Major interaction on record — check this product against your medications before combining. Based on 12 of 14 ingredients. Check your meds →
Dietary supplement

Cramp Bark Plus Ingredients & Drug Interactions

by Health Concerns

Cramp Bark Plus label
See full label image
Capsule Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Cramp Bark Plus against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Cramp Bark Plus is a dietary supplement by Health Concerns with 14 active ingredients. Its ingredients are commonly taken for nausea and vomiting, motion sickness, morning sickness in pregnancy.Based on those ingredients, 1,586 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Corydalis yanhusuo Root Extract, Ginger root extract, Chinese Peony Root Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Cramp Bark Plus by Health Concerns

Ask about any prescription or over-the-counter medication and we check it for interactions with Cramp Bark Plus by Health Concerns — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Cramp Bark Plus by Health Concerns

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 23, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 14 active ingredients.
  • “Proprietary Herbal Blend” is a proprietary blend — the label gives one combined amount (2,010 mg) without saying how much of each component you get.

Cramp Bark Plus contains 14 ingredients total. The active components include ginger root extract, safflower flower extract, black cohosh root extract, dong quai root extract, Chinese peony root extract, cyperus rhizome extract, poria mushroom extract, cassia twig extract, costus root extract, cramp bark, bupleurum root extract, and corydalis yanhusuo root extract — plus a proprietary herbal blend that combines some of these.

Two ingredients (achyranthes root extract and peach kernel extract) could not be checked for interactions. The inactive ingredients are hypromellose and rice bran.

These are excipients — materials that help form and stabilize the capsule but have no active therapeutic role.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Menstrual cramps and muscle spasms relief.
  • We looked for evidence on: Dysmenorrhea, Exercise-induced muscle soreness, Muscle tension, Abdominal cramping.
  • The strongest evidence on file: Ginger is rated "Possibly Effective" for Dysmenorrhea (Natural Medicines).
  • Also on file: Ginger is rated "Possibly Ineffective" for Exercise-induced muscle soreness.
  • Also on file: Peony is rated "Insufficient Reliable Evidence To Rate" for Dysmenorrhea.

The evidence for most ingredients in this product is limited. Ginger root extract shows possibly effective evidence for pregnancy-induced nausea and vomiting, dysmenorrhea, and osteoarthritis, but is possibly ineffective for exercise-induced muscle soreness and chemotherapy-induced nausea.

The remaining ingredients — safflower, black cohosh, dong quai, peony, cyperus, poria, cassia, costus, cramp bark, bupleurum, and corydalis yanhusuo — all carry insufficient reliable evidence to rate for their traditional uses. The product's intended purpose for cramp relief lacks established evidence in the data we hold.

The evidence, ingredient by ingredient Ginger Safflower Black Cohosh Dong Quai Peony Adrue Poria Mushroom Cassia Cinnamon

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 9 of the 12 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 12 of 12.
  • General safety write-ups exist for 12 of 12.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Ginger is generally well tolerated at typical doses, though doses above 5 grams daily increase side effects like abdominal discomfort, heartburn, diarrhea, and a burning sensation in the mouth and throat. Encapsulated forms tend to cause fewer of these mild effects than powder.

Safflower flower extract has raised concerns in case reports of liver failure (though doses and durations are unclear), and both safflower and dong quai may cause increased sun sensitivity. Black cohosh is generally well tolerated short-term but carries rare risk of liver concerns.

Cyperus, poria, and corydalis yanhusuo have very limited human safety data. Cassia cinnamon contains coumarin, which may cause liver harm at very high doses over long periods.

Overall, most ingredients are not well studied in humans at supplement doses — individual tolerance varies, and professional guidance is wise.

Side effects, ingredient by ingredient Ginger Safflower Black Cohosh Dong Quai Peony Adrue Poria Mushroom Cassia Cinnamon

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 10 of the 12 matched ingredients can interact with medications — Peony, Adrue, Safflower, Poria Mushroom, Corydalis Yanhusuo, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,587 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Cramp Bark Plus, double-check with your doctor or pharmacist if you take blood thinners like warfarin or other anticoagulants (Major risk with dong quai specifically; Moderate risk with ginger, safflower, peony, and bupleurum). Also flag diabetes medications, antidepressants or other serotonergic drugs (especially with black cohosh), blood pressure drugs, liver-damaging medications, sedatives or benzodiazepines, cisplatin or other chemotherapy agents, estrogen therapy or birth control, and medications metabolized by your liver (CYP2D6, CYP3A4, CYP2C9 systems).

No interactions are documented for cramp bark and costus as individual ingredients.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

Cramp Bark Plus is a multi-ingredient herbal formula with a long history in traditional medicine, but the evidence that it works for its intended purpose is not established in our data. More importantly, it carries documented interactions with blood thinners, diabetes drugs, antidepressants, blood pressure medications, sedatives, and several other drug classes — some Moderate, one Major.

If you take any prescription medications, talk with your doctor or pharmacist before starting this product and review your full medication list with them.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 12 of 14 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 22, 2022.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Cramp Bark Plus, straight from the product label.

Brand Health Concerns
Barcode (UPC) 810034440402
Net contents 90 Capsule(s)
Market status On market
Date entered into DSLD Jan 22, 2022
DSLD ID 259261
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Cramp Bark Plus by Health Concerns, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
3 Capsule(s)
Maximum serving Sizes:
3 Capsule(s)
Servings per container
30
UPC/BARCODE
810034440402
IngredientAmount% DV
Ginger root extract0 NP--
Proprietary Herbal Blend2010 mg--
Achyranthes Root Extract0 NP--
Safflower Flower Extract0 NP--
Black Cohosh root extract0 NP--
Dong Quai root extract0 NP--
Chinese Peony Root Extract0 NP--
Cyperus Rhizome Extract0 NP--
Poria sclerotium extract0 NP--
Cassia Twig Extract0 NP--
Costus Root Extract0 NP--
Cramp Bark0 NP--
Bupleurum Root extract0 NP--
Corydalis yanhusuo Root Extract0 NP--
Peach Kernel Extract0 NP--

Other ingredients: Hypromellose, Rice Bran

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

Chinese Traditional Formulas

Combining Modern Research and Ancient Wisdom

Suggested/Recommended/Usage/Directions

Suggested Use: Three capsules, 3 times per day between meals, or as recommended by your health care practitioner.

Precautions

Notice: As with any dietary supplement, do not take without first consulting your health care practitioner, especially if you are pregnant, nursing, or are under medical supervision for any reason.

Notice: As with any dietary supplement, do not take without first consulting your health care practitioner, especially if you are pregnant, nursing, or are under medical supervision for any reason.

Keep out of reach of children.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Formulation

Made in the U.S.A.

Formula

Modified Tong Jing Wan

FDA Statement of Identity

Herbal Supplement

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Cramp Bark Plus by Health Concerns label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Cramp Bark Plus label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Cramp Bark Plus by Health Concerns

These are the 14 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Other (inactive) ingredients: Hypromellose, Rice Bran. These complete the product’s ingredient list but are not active constituents.

Interaction report

Cramp Bark Plus by Health Concerns Drug Interactions

Want to check YOUR meds against Cramp Bark Plus?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,586Drugs
2 Major 1,573 Moderate 11 Minor

Ingredients driving the most interactions

Corydalis yanhusuo Root Extract 1,160
Ginger root extract 1,007
Chinese Peony Root Extract 811
Black Cohosh root extract 652
Cassia Twig Extract 442

Individual Drug Interactions

The ingredients in Cramp Bark Plus interact with 1,586 drugs. Click any drug to see the details.

