Drug & supplement interaction

Schisandra + Losartan Potassium

Losartan Potassium brand name: Cozaar.

Moderate Interaction
The bottom line Moderate

Losartan Potassium falls into 2 drug categories that Schisandra can interact with; the most serious is rated moderate. Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Schisandra and Losartan Potassium

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Schisandra interacts with whole categories of medication. Losartan Potassium falls into 2 of those categories, so it can interact with Schisandra in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Losartan Potassium

Losartan Potassium falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Schisandra interacts with.

Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
In vitro and animal research suggests that schisandra induces CYP2C9 enzymes. This effect has not been reported in humans.
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 wrinkle with losartan (Cozaar): it's actually a prodrug. Your liver uses an enzyme called CYP2C9 to convert it into its active form, which does most of the blood-pressure-lowering work. Schisandra, at least in lab and animal studies, seems to speed up that same enzyme. In theory, faster processing could shift how much active medicine you end up with, which is why this combo gets flagged.

The honest truth is this hasn't been shown in people, so the evidence is weak and mostly theoretical. Still, if your blood pressure starts creeping up or feels harder to control, that's worth noticing. Don't change anything on your own. Just give your pharmacist or doctor a heads-up before adding schisandra so they can keep an eye on your numbers.

References
  1. Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Losartan Potassium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Most clinical and laboratory research shows that schisandra, administered either as a single dose or up to twice daily for 14 days, inhibits CYP3A4 and increases the concentration of CYP3A4 substrates such as cyclophosphamide, midazolam, tacrolimus, and talinolol. Although one in vitro and animal study shows that schisandra may induce CYP3A4 metabolism, this effect appears to be overpowered by schisandra's CYP3A4 inhibitory activity and has not been reported in humans.
Severity Moderate Likelihood Probable Evidence D

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's something a little nuanced about losartan (Cozaar). Your body actually converts losartan into a more powerful active form, partly using a liver enzyme called CYP3A4. Schisandra tends to slow that enzyme down. So in theory, schisandra could reduce how much of the active blood-pressure-lowering form you make, which might make losartan work a bit less well. At the same time, slowing CYP3A4 can let the original losartan linger longer, so the net effect is genuinely hard to predict.

Honestly, this is based on lab and animal research, not solid human studies with losartan, so I wouldn't lose sleep over it. Still, if you take schisandra regularly, keep an eye on your blood pressure readings and mention it to your pharmacist or doctor before combining them.

References
  1. Iwata H, Tezuka Y, Kadota S, et al. Identification and characterization of potent CYP3A4 inhibitors in Schisandra fruit extract. Drug Metab Dispos 2004;32:1351-8. PubMed
  2. Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
  3. Qin XL, Bi HC, Wang XD, et al. Mechanistic understanding of the different effects of Wuhzi Tablet (Schisandra sphenanthera extract) on the absorption and first-pass intestinal and hepatic metabolism of tacrolimus (FK506). Int J Pharm 2010;389:114-21.
  4. Makino, T., Mizuno, F., and Mizukami, H. Does a kampo medicine containing schisandra fruit affect pharmacokinetics of nifedipine like grapefruit juice? Biol.Pharm.Bull. 2006;29(10):2065-2069. PubMed
  5. Fan L, Mao XQ, Tao GY, Wang G, Jiang F, Chen Y, Li Q, Zhang W, Lei HP, Hu DL, Huang YF, Wang D, Zhou HH. Effect of Schisandra chinensis extract and Ginkgo biloba extract on the pharmacokinetics of talinolol in healthy volunteers. Xenobiotica. 2009 Mar;39(
  6. Jiang W, Wang X, Xu X, Kong L. Effect of Schisandra sphenanthera extract on the concentration of tacrolimus in the blood of liver transplant patients. Int J Clin Pharmacol Ther. 2010 Mar;48(3):224-9. PubMed
  7. Xin HW, Wu XC, Li Q, Yu AR, Xiong L. Effects of Schisandra sphenanthera extract on the pharmacokinetics of midazolam in healthy volunteers. Br J Clin Pharmacol. 2009 May;67(5):541-6.
  8. Li J, Chen S, Qin X, et at. Wuzhi Tablet (<i>Schisandra sphenanthera</i> Extract) is a Promising Tacrolimus-Sparing Agent for Renal Transplant Recipients Who are CYP3A5 Expressers: a Two-Phase Prospective Study. Drug Metab Dispos. 2017;45(11):1114-1119.
  9. Qin XL, Li JL, Wang SH, Chen X, Huang M, Bi HC. Co-administration of Wuzhi tablet (Schisandra sphenanthera extract) alters tacrolimus pharmacokinetics in a dose- and time-dependent manner in rats. J Ethnopharmacol. 2020;263:113233. PubMed
  10. Chen L, Ji N, Zhang M, Chen W. The influence of Wuzhi capsule on the pharmacokinetics of cyclophosphamide. Recent Pat Anticancer Drug Discov 2021. PubMed
  11. Cheng F, Li Q, Wang J, Zeng F, Zhang Y. Effects and safety evaluation of Wuzhi capsules combined with tacrolimus for the treatment of kidney transplantation recipients. J Clin Pharm Ther 2021;46(6):1636-49. PubMed
  12. Teng F, Wang W, Zhang W, et al. Effect of hepar-protecting Wuzhi capsule on pharmacokinetics and dose-effect character of tacrolimus in healthy volunteers. Biopharm Drug Dispos 2022.
  13. Kou K, Sun X, Li M, et al. Beneficial effects of Wuzhi capsule on tacrolimus blood concentrations in liver transplant patients with different donor-recipient CYP3A5 genotypes. J Clin Pharm Ther 2022;47(2):200-10. PubMed
  14. Peng Y, Jiang F, Zhou R, et al. Clinical evaluation of the efficacy and safety of co-administration of Wuzhi capsule and tacrolimus in adult Chinese patients with myasthenia gravis. Neuropsychiatr Dis Treat 2021;17:2281-9. PubMed

