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Tree Of Heaven Drug Interactions, Uses, Safety & More

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Tree Of Heaven 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 Tree Of Heaven drug interaction appears low for most people, since the only known concern is theoretical and has not been confirmed in humans. None of the listed interactions are rated major, and every one traces back to a single lab-based finding rather than to problems reported in people.

Interactions deserving the most attention

The interactions that deserve the most attention involve blood thinners, meaning anticoagulant and antiplatelet medications. Lab research suggests Tree Of Heaven extract may make platelets less sticky, which could in theory add to the bleeding risk these medicines already carry. This effect has not been seen in humans, but because bleeding is a serious outcome, we treat the combination with extra caution rather than dismissing it.

What the rest of the list means

Although the number of medications on this list is large, that does not mean each combination has been shown to cause harm. Nearly all of these entries flow from one predicted effect on platelets observed only in laboratory studies. Until human research clarifies the picture, these remain cautions based on possibility, not proven interactions.

Check your medications against Tree Of Heaven

Based on HelloPharmacist’s Tree Of Heaven interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Tree Of Heaven

122 medications have a known interaction with Tree Of Heaven, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
AbciximabReoPro
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Abciximab interaction
AbrocitinibCibinqo
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Abrocitinib interaction Abrocitinib drug page: uses, dosage & side effects
AcenocoumarolSintrom
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Acenocoumarol interaction
Acetaminophen, AspirinGemnisyn
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, IbuprofenCombogesic
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Acetaminophen, Ibuprofen interaction
Acetylsalicylic AcidEntrophen
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Acetylsalicylic Acid interaction Acetylsalicylic Acid drug page: uses, dosage & side effects
Alteplase, TpaActilyse, Activase
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Alteplase, Tpa interaction
Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interaction
Aluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interaction Aluminum Hydroxide, Aspirin, Magnesium Hydroxide drug page: uses, dosage & side effects
Anacaulase-bcdbNexoBrid
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Anacaulase-bcdb interaction
AnagrelideAgrylin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Anagrelide interaction Anagrelide drug page: uses, dosage & side effects
AnisindioneMiradon
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Anisindione interaction
Antithrombin IiiThrombate III
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Antithrombin Iii interaction
ApixabanEliquis
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Apixaban interaction Apixaban drug page: uses, dosage & side effects
ArgatrobanArgatroban
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Argatroban interaction
AspirinAngettes 75, ASA, Asaphen, Aspirin, Caprin, Cartia +8 more
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin interaction Aspirin drug page: uses, dosage & side effects
Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interaction
Aspirin, ButalbitalAxotal
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Butalbital interaction
Aspirin, Butalbital, CaffeineFiorinal
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Butalbital, Caffeine interaction Aspirin, Butalbital, Caffeine drug page: uses, dosage & side effects
Aspirin, Butalbital, Caffeine, Codeine PhosphateFiorinal w/ Codeine
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Butalbital, Caffeine, Codeine Phosphate interaction
Aspirin, Butalbital, Caffeine, PhenacetinMarnal
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Butalbital, Caffeine, Phenacetin interaction
Aspirin, CaffeineAnacin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Caffeine interaction
Aspirin, Caffeine, Codeine PhosphateAnacin w/ Codeine
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Caffeine, Codeine Phosphate interaction
Aspirin, Caffeine, Dihydrocodeine BitartrateSynalgos DC
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Caffeine, Dihydrocodeine Bitartrate interaction
Aspirin, Caffeine, Dover's PwdAcedoval, Dovacet
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Caffeine, Dover's Pwd interaction
Aspirin, Caffeine, HydrocodoneDamason-P
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Caffeine, Hydrocodone interaction
Aspirin, Caffeine, Isobutylallylbarbituric Acid, PhenacetinLanorinal
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interaction Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin drug page: uses, dosage & side effects
Aspirin, Caffeine, OrphenadrineInvagesic, Invagesic Forte, Norgesic, Norgesic Forte, Orphengesic, Orphengesic Forte
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Caffeine, Orphenadrine interaction
Aspirin, Caffeine, Phenacetin, PropoxypheneMargesic Comp. 65
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs.

