Sweet Annie Drug Interactions, Uses, Effectiveness, Safety & More
What is this page for?
First and foremost: how Sweet Annie interacts with medications. The heart of this page is the interaction list — every drug Sweet Annie is known to interact with, and how serious each one is.
But these pages have grown well beyond that into a full monograph — what Sweet Annie 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 Sweet Annie against your medication
Add one medicationSweet Annie Drug Interactions: The Bottom Line
From the HelloPharmacist Editorial Team · Updated July 2026Based on the available evidence, the overall risk of a clinically significant Sweet Annie drug interaction appears low for most people, even though many medications appear on the list. None of the listed interactions are rated major, and every one rests on lab research rather than documented problems in people.
The concern that stands out most is with drugs that can stress the liver, since Sweet Annie itself may adversely affect the liver, and combining the two could in theory add to that strain. Beyond that, lab studies suggest Sweet Annie could change how the body clears medications processed by certain liver enzymes, which covers a very wide range of prescriptions. The findings conflict, though, with one Sweet Annie compound speeding these enzymes up while the whole extract appears to slow them down, so the real-world effect in people is unclear.
The long list exists because those liver enzymes handle hundreds of common medications, so each one is counted. These interactions are theoretical, based on test-tube findings, and none has been confirmed to cause meaningful changes in people.
Based on HelloPharmacist’s Sweet Annie interaction data and reviewed under our editorial standards.
Drugs that interact with Sweet Annie
892 medications have a known interaction with Sweet Annie, 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 Sweet Annie using our pharmacist-reviewed interaction data.
AI summaries are generated from our Sweet Annie 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 Sweet Annie 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 Sweet Annie affects
Every type of medication (drug category) Sweet Annie is known to interact with. Open any category for the detail — or search your exact drug in the checker above.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Sweet Annie may alter plasma levels and clinical effects of drugs metabolized by CYP2B6.
In vitro research shows that the Sweet Annie constituent artemisinin induces CYP2B6, possibly increasing CYP2B6 activity by 1.6-fold. However, Sweet Annie extract seems to inhibit the activity of CYP2B6 in vitro, suggesting that other constituents of Sweet Annie play a role in its effects on the overall activity of this enzyme. More information is needed to determine whether taking Sweet Annie extract affects the metabolism of CYP2B6 substrates.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Sweet Annie may alter plasma levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research shows that the Sweet Annie constituent artemisinin induces CYP3A4, possibly increasing CYP3A4 activity by 1.9-fold. However, Sweet Annie extract seems to inhibit the activity of CYP3A4 in vitro, suggesting that other constituents of Sweet Annie play a role in its effects on the overall activity of this enzyme. More information is needed to determine whether taking Sweet Annie extract affects the metabolism of CYP3A4 substrates.
Hepatotoxic Drugs
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
There is some concern that Sweet Annie can adversely affect the liver.
Sweet Annie: Uses, Safety & Side Effects
Sweet Annie (Artemisia annua) is the source of artemisinin, a compound used in prescription antimalarial drugs. While the purified drug is well studied for malaria, the herb itself as a supplement is not proven for the wide range of conditions people use it for, and self-treating malaria with the raw herb is dangerous. Talk to a pharmacist or doctor before using it.

- Scientific name
- Artemisia annua
- Family
- Asteraceae
- Part used
- Aerial parts (leaves and flowering tops)
- Common forms
- Tea, dried herb, capsules, tablets, tinctures, standardized extracts
- Malaria (traditional)
- Fever
- Inflammation
- Digestive complaints
- Antimicrobial support
- Insect repellent
Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.
Generally used short-term, but quality and dose vary widely and it should not replace proven treatments.
Insufficient reliable information available; avoid using.
Read the full pregnancy detailInsufficient reliable information available; avoid using.
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
Sweet Annie is a fast-growing annual plant in the daisy (Asteraceae) family. It is native to parts of Asia, especially China, and now grows in many temperate regions around the world. The plant has feathery leaves and a strong, sweet aroma, which is why it is sometimes called "sweet wormwood."
In traditional Chinese medicine it is known as qinghao and has a long history of use for fevers and other illnesses. Today it is best known as the natural source of artemisinin, a compound that scientists developed into modern antimalarial medicines.
