Siberian Cocklebur Drug Interactions, Uses, Safety & More
What is this page for?
First and foremost: how Siberian Cocklebur interacts with medications. The heart of this page is the interaction list — every drug Siberian Cocklebur is known to interact with, and how serious each one is.
But these pages have grown well beyond that into a full monograph — what Siberian Cocklebur 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
Check Siberian Cocklebur against your medication
Add one medicationSiberian Cocklebur Drug Interactions: The Bottom Line
From the HelloPharmacist Editorial Team · Updated July 2026Based on the available evidence, the risk of a serious Siberian Cocklebur drug interaction is high, and we advise most people taking prescription medications to avoid this supplement. Every interaction in this profile is rated major, and the most important ones are documented in humans, not just in the lab.
The clearest danger involves diabetes medications such as insulin, glyburide, and glimepiride: Siberian cocklebur has caused severe low blood sugar in people, often soon after it is taken, so this combination should not be used. It has also been linked to real cases of liver damage and even liver failure, which makes combining it with medications that can harm the liver, like atorvastatin or amiodarone, a genuine concern. Pairing it with medications that can strain the kidneys, such as cyclosporine or certain antibiotics, may add to kidney harm, though that risk is more theoretical.
The list of interacting medications is long mainly because so many common drugs lower blood sugar or can affect the liver or kidneys. The concern here is not a long list of small theoretical issues; it reflects the plant's own documented toxicity, which is why every interaction carries a major rating.
Based on HelloPharmacist’s Siberian Cocklebur interaction data and reviewed under our editorial standards.
Drugs that interact with Siberian Cocklebur
664 medications have a known interaction with Siberian Cocklebur, graded by severity. Select any drug for the full evidence-based detail.
664 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Siberian Cocklebur.
Don’t want to scroll the list? Just ask.
Tell us the medications you take and we’ll check each one against Siberian Cocklebur using our pharmacist-reviewed interaction data.
AI summaries are generated from our Siberian Cocklebur interaction data for education only — always confirm with your pharmacist. How we use AI
No drugs match “”.
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 Siberian Cocklebur combination — clinical detail, likelihood, evidence level, and citations.
- Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The kinds of drugs Siberian Cocklebur affects
Every type of medication (drug category) Siberian Cocklebur is known to interact with. Open any category for the detail — or search your exact drug in the checker above.
Antidiabetes Drugs
Siberian cocklebur seedlings and seeds have caused severe hypoglycemia in humans. Hypoglycemia occurs soon after consumption and worsens with time in most cases. Do not use Siberian cocklebur in people taking medications that also lower blood glucose.
Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
Hepatotoxic Drugs
Siberian cocklebur can adversely affect the liver. It has been linked to many cases of hepatotoxicity and some cases of liver failure. Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage. Some of these drugs include acarbose (Precose, Prandase), amiodarone (Cordarone), atorvastatin (Lipitor), azathioprine (Imuran), carbamazepine (Tegretol), cerivastatin (Baycol), diclofenac (Voltaren), felbamate (Felbatol), fenofibrate (TriCor), fluvastatin (Lescol), gemfibrozil (Lopid), isoniazid, itraconazole, (Sporanox), ketoconazole (Nizoral), leflunomide (Arava), lovastatin (Mevacor), methotrexate (Rheumatrex), nevirapine (Viramune), niacin, nitrofurantoin (Macrodantin), pioglitazone (Actos), pravastatin (Pravachol), pyrazinamide, rifampin (Rifadin), ritonavir (Norvir), rosiglitazone (Avandia), simvastatin (Zocor), tacrine (Cognex), tamoxifen, terbinafine (Lamisil), valproic acid, and zileuton (Zyflo).
Nephrotoxic Drugs
Siberian cocklebur can adversely affect the kidney. Theoretically, combining Siberian cocklebur with potentially nephrotoxic drugs might have additive harmful effects on kidney function.
Some potentially nephrotoxic drugs include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); and numerous others.
Siberian Cocklebur: Uses, Safety & Side Effects
Siberian cocklebur is a fruit used in traditional Chinese and other Asian herbal medicine, mainly for nasal congestion, sinus issues, and allergies. Human evidence is very limited, and the plant contains naturally toxic compounds that can cause serious poisoning, so it should only be used under expert guidance, if at all.
