Evid Based Complement Alternat Med. 2014;2014:963208. PubMed
    3. 94378. Song H, Wang P, Liu J, Wang C. Panax notoginseng Preparations for Unstable Angina Pectoris: A Systematic Review and Meta-Analysis. Phytother Res. 2017 Jun 20.
    4. 98976. Li C, Xu T, Zhou P, et al. Post-marketing safety surveillance and re-evaluation of Xueshuantong injection. BMC Complement Altern Med. 2018;18(1):277. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • Fever / A skin rash Additional detail

    Panax Notoginseng

    “Intravenously, Panax notoginseng saponins have been associated with five cases of pustular drug eruption due to acute generalized exanthematous pustulosis. The skin eruption was associated with fever and an increased neutrophil count in some cases. Symptoms were deemed to be probably or likely due to the Panax notoginseng product.”

    Panax Notoginseng · Natural Medicines adverse-effect record, reported in pregnancy-related edema.

    2 sources cited
    1. 94327. Yin Z, Ma L, Xu J, Xia J, Luo D. Pustular drug eruption due to Panax notoginseng saponins. Drug Des Devel Ther. 2014 Jul 16;8:957-61. PubMed
    2. 98976. Li C, Xu T, Zhou P, et al. Post-marketing safety surveillance and re-evaluation of Xueshuantong injection. BMC Complement Altern Med. 2018;18(1):277. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • Itching Additional detail

    Panax Notoginseng

    “Orally, Panax notoginseng can cause flushed skin. When given orally or intravenously, rash has been reported. There is a case of interstitial granulomatous drug reaction in a 73-year-old male who had been using oral Panax notoginseng extract for 2 months. The condition repeated after 5 days of intravenous use at a later time. The skin condition gradually cleared after use of the product was discontinued.”

    Panax Notoginseng · Natural Medicines adverse-effect record, reported in pruritus.

    6 sources cited
    1. 5558. Huang KC. The Pharmacology of Chinese Herbs. 2nd ed. New York, NY: CRC Press, LLC 1999:101-102.
    2. 94321. Shang Q, Xu H, Liu Z, Chen K, Liu J. Oral Panax notoginseng Preparation for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013;2013:940125.
    3. 94324. Xu D, Huang P, Yu Z, Xing DH, Ouyang S, Xing G. Efficacy and Safety of Panax notoginseng Saponin Therapy for Acute Intracerebral Hemorrhage, Meta-Analysis, and Mini Review of Potential Mechanisms of Action. Front Neurol. 2015 Jan 7;5:274. PubMed
    4. 94326. Yang X, Xiong X, Wang J. Sanqi panax notoginseng injection for angina pectoris. Evid Based Complement Alternat Med. 2014;2014:963208. PubMed
    5. 94378. Song H, Wang P, Liu J, Wang C. Panax notoginseng Preparations for Unstable Angina Pectoris: A Systematic Review and Meta-Analysis. Phytother Res. 2017 Jun 20.
    6. 98976. Li C, Xu T, Zhou P, et al. Post-marketing safety surveillance and re-evaluation of Xueshuantong injection. BMC Complement Altern Med. 2018;18(1):277. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • Vomiting / Nausea Additional detail

    Panax Notoginseng

    “Orally and intravenously, Panax notoginseng can cause dry mouth, nausea, and vomiting. In one case report, a patient developed a large submucosal hematoma extending from the hypopharynx to lower esophagus after taking one oral dose of an unknown quantity of Panax notoginseng and hirudin. It is unclear if this event was due to Panax notoginseng, hirudin, or other factors.”

    Panax Notoginseng · Natural Medicines adverse-effect record, reported in dry mouth.