10 of the 14 ingredients in Cramp Bark Plus interact with drugs. Each result below shows which ingredient is responsible. Corydalis yanhusuo Root Extract Ginger root extract Chinese Peony Root Extract Black Cohosh root extract Cassia Twig Extract Poria sclerotium extract Bupleurum Root extract Cyperus Rhizome Extract Safflower Flower Extract Dong Quai root extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Cramp Bark Plus with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Corydalis yanhusuo Root Extract14 drug types · 1,160 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, Corydalis yanhusuo might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Corydalis yanhusuo contains berberine. In vitro and in vivo research suggest that berberine can inhibit platelet aggregation. Theoretically, Corydalis yanhusuo might also inhibit platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, Corydalis yanhusuo may increase the risk of hypoglycemia when taken with antidiabetes drugs.
Corydalis yanhusuo contains berberine. Clinical research shows that berberine may lower blood glucose levels. Theoretically, Corydalis yanhusuo might also lower blood glucose levels.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, Corydalis yanhusuo might have additive effects with antihypertensive drugs.
Corydalis yanhusuo contains berberine. Animal research suggests that berberine can have hypotensive effects. Also, a clinical study suggests that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone. Theoretically, Corydalis yanhusuo might also reduce blood pressure.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, Corydalis yanhusuo might increase the sedative effects of CNS depressants.
Corydalis yanhusuo contains berberine. Animal research suggests that berberine may have sedative effects. Theoretically, Corydalis yanhusuo might also have CNS depressants effects.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, Corydalis yanhusuo might increase blood levels of cyclosporine.
Corydalis yanhusuo contains berberine. Preliminary clinical research shows that berberine can reduce metabolism of cyclosporine and increase serum levels, likely through inhibition of cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporine. Theoretically, Corydalis yanhusuo might also reduce the metabolism of cyclosporine.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP2C9.
Corydalis yanhusuo contains berberine. Preliminary clinical research shows that berberine can inhibit CYP2C9. Theoretically, Corydalis yanhusuo might also inhibit CYP2C9.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP2D6.
Corydalis yanhusuo contains berberine. In vitro research and preliminary clinical evidence show that berberine can inhibit CYP2D6. Theoretically, Corydalis yanhusuo might also inhibit CYP2D6.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP3A4.
Corydalis yanhusuo contains berberine. In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, Corydalis yanhusuo might also inhibit CYP3A4.

Likelihood Possible Evidence D
Dextromethorphan (Robitussin Dm, Others)

Theoretically, Corydalis yanhusuo may increase serum levels of dextromethorphan.
Corydalis yanhusuo contains berberine. Preliminary clinical research shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan. Theoretically, Corydalis yanhusuo may also inhibit the metabolism of dextromethorphan.

Likelihood Possible Evidence D
Losartan (Cozaar)

Theoretically, Corydalis yanhusuo might reduce the therapeutic effects of losartan by decreasing its conversion to its active form.
Corydalis yanhusuo contains berberine. Preliminary clinical research suggests that berberine can inhibit cytochrome P450 2C9 (CYP2C9) activity and reduce metabolism of losartan. Theoretically, Corydalis yanhusuo might also inhibit the metabolism of losartan.

Likelihood Possible Evidence D
Metformin (Glucophage)

Theoretically, Corydalis yanhusuo might increase the therapeutic and adverse effects of metformin.
Corydalis yanhusuo contains berberine. In vitro and animal studies show that berberine can increase the systemic exposure and half-life of metformin, potentially increasing metformin's effects and side effects. This interaction seems to be most apparent when berberine is administered 2 hours prior to metformin. Taking berberine and metformin at the same time does not appear to increase systemic exposure to metformin. It is unclear if Corydalis yanhusuo might have this same effect.

Likelihood Possible Evidence D
Midazolam (Versed)

Theoretically, Corydalis yanhusuo might reduce metabolism of midazolam, which might increase the risk of severe adverse effects.
Corydalis yanhusuo contains berberine. Preliminary clinical research shows that berberine can inhibit cytochrome P450 3A4 (CYP3A4) activity and reduce metabolism of midazolam. Theoretically, Corydalis yanhusuo might also inhibit the metabolism of midazolam.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, Corydalis yanhusuo might increase the sedative effect of pentobarbital.
Corydalis yanhusuo contains berberine. Animal research shows that berberine can prolong pentobarbital-induced sleeping time. Theoretically, Corydalis yanhusuo might increase the sedative effects of pentobarbital.

Likelihood Possible Evidence D
Tacrolimus (Prograf)

Theoretically, Corydalis yanhusuo might increase blood levels of tacrolimus.
Corydalis yanhusuo contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of the tacrolimus dose to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL. It is unclear if Corydalis yanhusuo might have this same effect.

Likelihood Possible Evidence D
Corydalis yanhusuo Root Extract full monograph & interactions

Ginger root extract14 drug types · 1,007 drugs

Anticoagulant/Antiplatelet Drugs

Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Losartan (Cozaar)

Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.

Likelihood Possible Evidence D
Nifedipine (Procardia)

Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.

Likelihood Possible Evidence D
Phenprocoumon (Marcoumar, Others)

Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.

Likelihood Possible Evidence B
Calcium Channel Blockers

Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.

Likelihood Unlikely Evidence D
Cyclosporine (Neoral, Sandimmune)

Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Metronidazole (Flagyl)

Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.

Likelihood Possible Evidence D
Ginger root extract full monograph & interactions

Chinese Peony Root Extract7 drug types · 811 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, combining peony with anticoagulant or antiplatelet drugs might increase the risk of bleeding.
In vitro research suggests that peony might have antiplatelet, anticoagulant, and antithrombotic effects.

Likelihood Possible Evidence D
Clozapine (Clozaril)

Theoretically, peony might increase the levels and clinical effects of clozapine.
In vitro research shows that peony suppresses the metabolism of clozapine via weak-to-moderate inhibitory effects on cytochromes P450 (CYP) 1A2 and CYP3A4. This effect has not been reported in humans.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, peony might interfere with contraceptive drugs due to competition for estrogen receptors.
In vitro and animal research shows that peony extract has estrogenic activity. Concomitant use might also increase the risk for estrogen-related adverse effects.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, use of peony may increase the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research shows that peony suppresses the metabolism of clozapine via weak-to-moderate inhibitory effects on CYP1A2 and CYP3A4. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, use of peony may increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research shows that peony suppresses the metabolism of clozapine via weak-to-moderate inhibitory effects on CYP1A2 and CYP3A4. This effect has not been reported in humans.

Likelihood Possible Evidence D
Estrogens

Theoretically, concomitant use of large amounts of peony might interfere with hormone replacement therapy and/or increase the risk for estrogen-related adverse effects.
In vitro and animal research shows that peony extract has estrogenic activity. Theoretically, peony might compete for estrogen receptors and/or cause additive estrogenic effects.

Likelihood Possible Evidence D
Phenytoin (Dilantin)

Theoretically, peony might reduce the levels and clinical effects of phenytoin.
Animal research shows that taking peony root reduces levels of phenytoin. Some researchers suggest that peony root might affect cytochrome P450 (CYP) 2C9, which metabolizes phenytoin. However, preliminary research in humans shows that peony root does not alter levels of losartan (Cozaar), which is also metabolized by CYP2C9.

Likelihood Probable Evidence D
Chinese Peony Root Extract full monograph & interactions

Black Cohosh root extract7 drug types · 652 drugs

Atorvastatin (Lipitor)

Taking black cohosh with atorvastatin might increase the risk for elevated liver function tests.
In one case report, a patient taking atorvastatin (Lipitor) developed significantly elevated liver function enzymes after starting black cohosh 100 mg four times daily. Liver enzymes returned to normal when black cohosh was discontinued. It is unclear whether the elevated liver enzymes were due to black cohosh itself or an interaction between atorvastatin and black cohosh.

Likelihood Possible Evidence D
Cisplatin (Platinol-Aq)

Theoretically, black cohosh may reduce the clinical effects of cisplatin.
Animal research suggests that black cohosh might decrease the cytotoxic effect of cisplatin on breast cancer cells.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Some clinical research suggests that black cohosh might modestly inhibit CYP2D6 and increase levels of drugs metabolized by this enzyme. However, contradictory clinical research shows a specific black cohosh product (Remifemin, Enzymatic Therapy) 40 mg twice daily does not significantly inhibit metabolism of a CYP2D6 substrate in healthy study volunteers. Until more is known, use black cohosh cautiously in patients taking drugs metabolized by CYP2D6.

Likelihood Possible Evidence B
Estrogens

Theoretically, black cohosh may alter the effects of estrogen therapy.
Some research suggests that black cohosh has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
There is concern that black cohosh might be linked to cases of liver failure and autoimmune hepatitis.