- Scientific name
- Xanthium sibiricum
- Family
- Asteraceae
- Part used
- Fruit (burr), sometimes leaves and aerial parts
- Common forms
- Dried fruit, decoctions (teas), powders, capsules, traditional herbal formulas
- Nasal congestion and sinus problems
- Allergic rhinitis (hay fever)
- Headache
- Skin conditions and itching
- Joint and muscle discomfort
Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.
The fruit contains toxic compounds and has caused serious poisoning, so it requires careful processing and professional oversight.
When the seeds and seedlings of Siberian cocklebur are used orally.
Read the full pregnancy detailWhen the seeds and seedlings of Siberian cocklebur are used orally.
Read the full breastfeeding detailPregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.
Overview
Siberian cocklebur (Xanthium sibiricum) is a flowering plant in the daisy family (Asteraceae). It produces spiny, burr-like fruits that cling to clothing and animal fur. The plant grows widely across parts of Asia, including China, Korea, and Russia, often in fields, roadsides, and disturbed ground.
In traditional Chinese medicine and other Asian herbal systems, the dried fruit (sometimes called Cang Er Zi) is most often used. It is usually combined with other herbs in formulas and prepared as a decoction. People have traditionally used it to help with nasal stuffiness, sinus problems, and certain skin and joint complaints.
Uses & effectiveness
The most common traditional use of Siberian cocklebur is for nasal and sinus congestion, including allergic rhinitis (hay fever) and chronic sinus inflammation. It is also used in traditional practice for headaches, itchy skin conditions, and aches in the joints and muscles.
It is important to be honest about the evidence: high-quality human studies are very limited. Much of what is known comes from traditional use, laboratory experiments, and animal research. These early studies cannot prove that the herb is safe or effective in people. For most of its uses, there is not enough reliable evidence to say whether it works.
How it works
Siberian cocklebur contains a variety of natural compounds, including sesquiterpene lactones, glycosides, and other plant chemicals. Laboratory and animal studies suggest some of these may have anti-inflammatory or antimicrobial effects, which is the proposed basis for its use in sinus and allergy complaints.
The fruit also contains a toxic substance called carboxyatractyloside (and related compounds), which can harm the liver and other organs. Traditional processing is meant to reduce these toxins, but they remain a real safety concern. Keep in mind that most of these mechanisms come from laboratory or animal research, not from well-designed human trials.
Safety & precautions
Siberian cocklebur is not a low-risk herb. The raw or improperly prepared fruit, and especially the young seedlings, contain toxins that have caused serious and sometimes fatal poisoning. Reported effects of poisoning include liver damage, low blood sugar, nausea, vomiting, and harm to other organs.
Because of this, it should only be used when properly processed and under the guidance of a qualified, experienced practitioner. People with liver disease, children, older adults, and anyone with a chronic illness should be especially careful.
Pregnancy and breastfeeding: Avoid using Siberian cocklebur if you are pregnant or breastfeeding. There is not enough safety information, and the plant's toxic compounds make it a particular concern during these times. Always talk to a pharmacist or doctor before using it.
Side effects
Mild side effects can include nausea, stomach upset, vomiting, and dizziness. More serious problems are possible, especially with high doses or poorly processed products.
Serious risks include liver injury, low blood sugar, and toxic poisoning, which can be life-threatening. Seek medical care right away if someone develops severe vomiting, abdominal pain, confusion, yellowing of the skin or eyes, or signs of severe illness after taking this herb. People allergic to plants in the daisy family may also react to it.
Siberian Cocklebur: Reported Adverse Effects
Documented safety reports on Siberian Cocklebur from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.
Siberian cocklebur is generally regarded as unsafe for use. Any benefits of therapy might not outweigh the risk of toxicity. Orally, Siberian cocklebur seeds and seedlings can cause various adverse effects. Initial effects include abdominal pain, nausea, vomiting, hypoglycemia, elevated liver function tests, increased risk of bleeding, drowsiness, dizziness, dyspnea, sweating, fever, and palpitations. In some cases, symptoms have progressed to metabolic acidosis, worsening changes in blood sugar, arrhythmia, seizures, convulsions, coma, pancreatitis, hepatic failure, renal failure, myocardial and muscle injury, and death due to multi-organ failure. Fatal hepatic failure due to the Siberian cocklebur fruit has also been reported in a 20-month old child.