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

Schisandra Also Interacts With Other Medications

Schisandra has 802 moderate known drug interactions in our database — the Losartan Potassium one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Schisandra

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

From our Q&A

Questions About Schisandra or Losartan Potassium

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

This page covers Schisandra only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Losartan Potassium page lists 253 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Grapefruit (major) and St. John's Wort (major).

By severity: 6 major · 205 moderate · 42 minor.

From our pharmacist’s overview on the Losartan Potassium page

“Losartan potassium (Cozaar) treats high blood pressure, and this is a list to respect, because six of its 253 supplement interactions carry a major rating. Most entries do one of two things.”

Reviewed by 2 · Jul 18, 2026

Open the Losartan Potassium interaction page

One more smart check

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

We hold 2,577 real supplement products containing Schisandra, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Schisandra. Your product may carry other ingredients that interact with Losartan Potassium too, on top of Schisandra — 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 Schisandra and Losartan Potassium 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 Schisandra
Top 10%

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

29 days ago today
Medication Losartan Potassium
Top 10

#7 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 Schisandra

What is Schisandra?

Schisandra
  • Fatigue and low energy
  • Stress and adaptogen support
  • Liver health
  • Mental focus and performance
  • Menopause symptoms
  • Respiratory complaints

Schisandra is a traditional Chinese medicine berry used as an adaptogen for stress, fatigue, and liver support. Human evidence is limited and most claims are not well proven, but it appears reasonably well tolerated by most healthy adults when used short term. Pregnant and breastfeeding people should avoid it, and anyone with a health condition should check with a pharmacist or doctor first.

Read the full Schisandra monograph & all interactions
Medication

About Losartan

What Is Losartan Used For?

Brand name: Cozaar

Losartan tablets — available as branded Cozaar and several generic products — are used to treat high blood pressure (hypertension) in adults and children 6 years and older. Lowering blood pressure reduces the risk of strokes and heart attacks. Losartan tablets are also used to reduce the risk of stroke in people with high blood pressure who also have left ventricular hypertrophy (an enlarged left side of the heart). Note: evidence suggests this stroke-risk benefit may not apply to Black patients.

Losartan tablets are additionally approved to protect the kidneys in people with type 2 diabetes, high blood pressure, and signs of kidney damage (diabetic nephropathy). Arbli, the oral suspension form, shares these same approved uses.

See full Losartan drug information
Keep checking

Other Drugs & Schisandra

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

0Major
802Moderate
0Minor
2,027No known interaction
Moderate

802 interactions

Showing 60 of 802 moderate interactions — see all 802 on the Schisandra page.

No interaction 2,027 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Schisandra and Losartan Potassium Together: Common Questions

Can you take Schisandra with Losartan Potassium?
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.
Why are there 2 interactions listed for Schisandra and Losartan Potassium?
Losartan Potassium belongs to more than one drug category, and Schisandra interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Schisandra and Losartan Potassium 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 Losartan Potassium and Schisandra?

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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.