Drug & supplement interaction

Panax Notoginseng + Palifermin

Palifermin brand name: Kepivance.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Panax Notoginseng and Palifermin 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 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 Palifermin

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 Palifermin 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 Palifermin and Panax Notoginseng? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Palifermin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Palifermin is filed under a single classification — 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 Palifermin’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 — Palifermin 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. Palifermin)
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 Palifermin 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.

  • Fever / A skin rash reported in 16.0% of FDA reports for Palifermin 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

    Palifermin

    Listed in the ADVERSE REACTIONS section of the FDA label for Palifermin, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Numbness or tingling 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

    Palifermin

    Listed in the ADVERSE REACTIONS section of the FDA label for Palifermin. 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

    Palifermin

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

  • Swelling Additional detail

    Panax Notoginseng

    Recorded for Panax Notoginseng in the same Natural Medicines adverse-effect record shown under Fever / A skin rash above.

    Palifermin

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

Reported for Panax Notoginseng but not commonly for Palifermin: anxiety or restlessness, dry mouth, vomiting and headache.

Effects for Palifermin come from the ADVERSE REACTIONS section of its FDA label; effects for Panax Notoginseng come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 388 voluntary FDA FAERS reports for Palifermin that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. 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

Everything else you take

See Every Supplement That Interacts With Palifermin

This page covers Panax Notoginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Palifermin page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Palifermin page

“Palifermin (Kepivance) is given by IV to prevent the severe mouth sores that intensive chemotherapy can cause, most often in patients heading into a stem cell transplant, and I read its interaction list with genuine caution because of how fragile those patients already are. All 17 supplements on file act on absorption through the gut,…”

Reviewed by 2 · Jul 18, 2026

Open the Palifermin 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 Palifermin, 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 Palifermin 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

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

29 days ago today
Medication Palifermin
Steady interest

#1,907 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 20, 2026. The Panax Notoginseng and Palifermin 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 Palifermin

What Is Palifermin Used For?

Brand name: Kepivance

Kepivance (palifermin) is used to decrease how often and how long severe oral mucositis — painful sores in the mouth and throat — occurs in patients with hematologic malignancies (blood cancers such as lymphoma, leukemia, or multiple myeloma) who are receiving high-dose, cell-damaging (myelotoxic) therapy before an autologous hematopoietic stem cell transplant (a transplant using the patient's own stem cells).

Kepivance is specifically indicated when the preparative chemotherapy or radiation regimen is expected to cause severe mucositis in most patients. It is not recommended for use with a high-dose melphalan conditioning regimen, and it was not found to be effective in the setting of allogeneic stem cell transplant (using a donor's cells). Its safety and effectiveness have not been established for patients with non-blood cancers (non-hematologic malignancies).

Most-Reported Side Effects for Palifermin

From FAERS, the FDA’s public side-effect reporting system (388 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Mucosal inflammation 56 reports
Febrile neutropenia 39 reports
Rash 39 reports
Stomatitis 34 reports
Erythema 28 reports
See full Palifermin 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 Palifermin, 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 Palifermin Together: Common Questions

Is it safe to take Panax Notoginseng with Palifermin?
We do not list a known interaction between Panax Notoginseng and Palifermin. 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 Palifermin have any of the same side effects?
Yes — our sources link each of them separately to 5 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.
How was the Panax Notoginseng and Palifermin combination checked?
Interactions in our licensed database are recorded against drug classes. Palifermin is filed under 1 classification, and Panax Notoginseng has documented interactions with 4 drug classes — none of Palifermin'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 — Palifermin 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 Palifermin interact with any supplements?
Yes. Palifermin has documented interactions with 17 supplements in our database — Panax Notoginseng is not one of them. The Palifermin 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 Palifermin drug information The full plain-English guide to this medication Palifermin supplement interactions Every supplement checked against Palifermin, 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

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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.