- Gurley ES, Rahman M, Hossain MJ, et al. Fatal outbreak from consuming Xanthium strumarium seedlings during time of food scarcity in northeastern Bangladesh. PLoS One 2010 Mar 18;5(3):e9756.
- Turgut M, Alhan CC, Gurgoze M, et al. Carboxyatractyloside poisoning in humans. Ann Trop Paediatr 2005;25(2):125-34.
- Karabiber H, Almis H, Selimoglu MA, Yakinci C, Yilmaz S. Xanthium strumarium poisoning requiring liver transplantation. J Pediatr Gastroenterol Nutr. 2014;58(1):e6-9.
- Wu, M. L., Wang, C. P., and Deng, J. F. Fatal hepatic failure due to fructus xanthii in a child. Abstracts of the 2005 North American Congress of Clinical Toxicology Annual Meeting. Clin Toxicol 2005;43:639.
Arrhythmia Cardiovascular
Orally, Siberian cocklebur seed can cause both tachycardia and bradycardia. Palpitations can occur in as little as 3 hours after ingestion, with arrhythmia occurring a few hours later. Elevated heart enzymes can also occur soon after intake. White blood cell infiltration in the myocardium has been reported in autopsy findings from patients who died after consuming Siberian cocklebur.
Bleeding Hematologic
Orally, Siberian cocklebur seedlings and seeds can increase the risk of bleeding, mainly due to hepatotoxic effects.
Epilepsy Endocrine
Orally, Siberian cocklebur seedlings and seeds can cause hypoglycemia. This occurs soon after consumption. Later, metabolic acidosis, hyperglycemia, and/or worsening hypoglycemia might occur. In some individuals, these changes can cause seizures.
Epilepsy Neurologic/CNS
Orally, Siberian cocklebur seedlings and seeds can cause altered mental status, malaise, dizziness, sweating, fever, seizures, convulsions, unconsciousness, and coma. Malaise, dizziness, and sweating onset are rapid. Fever onset is usually after the onset of vomiting. Unconsciousness can follow vomiting within minutes or hours, with coma occurring later in some individuals. Microvascular hemorrhage in the brain has been reported in autopsy findings for patients who died after consuming Siberian cocklebur.
- Gurley ES, Rahman M, Hossain MJ, et al. Fatal outbreak from consuming Xanthium strumarium seedlings during time of food scarcity in northeastern Bangladesh. PLoS One 2010 Mar 18;5(3):e9756.
- Turgut M, Alhan CC, Gurgoze M, et al. Carboxyatractyloside poisoning in humans. Ann Trop Paediatr 2005;25(2):125-34.
- Karabiber H, Almis H, Selimoglu MA, Yakinci C, Yilmaz S. Xanthium strumarium poisoning requiring liver transplantation. J Pediatr Gastroenterol Nutr. 2014;58(1):e6-9.
Kidney failure Renal
Orally, Siberian cocklebur seedlings and seeds have resulted in cases of renal injury with increased levels of creatinine and blood urea nitrogen. This can result in decreased urine output. In some individuals, renal symptoms return to normal. However, renal failure can occur and renal proximal tubular necrosis has been reported in autopsy findings for patients who died after consuming Siberian cocklebur.
Liver transplant Hepatic
Orally, Siberian cocklebur seedlings and seeds can cause liver damage, including increased bilirubin levels and increases in liver enzyme levels by as much as 6 times the normal value. These symptoms can progress to include jaundice, hepatomegaly, and edema, resulting in liver failure and death in some patients. In one case, grade 3 encephalopathy and liver failure necessitated a liver transplant in a 15-year-old girl who had consumed approximately 80 Siberian cocklebur seeds.
The Siberian cocklebur fruit has also been reported to cause fatal hepatic failure in a 20-month old child who consumed Siberian cocklebur fruit over a 2-month period
- Gurley ES, Rahman M, Hossain MJ, et al. Fatal outbreak from consuming Xanthium strumarium seedlings during time of food scarcity in northeastern Bangladesh. PLoS One 2010 Mar 18;5(3):e9756.
- Turgut M, Alhan CC, Gurgoze M, et al. Carboxyatractyloside poisoning in humans. Ann Trop Paediatr 2005;25(2):125-34.
- Karabiber H, Almis H, Selimoglu MA, Yakinci C, Yilmaz S. Xanthium strumarium poisoning requiring liver transplantation. J Pediatr Gastroenterol Nutr. 2014;58(1):e6-9.