    4 sources cited
    1. 5558. Huang KC. The Pharmacology of Chinese Herbs. 2nd ed. New York, NY: CRC Press, LLC 1999:101-102.
    2. 94321. Shang Q, Xu H, Liu Z, Chen K, Liu J. Oral Panax notoginseng Preparation for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013;2013:940125.
    3. 98976. Li C, Xu T, Zhou P, et al. Post-marketing safety surveillance and re-evaluation of Xueshuantong injection. BMC Complement Altern Med. 2018;18(1):277. PubMed
    4. 109671. Liu L, Shen XJ, Xue LJ, Yao SK, Zhu JY. Submucosal hematoma with a wide range of lesions, severe condition and atypical clinical symptoms: A case report. World J Clin Cases 2021;9(20):5683-5688. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

Reported for Panax Notoginseng but not commonly for Levothyroxine: numbness or tingling, dry mouth and swelling.

Effects for Levothyroxine come from the ADVERSE REACTIONS section of its FDA label; effects for Panax Notoginseng come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Panax Notoginseng in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When used orally. Ginsenoside Rb1, an active constituent of Panax notoginseng, has teratogenic effects in animal models.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Levothyroxine Products Have a Food Rule — Panax Notoginseng Should Not Break It

At least one FDA label for a product containing Levothyroxine says to take it on an empty stomach. Most supplements — Panax Notoginseng included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Levothyroxine on its own and move Panax Notoginseng to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Levothyroxine products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Panax Notoginseng or Levothyroxine

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

This page covers Panax Notoginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levothyroxine page lists 50 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Tiratricol (major), Acetyl-l-carnitine (moderate), Alpha-lipoic Acid (moderate) and Ascophyllum Nodosum (moderate).

By severity: 2 major · 39 moderate · 9 minor.

From our pharmacist’s overview on the Levothyroxine page

“Levothyroxine replaces a hormone your body measures in tiny amounts, so small shifts in its blood level show up in how you feel, and I treat this list with genuine care. Nearly everything on it does one of two things: blocks the pill from being absorbed in the gut, the way everyday minerals like calcium do by binding it into complexes,…”

Reviewed by 2 · Jul 18, 2026

Open the Levothyroxine 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. Even though Panax Notoginseng itself has no known interaction with Levothyroxine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Panax Notoginseng and Levothyroxine 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 Levothyroxine
Top 10

#2 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Panax Notoginseng reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Panax Notoginseng and Levothyroxine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Panax notoginseng · Araliaceae · Root (and sometimes flowers and leaves) · Capsules, tablets, powders, topical preparations, and dried root used in traditional formulas

An interaction check asks whether these two react with each other — it does not ask whether Panax Notoginseng is a good idea for someone in your situation. Here is what our Panax Notoginseng record says about it on its own.

Panax Notoginseng: dosing

There is no well-established standard dose of Panax notoginseng for supplement use. Doses used in traditional practice and in studies have varied widely depending on the form and product.If you choose to use it, follow the directions on the product label and do not exceed them.

From our Panax Notoginseng monograph — the full record covers uses, side effects and every documented interaction.

Read the full Panax Notoginseng monograph & all interactions
Medication

About Levothyroxine

What Is Levothyroxine Used For?

Brand names: Euthyrox, Levothroid, Unithroid, Synthroid, Levoxyl, Levo-T, Eltroxin, Estre, Levothyroxine, Novothyrox, Levolet

Levothyroxine replaces or supplements the thyroid hormone your body isn't making enough of. It's used for hypothyroidism — an underactive thyroid — in adults, children, and even newborns, whether the cause is the thyroid gland itself, the pituitary gland, or the hypothalamus in the brain.

It's also used alongside surgery and radioiodine treatment in people with certain types of thyroid cancer, to help suppress the hormone that can stimulate cancer growth. It is not meant for weight loss, treating benign thyroid nodules in people who have enough iodine, or for hypothyroidism during recovery from a temporary condition called subacute thyroiditis.

See full Levothyroxine 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
207Moderate
0Minor
2,622No known interaction
207 Moderate 2,622 No interaction
Moderate

207 interactions

Showing 60 of 207 moderate interactions — see all 207 on the Panax Notoginseng page.

No interaction 2,622 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 2,622 medications checked with no known interaction — see the full Panax Notoginseng list.