Likelihood Possible Evidence D
Serotonergic Drugs

Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Black cohosh might increase the risk of serotonin syndrome when combined with other serotonergic drugs. Black cohosh acts as an agonist at several serotonin receptor subtypes and might interact with other serotonergic medications. In one case, a 55-year-old female who had been on stable treatment with sertraline 50 mg and duloxetine 60 mg daily developed serotonin syndrome after taking black cohosh extract 40 mg daily for 3 days.

Likelihood Possible Evidence D
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Black cohosh may inhibit one form of OATP, OATP2B1, which could reduce the bioavailability and clinical effects of OATP2B1 substrates.
In vitro research shows that black cohosh modestly inhibits OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.

Likelihood Possible Evidence D
Black Cohosh root extract full monograph & interactions

Cassia Twig Extract2 drug types · 442 drugs

Antidiabetes Drugs

Theoretically, cassia cinnamon may have additive effects with antidiabetes drugs.
Cassia cinnamon may lower blood glucose levels, and have additive effects in patients treated with antidiabetic agents. Dose adjustments to diabetes medications might be necessary.

Likelihood Possible Evidence B
Hepatotoxic Drugs

Theoretically, large doses of cassia cinnamon might cause additive effects when used with hepatotoxic drugs.
There is some concern that ingesting large amounts of cassia cinnamon for an extended duration might cause hepatotoxicity in some people. Cassia cinnamon contains coumarin, which can cause hepatotoxicity in animal models. In humans, very high doses of coumarin from 50-7000 mg/day can result in hepatotoxicity that resolves when coumarin use is discontinued. Lower amounts might also cause liver problems in sensitive people, such as those with liver disease or those taking potentially hepatotoxic agents.

Likelihood Possible Evidence D
Cassia Twig Extract full monograph & interactions

Poria sclerotium extract3 drug types · 417 drugs

Anticholinergic Drugs

Theoretically, poria mushroom might decrease the clinical effects of anticholinergic drugs.
In animal research, poria mushroom essential oil reduces acetylcholinesterase activity. This interaction has not been shown in humans.

Likelihood Possible Evidence D
Cholinergic Drugs

Theoretically, poria mushroom might have additive effects when used with cholinergic drugs.
In animal research, poria mushroom essential oil reduces acetylcholinesterase activity. This interaction has not been shown in humans.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Animal research shows that poria mushroom extract has sedative properties. This interaction has not been shown in humans.

Likelihood Possible Evidence D
Poria sclerotium extract full monograph & interactions

Bupleurum Root extract3 drug types · 327 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, bupleurum might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research suggests that saikosaponins, constituents of bupleurum, can inhibit platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, bupleurum might decrease the effects of antidiabetes drugs.
Animal research suggests that saikosaponins, constituents of bupleurum, can increase blood glucose.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, bupleurum might decrease the effects of immunosuppressants.
In vitro and animal research suggests that bupleurum might stimulate immune function.

Likelihood Possible Evidence D
Bupleurum Root extract full monograph & interactions

Cyperus Rhizome Extract3 drug types · 256 drugs

Barbiturates

Animal research suggests that taking adrue in combination with sodium thiopental increases total sleep time three-fold compared to the effects of sodium thiopental alone. Theoretically, concomitant use of adrue and barbiturates might increase the risk of drowsiness and motor reflex depression. Some barbiturates include amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), and others.

Likelihood Possible Evidence D
Benzodiazepines

Animal research suggests that taking adrue in combination with diazepam increases total sleep time four-fold compared to the effects of diazepam alone. Theoretically, concomitant use adrue and benzodiazepines might increase the risk of drowsiness and motor reflex depression. Some benzodiazepines include clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), and others.

Likelihood Possible Evidence D
Cns Depressants

Animal research suggests that taking adrue in combination with sodium thiopental or diazepam increases total sleep time up to four-fold compared to the effects of the drugs alone. Theoretically, concomitant use of adrue with CNS depressants might cause additive sedation. Some CNS depressants include benzodiazepines, such as diazepam (Valium), alprazolam (Xanax), triazolam (Halcion), and estazolam (ProSom); barbiturates, such as mephobarbital (Mebaral), phenobarbital (Luminal Sodium), and pentobarbital sodium (Nembutal); zolpidem (Ambien); and others.

Likelihood Possible Evidence D
Cyperus Rhizome Extract full monograph & interactions

Safflower Flower Extract3 drug types · 208 drugs

Anticoagulant/Antiplatelet Drugs

High doses of safflower oil might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Small clinical studies show that taking safflower oil, approximately 55 grams daily for 2-3 weeks, decreases platelet aggregation. However, taking lower doses of safflower oil, such as 5 grams daily for 4 weeks, does not seem to affect platelet function. In one case report, a 74-year-old male stabilized on warfarin developed urinary tract bleeding and an elevated INR after taking a safflower extract 20 grams daily for 14 days.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, safflower oil might alter the effects of antidiabetes drugs.
Some clinical research shows that taking safflower oil 10 grams daily for 3 weeks can increase fasting blood glucose in patients with type 2 diabetes. However, clinical research in patients with metabolic syndrome with or without impaired glucose tolerance shows that taking safflower oil 8 grams daily for 12 weeks reduces fasting glucose levels by around 8 mg/dL. Some clinical research also shows that taking safflower oil 8 grams daily for 16 weeks does not affect fasting glucose levels in patients with type 2 diabetes.

Likelihood Possible Evidence B
Warfarin

Theoretically, safflower oil might increase the risk of bleeding when taken with warfarin.
In one case report, a 74-year-old male stabilized on warfarin developed urinary tract bleeding and an elevated INR after taking a safflower extract 20 grams daily for 14 days.

Likelihood Possible Evidence D
Safflower Flower Extract full monograph & interactions

Dong Quai root extract3 drug types · 163 drugs

Warfarin (Coumadin)

Dong quai may increase the risk of bleeding when used with warfarin.
Case reports suggest that concomitant use of dong quai with warfarin can increase the anticoagulant effects of warfarin and increase the risk of bleeding. In one case, after 4 weeks of taking dong quai 565 mg once or twice daily, the international normalized ratio (INR) increased to 4.9. The INR normalized 4 weeks after discontinuation of dong quai.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Animal studies suggest that dong quai has antithrombin activity and inhibits platelet aggregation due to its coumarin components. Additionally, some case reports in humans suggest that dong quai can increase the anticoagulant effects of warfarin. However, clinical research in healthy adults shows that taking 1 gram of dong quai root daily for 3 weeks does not significantly inhibit platelet aggregation or cause bleeding. Until more is known, use dong quai with caution in patients taking antiplatelet/anticoagulant drugs.

Likelihood Possible Evidence D
Estrogens

Theoretically, dong quai may reduce the effects of estrogens.
Dong quai has estrogenic effects. Theoretically, concomitant use of large amounts of dong quai might interfere with hormone replacement therapy due to competition for estrogen receptors.

Likelihood Possible Evidence D
Dong Quai root extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Cramp Bark Plus, from the product label.