As a dietary supplement, Sweet Annie is sold as a dried herb, tea, capsule, tincture, or standardized extract. People also use the plant in folk remedies and as a natural insect repellent.
How it works
The most studied compound in Sweet Annie is artemisinin and its related forms. Artemisinin contains a special chemical structure (a peroxide bridge) that is thought to react with iron inside malaria parasites, producing damaging molecules that kill the parasite.
The plant also contains flavonoids, essential oils, and other plant compounds that may have antioxidant or antimicrobial effects in laboratory tests. Researchers are studying whether these compounds could help fight inflammation, bacteria, or viruses, but most of this work is early and done in cells or animals rather than people.
Because the natural plant contains only small and variable amounts of artemisinin, the herb does not work the same way as a standardized prescription drug.
Does Sweet Annie work?
How to read these evidence grades
Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.
Possibly Effective Allergic rhinitis (hay fever)
Sweet Annie sublingual immunotherapy drops seem to be beneficial for preventing or reducing seasonal allergic rhinitis and rhinoconjunctivits symptoms related to Sweet Annie (Artemisia annua) pollen.
Also studied for 4 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Malaria
It is unclear if Sweet Annie is beneficial for malaria.
Insufficient Reliable Evidence To Rate Nonalcoholic fatty liver disease (NAFLD)
It is unclear if Sweet Annie is beneficial for NAFLD.
Insufficient Reliable Evidence To Rate Osteoarthritis
It is unclear if Sweet Annie is beneficial for osteoarthritis.
Insufficient Reliable Evidence To Rate Rheumatoid arthritis (RA)
It is unclear if Sweet Annie is beneficial for RA.
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
Short-term use of Sweet Annie is generally considered reasonably well tolerated by healthy adults, but product quality and the amount of active compounds can vary a lot between brands. It should not be used to treat malaria on its own — this is a medical emergency that needs prescription treatment.
People who are allergic to plants in the daisy family (such as ragweed, marigolds, daisies, or chrysanthemums) may react to Sweet Annie. Those with liver problems or who are taking many medications should be especially careful and check with a healthcare provider first.
Pregnancy: Avoid. Animal studies and concerns about effects on a developing baby make this herb unsafe to use during pregnancy. Breastfeeding: Avoid, because there is not enough information to know if it is safe. Do not give Sweet Annie to children without medical guidance.
Side effects
Reported side effects are usually mild and can include upset stomach, nausea, diarrhea, dizziness, or ringing in the ears. Some people may develop an allergic skin reaction, especially if they are sensitive to other daisy-family plants.
Rarely, artemisinin-type compounds have been linked to liver irritation or, in high doses, effects on blood cells. If you notice yellowing of the skin or eyes, dark urine, severe stomach pain, unusual tiredness, or a rash, stop using it and contact a healthcare provider.
Sweet Annie: Reported Adverse Effects
Documented safety reports on Sweet Annie from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.
Orally, Sweet Annie is generally well-tolerated.
Most Common Adverse Effects:
Orally: Nausea and vomiting.
Serious Adverse Effects (Rare):
Orally: Hepatotoxicity.
Anorexia Hepatic
Orally, Sweet Annie might cause hepatic adverse effects. In one case, a 52-year-old patient developed hepatitis after taking the Sweet Annie constituent artemisinin 200 mg three times daily for 10 days. The patient developed abdominal pain and dark urine and was found to have elevated liver enzymes consistent with hepatitis. Symptoms resolved within 2 weeks of discontinuing use. Although it is possible this supplement caused liver disease in this patient, it is not certain. In clinical trials evaluating artemisinin, elevated liver enzymes have only been reported in around 0.9% of patients. However, the dose of artemisinin in this case was substantially higher than a typical dose. A case of severe acute cholestatic hepatitis has also been reported in a 51-year-old male who drank Sweet Annie tea daily, prepared using 1.25 grams of Sweet Annie powder, for malaria prophylaxis during a 4-week trip to Ethiopia. Three weeks after his return, he presented with malaise, abdominal discomfort, jaundice, elevated liver enzymes, and markers of cholestasis. The patient was treated with corticosteroids and ursodeoxycholic acid and ultimately recovered.
