Herb & supplement monograph

Black Hoof Mushroom Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated June 2026
What is this page for?

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

But these pages have grown well beyond that into a full monograph — what Black Hoof Mushroom 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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Black Hoof Mushroom 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 Black Hoof Mushroom drug interaction appears low for most people. None of the listed interactions are rated major, and every one is theoretical, coming from lab or animal research rather than studies in people.

Interactions deserving the most attention

The combination we would watch most closely is with immunosuppressants, such as those used after an organ transplant, because animal research suggests black hoof mushroom can stimulate the immune system and might work against these medicines. Lab studies also show it may block enzymes the body uses to clear certain medications, which could theoretically raise levels of those drugs. Neither effect has been reported in humans, so these remain precautions rather than proven problems.

What the rest of the list means

The long list of interacting medications looks alarming, but it reflects just a few underlying concerns applied to hundreds of drugs that share the same clearance pathways or immune-related effects. Because all of the evidence comes from test-tube or animal studies, most of these combinations may never cause a meaningful change in people.

Check your medications against Black Hoof Mushroom

Based on HelloPharmacist’s Black Hoof Mushroom interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Black Hoof Mushroom

308 medications have a known interaction with Black Hoof Mushroom, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
6-mercaptopurinePurinethol› AbrocitinibCibinqo› AcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength› Acetaminophen, AspirinGemnisyn› Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine› Acetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu› Acetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more› Acetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more› Acetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine› Acetaminophen, Butalbital, CodeineBancap w/ Codeine› Acetaminophen, Butalbital, Codeine PhosphatePhrenilin #3› Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound› Acetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more› Acetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3› Acetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS› Acetaminophen, Caffeine, IsomethepteneMigralam› Acetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual› Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief› Acetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex› Acetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu› Acetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu› Acetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief› Acetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength› Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG› Acetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid› Acetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR› Acetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin› Acetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule› Acetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus› Acetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more›
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 Black Hoof Mushroom 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 Black Hoof Mushroom affects

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

All 3 drug categories Black Hoof Mushroom interacts with
Cytochrome P450 1a2 (cyp1a2) SubstratesCytochrome P450 2e1 (cyp2e1) SubstratesImmunosuppressants
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, black hoof mushroom might increase the levels and clinical effects of CYP1A2 substrates.
In vitro, polysaccharides from black hoof mushroom grown in culture inhibit CYP1A2. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, black hoof mushroom might increase the levels and clinical effects of CYP2E1 substrates.
In vitro, polysaccharides from black hoof mushroom grown in culture inhibit CYP2E1. This effect has not been reported in humans.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, black hoof mushroom might reduce the effects of immunosuppressant medications.
In animal research, polysaccharides from black hoof mushroom and black hoof mushroom extract stimulate immune responses.

Likelihood Possible Evidence D
Monograph

Black Hoof Mushroom: Uses, Safety & Side Effects

Medically reviewed by · Reviewed June 2026 ·
The bottom line

Black Hoof Mushroom (Phellinus linteus) is a medicinal mushroom long used in East Asian traditional medicine, mainly for immune support. Most of the supporting evidence comes from laboratory and animal studies, and high-quality human research is limited. Talk to your pharmacist or doctor before using it, especially if you have a health condition or take other medicines.

Black Hoof Mushroom
Scientific name
Phellinus linteus
Family
Hymenochaetaceae
Part used
Fruiting body (the woody mushroom that grows on tree trunks)
Common forms
Capsules, tablets, powdered extracts, teas, and tinctures
People commonly use it for
  • Immune system support
  • Antioxidant support
  • General wellness
  • Traditional cancer-supportive use
  • Inflammation

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

Safety at a glance
OverallUse caution

Generally used in traditional medicine, but human safety data are limited.

PregnancyInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full pregnancy detail
BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

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.

Jump to a section

Overview

Black Hoof Mushroom is a hard, woody fungus that grows on the trunks of certain trees, especially mulberry trees, in East Asia. Its scientific name is Phellinus linteus, and it is also known as Mesima, Meshima, or Sanghuang. The mushroom has a dark, hoof-like shape, which is how it got its common name.

This mushroom has been used for many years in traditional Korean, Chinese, and Japanese medicine. People most often use it to support the immune system and general health. Because the raw mushroom is very tough and woody, it is usually processed into powders, extracts, capsules, or teas before being taken.

How it works

The mushroom contains compounds called polysaccharides (including beta-glucans), as well as proteoglycans and other plant chemicals. In laboratory studies, these compounds appear to interact with immune cells and may help adjust how the immune system responds.

Researchers have also studied possible antioxidant and anti-inflammatory actions, meaning the mushroom may help reduce certain kinds of cell stress in lab settings. Some test-tube and animal studies have looked at effects on tumor cells.

It is important to remember that results seen in a test tube or in animals do not always happen the same way in people. These proposed mechanisms are not the same as proven benefits in humans.

