Herb & supplement monograph

Astragalus Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Astragalus interacts with medications. The heart of this page is the interaction list — every drug Astragalus is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Astragalus is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Astragalus Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Astragalus drug interaction is moderate, and it matters most for people taking certain closely monitored medicines. None of the known interactions are rated major, all are rated moderate, and only some are supported by human research.

Interactions deserving the most attention

The best-documented concern involves diabetes medications: human studies show astragalus may lower blood sugar, so combining them could raise the chance of blood sugar dropping too low. Because astragalus seems to stimulate the immune system, it could also work against immunosuppressants, a real issue for transplant patients whose drug effects must stay steady. Animal research also suggests astragalus acts as a mild diuretic, which in theory could slow the body's clearance of lithium and raise its levels.

What the rest of the list means

The long list of medications largely reflects these few shared concerns rather than hundreds of separate problems. Many of the predicted effects are theoretical, drawn from animal or lab research rather than human studies, and some evidence conflicts, as with cyclophosphamide, where animal findings point in both directions. In other words, a listed interaction signals a reason for awareness, not proof of harm.

Check your medications against Astragalus

Based on HelloPharmacist’s Astragalus interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Astragalus

208 medications have a known interaction with Astragalus, graded by severity. Select any drug for the full evidence-based detail.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Astragalus using our pharmacist-reviewed interaction data.

AI summaries are generated from our Astragalus interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. 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.
Possible. 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
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Astragalus combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Astragalus affects

Every type of medication (drug category) Astragalus is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 4 drug categories Astragalus interacts with

Antidiabetes DrugsCyclophosphamideImmunosuppressantsLithium

Antidiabetes Drugs

Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research in humans shows that astragalus might have hypoglycemic effects. Theoretically, taking astragalus, especially in combination with other hypoglycemic agents, might increase the risk of hypoglycemia.

Likelihood Probable Evidence A

Cyclophosphamide

Theoretically, astragalus might interfere with cyclophosphamide therapy.
Evidence regarding the effect of astragalus on immunosuppression caused by cyclophosphamide is conflicting. Some animal research suggests that astragalus reverses cyclophosphamide-induced immunosuppression. However, other animal research shows no effect.

Likelihood Possible Evidence D

Immunosuppressants

Theoretically, astragalus might interfere with immunosuppressive therapy.
Astragalus seems to stimulate immune function. Theoretically, taking astragalus might decrease the effects of immunosuppressive therapy.

Likelihood Possible Evidence D

Lithium

Theoretically, astragalus might increase levels and adverse effects of lithium.
Animal research suggests that astragalus has diuretic properties. Theoretically, due to this diuretic effect, astragalus might reduce excretion and increase levels of lithium.

Likelihood Probable Evidence D

Monograph

Astragalus: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Astragalus is a root used for centuries in traditional Chinese medicine, mainly to support the immune system and help the body cope with stress. While early studies are interesting, strong human evidence for most uses is still lacking. It is generally well tolerated by healthy adults for short-term use, but should be avoided during pregnancy and breastfeeding due to limited safety data.

Scientific name: Astragalus membranaceus
Family: Fabaceae
Part used: Root
Common forms: Capsules, tablets, dried root, tea, liquid extract (tincture), powder, and injectable forms used in some countries

People commonly use it for

Immune support
Colds and flu
Upper respiratory infections
Fatigue and stress (adaptogen)
Heart health
General wellness in traditional medicine

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallUse caution

Generally well tolerated short-term in healthy adults, but quality human safety data is limited.

PregnancyInsufficient reliable information

There is insufficient reliable information in humans. However, astragaloside, a constituent of astragalus, has maternal and fetal toxic effects in ani...

Read the full pregnancy detail

BreastfeedingInsufficient reliable information

There is insufficient reliable information in humans. However, astragaloside, a constituent of astragalus, has maternal and fetal toxic effects in ani...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Astragalus is a plant whose dried root has been used in traditional Chinese medicine for hundreds of years. The most commonly used species is Astragalus membranaceus. The plant is native to parts of Asia, including China and Mongolia, and has small yellow or purple flowers and a long, tapering root.

In traditional medicine, astragalus is often called a "tonic" or adaptogen — a term used for herbs thought to help the body resist stress and stay balanced. People most often take it to support the immune system and to help with tiredness, colds, and general wellness.

Today astragalus is sold as capsules, teas, powders, and liquid extracts. In some countries it is also given as an injection in hospital settings, but that form is not available as a dietary supplement in the United States.

How it works

Astragalus root contains several types of natural compounds that researchers have studied, including polysaccharides, saponins (such as astragalosides), and flavonoids. These are the substances most often credited with its possible effects.

In laboratory and animal studies, these compounds appear to influence parts of the immune system and may act as antioxidants, helping protect cells from a type of damage called oxidative stress. Some studies suggest possible effects on inflammation and on the heart.

It is important to remember that these mechanisms are mostly based on test-tube and animal research. What happens in a lab dish or in a mouse does not always happen in the human body, so these findings should be seen as early clues rather than proof.

Effectiveness

Does Astragalus work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 44 uses evaluated

44 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

For Astragalus, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 44 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Allergic rhinitis (hay fever)