Read the full Tree Of Heaven + Aspirin, Caffeine, Phenacetin, Propoxyphene interaction
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 Tree Of Heaven 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 Tree Of Heaven affects

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

All 1 drug category Tree Of Heaven interacts with
Anticoagulant/antiplatelet Drugs
Anticoagulant/Antiplatelet Drugs

Theoretically, tree of heaven extract might reduce platelet aggregation and increase the risk of bleeding if used with antiplatelet or anticoagulant drugs. In vitro evidence shows that tree of heaven crude extract attenuates epinephrine and adenosine diphosphate-induced platelet aggregation. This interaction has not been seen in humans. Until more is known, use with caution in patients taking anticoagulant or antiplatelet drugs.

Likelihood Possible Evidence D
Monograph

Tree Of Heaven: Uses, Safety & Side Effects

The bottom line

Tree of Heaven (Ailanthus altissima) is a fast-growing, invasive tree whose bark has been used in traditional medicine, mostly for digestive complaints and parasites. Modern scientific evidence in humans is very limited, and the plant can cause stomach upset and skin reactions, so it should be used cautiously and not without professional guidance.

Scientific name
Ailanthus altissima
Family
Simaroubaceae
Part used
Bark (especially root and stem bark), leaves
Common forms
Dried bark, tinctures, teas/decoctions, traditional herbal preparations
People commonly use it for
  • Diarrhea and dysentery
  • Intestinal parasites
  • Menstrual or vaginal complaints
  • Asthma and cough (traditional use)
  • Skin conditions (topical, traditional use)

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

Safety at a glance
OverallUse caution

Human safety data are limited, and the plant can irritate the stomach and skin.

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

Tree of Heaven (Ailanthus altissima) is a fast-growing deciduous tree that is native to China and parts of Asia. It has spread widely around the world and is now considered an invasive weed in many regions, including North America and Europe. You may recognize it by its long, feathery leaves and a strong, unpleasant smell when the leaves or bark are crushed.

In traditional Chinese medicine and some folk medicine systems, the bark (especially the root and stem bark) has been used to treat digestive problems and other complaints. The leaves have also been used in some preparations. Despite its long history of traditional use, it is not a common supplement on store shelves today, and high-quality human studies are scarce.

Uses & effectiveness

People have traditionally used Tree of Heaven bark for diarrhea, dysentery, and intestinal parasites (worms). It has also been used for menstrual and vaginal complaints, asthma, cough, and, applied to the skin, for certain skin conditions.

It is important to be honest about the evidence: there is very little reliable research in humans to show that Tree of Heaven works for any of these conditions. Most of what we know comes from laboratory studies (such as testing extracts against bacteria, parasites, or cancer cells in a dish) and from a small number of animal studies. These early findings do not prove that the plant is safe or effective for people.

Because the evidence is so limited, Tree of Heaven should not be relied on to treat any medical condition. If you have symptoms like ongoing diarrhea or a suspected parasite infection, see a healthcare provider for proven treatment.

How it works

Tree of Heaven contains a variety of natural compounds. Among the most studied are quassinoids (bitter substances, such as ailanthone), along with alkaloids, flavonoids, and other plant chemicals. These compounds are responsible for the plant's bitter taste and many of its biological effects.

In laboratory research, extracts have shown antimicrobial, antiparasitic, anti-inflammatory, and cell-growth-blocking activity. Quassinoids in particular have drawn interest for their effects on bacteria, parasites, and cancer cells in test-tube studies.

It is important to understand that these are mainly laboratory and animal findings. What happens in a dish or in an animal does not always translate to a safe or helpful effect in the human body, and the doses used in labs may not match what a person could safely take.

Safety & precautions

The overall safety of Tree of Heaven in people is not well established. Handling the plant can cause skin irritation in some people, and the bark and leaves can irritate the digestive tract when taken by mouth. Some of its compounds are bitter and potentially toxic in larger amounts.

