Drug & supplement interaction

Sida Cordifolia + Asfotase Alfa

Asfotase Alfa brand name: Strensiq.

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 Sida Cordifolia and Asfotase Alfa 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

Sida Cordifolia and Asfotase Alfa

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 Asfotase Alfa and Sida Cordifolia 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.

Sida Cordifolia safety at a glance

Sida Cordifolia overall Avoid It contains ephedrine, a stimulant linked to serious heart and blood pressure risks, and is banned in many products.
Pregnancy Likely Unsafe When used orally. The ephedrine constituent of Sida cordifolia has been linked to several cases of severe side effects. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally. The ephedrine constituent of Sida cordifolia has been linked to several cases of severe side effects. 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 Asfotase Alfa and Sida Cordifolia? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
Keep it in perspective

Sida Cordifolia Does Interact With Other Medications

Sida Cordifolia has 337 major, 108 moderate known drug interactions in our database — Asfotase Alfa isn’t one of them. If you take anything else, check it against the full list below.

Major 337 Moderate 108 No known interaction 2,385 (incl. Asfotase Alfa)
Taking anything else?

Check Another of Your Medications Against Sida Cordifolia

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

What to actually watch for

No Interaction Found — But Data Suggests Sida Cordifolia and Asfotase Alfa 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. 2 of them are worth acting on rather than waiting out — marked below.

  • Bleeding or bruising / An allergic reaction Worth acting on Additional detail

    Sida Cordifolia

    “Sida cordifolia contains ephedrine. Ephedrine-containing products have been associated with cardiovascular side effects such as arrythmias, heart palpitations, tachycardia, prolonged QT interval, increased blood pressure, cardiomyopathy, hypersensitivity myocarditis, myocardial infarction, cardiac arrest, stroke, transient ischemic attack, cerebral hemorrhage, and sudden cardiac death.”

    Sida Cordifolia · Natural Medicines adverse-effect record, reported in cardiac arrest.

    6 sources cited
    1. 1270. Okada S, Rohan PJ, Miller FW, et al. Myopathies following ingestion of special nutritional products. Arthritis Rheum 1996;39:349.
    2. 1271. Zaacks SM, Klein L, Tan CD, et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol 1999;37:485-9. PubMed
    3. 1274. Theoharides TC. Sudden death of a healthy college student related to ephedrine toxicity from a ma-huang containing drink. J Clin Psychopharmacol 1997;17:437-9. PubMed
    4. 1275. Vahedi K, Domingo V, Amarenco P, Bousser MG. Ischemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for bodybuilding. J Neurol Neurosurg Psychiatr 2000;68:112-3.
    5. 1276. Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756. PubMed
    6. 1380. For Dieter, Nearly the Ultimate Loss. The Washington Post. Available at: http://www.washingtonpost.com/archive/politics/2000/03/19/for-dieter-nearly-the-ultimate-loss/c0f07474-489d-4f44-bc17-1f1367c956ae/ (Accessed 19 March 2000).

    Asfotase Alfa

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

  • Mood changes or irritability / Headache Additional detail

    Sida Cordifolia

    “Sida cordifolia contains ephedrine. Ephedrine-containing products have been associated with dizziness, restlessness, irritability, difficulty concentrating, insomnia, headache, and anorexia. These side effects might also occur in patients taking Sida cordifolia-containing supplements.”

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

    6 sources cited
    1. 1276. Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756. PubMed
    2. 3719. Boozer CN, Nasser JA, Heymsfield SB, et al. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Relat Metab Disord 2001;25:316-24. PubMed
    3. 6008. Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000;57:963-9. PubMed
    4. 6486. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. PubMed
    5. 8647. Boozer CN, Daly PA, Homel P, et al. Herbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial. Int J Obes Relat Metab Disord 2002;26:593-604. PubMed
    6. 10004. Kalman D, Incledon T, Gaunaurd I, et al. An acute clinical trial evaluating the cardiovascular effects of an herbal ephedra-caffeine weight loss product in healthy overweight adults. Int J Obes 2002;26:1363-66.. PubMed

    Asfotase Alfa

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

Reported for Sida Cordifolia but not commonly for Asfotase Alfa: a stroke or mini-stroke, trouble concentrating, raised blood pressure and a heart attack.

Effects for Asfotase Alfa come from the ADVERSE REACTIONS section of its FDA label; effects for Sida Cordifolia come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 9,959 voluntary FDA FAERS reports for Asfotase Alfa 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

Sida Cordifolia in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When used orally. The ephedrine constituent of Sida cordifolia has been linked to several cases of severe side effects.

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

One more smart check

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

We hold 48 real supplement products containing Sida Cordifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sida Cordifolia. Even though Sida Cordifolia itself has no known interaction with Asfotase Alfa, 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 Sida Cordifolia and Asfotase Alfa 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 Sida Cordifolia
Top half

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

29 days ago today
Medication Asfotase Alfa
Steady interest

#1,609 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 Sida Cordifolia reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Sida Cordifolia and Asfotase Alfa 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 Sida Cordifolia

What is Sida Cordifolia?

Sida Cordifolia
  • Weight loss and energy
  • Asthma and breathing problems
  • Joint and muscle pain
  • Fever and cough
  • General fatigue or 'tonic'

Sida cordifolia (bala or country mallow) is a traditional Ayurvedic plant that naturally contains ephedrine, a powerful stimulant. Because of this, many supplements containing it have been banned or restricted, and it carries real risks to the heart and blood pressure. There is little reliable human evidence that it works, so most people should avoid it and talk with a pharmacist or doctor first.