See the full Panax Notoginseng interactions page
See every supplement checked against Levothyroxine, ranked by severity
Evidence & sources

Panax Notoginseng References

The 15 references that drive our Panax Notoginseng monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Huang KC. The Pharmacology of Chinese Herbs. 2nd ed. New York, NY: CRC Press, LLC 1999:101-102.
  2. Bensky D, Gamble A, Kaptchuk T. Chinese Herbal Medicine Materia Medica. Seattle, WA: Eastland Press, 1996:359-60.
  3. Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8..
  4. Du XF, Yin XP, Zhang GL, Shi HJ, Shao MH. Interstitial granulomatous drug reaction to a Chinese herb extract. Eur J Dermatol. 2012 May-Jun;22(3):419-20. PubMed
  5. 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.
  6. Shang Q, Xu H, Liu Z, Chen K, Liu J. Oral Panax notoginseng Preparation for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013;2013:940125.
  7. Tian Z, Pang H, Du S, Lu Y, Zhang L, Wu H, Guo S, Wang M, Zhang Q. Effect of Panax notoginseng saponins on the pharmacokinetics of aspirin in rats. J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jan 1;1040:136-143. PubMed
  8. Xu D, Huang P, Yu Z, Xing DH, Ouyang S, Xing G. Efficacy and Safety of Panax notoginseng Saponin Therapy for Acute Intracerebral Hemorrhage, Meta-Analysis, and Mini Review of Potential Mechanisms of Action. Front Neurol. 2015 Jan 7;5:274. PubMed
  9. Yang X, Xiong X, Wang J. Sanqi panax notoginseng injection for angina pectoris. Evid Based Complement Alternat Med. 2014;2014:963208. PubMed
  10. Yin Z, Ma L, Xu J, Xia J, Luo D. Pustular drug eruption due to Panax notoginseng saponins. Drug Des Devel Ther. 2014 Jul 16;8:957-61. PubMed
  11. Song H, Wang P, Liu J, Wang C. Panax notoginseng Preparations for Unstable Angina Pectoris: A Systematic Review and Meta-Analysis. Phytother Res. 2017 Jun 20.
  12. Tian Z, Pang H, Zhang Q, et al. Effect of aspirin on the pharmacokinetics and absorption of panax notoginsengsaponins. J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Jan 2;1074-75.
  13. Li C, Xu T, Zhou P, et al. Post-marketing safety surveillance and re-evaluation of Xueshuantong injection. BMC Complement Altern Med. 2018;18(1):277. PubMed
  14. Liu L, Shen XJ, Xue LJ, Yao SK, Zhu JY. Submucosal hematoma with a wide range of lesions, severe condition and atypical clinical symptoms: A case report. World J Clin Cases 2021;9(20):5683-5688. PubMed
  15. Qian J, Chen W, Wu J, et al. Effects and Mechanism of Action of Panax notoginseng Saponins on the Pharmacokinetics of Warfarin. Eur J Drug Metab Pharmacokinet 2022;47(3):331-342. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Panax Notoginseng and Levothyroxine Together: Common Questions

Is it safe to take Panax Notoginseng with Levothyroxine?
We do not list a known interaction between Panax Notoginseng and Levothyroxine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Panax Notoginseng and Levothyroxine have any of the same side effects?
Yes — our sources link each of them separately to 8 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Panax Notoginseng and Levothyroxine at the same time of day?
At least one FDA label for a product containing Levothyroxine says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Levothyroxine on its own and move Panax Notoginseng to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.
How was the Panax Notoginseng and Levothyroxine combination checked?
Interactions in our licensed database are recorded against drug classes. Levothyroxine is filed under 3 classifications, and Panax Notoginseng has documented interactions with 4 drug classes — none of Levothyroxine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Panax Notoginseng interact with any other medications?
Yes. Panax Notoginseng has 207 documented drug interactions in our database — Levothyroxine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Levothyroxine interact with any supplements?
Yes. Levothyroxine has documented interactions with 50 supplements in our database — Panax Notoginseng is not one of them. The Levothyroxine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Panax Notoginseng monograph Uses, safety profile, and every drug interaction in one place Levothyroxine drug information The full plain-English guide to this medication Levothyroxine supplement interactions Every supplement checked against Levothyroxine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 15 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Levothyroxine 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.