A series of cases linking the use of a supercritical carbon dioxide extract of Sweet Annie to hepatoxicity has also been reported. Of the 29 reports of adverse hepatic reactions to this extract, 19 patients noted symptoms within 12 weeks of starting the extract, 16 patients experienced jaundice, and 9 patients required hospitalization. Other common symptoms of hepatotoxicity included abdominal pain, vomiting, nausea, fever, headache, anorexia, malaise, fatigue, and lethargy. All but one case involved doses below or up to the extract's recommended dose of 300 mg daily. Upon discontinuation, symptoms resolved completely or were improved in nearly all cases.
- Centers for Disease Control and Prevention (CDC). Hepatitis temporally associated with an herbal supplement containing artemisinin-Washington, 2008. MMWR Morb Mortal Wkly Rep 2009;58:854-8.
- Savage RL, Hill GR, Barnes J, Kenyon SH, Tatley MV. Suspected hepatotoxicity with a supercritical carbon dioxide extract of Artemisia annua in grapeseed oil used in New Zealand. Front Pharmacol. 2019;10:1448.
- Ruperti-Repilado FJ, Haefliger S, Rehm S, et al. Danger of herbal tea: a case of acute cholestatic hepatitis due to Artemisia annua tea. Front Med (Lausanne). 2019;6:221.
Cough Immunologic
One case of a mild allergic reaction to Sweet Annie tea has been reported. The reaction was characterized by a rash and cough that resolved quickly and did not require treatment. When low doses are taken sublingually by individuals allergic to Sweet Annie, numbness of the tongue and throat itching have been reported.
- Rath K, Taxis K, Walz G, et al. Pharmacokinetic study of artemisinin after oral intake of a traditional preparation of Artemisia annua L. (annual wormwood). Am J Trop Med Hyg 2004;70:128-32.
- Yang J, Shen Z, Liu L, et al. Clinical efficacy and safety of Artesimia annua-Sublingual immunotherapy in seasonal allergic rhinitis patients based on different intervention time. Int Arch Allergy Immunol 2022;183(8):852-859.
- Feng Y, Cao Y, Liu Y, et al. Clinical efficacy and safety of coseasonal initiation of Artemisia annua sublingual immunotherapy on patients with Artemisia-induced rhinoconjunctivitis. Am J Otolaryngol 2023;44(5):103942.
- Yang J, Wang W, Shen Z, et al. Efficacy and safety of Artemisia annua sublingual immunotherapy in patients with seasonal allergic rhinoconjunctivitis over two pollen seasons. Eur Arch Otorhinolaryngol. 2023;280(11):4939-4947.
- Shen Z, Zhang P, Kang W, et al. Clinical efficacy in one-year treatment with Artemisia annua-SLIT drops in monosensitized and polysensitized individuals. Am J Otolaryngol 2023;44(6):104002.
Nausea and vomiting Gastrointestinal
Orally, Sweet Annie might cause gastrointestinal upset including nausea and vomiting in some patients.
- Mueller MS, Karhagomba IB, Hirt HM, Wemakor E. The potential of Artemisia annua L. as a locally produced remedy for malaria in the tropics: agricultural, chemical and clinical aspects. J Ethnopharmacol 2000;73:487-93.
- Yang J, Wang W, Shen Z, et al. Efficacy and safety of Artemisia annua sublingual immunotherapy in patients with seasonal allergic rhinoconjunctivitis over two pollen seasons. Eur Arch Otorhinolaryngol. 2023;280(11):4939-4947.
Adverse-effects data: Natural Medicines, Therapeutic Research Center
Dosing
There is no well-established standard dose for Sweet Annie as a supplement, and the amount of artemisinin in plant products varies widely. Because of this, it is hard to know how much active compound you are actually getting.
If you choose to use a product, follow the directions on the label and do not exceed them. Look for reputable brands that provide quality testing. Most importantly, check with a pharmacist or doctor before starting — especially if you are pregnant, breastfeeding, have a health condition, or take other medications. Never use Sweet Annie or its tea as a substitute for proven malaria treatment.