Health Concerns

See all Health Concerns products
Name
Health Concerns
City
Springville
State
Utah
Phone Number
1 (800) 233-9355
Web Address
www.healthconcerns.com/pro
Pharmacist Counseling Corner

Cramp Bark Plus by Health Concerns: Common Questions

Does Cramp Bark Plus by Health Concerns interact with any medications?
Yes. Based on its ingredients, Cramp Bark Plus has a known interaction with 1,586 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Cramp Bark Plus contains 14 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is ginger in this product safe if I take a blood thinner like warfarin?
No — ginger may increase warfarin's blood-thinning effects and raise your bleeding risk. This is a Moderate-severity interaction. Dong quai in this formula carries an even higher (Major) risk with warfarin. Do not combine these without your doctor's explicit approval and close monitoring.
Can I take this if I'm on a diabetes medication?
Not safely without checking first. Ginger, safflower, cassia cinnamon, bupleurum, and corydalis yanhusuo may all lower blood sugar or interfere with how your diabetes drugs work, raising the risk of low blood sugar. Talk with your doctor before adding this product.
What are the most common side effects I might notice?
Ginger (the most studied ingredient here) commonly causes mild abdominal discomfort, heartburn, diarrhea, burping, and a burning sensation in the mouth or throat — especially at higher doses. Encapsulated ginger tends to cause fewer of these than powder. Black cohosh may cause breast tenderness, dizziness, headache, or tiredness.
Is it safe to take while pregnant?
There is not enough safety data to know either way for most ingredients in this formula. Ginger is rated Likely Safe in pregnancy in small amounts, but several others — particularly safflower, black cohosh, dong quai, peony, cyperus, costus, cramp bark, bupleurum, and corydalis yanhusuo — either carry Possibly Unsafe ratings or have no reliable pregnancy data. Talk with your doctor before use.
Does this product actually work for muscle cramps?
Evidence is not established in our data. The main ingredient tied to cramp relief — cramp bark itself — has insufficient reliable evidence to rate for muscle cramps or dysmenorrhea. Other ingredients were traditionally used for these purposes, but rigorous modern evidence is lacking.
Can I take this with my antidepressant?
It depends on your specific drug, but there is risk. Black cohosh in this formula can increase serotonin effects and may cause serotonin syndrome (a serious condition) when combined with serotonergic antidepressants like SSRIs. Check with your doctor or pharmacist before combining them.

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

Not sure if Cramp Bark Plus is safe with your meds?

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Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Cramp Bark Plus label
Go deeper

The Full Monographs Behind Cramp Bark Plus’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Ginger

Interacts with 1,007 drugs

Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...

Read the full Ginger monograph → Herb & supplement monograph

Safflower

Interacts with 208 drugs

Safflower is a thistle-like plant used mainly for its seed oil (a common cooking oil) and its colorful flowers. Safflower oil is a reasonable source of unsaturated fats, but strong proof tha...

Read the full Safflower monograph → Herb & supplement monograph

Black Cohosh

Interacts with 652 drugs

Black cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It is generally well tolerated for short-t...

Read the full Black Cohosh monograph → Herb & supplement monograph

Dong Quai

Interacts with 163 drugs

Dong Quai is a traditional Chinese herb often called "female ginseng" and is mostly used for menstrual and menopausal complaints. High-quality scientific evidence that it works for these use...

Read the full Dong Quai monograph → Herb & supplement monograph

Peony

Interacts with 811 drugs

Peony root is a traditional Chinese medicine herb often used for menstrual problems, cramps, and inflammation, frequently as part of combination formulas. Human evidence for most uses is lim...

Read the full Peony monograph → Herb & supplement monograph

Adrue

Interacts with 256 drugs

Adrue (Cyperus articulatus) is a sedge whose rhizome has long been used in traditional medicine for nausea and other stomach complaints, and as a mild calming agent. Solid human studies are...

Read the full Adrue monograph → Herb & supplement monograph

Poria Mushroom

Interacts with 417 drugs

Poria mushroom (Fu Ling) is a fungus long used in Traditional Chinese Medicine, mainly as a mild diuretic and digestive and calming aid. Modern scientific evidence in humans is very limited,...

Read the full Poria Mushroom monograph → Herb & supplement monograph

Cassia Cinnamon

Interacts with 442 drugs

Cassia cinnamon is the common, inexpensive cinnamon used in cooking, and it is also taken as a supplement, most often for blood sugar support. The evidence for its health benefits is mixed a...

Read the full Cassia Cinnamon monograph → Herb & supplement monograph

Costus

Costus (Saussurea costus) is a root used in Ayurvedic, Unani, and traditional Chinese medicine, mostly for digestive and respiratory complaints. High-quality human evidence is very limited,...

Read the full Costus monograph → Herb & supplement monograph

Cramp Bark

Cramp Bark is the dried bark of Viburnum opulus, traditionally used to ease muscle and menstrual cramps. Modern, high-quality human studies are very limited, so its effectiveness is not well...

Read the full Cramp Bark monograph → Herb & supplement monograph

Bupleurum

Interacts with 327 drugs

Bupleurum (Chai Hu) is a root used in traditional Chinese medicine, usually as part of multi-herb formulas, for liver, digestive, and fever-related complaints. High-quality human evidence fo...

Read the full Bupleurum monograph → Herb & supplement monograph

Corydalis Yanhusuo

Interacts with 1,160 drugs

Corydalis yanhusuo is a traditional Chinese herb used mainly for pain. Some early laboratory and animal research suggests its compounds may affect pain and the nervous system, but high-quali...

