Drug & supplement interaction

Peony + Oxcarbazepine

Oxcarbazepine brand names: Trileptal, Oxtellar XR.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Peony and Oxcarbazepine 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

Peony and Oxcarbazepine

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 Oxcarbazepine and Peony 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.

Peony safety at a glance

Peony overall Use caution Generally considered well tolerated for short-term use, but high-quality safety data are limited.
Pregnancy Possibly Unsafe When used orally. Preliminary research suggests that peony can cause uterine contractions. However, other preliminary research suggests a combination of peony a... Read the full pregnancy detail
Breastfeeding Avoid There is not enough reliable information to consider it safe while breastfeeding.

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 Oxcarbazepine and Peony? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Oxcarbazepine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Oxcarbazepine is filed under 5 classifications — including anticonvulsants, cytochrome p450 2c19 (cyp2c19) inhibitors, cytochrome p450 3a4 (cyp3a4) inducers. Peony has documented interactions with 7 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), clozapine (clozaril) (moderate) and contraceptive drugs (moderate) — and none of Oxcarbazepine’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

Peony Does Interact With Other Medications

Peony has 811 moderate known drug interactions in our database — Oxcarbazepine isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Peony

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

What to actually watch for

No Interaction Found — But Data Suggests Peony and Oxcarbazepine 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.

  • A skin rash Additional detail

    Peony

    “Topically, peony has been reported to cause contact dermatitis.”

    Peony · Natural Medicines adverse-effect record, reported in dermatitis.

    1 source cited
    1. 13555. Bruynzeel DP. Contact Dermatitis Due to Paeonia (Peony). Contact Dermatitis 1989; 20:152-3..

    Oxcarbazepine

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

  • Nausea Additional detail

    Peony

    “Orally, peony and total glucosides of peony (TGP) have been reported to cause gastrointestinal discomfort, including abdominal distension, anorexia, diarrhea, and nausea, in some patients. In one clinical study, diarrhea was reported in 5% of patients taking TGP 600 mg three times daily for 24 weeks versus 1% of patients taking placebo.”

    Peony · Natural Medicines adverse-effect record, reported in anorexia.

    5 sources cited
    1. 13538. Anon. Monograph. Peony (Paeonia spp). Alt Med Rev 2001;6:495-9.
    2. 92785. Cai Y, Yuan Q, Xu K, et al. Assessment of the therapeutic effect of total glycosides of peony for juvenile idiopathic arthritis: a systematic review and meta-analysis. Evid Based Complement Alternat Med 2016;2016:8292486.
    3. 97949. Zhou Y, Jin L, Kong F, et al. Clinical and immunological consequences of total glucosides of paeony treatment in Sjögren's syndrome: A randomized controlled pilot trial. Int Immunopharmacol. 2016 Oct;39:314-319. doi: 10.1016/j.intimp.2016.08.006. PubMed
    4. 98466. Zhu Q, Qi X, Wu Y, Wang K. Clinical study of total glucosides of paeony for the treatment of diabetic kidney disease in patients with diabetes mellitus. Int Urol Nephrol. 2016 Nov;48(11):1873-1880. doi: 10.1007/s11255-016-1345-5. PubMed
    5. 100992. Liu X, Li X, Li X, et al. The efficacy and safety of total glucosides of peony in the treatment of primary Sjögren's syndrome: a multi-center, randomized, double-blinded, placebo-controlled clinical trial. Clin Rheumatol. 2019;38(3):657-64. Erratum i

    Oxcarbazepine

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

Reported for Peony but not commonly for Oxcarbazepine: stomach upset, bloating or gas, bleeding or bruising and diarrhea.

Effects for Oxcarbazepine come from the ADVERSE REACTIONS section of its FDA label; effects for Peony 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

Peony in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally. Preliminary research suggests that peony can cause uterine contractions. However, other preliminary research suggests a combination of peony and angelica with or without motherwort, banksias rose, and ligustica, might be safe. Until more is known, avoid use.

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 Peony or Oxcarbazepine

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

This page covers Peony only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Oxcarbazepine page lists 122 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 7 major · 99 moderate · 16 minor.

From our pharmacist’s overview on the Oxcarbazepine page

“People take oxcarbazepine (Trileptal, Oxtellar XR) to keep seizures in check, and I want anyone on it to read the seven major-rated interactions below before adding any supplement. Of the 122 ingredients on file, 78 have sedative effects, so the calming and sleep aids many patients reach for, kava among them, can pile drowsiness on top…”

Reviewed by 2 · Jul 18, 2026

Open the Oxcarbazepine interaction page

One more smart check

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

We hold 71 real supplement products containing Peony, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Peony. Even though Peony itself has no known interaction with Oxcarbazepine, 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 Peony and Oxcarbazepine 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 Peony
Top 25%

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

29 days ago today
Medication Oxcarbazepine
Top 25%

#459 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 Peony reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 27, 2026. The Peony and Oxcarbazepine records this page draws on were last updated July 11, 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 Peony

What is Peony?

Peony
  • Menstrual cramps and irregular periods
  • Muscle cramps and spasms
  • Anxiety and stress
  • Inflammation and pain
  • Polycystic ovary syndrome (PCOS)

Peony root is a traditional Chinese medicine herb often used for menstrual problems, cramps, and inflammation, frequently as part of combination formulas. Human evidence for most uses is limited or preliminary, so it should not replace proven treatments. Talk to your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.

Paeonia lactiflora · Paeoniaceae · Root (and sometimes the root bark, flower, and seeds) · Dried root, powders, capsules, tinctures, teas, and combination herbal formulas

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

Peony: dosing

There is no well-established standardized dose for peony. The amount used varies depending on the form (dried root, powder, capsule, tincture, or tea) and whether it is used alone or in a combination formula.The safest approach is to follow the directions on the product label and to choose products from reputable manufacturers.