Sida cordifolia · Malvaceae · Whole plant, including roots, seeds, leaves, and stems · Capsules, powders, dried herb, teas, and traditional Ayurvedic preparations

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

Sida Cordifolia: dosing

There is no established safe or standardized dose for Sida cordifolia, and the amount of ephedrine in a product can vary widely and unpredictably. Many health authorities recommend avoiding ephedrine-containing supplements entirely.

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

Read the full Sida Cordifolia monograph & all interactions
Medication

About Asfotase Alfa

What Is Asfotase Alfa Used For?

Brand name: Strensiq

Strensiq (asfotase alfa), given as a subcutaneous injection, is approved to treat perinatal/infantile-onset and juvenile-onset hypophosphatasia (HPP) — a rare genetic disorder in which the body lacks enough of an enzyme called TNSALP, leading to problems with bone mineralization, rickets, bone deformity, and muscle weakness.

HPP can present at birth or in childhood. Strensiq is the specific brand approved for these forms of the disease. Safety and effectiveness have been established in pediatric patients across both onset types.

Most-Reported Side Effects for Asfotase Alfa

From FAERS, the FDA’s public side-effect reporting system (9,959 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Injection site pain 1,327 reports
Fatigue 952 reports
Injection site erythema 869 reports
Injection site reaction 747 reports
Arthralgia 665 reports
See full Asfotase Alfa drug information
Keep checking

Other Drugs & Sida Cordifolia

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

337Major
108Moderate
0Minor
2,384No known interaction
337 Major 108 Moderate 2,384 No interaction
Major

337 interactions

Showing 60 of 337 major interactions — see all 337 on the Sida Cordifolia page.

Moderate

108 interactions

Showing 60 of 108 moderate interactions — see all 108 on the Sida Cordifolia page.

No interaction 2,384 drugs checked — show the list

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

Showing the 60 most looked-up of 2,384 medications checked with no known interaction — see the full Sida Cordifolia list.

See the full Sida Cordifolia interactions page
See every supplement checked against Asfotase Alfa, ranked by severity
Evidence & sources

Sida Cordifolia References

The 29 references that drive our Sida Cordifolia 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. Okada S, Rohan PJ, Miller FW, et al. Myopathies following ingestion of special nutritional products. Arthritis Rheum 1996;39:349.
  2. Zaacks SM, Klein L, Tan CD, et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol 1999;37:485-9. PubMed
  3. Powell T, Hsu FF, Turk J, Hruska K. Ma-huang strikes again: ephedrine nephrolithiasis. Am J Kidney Dis 1998;32:153-9. PubMed
  4. Theoharides TC. Sudden death of a healthy college student related to ephedrine toxicity from a ma-huang containing drink. J Clin Psychopharmacol 1997;17:437-9. PubMed
  5. Vahedi K, Domingo V, Amarenco P, Bousser MG. Ischemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for bodybuilding. J Neurol Neurosurg Psychiatr 2000;68:112-3.
  6. Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756. PubMed
  7. For Dieter, Nearly the Ultimate Loss. The Washington Post. Available at: http://www.washingtonpost.com/archive/politics/2000/03/19/for-dieter-nearly-the-ultimate-loss/c0f07474-489d-4f44-bc17-1f1367c956ae/ (Accessed 19 March 2000).
  8. FDA Takes Aim at Ephedra. The Washington Post. Available at: http://www.washingtonpost.com/archive/politics/2000/03/19/fda-takes-aim-at-ephedra/4ce534a7-d291-44ec-88a8-38e97ff27e3b/ (Accessed 19 March 2000).
  9. FDA. Proposed rule: dietary supplements containing ephedrine alkaloids. Available at: www.verity.fda.gov (Accessed 25 January 2000).
  10. Boozer CN, Nasser JA, Heymsfield SB, et al. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Relat Metab Disord 2001;25:316-24. PubMed
  11. Anon. Sida Cordifolia. Metro Marketing, Inc. Available at: http://metromkt.net/viable/1sidacor.shtml (Accessed 9 March 2000).
  12. Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000;57:963-9. PubMed
  13. White LM, Gardner SF, Gurley BJ, et al. Pharmacokinetics and Cardiovascular Effects of Ma-Huang (Ephedra sinica) in Normotensive Adults. J Clin Pharmacol 1997;37:116-22.
  14. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. PubMed
  15. Leikin JB, Klein L. Ephedra causes myocarditis. Clin Toxicol 2000;38:353-4.

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 Sida Cordifolia and Asfotase Alfa Together: Common Questions

Is it safe to take Sida Cordifolia with Asfotase Alfa?
We do not list a known interaction between Sida Cordifolia and Asfotase Alfa. 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 Sida Cordifolia and Asfotase Alfa have any of the same side effects?
Yes — our sources link each of them separately to 4 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.
Does Sida Cordifolia interact with any other medications?
Yes. Sida Cordifolia has 445 documented drug interactions in our database — Asfotase Alfa is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

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

Where next

Keep Exploring

Sida Cordifolia monograph Uses, safety profile, and every drug interaction in one place Asfotase Alfa drug information The full plain-English guide to this medication Asfotase Alfa supplement interactions Every supplement checked against Asfotase Alfa, 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 29 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.