Effectiveness

Does Black Hoof Mushroom work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 1 use evaluated
1 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 Black Hoof Mushroom, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 1 condition — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Coronavirus disease 2019 (COVID-19)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral black hoof mushroom for COVID-19, there is insufficient reliable information about the clinical effects of black hoof mushroom for this purpose.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Black Hoof Mushroom has a long history of traditional use, but reliable human safety data are limited. Because of this, use it cautiously and under the guidance of a pharmacist or doctor.

People with mushroom allergies should avoid it. Those with autoimmune conditions should be especially careful, since the mushroom may affect immune activity. People who are scheduled for surgery, who have bleeding disorders, or who have liver or kidney problems should check with a healthcare provider first.

Pregnancy and breastfeeding: There is not enough information to know if it is safe. To be on the safe side, it is best to avoid Black Hoof Mushroom if you are pregnant or breastfeeding.

Choose products from reputable companies, since supplements are not tightly regulated and quality can vary.

Side effects

Reported side effects are not well documented because of the lack of large human studies. Some people may experience mild digestive upset, such as nausea or stomach discomfort.

Allergic reactions are possible, especially in people sensitive to mushrooms. Stop using it and seek medical care if you notice signs of an allergic reaction such as rash, itching, swelling, or trouble breathing.

Because long-term safety is not well studied, watch for any unusual symptoms and report them to your healthcare provider.

Dosing

There is no well-established standard dose for Black Hoof Mushroom. The amount can vary widely depending on the product, the type of extract, and how it is made.

The best approach is to follow the directions on the product label and not take more than recommended. Because formulations differ so much, it is a good idea to review the specific product with your pharmacist or doctor before starting.

Pregnancy & Breastfeeding

Black Hoof Mushroom & Pregnancy

Insufficient reliable information

Insufficient reliable information available; avoid using.

Black Hoof Mushroom & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; avoid using.

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

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 6 references that drive our Black Hoof Mushroom 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. Song, K. S., Cho, S. M., Lee, J. H., Kim, H. M., Han, S. B., Ko, K. S., and Yoo, I. D. B-lymphocyte-stimulating polysaccharide from mushroom Phellinus linteus. Chem Pharm Bull (Tokyo) 1995;43(12):2105-2108. PubMed
  2. Matsuba, S., Matsuno, H., Sakuma, M., and Komatsu, Y. Phellinus linteus Extract Augments the Immune Response in Mitomycin C-Induced Immunodeficient Mice. Evid Based Complement Alternat Med 2008;5(1):85-90.
  3. Kim, G. Y., Roh, S. I., Park, S. K., Ahn, S. C., Oh, Y. H., Lee, J. D., and Park, Y. M. Alleviation of experimental septic shock in mice by acidic polysaccharide isolated from the medicinal mushroom Phellinus linteus. Biol Pharm Bull 2003;26(10):1418-1423 PubMed
  4. Shon, Y. H. and Nam, K. S. Inhibition of cytochrome P450 isozymes in rat liver microsomes by polysaccharides derived from Phellinus linteus. Biotechnol Lett 2003;25(2):167-172. PubMed
  5. Oh, G. S., Lee, M. S., Pae, H. O., Kwon, J., Lee, S. S., Jeong, J. G., Shin, M. K., Kwon, T. O., and Chung, H. T. Effects of oral administration of Phellinus linteus on the production of Th1- and Th2-type cytokines in mice. Immunopharmacol Immunotoxicol 2
  6. Kim, G. Y., Lee, J. Y., Lee, J. O., Ryu, C. H., Choi, B. T., Jeong, Y. K., Lee, K. W., Jeong, S. C., and Choi, Y. H. Partial characterization and immunostimulatory effect of a novel polysaccharide-protein complex extracted from Phellinus linteus. Biosci B
Keep reading

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.

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

Pharmacist Counseling Corner

Black Hoof Mushroom: Common Questions

What is Black Hoof Mushroom used for, and does it work?
People use Black Hoof Mushroom for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Black Hoof Mushroom interact with prescription medications?
Yes. We list 308 medications with a known interaction with Black Hoof Mushroom. Use the checker above to see how Black Hoof Mushroom interacts with a specific drug.
How are Black Hoof Mushroom interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Black Hoof Mushroom with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Black Hoof Mushroom interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Black Hoof Mushroom used for?
It is most commonly used in traditional medicine to support the immune system and general wellness, and sometimes alongside conventional care for serious illnesses. Strong human evidence for these uses is lacking.
Is Black Hoof Mushroom safe to take?
It has a long history of traditional use, but human safety data are limited. Talk to your pharmacist or doctor first, especially if you have an autoimmune condition, allergies, or another health problem.
Can I take it during pregnancy or while breastfeeding?
There is not enough safety information, so it is best to avoid Black Hoof Mushroom during pregnancy and breastfeeding.
How is Black Hoof Mushroom taken?
It is usually taken as capsules, tablets, powdered extracts, or teas. Since the raw mushroom is very woody, it is processed before use; follow the product label for how to take it.

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

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