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

Read the full Peony monograph & all interactions
Medication

About Oxcarbazepine

What Is Oxcarbazepine Used For?

Brand names: Trileptal, Oxtellar XR

Oxcarbazepine treats partial-onset seizures (seizures that start in one area of the brain). Which uses are approved depends on the product and the patient's age.

Trileptal and oxcarbazepine tablets or oral suspension are used alone or added to other seizure medicines in adults. They are used alone in children 4 to 16 years and added to other medicines in children 2 to 16 years. Oxtellar XR and oxcarbazepine extended-release tablets are used for partial-onset seizures in patients 6 years and older.

See full Oxcarbazepine drug information
Keep checking

Other Drugs & Peony

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

0Major
811Moderate
0Minor
2,018No known interaction
Moderate

811 interactions

Showing 60 of 811 moderate interactions — see all 811 on the Peony page.

No interaction 2,018 drugs checked — show the list

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

Showing the 60 most looked-up of 2,018 medications checked with no known interaction — see the full Peony list.

Evidence & sources

Peony References

The 15 references that drive our Peony 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. Chen LC, Chou MH, Lin MF, Yang LL. Effects of Paeoniae Radix, a traditional Chinese medicine, on the pharmacokinetics of phenytoin. J Clin Pharm Ther 2001;26:271-8. PubMed
  2. Guo TL, Zhou XW. [Clinical observations on the treatment of the gestational hypertension syndrome with Angelica and Paeonia powder]. Zhong Xi Yi Jie He Za Zhi 1986;6:714-6, 707.
  3. Xie HJ, Yasar U, Sandberg M, Rane A. Paeoniae Radix, a traditional Chinese medicine, and CYP2C9 activity. J Clin Pharm Ther 2002;27:229-30. . PubMed
  4. Harada M, Suzuki M, Ozaki Y. Effect of Japanese Angelica root and peony root on uterine contraction in the rabbit in situ. J Pharmacobiodyn 1984;7:304-11. PubMed
  5. Anon. Monograph. Peony (Paeonia spp). Alt Med Rev 2001;6:495-9.
  6. Bruynzeel DP. Contact Dermatitis Due to Paeonia (Peony). Contact Dermatitis 1989; 20:152-3..
  7. Bian, X., Xu, Y., Zhu, L., Gao, P., Liu, X., Liu, S., Qian, M., Gai, M., Yang, J., and Wu, Y. Prevention of maternal-fetal blood group incompatibility with traditional Chinese herbal medicine. Chin Med J (Engl.) 1998;111(7):585-587.
  8. Wong, A. L. and Chan, T. Y. Interaction between warfarin and the herbal product quilinggao. Ann Pharmacother 2003;37(6):836-838.
  9. Cai Y, Yuan Q, Xu K, et al. Assessment of the therapeutic effect of total glycosides of peony for juvenile idiopathic arthritis: a systematic review and meta-analysis. Evid Based Complement Alternat Med 2016;2016:8292486.
  10. Koo YK, Kim JM, Koo JY, et al. Platelet anti-aggregatory and blood anti-coagulant effects of compounds isolated from Paeonia lactiflora and Paeonia suffruticosa. Pharmazie 2010;65(8):624-8.
  11. Wang W, Tian DD, Zheng B, et al. Peony-glycyrrhiza decoction, an herbal preparation, inhibits clozapine metabolism via cytochrome P450s, but not flavin-containing monooxygenase in in vitro models. Drug Metab Dispos 2015;43(7):1147-53. PubMed
  12. Zhou Y, Jin L, Kong F, et al. Clinical and immunological consequences of total glucosides of paeony treatment in Sjögren's syndrome: A randomized controlled pilot trial. Int Immunopharmacol. 2016 Oct;39:314-319. doi: 10.1016/j.intimp.2016.08.006. PubMed
  13. Zhu Q, Qi X, Wu Y, Wang K. Clinical study of total glucosides of paeony for the treatment of diabetic kidney disease in patients with diabetes mellitus. Int Urol Nephrol. 2016 Nov;48(11):1873-1880. doi: 10.1007/s11255-016-1345-5. PubMed
  14. Xu Y, Li X, Chen T, et al. Radix Paeoniae Alba increases serum estrogen level and up-regulates estrogen receptor expression in uterus and vagina of immature/ovariectomized mice. Phytother Res. 2019;33(1):117-29. [RETRACTED].
  15. Liu X, Li X, Li X, et al. The efficacy and safety of total glucosides of peony in the treatment of primary Sjögren's syndrome: a multi-center, randomized, double-blinded, placebo-controlled clinical trial. Clin Rheumatol. 2019;38(3):657-64. Erratum i

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 Peony and Oxcarbazepine Together: Common Questions

Is it safe to take Peony with Oxcarbazepine?
We do not list a known interaction between Peony and Oxcarbazepine. 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 Peony and Oxcarbazepine have any of the same side effects?
Yes — our sources link each of them separately to 2 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 Peony and Oxcarbazepine combination checked?
Interactions in our licensed database are recorded against drug classes. Oxcarbazepine is filed under 5 classifications, and Peony has documented interactions with 7 drug classes — none of Oxcarbazepine'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 Peony interact with any other medications?
Yes. Peony has 811 documented drug interactions in our database — Oxcarbazepine 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 Oxcarbazepine interact with any supplements?
Yes. Oxcarbazepine has documented interactions with 122 supplements in our database — Peony is not one of them. The Oxcarbazepine interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Oxcarbazepine and Peony?

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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.