Read the full Corydalis Yanhusuo monograph →
Sources

Sources & How We Checked

Cramp Bark Plus's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 248 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Ginger 64 references
  1. Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 1991;38:19-24. PubMed
  2. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2000;(2):CD000145. PubMed
  3. Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol 2001;97:577-82. DOI
  4. Backon J. Ginger in preventing nausea and vomiting of pregnancy; a caveat due to its thromboxane synthetase activity and effect on testosterone binding. Eur J Obstet Gynecol Reprod Biol 1991;42:163-4. PubMed
  5. Srivastava KC. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukot Essent Fatty Acids 1989;35:183-5. PubMed
  6. Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology 1991;42:111-20. PubMed
  7. Smith C, Crowther C, Willson K, et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
  8. Portnoi G, Chng LA, Karimi-Tabesh L, et al. Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Am J Obstet Gynecol 2003;189:1374-7.. PubMed
  9. Wigler I, Grotto I, Caspi D, Yaron M. The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis. Osteoarthritis Cartilage 2003;11:783-9. PubMed
  10. Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol 2005;45:74-80. PubMed
  11. Thomson M, Al-Qattan KK, Al-Sawan SM, et al. The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent. Prostaglandins Leukot Essent Fatty Acids 2002;67:475-8. PubMed
  12. Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis 1996;35:157-62. PubMed
  13. Akhani SP, Vishwakarma SL, Goyal RK. Anti-diabetic activity of Zingiber officinale in streptozotocin-induced type I diabetic rats. J Pharm Pharmacol 2004;56:101-5.
  14. Kruth P, Brosi E, Fux R, et al. Ginger-associated overanticoagulation by phenprocoumon. Ann Pharmacother 2004;38:257-60. PubMed
  15. Jiang X, Williams KM, Liauw WS, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32. PubMed
  16. Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005;105:849-56. PubMed
  17. Smith C, Crowther C, Wilson K et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
  18. Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
  19. Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.
  20. Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 2009;15:129-32. PubMed
  21. Black CD, Herring MP, Hurley DJ, O'Connor PJ. Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise. J Pain 2010;11:894-903. PubMed
  22. Heitmann K, Nordeng H, Holst L. Safety of ginger use in pregnancy: results from a large population-based cohort study. Eur J Clin Pharmacol 2012 Jun 17. PubMed
  23. Ryan JL, Heckler CE, Roscoe JA, et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer. 2012;20:1479-89. PubMed
  24. Backon J. Ginger as an antiemetic: possible side effects due to its thromboxane synthetase activity. Anaesthesia. 1991;46(8):705-6.. PubMed
  25. Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27:391-401. PubMed
  26. Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants and medicinal plants. An emerging interaction]. Ann Ital Med Int. 2000;15:139-43.
  27. Young HY, Liao JC, Chang YS, et al. Synergistic effect of ginger and nifedipine on human platelet aggregation: a study in hypertensive patients and normal volunteers. Am J Chin Med. 2006;34:545-51. PubMed
  28. Greenway FL, Liu Z, Martin CK, et al. Safety and efficacy of NT, an herbal supplement, in treating human obesity. Int J Obes (Lond). 2006;30:1737-41. PubMed
  29. Shalansky S, Lynd L, Richardson K, et al. Risk of warfarin-related bleeding events and supratherapeutic international normalized ratios associated with complementary and alternative medicine: a longitudinal analysis. Pharmacotherapy. 2007;27:1237-47. PubMed
  30. Lesho EP, Saullo L, Udvari-Nagy S. A 76-year-old woman with erratic anticoagulation. Cleve Clin J Med. 2004;71:651-6. PubMed
  31. Okonta JM, Uboh M, Obonga WO. Herb-Drug Interaction: A Case Study of Effect of Ginger on the Pharmacokinetic of Metronidazole in Rabbit. Indian Journal of Pharmaceutical Sciences (India) 2008;70(230):232. PubMed
  32. Chiang HM, Chao PD, Hsiu SL, et al. Ginger significantly decreased the oral bioavailability of cyclosporine in rats. Am J Chin Med. 2006;34:845-55. PubMed
  33. Bhandari U, Kanojia R, Pillai KK. Effect of ethanolic extract of Zingiber officinale on dyslipidaemia in diabetic rats. J Ethnopharmacol. 2005;97:227-30. PubMed
  34. Ojewole JA. Analgesic, antiinflammatory and hypoglycaemic effects of ethanol extract of Zingiber officinale (Roscoe) rhizomes (Zingiberaceae) in mice and rats. Phytother Res. 2006;20:764-72.
  35. Al-Amin ZM, Thomson M, Al-Qattan KK, et al. Anti-diabetic and hypolipidaemic properties of ginger (Zingiber officinale) in streptozotocin-induced diabetic rats. Br J Nutr. 2006;96:660-6.
  36. Islam MS, Choi H. Comparative effects of dietary ginger (Zingiber officinale) and garlic (Allium sativum) investigated in a type 2 diabetes model of rats. J Med Food. 2008;11:152-9.
  37. Cady RK, Goldstein J, Nett R, et al. A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine. Headache 2011;51:1078-86.
  38. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  39. Sripramote, M. and Lekhyananda, N. A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc.Thai. 2003;86(9):846-853.
  40. Lohsiriwat, S., Rukkiat, M., Chaikomin, R., and Leelakusolvong, S. Effect of ginger on lower esophageal sphincter pressure. J.Med.Assoc.Thai. 2010;93(3):366-372.
  41. Liu, P. H. and Ho, H. L. Ginger and drug bezoar induced small bowel obstruction. J R.Coll.Surg.Edinb. 1983;28(6):397-398.
  42. Maghbooli M, Golipour F, Moghimi Esfandabadi A, Yousefi M. Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine. Phytother Res 2014;28(3):412-5. PubMed
  43. Mahluji S, Attari VE, Mobasseri M, Payahoo L, Ostadrahimi A, Golzari SE. Effects of ginger (Zingiber officinale) on plasma glucose level, HbA1c and insulin sensitivity in type 2 diabetic patients. Int J Food Sci Nutr 2013;64(6):682-6.
  44. Mozaffari-Khosravi H, Talaei B, Jalali BA, Najarzadeh A, Mozayan MR. The effect of ginger powder supplementation on insulin resistance and glycemic indices in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Complement PubMed
  45. Paramdeep G. Efficacy and tolerability of ginger (Zingiber officinale) in patients of osteoarthritis of knee. Indian J Physiol Pharmacol 2013;57(2):177-83.
  46. Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med 2012;12:92. PubMed
  47. Viljoen E, Visser J, Koen N, Musekiwa A. A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutr J 2014;13:20. PubMed
  48. Bartels EM, Folmer VN, Bliddal H, et al. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis Cartilage. 2015;23(1):13-21. PubMed
  49. Choi JS, Han JY, Ahn HK, et al. Assessment of fetal and neonatal outcomes in the offspring of women who had been treated with dried ginger (Zingiberis rhizoma siccus) for a variety of illnesses during pregnancy. J Obstet Gynaecol. 2015;35(2):125-30.
  50. Marx W, McKavanagh D, McCarthy AL, Bird R, Ried K, Chan A, Isenring L. The effect of ginger (Zingiber officinale) on platelet aggregation: A systematic literature review. PLoS One. 2015;10(10):e0141119. PubMed
  51. Crichton M, Marshall S, Marx W, McCarthy AL, Isenring E. Efficacy of ginger (Zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: A systematic review update and meta-analysis. J Acad Nutr Diet. 2 PubMed
  52. Martins LB, Rodrigues AMDS, Monteze NM, et al. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) in the prophylactic treatment of migraine. Cephalalgia. 2020;40(1):88-95.
  53. Martins LB, Rodrigues AMDS, Rodrigues DF, Dos Santos LC, Teixeira AL, Ferreira AVM. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) addition in migraine acute treatment. Cephalalgia. 2019;39(1):68-76.
  54. Ahad A, Raish M, Bin Jardan YA, Alam MA, Al-Mohizea AM, Al-Jenoobi FI. Effect of Hibiscus sabdariffa and Zingiber officinale on the antihypertensive activity and pharmacokinetic of losartan in hypertensive rats. Xenobiotica. 2020:1-11.
  55. Okuhira H, Nakatani Y, Furukawa F, Kanazawa N. Anaphylaxis to ginger induced by herbal medicine. Allergol Int. 2020;69(1):159-160. PubMed
  56. Yamprasert R, Chanvimalueng W, Mukkasombut N, Itharat A. Ginger extract versus Loratadine in the treatment of allergic rhinitis: a randomized controlled trial. BMC Complement Med Ther. 2020;20(1):116. PubMed
  57. Ebrahimzadeh A, Ebrahimzadeh A, Mirghazanfari SM, Hazrati E, Hadi S, Milajerdi A. The effect of ginger supplementation on metabolic profiles in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. PubMed
  58. Alam MA, Bin Jardan YA, Alzenaidy B, et al. Effect of Hibiscus sabdariffa and Zingiber officinale on pharmacokinetics and pharmacodynamics of amlodipine. J Pharm Pharmacol 2021;73(9):1151-60.
  59. Akbarzadeh E, Heydari M, Atarzadeh F, Jaladat AM. Chronic dysuria following ginger (Zingiber officinale) use: a case report. Galen Med J 2018;7:e1086. DOI
  60. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  61. Rostamkhani H, Veisi P, Niknafs B, Jafarabadi MA, Ghoreishi Z. The effect of zingiber officinale on prooxidant-antioxidant balance and glycemic control in diabetic patients with ESRD undergoing hemodialysis: a double-blind randomized control trial. BMC Co PubMed
  62. Husain I, Dale OR, Idrisi M, et al. Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. J Agric Food Chem. 2023;71(19):7521-7534.
  63. Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018;131(1):e15-e30. PubMed
  64. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed

See these in context on the Ginger monograph →

Safflower 14 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Borkman M, Chisholm DJ, Furler SM, et al. Effects of fish oil supplementation on glucose and lipid metabolism in NIDDM. Diabetes 1989;38:1314-9.. PubMed
  5. Amato, P. and Quercia, R. A. A historical perspective and review of the safety of lipid emulsion in pregnancy. Nutr Clin Pract. 1991;6(5):189-192. PubMed
  6. Demke, D. M., Peters, G. R., Linet, O. I., Metzler, C. M., and Klott, K. A. Effects of a fish oil concentrate in patients with hypercholesterolemia. Atherosclerosis 1988;70(1-2):73-80. PubMed
  7. Kaji, K., Yoshida, S., Nagata, N., Yamashita, T., Mizukoshi, E., Honda, M., Kojima, Y., and Kaneko, S. An open-label study of administration of EH0202, a health-food additive, to patients with chronic hepatitis C. J Gastroenterol. 2004;39(9):873-878. PubMed
  8. Kwon, J. S., Snook, J. T., Wardlaw, G. M., and Hwang, D. H. Effects of diets high in saturated fatty acids, canola oil, or safflower oil on platelet function, thromboxane B2 formation, and fatty acid composition of platelet phospholipids. Am.J.Clin.Nutr. PubMed
  9. Lloyd-Still, J. D., Simon, S. H., Wessel, H. U., and Gibson, L. E. Negative effects of oral fatty acid supplementation on sweat chloride in cystic fibrosis. Pediatrics 1979;64(1):50-52. DOI
  10. Challen, A. D., Branch, W. J., and Cummings, J. H. The effect of aspirin and linoleic acid on platelet aggregation, platelet fatty acid composition and haemostasis in man. Hum Nutr Clin Nutr 1983;37(3):197-208.
  11. Asp ML, Collene AL, Norris LE, Cole RM, Stout MB, Tang SY, Hsu JC, Belury MA. Time-dependent effects of safflower oil to improve glycemia, inflammation and blood lipids in obese, post-menopausal women with type 2 diabetes: a randomized, double-masked, cro
  12. Liu Y, Liu S, Shi Y, et al. Effects of safflower injection on the pharmacodynamics and pharmacokinetics of warfarin in rats. Xenobiotica. 2017 Oct 25:1-6. [Epub ahead of print] PubMed
  13. de Ataide EC, Reges Perales S, de Oliveira Peres MA, et al. Acute liver failure induced by Carthamus tinctorius oil: Case reports and literature review. Transplant Proc. 2018;50(2):476-477. PubMed
  14. Ruyvaran M, Zamani A, Mohamadian A, et al. Safflower (Carthamus tinctorius L.) oil could improve abdominal obesity, blood pressure, and insulin resistance in patients with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial. PubMed