Sweet Annie & Pregnancy
Sweet Annie & Breastfeeding
© 2026 Therapeutic Research Center
Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center
References & further reading
The 11 references that drive our Sweet Annie 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.
- Mueller MS, Karhagomba IB, Hirt HM, Wemakor E. The potential of Artemisia annua L. as a locally produced remedy for malaria in the tropics: agricultural, chemical and clinical aspects. J Ethnopharmacol 2000;73:487-93. PubMed
- Rath K, Taxis K, Walz G, et al. Pharmacokinetic study of artemisinin after oral intake of a traditional preparation of Artemisia annua L. (annual wormwood). Am J Trop Med Hyg 2004;70:128-32. DOI
- Centers for Disease Control and Prevention (CDC). Hepatitis temporally associated with an herbal supplement containing artemisinin-Washington, 2008. MMWR Morb Mortal Wkly Rep 2009;58:854-8.
- Xing J, Kirby BJ, Whittington D, et al. Evaluation of P450 inhibition and induction by artemisinin antimalarials in human liver microsomes and primary human hepatocytes. Drug Metabl Dispos 2012;40(9):1757-64. PubMed
- Savage RL, Hill GR, Barnes J, Kenyon SH, Tatley MV. Suspected hepatotoxicity with a supercritical carbon dioxide extract of Artemisia annua in grapeseed oil used in New Zealand. Front Pharmacol. 2019;10:1448. PubMed
- Ruperti-Repilado FJ, Haefliger S, Rehm S, et al. Danger of herbal tea: a case of acute cholestatic hepatitis due to Artemisia annua tea. Front Med (Lausanne). 2019;6:221. PubMed
- Yang J, Shen Z, Liu L, et al. Clinical efficacy and safety of Artesimia annua-Sublingual immunotherapy in seasonal allergic rhinitis patients based on different intervention time. Int Arch Allergy Immunol 2022;183(8):852-859.
- Kane NF, Kiani BH, Desrosiers MR, Towler MJ, Weathers PJ. Artemisia extracts differ from artemisinin effects on human hepatic CYP450s 2B6 and 3A4 in vitro. J Ethnopharmacol 2022. DOI
- Feng Y, Cao Y, Liu Y, et al. Clinical efficacy and safety of coseasonal initiation of Artemisia annua sublingual immunotherapy on patients with Artemisia-induced rhinoconjunctivitis. Am J Otolaryngol 2023;44(5):103942. PubMed
- Yang J, Wang W, Shen Z, et al. Efficacy and safety of Artemisia annua sublingual immunotherapy in patients with seasonal allergic rhinoconjunctivitis over two pollen seasons. Eur Arch Otorhinolaryngol. 2023;280(11):4939-4947. PubMed
- Shen Z, Zhang P, Kang W, et al. Clinical efficacy in one-year treatment with Artemisia annua-SLIT drops in monosensitized and polysensitized individuals. Am J Otolaryngol 2023;44(6):104002. PubMed
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 Sweet Annie
68 brands in our database make a supplement containing Sweet Annie.
Supplement products with Sweet Annie
243 products in our database contain Sweet Annie. Open any to see its full ingredient list and every drug interaction we check.
Sweet Annie: Common Questions
What is Sweet Annie used for, and does it work?
Does Sweet Annie interact with prescription medications?
How are Sweet Annie interactions rated?
Is it safe to take Sweet Annie with my medications?
Where does this Sweet Annie interaction information come from?
What is Sweet Annie used for?
Can I use Sweet Annie tea to treat or prevent malaria?
Is Sweet Annie safe during pregnancy or breastfeeding?
Does Sweet Annie have side effects?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Products that contain Sweet Annie
A rotating sample of real supplements in our database that list Sweet Annie — open any to see its full ingredients and every drug interaction we check.
- Parasite-Ease Vermifuge by Earth Friend Herb Co.
- Artemisia Annua by NutraMedix
- Core Para-V Blend by Energetix
- Paracid Forte by Ortho Molecular Products
- Zi Sheng Teapills by Plum Flower
- MicroDefense by Pure Encapsulations
- Anti-Gas by Nature's Sunshine
- NDF Happy Peach by Bioray Kids
- Parasitab +BioPerine by Approved Science
- Para Purge by Crystal Star
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