People who should be especially careful include those with sensitive stomachs, anyone with liver or kidney problems, and people who are prone to allergic or skin reactions. Because product quality and strength can vary widely and standardized products are uncommon, it is hard to know exactly what you are getting.

Pregnancy: Avoid Tree of Heaven during pregnancy. There is not enough safety information, and its traditional use to affect menstruation raises concern about potential harm. Breastfeeding: Avoid it while breastfeeding, since there is no reliable safety data. Always talk with a pharmacist or doctor before using any herbal product.

Side effects

Reported and likely side effects include nausea, vomiting, stomach cramps, and diarrhea, especially with larger amounts. Direct contact with the sap, leaves, or bark may cause skin irritation or rash in sensitive people.

Because the plant contains potentially toxic compounds, taking too much could cause more serious problems. Stop using it and seek medical care if you have severe stomach pain, persistent vomiting, signs of an allergic reaction, or any unusual symptoms.

Tree Of Heaven: Reported Adverse Effects

Documented safety reports on Tree Of Heaven from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

There is currently a limited amount of information available about the safety of tree of heaven. Orally, large amounts of the bark have been reported to cause queasiness, dizziness, headache, limb tingling, and diarrhea.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
Reports by condition
Cluster headache Neurologic/CNS

Orally, large amounts of tree of heaven bark have been reported to cause dizziness, headache, and limb tingling.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
Diarrhea Gastrointestinal

Orally, large amounts of tree of heaven bark have been reported to cause queasiness and diarrhea.

  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
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.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no well-established or standardized dose for Tree of Heaven. Traditional preparations such as bark decoctions varied widely, and they were not measured against modern safety standards.

If you choose to use a commercial product, follow the directions on the label and do not exceed them. Because strength and quality differ between products, and because human safety data are limited, it is best to check with a pharmacist or doctor first, especially if you take other medicines or have a health condition.

Pregnancy & Breastfeeding

Tree Of Heaven & Pregnancy

Insufficient reliable information

Insufficient reliable information available; avoid using.

Tree Of Heaven & 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 2 references that drive our Tree Of Heaven 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. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Rahman HMA, Rasool MF, Imran I. Pharmacological Studies Pertaining to Smooth Muscle Relaxant, Platelet Aggregation Inhibitory and Hypotensive Effects of Ailanthus altissima. Evid Based Complement Alternat Med. 2019;2019:1871696.
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

Brand directory

Brands that make products with Tree Of Heaven

6 brands in our database make a supplement containing Tree Of Heaven.

Product directory

Supplement products with Tree Of Heaven

14 products in our database contain Tree Of Heaven. Open any to see its full ingredient list and every drug interaction we check.

Pharmacist Counseling Corner

Tree Of Heaven: Common Questions

Does Tree Of Heaven interact with prescription medications?
Yes. We list 122 medications with a known interaction with Tree Of Heaven. Use the checker above to see how Tree Of Heaven interacts with a specific drug.
How are Tree Of Heaven 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 Tree Of Heaven 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 Tree Of Heaven 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 Tree Of Heaven used for?
Traditionally, its bark has been used for diarrhea, dysentery, intestinal parasites, and certain menstrual and respiratory complaints. However, there is very little human research proving it works for any of these.
Is Tree Of Heaven safe to take?
Its safety in people is not well studied. It can cause stomach upset and skin irritation, and it contains potentially toxic compounds, so it should be used cautiously and ideally under professional guidance.
Can I use Tree Of Heaven during pregnancy or while breastfeeding?
No. There is not enough safety information, and its traditional use to affect menstruation is a concern, so it should be avoided during pregnancy and breastfeeding.
Is Tree Of Heaven the same as the tree growing in my yard?
Quite possibly—Ailanthus altissima is a common invasive tree in many areas. Even so, you should not harvest or consume it on your own, because identifying plants and preparing them safely is risky without expert help.

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

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