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Black Cohosh 68 references
  1. McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16. PubMed
  2. Whiting PW, Clouston A, Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2002;177:440-3. PubMed
  3. Pepping J. Black cohosh: Cimicifuga racemosa. Am J Health Syst Pharm 1999;56:1400-2. PubMed
  4. Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders. Adv Ther 1998;15:45-53.
  5. Kruse SO, Lohning A, Pauli GF, et al. Fukiic and piscidic acid esters from the rhizome of Cimicifuga racemosa and the in vitro estrogenic activity of fukinolic acid. Planta Med 1999;65:763-4.
  6. Jacobson JS, Troxel AB, Evans J, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol 2001;19:2739-45. PubMed
  7. Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
  8. Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
  9. Lontos S, Jones RM, Angus PW, Gow PJ. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2003;179:390-1.. DOI
  10. Wuttke W, Seidlova-Wuttke D, Gorkow C. The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas 2003;44:S67-77. PubMed
  11. Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause 2003;10:58-64.. DOI
  12. Cohen SM, O'Connor AM, Hart J, et al. Autoimmune hepatitis associated with the use of black cohosh: a case study. Menopause 2004;11:575-7. PubMed
  13. Vitetta L, Thomsen M, Sali A. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2003;178:411-2.. PubMed
  14. Thomsen M, Vitetta L, Schmidt M, Sali A. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2004;180:598-600.. DOI
  15. Cohen B, Schardt D. Center for Science in the Public Interest. Letter to Food and Drug Administration. Commissioner Mark McClellan, MD, PhD. March 4, 2004.
  16. Seidlova-Wuttke D, Hesse O, Jarry H, et al. Evidence for selective estrogen receptor modulator activity in a black cohosh (Cimicifuga racemosa) extract: comparison with estradiol-17beta. Eur J Endocrinol 2003;149:351-62. PubMed
  17. Rockwell S, Liu Y, Higgins SA. Alteration of the effects of cancer therapy agents on breast cancer cells by the herbal medicine black cohosh. Breast Cancer Res Treat 2005;90:233-9. PubMed
  18. Levitsky J, Alli TA, Wisecarver J, Sorrell MF. Fulminant liver failure associated with the use of black cohosh. Dig Dis Sci 2005;50:538-9. PubMed
  19. Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
  20. Nappi RE, Malavasi B, Brundu B, Facchinetti F. Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol. Gynecol Endocrinol 2005;20:30-5.
  21. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
  22. Minciullo PL, Saija A, Patafi M, et al. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine 2006;13:115-8. PubMed
  23. Wuttke W, Gorkow C, Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Men PubMed
  24. MHRA. Black cohosh (Cimicifuga racemosa) - risk of liver problems. Herbal Safety News July 2006. Available at: http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary= true&ssDocName=CON2024131&ssTargetNodeId=663.
  25. Dugoua JJ, Seely D, Perri D, et al. Safety and efficacy of black cohosh (cimicifuga racemosa) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e257-61.
  26. Raus K, Brucker C, Gorkow C, Wuttke W. First-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055. Menopause 2006;13:678-91. PubMed
  27. Lynch CR, Folkers ME, Hutson WR. Fulminant hepatic failure associated with the use of black cohosh: a case report. Liver Transpl 2006;12:989-92. PubMed
  28. Bai W, Henneicke-von Zepelin HH, Wang S, et al. Efficacy and tolerability of a medicinal product containing an isopropanolic black cohosh extract in Chinese women with menopausal symptoms: A randomized, double blind, parallel-controlled study versus tibol
  29. Meyer S, Vogt T, Obermann EC, et al. Cutaneous pseudolymphoma induced by Cimicifuga racemosa. Dermatology 2007;214:94-6.
  30. Gori L, Firenzuoli F. Is black cohosh a hepatotoxic medicinal herb? Forsch Komplementarmed 2007;14:109-10. PubMed
  31. Assessment of case reports connected to herbal medicinal products containing cimicifugae racemosa rhizoma (black cohosh, root). Doc. Ref. EMEA/269259/2006. Available at: www.emea.eu.int/pdfs/human/hmpc/26925806en.pdf (Accessed 30 November 2007).
  32. Chung DJ, Kim HY, Park KH, et al. Black cohosh and St. John's wort (GYNO-Plus) for climacteric symptoms. Yonsei Med J 2007;48:289-94. PubMed
  33. Chow ECY, Teo M, Ring JA, Chen JW. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust 2008;188:420-2. PubMed
  34. Mahady GB, Low Dog T, Barrett ML, et al. United States Pharmacopeia review of the black cohosh case reports of hepatotoxicity. Menopause 2008;15:628-38. PubMed
  35. Hepatotoxicity with black cohosh. Australian Adv Drug Reactions Bull 2006;25:6. Available at: www.tga.gov.au/adr/aadrb/aadr0604.htm#a1.
  36. Dunbar K, Solga SF. Black cohosh, safety, and public awareness. Liver Int 2007;27:1017. PubMed
  37. Patel NM, Derkits RM. Possible increase in liver enzymes secondary to atorvastatin and black cohosh administration. J Pharm Pract 2007;20:341-6. DOI
  38. Joy D, Joy J, Duane P. Black cohosh: a cause of abnormal postmenopausal liver function tests. Climacteric 2008;11:84-8. PubMed
  39. Australian Adverse Drug Reactions Advisory Committee. Black cohosh and liver toxicity - an update. Aust Adv Drug Reactions Bull 2007;26:11.
  40. Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
  41. Spangler L, Newton KM, Grothaus LC, et al. The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin. Maturitas 2007;57:195-204. PubMed
  42. Teschke R, Bahre R, Genthner A, et al. Suspected black cohosh hepatotoxicity - challenges and pitfalls of causality assessment. Maturitas 2009;63:302-14. PubMed
  43. Brasky TM, Lampe JW, Potter JD, et al. Specialty supplements and breast cancer risk in the VITamins And Lifestyle (VITAL) cohort. Cancer Epidemiol Biomarkers Prev 2010;19:1696-708. PubMed
  44. Fuchikami H, Satoh H, Tsujimoto M, Ohdo S, Ohtani H, Sawada Y. Effects of herbal extracts on the function of human organic anion-transporting polypeptide OATP-B. Drug Metab Dispos 2006;34:577-82. PubMed
  45. Vermes G, Bánhidy F, Acs N. The effects of remifemin on subjective symptoms of menopause. Adv Ther 2005;22:148-54. PubMed
  46. Nuntanakorn, P., Jiang, B., Einbond, L. S., Yang, H., Kronenberg, F., Weinstein, I. B., and Kennelly, E. J. Polyphenolic constituents of Actaea racemosa. J Nat Prod 2006;69(3):314-318.
  47. Oktem M, Eroglu D, Karahan HB, Taskintuna N, Kuscu E, Zeyneloglu HB. Black cohosh and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized trial. Adv Ther 2007;24:448-61. PubMed
  48. Briese V, Stammwitz U, Friede M, Henneicke-von Zepelin HH. Black cohosh with or without St. John's wort for symptom-specific climacteric treatment--results of a large-scale, controlled, observational study. Maturitas 2007;57:405-14. PubMed
  49. Naser, B. and Liske, E. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust. 1-19-2009;190(2):99. PubMed
  50. van de Meerendonk, H. W., van Hunsel, F. P., and van der Wiel, H. E. [Autoimmune hepatitis induced by Actaea racemosa. Side affects of an herb extract]. Ned.Tijdschr.Geneeskd. 2-7-2009;153(6):246-249.
  51. Wong, V. C., Lim, C. E., Luo, X., and Wong, W. S. Current alternative and complementary therapies used in menopause. Gynecol.Endocrinol. 2009;25(3):166-174. PubMed
  52. Pierard, S., Coche, J. C., Lanthier, P., Dekoninck, X., Lanthier, N., Rahier, J., and Geubel, A. P. Severe hepatitis associated with the use of black cohosh: a report of two cases and an advice for caution. Eur J Gastroenterol Hepatol. 2009;21(8):941-945 PubMed
  53. Vannacci, A., Lapi, F., Gallo, E., Vietri, M., Toti, M., Menniti-Ippolito, F., Raschetti, R., Firenzuoli, F., and Mugelli, A. A case of hepatitis associated with long-term use of Cimicifuga racemosa. Altern.Ther Health Med 2009;15(3):62-63.
  54. Zimmermann, R., Witte, A., Voll, R. E., Strobel, J., and Frieser, M. Coagulation activation and fluid retention associated with the use of black cohosh: a case study. Climacteric. 2010;13(2):187-191. PubMed
  55. Amsterdam JD, Yao Y, Mao JJ, Soeller I, Rockwell K, Shults J. Randomized, double-blind, placebo-controlled trial of Cimicifuga racemosa (black cohosh) in women with anxiety disorder due to menopause. J Clin Psychopharmacol 2009;29:478-83. PubMed
  56. Bai WP, Wang SY, Liu JL, Geng L, Hu LN, Zhang ZL, Chen SL, Zheng SR. [Efficacy and safety of remifemin compared to tibolone for controlling of perimenopausal symptoms]. Zhonghua Fu Chan Ke Za Zhi 2009;44:597-600.
  57. McKenzie, S. C. and Rahman, A. Bradycardia in a patient taking black cohosh. Med J Aust. 10-18-2010;193(8):479-481. PubMed
  58. Stolze H. [An alternative to treat menopausal complaints]. Gynecologie 1982;1:14-16.
  59. Guzman G, Kallwitz ER, Wojewoda C, et al. Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh. Case Rep Med. 2009;2009:918156. PubMed
  60. Enbom ET, Le MD, Oesterich L, Rutgers J, French SW. Mechanism of hepatotoxicity due to black cohosh (Cimicifuga racemosa): histological, immunohistochemical and electron microscopy analysis of two liver biopsies with clinical correlation. Exp Mol Pathol. PubMed
  61. Sen A. Orobuccolingual dyskinesia after long-term use of black cohosh and ginseng. J Neuropsychiatry Clin Neurosci 2013 Fall;25(4):E50. PubMed
  62. Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
  63. Pkhaladze L, Davidova N, Khomasuridze A, Shengelia R, Panossian AG. Actaea racemosa L. is more effective in combination with Rhodiola rosea L. for relief of menopausal symptoms: a randomized, double-blind, placebo-controlled study. Pharmaceuticals (Basel) PubMed
  64. Yalçin M, Oguz A, Bestepe EE, Saglam NGU, Ergelen M. Black cohosh associated mania in a patient with unipolar depression. Int J Psychiatry Med 2020 Sep 21:91217420961185. doi: 10.1177/0091217420961185. PubMed
  65. Brar HS, Marathi R. Case of cholestatic drug-induced liver injury (DILI) associated with black cohosh. BMJ Case Rep 2021;14(5):e240408. PubMed
  66. Castelo-Branco C, Navarro C, Beltrán E, Losa F, Camacho M; on the behalf of the Natural Products Study Group of the Spanish Menopause Society. Black cohosh efficacy and safety for menopausal symptoms. The Spanish Menopause Society statement. Gynecol Endoc PubMed
  67. Trant AA, Chagpar A, Wei W, et al. The Effect of Black Cohosh on Ki67 expression and Tumor Volume: A Pilot Study of Ductal Carcinoma in Situ Patients. Integr Cancer Ther 2022;21:15347354221137290. PubMed
  68. Dernbach MR, Carpenter JE, Shah N, Carter GB. Black Cohosh Interactions with Prescription Medications Associated with Serotonin Toxicity and Rhabdomyolysis: A Case Report. J Emerg Med 2024;66(5):e592-e596. PubMed