- Wu, M. L., Wang, C. P., and Deng, J. F. Fatal hepatic failure due to fructus xanthii in a child. Abstracts of the 2005 North American Congress of Clinical Toxicology Annual Meeting. Clin Toxicol 2005;43:639.
Muscle breakdown Musculoskeletal
Orally, Siberian cocklebur seedlings and seeds can cause rhabdomyolysis. White blood cell infiltration in the muscles has been reported in autopsy findings from patients who died after consuming Siberian cocklebur.
Nausea and vomiting Gastrointestinal
Orally, Siberian cocklebur seedlings and seeds can cause abdominal pain, nausea, and vomiting. Gastrointestinal symptoms occur within a few hours after consumption. In one case, pancreatitis occurred approximately 2 days after intake of the seeds in a 15-year-old girl.
Poisoning Other
Orally, Siberian cocklebur can cause death associated with multi-organ failure. In some cases, death occurred less than 12 hours following intake. In one outbreak of illness related to consumption of Siberian cocklebur seedlings, death occurred in 25% of those affected. In another group of individuals with Siberian cocklebur seed poisoning, death occurred in three of nine of those affected. Death is more likely to occur in young children, especially those less than 15 years of age.
The quantity of Siberian cocklebur associated with death is not clear. In one illness outbreak, deaths were mainly in children and the seedlings were consumed in large quantities due to a food shortage. In another, children died after consuming an unknown quantity of seeds while working on a farm.
- Gurley ES, Rahman M, Hossain MJ, et al. Fatal outbreak from consuming Xanthium strumarium seedlings during time of food scarcity in northeastern Bangladesh. PLoS One 2010 Mar 18;5(3):e9756.
- Turgut M, Alhan CC, Gurgoze M, et al. Carboxyatractyloside poisoning in humans. Ann Trop Paediatr 2005;25(2):125-34.
Adverse-effects data: Natural Medicines, Therapeutic Research Center
Dosing
There is no well-established standardized dose for Siberian cocklebur, and dosing in traditional medicine depends on the specific preparation and formula used. Because of the toxicity risk, the difference between a traditional dose and a harmful one can be small.
Do not self-dose with this herb. If you are considering it, only use products from a reputable source and follow the directions of a qualified practitioner. Always check with your pharmacist or doctor first.
Siberian Cocklebur & Pregnancy
Siberian Cocklebur & Breastfeeding
© 2026 Therapeutic Research Center
Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center
References & further reading
The 4 references that drive our Siberian Cocklebur 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.
- Wu, M. L., Wang, C. P., and Deng, J. F. Fatal hepatic failure due to fructus xanthii in a child. Abstracts of the 2005 North American Congress of Clinical Toxicology Annual Meeting. Clin Toxicol 2005;43:639. DOI
- Gurley ES, Rahman M, Hossain MJ, et al. Fatal outbreak from consuming Xanthium strumarium seedlings during time of food scarcity in northeastern Bangladesh. PLoS One 2010 Mar 18;5(3):e9756. PubMed
- Turgut M, Alhan CC, Gurgoze M, et al. Carboxyatractyloside poisoning in humans. Ann Trop Paediatr 2005;25(2):125-34. PubMed
- Karabiber H, Almis H, Selimoglu MA, Yakinci C, Yilmaz S. Xanthium strumarium poisoning requiring liver transplantation. J Pediatr Gastroenterol Nutr. 2014;58(1):e6-9.
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
Brands that make products with Siberian Cocklebur
22 brands in our database make a supplement containing Siberian Cocklebur.
Supplement products with Siberian Cocklebur
84 products in our database contain Siberian Cocklebur. Open any to see its full ingredient list and every drug interaction we check.
Siberian Cocklebur: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Products that contain Siberian Cocklebur
A rotating sample of real supplements in our database that list Siberian Cocklebur — open any to see its full ingredients and every drug interaction we check.
- Bao He Teapills by Plum Flower
- Xanthium Chinese 1000 mg by GM Germa
- Phyllanthus Niruri with Xanthium Chinese 1000 mg by GM Germa
- Cold Away by Health Concerns
- Congest Free by Herbs Etc.
- Rootology by RedTree Nutraceuticals
- Sugar Coated Bi Yan Pian by Plum Flower
- Upper Chamber Teapills by Plum Flower
- Upper Chamber Teapills by Plum Flower
- Pe Min Kan Wan by Plum Flower
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