Drug & supplement interaction

Panax Notoginseng + Sirolimus

Sirolimus brand name: Rapamune.

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 Sirolimus 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 Sirolimus

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

Why No Interaction Is Listed for Sirolimus

Interactions in our licensed database are recorded against drug classes, not just single drug names. Sirolimus is filed under 5 classifications — including immunosuppressants, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. 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 Sirolimus’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 — Sirolimus 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. Sirolimus)
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 Sirolimus 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 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

    Sirolimus

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

    Sirolimus

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

  • 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

    Sirolimus

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

  • 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

    Sirolimus

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

Reported for Panax Notoginseng but not commonly for Sirolimus: numbness or tingling, anxiety or restlessness, dry mouth and vomiting.

Effects for Sirolimus 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

From our Q&A

Questions About Panax Notoginseng or Sirolimus

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 Sirolimus, 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 Sirolimus

This page covers Panax Notoginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sirolimus page lists 188 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 149 moderate · 36 minor.

From our pharmacist’s overview on the Sirolimus page

“Sirolimus (Rapamune) is the anti-rejection medicine transplant patients depend on, and it is a narrow-therapeutic-index drug, meaning small shifts in its blood level can invite rejection on one side or toxicity on the other. That is why the 188 supplements on this page deserve genuine wariness, starting with the three rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Sirolimus 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 Sirolimus, 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 Sirolimus 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

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

29 days ago today
Medication Sirolimus
Steady interest

#2,157 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 Sirolimus 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 Sirolimus

What Is Sirolimus Used For?

Brand name: Rapamune

Sirolimus oral solution and tablets are used to help prevent organ rejection in kidney (renal) transplant patients aged 13 and older. They are also used to treat lymphangioleiomyomatosis (LAM) — a rare lung disease in which abnormal muscle-like cells invade lung tissue.

Fyarro (sirolimus, intravenous injection) is used to treat adults with locally advanced, unresectable, or metastatic malignant PEComa — a rare tumor that grows in soft tissue or organs. Hyftor (sirolimus topical gel) is used to treat facial angiofibroma (small benign skin growths on the face) associated with tuberous sclerosis in adults and children aged 6 and older.

Most-Reported Side Effects for Sirolimus

From FAERS, the FDA’s public side-effect reporting system (13,394 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fever 525 reports
Diarrhea 515 reports
Pneumonia 487 reports
Acute kidney injury 435 reports
Thrombotic microangiopathy 376 reports
See full Sirolimus 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 Sirolimus, 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 Sirolimus Together: Common Questions

Is it safe to take Panax Notoginseng with Sirolimus?
We do not list a known interaction between Panax Notoginseng and Sirolimus. 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 Sirolimus 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 Sirolimus combination checked?
Interactions in our licensed database are recorded against drug classes. Sirolimus is filed under 5 classifications, and Panax Notoginseng has documented interactions with 4 drug classes — none of Sirolimus'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 — Sirolimus 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 Sirolimus interact with any supplements?
Yes. Sirolimus has documented interactions with 188 supplements in our database — Panax Notoginseng is not one of them. The Sirolimus 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 Sirolimus drug information The full plain-English guide to this medication Sirolimus supplement interactions Every supplement checked against Sirolimus, 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 Sirolimus 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.