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Dong Quai 19 references
  1. Hirata JD, Swiersz LM, Zell B, et al. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertil Steril 1997;68:981-6. PubMed
  2. Page RL II, Lawrence JD. Potentiation of warfarin by dong quai. Pharmacotherapy 1999;19:870-6. PubMed
  3. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
  4. Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
  5. Dr. Duke's Phytochemical and Ethnobotanical Databases. Available at: http://www.ars-grin.gov/duke/.
  6. Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause 2002;9:145-50. PubMed
  7. Shi M, Chang L, He G. [Stimulating action of Carthamus tinctorius L., Angelica sinensis (Oliv.) Diels and Leonurus sibiricus L. on the uterus]. Zhongguo Zhong Yao Za Zhi 1995;20:173-5, 192.
  8. Hoult JR, Paya M. Pharmacological and biochemical actions of simple coumarins: natural products with therapeutic potential. Gen Pharmacol 1996;27:713-22.. PubMed
  9. Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
  10. Chang CJ, Chiu JH, Tseng LM, et al. Modulation of HER2 expression by ferulic acid on human breast cancer MCF7 cells. Eur J Clin Invest 2006;36:588-96. PubMed
  11. Chuang CH, Doyle P, Wang JD, et al. Herbal medicines used during the first trimester and major congenital malformations: an analysis of data from a pregnancy cohort study. Drug Saf 2006;29:537-48. PubMed
  12. Lau CBS, Ho TCY, Chan TWL, Kim SCF. Use of dong quai (Angelica sinensis) to treat peri- and postmenopausal symptoms in women with breast cancer: is it appropriate? Menopause 2005;12:734-40.
  13. Ellis GR, Stephens MR. Untitled (photograph and a brief case report). BMJ 1999;319:650.
  14. Nambiar, S., Schwartz, R. H., and Constantino, A. Hypertension in mother and baby linked to ingestion of Chinese herbal medicine. West J Med 1999;171(3):152.
  15. Lee, S. K., Cho, H. K., Cho, S. H., Kim, S. S., Nahm, D. H., and Park, H. S. Occupational asthma and rhinitis caused by multiple herbal agents in a pharmacist. Ann.Allergy Asthma Immunol. 2001;86(4):469-474. PubMed
  16. Xu, J. and Li, G. [Observation on short-term effects of Angelica injection on chronic obstructive pulmonary disease patients with pulmonary hypertension]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2000;20(3):187-189.
  17. Scott, G. N. and Elmer, G. W. Update on natural product--drug interactions. Am J Health Syst.Pharm 2-15-2002;59(4):339-347. PubMed
  18. Circosta, C., Pasquale, R. D., Palumbo, D. R., Samperi, S., and Occhiuto, F. Estrogenic activity of standardized extract of Angelica sinensis. Phytother.Res. 2006;20(8):665-669.
  19. Fung FY, Wong WH, Ang SK, et al. A randomized, double-blind, placebo- controlled study on the anti-haemostatic effects of Curcuma longa, Angelica sinensis and Panax ginseng. Phytomedicine. 2017;32:88-96. PubMed

See these in context on the Dong Quai monograph →

Peony 15 references
  1. Chen LC, Chou MH, Lin MF, Yang LL. Effects of Paeoniae Radix, a traditional Chinese medicine, on the pharmacokinetics of phenytoin. J Clin Pharm Ther 2001;26:271-8. PubMed
  2. Guo TL, Zhou XW. [Clinical observations on the treatment of the gestational hypertension syndrome with Angelica and Paeonia powder]. Zhong Xi Yi Jie He Za Zhi 1986;6:714-6, 707.
  3. Xie HJ, Yasar U, Sandberg M, Rane A. Paeoniae Radix, a traditional Chinese medicine, and CYP2C9 activity. J Clin Pharm Ther 2002;27:229-30. . PubMed
  4. Harada M, Suzuki M, Ozaki Y. Effect of Japanese Angelica root and peony root on uterine contraction in the rabbit in situ. J Pharmacobiodyn 1984;7:304-11. PubMed
  5. Anon. Monograph. Peony (Paeonia spp). Alt Med Rev 2001;6:495-9.
  6. Bruynzeel DP. Contact Dermatitis Due to Paeonia (Peony). Contact Dermatitis 1989; 20:152-3..
  7. Bian, X., Xu, Y., Zhu, L., Gao, P., Liu, X., Liu, S., Qian, M., Gai, M., Yang, J., and Wu, Y. Prevention of maternal-fetal blood group incompatibility with traditional Chinese herbal medicine. Chin Med J (Engl.) 1998;111(7):585-587.
  8. Wong, A. L. and Chan, T. Y. Interaction between warfarin and the herbal product quilinggao. Ann Pharmacother 2003;37(6):836-838.
  9. Cai Y, Yuan Q, Xu K, et al. Assessment of the therapeutic effect of total glycosides of peony for juvenile idiopathic arthritis: a systematic review and meta-analysis. Evid Based Complement Alternat Med 2016;2016:8292486.
  10. Koo YK, Kim JM, Koo JY, et al. Platelet anti-aggregatory and blood anti-coagulant effects of compounds isolated from Paeonia lactiflora and Paeonia suffruticosa. Pharmazie 2010;65(8):624-8.
  11. Wang W, Tian DD, Zheng B, et al. Peony-glycyrrhiza decoction, an herbal preparation, inhibits clozapine metabolism via cytochrome P450s, but not flavin-containing monooxygenase in in vitro models. Drug Metab Dispos 2015;43(7):1147-53. PubMed
  12. Zhou Y, Jin L, Kong F, et al. Clinical and immunological consequences of total glucosides of paeony treatment in Sjögren's syndrome: A randomized controlled pilot trial. Int Immunopharmacol. 2016 Oct;39:314-319. doi: 10.1016/j.intimp.2016.08.006. PubMed
  13. Zhu Q, Qi X, Wu Y, Wang K. Clinical study of total glucosides of paeony for the treatment of diabetic kidney disease in patients with diabetes mellitus. Int Urol Nephrol. 2016 Nov;48(11):1873-1880. doi: 10.1007/s11255-016-1345-5. PubMed
  14. Xu Y, Li X, Chen T, et al. Radix Paeoniae Alba increases serum estrogen level and up-regulates estrogen receptor expression in uterus and vagina of immature/ovariectomized mice. Phytother Res. 2019;33(1):117-29. [RETRACTED].
  15. Liu X, Li X, Li X, et al. The efficacy and safety of total glucosides of peony in the treatment of primary Sjögren's syndrome: a multi-center, randomized, double-blinded, placebo-controlled clinical trial. Clin Rheumatol. 2019;38(3):657-64. Erratum i

See these in context on the Peony monograph →

Adrue 1 reference
  1. Rakotonirina, V. S., Bum, E. N., Rakotonirina, A., and Bopelet, M. Sedative properties of the decoction of the rhizome of Cyperus articulatus. Fitoterapia 2001;72(1):22-29. PubMed

See these in context on the Adrue monograph →

Poria Mushroom 3 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Kim H, Park I, Park K, Park S, Kim YI, Park BG. The positive effects of Poria cocos extract on quality of sleep in insomnia rat models. Int J Environ Res Public Health 2022;19(11):6629. PubMed
  3. Lv Q, Di X, Bian B, Li K, Guo J. Neuroprotective effects of Poria cocos (Agaricomycetes) essential oil on Aß1-40-induced learning and memory deficit in rats. Int J Med Mushrooms 2022;24(10):73-82.

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Cassia Cinnamon 20 references
  1. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  2. Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26:3215-8. PubMed
  3. De Benito V, Alzaga R. Occupational allergic contact dermatitis from cassia (Chinese cinnamon) as a flavouring agent in coffee. Contact Dermatitis 1999;40:165. PubMed
  4. Drake TE, Maibach HI. Allergic contact dermatitis and stomatitis caused by a cinnamic aldehyde-flavored toothpaste. Arch Dermatol 1976;112:202-3.
  5. Press release. Cinnamon capsules to reduce blood sugar are medicinal products! Efficacy has not been scientifically proven - some products contain high levels of coumarin. Federal Institute of Risk Assessment (BfM), Germany, November 11, 2006. Available a
  6. Felter SP, Vassallo JD, Carlton BD, Daston GP. A safety assessment of coumarin taking into account species-specificity of toxicokinetics. Food Chem Toxicol 2006;44:462-75. PubMed
  7. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009;22:507-12. PubMed
  8. Akilen, R., Tsiami, A., Devendra, D., and Robinson, N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet.Med. 2010; PubMed
  9. Lu T, Sheng H Wu J Cheng Y Zhu J Chen Y. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res. 2012;32(6):408-412. PubMed
  10. Choi, J., Lee, K. T., Ka, H., Jung, W. T., Jung, H. J., and Park, H. J. Constituents of the essential oil of the Cinnamomum cassia stem bark and the biological properties. Arch Pharm Res 2001;24(5):418-423.
  11. Altschuler JA, Casella SJ, MacKenzie TA, Curtis KM. The effect of cinnamon on A1C among adolescents with type 1 diabetes. Diabetes Care 2007;30(4):813-6. PubMed
  12. Stoecker BR, Zhan Z, Luo R, et al. Cinnamon extract lowers blood glucose in hyperglycemic subjects. FASEB J. 2010;22:722.1 (Abstract only). DOI
  13. Admani S, Hill H, Jacob SE. Cinnamon Sugar Scrub Dermatitis: "Natural" Is Not Always Best. Pediatr Dermatol. 2017;34(1):e42-e43. PubMed
  14. Isaac-Renton M, Li MK, Parsons LM. Cinnamon spice and everything not nice: many features of intraoral allergy to cinnamic aldehyde. Dermatitis. 2015;26(3):116-21. PubMed
  15. Vandersall A, Katta R. Eyelid dermatitis as a manifestation of systemic contact dermatitis to cinnamon. Dermatitis. 2015 Jul-Aug;26(4):189. PubMed
  16. Wickenberg J, Lindstedt S, Nilsson J, Hlebowicz J. Cassia cinnamon does not change the insulin sensitivity or the liver enzymes in subjects with impaired glucose tolerance. Nutr J 2014 Sep 24;13:96. PubMed
  17. Brancheau D, Patel B, Zughaib M. Do cinnamon supplements cause acute hepatitis? Am J Case Rep 2015;16:250-4. PubMed
  18. Shekarchizadeh-Esfahani P, Heydarpour F, Izadi F, Jalili C. The effect of cinnamon supplementation on liver enzymes in adults: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2021;58:102699. PubMed
  19. Bernaola J, Valverde-Monge M, Otal-Buesa M, Cullen D, Heras-Mendaza F. Cinnamon allergic contact cheilitis. Contact Dermatitis 2023;88(5):418-419. PubMed
  20. Patel K, Howard M, Tate B. Cheilitis caused by allergic contact dermatitis to cinnamon in chai tea: A case report. Contact Dermatitis 2023;88(3):239-240. PubMed

See these in context on the Cassia Cinnamon monograph →

Costus 6 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Marzulli, F. N. and Maibach, H. I. Effects of vehicles and elicitation concentration in contact dermatitis testing. I. Experimental contact sensitization in humans. Contact Dermatitis 1976;2(6):325-329. PubMed
  3. Mitchell, J. C. Contact hypersensitivity to some perfume materials. Contact Dermatitis 1975;1(4):196-199. PubMed
  4. Benezra, C. and Epstein, W. L. Molecular recognition patterns of sesquiterpene lactones in costus-sensitive patients. Contact Dermatitis 1986;15(4):223-230. PubMed
  5. Mitchell, J. C. and Epstein, W. L. Contact hypersensitivity to a perfume material, Costus Absolute. The role of sesquiterpene lactones. Arch.Dermatol 1974;110(6):871-873. DOI
  6. Cheminat, A., Stampf, J. L., Benezra, C., Farrall, M. J., and Frechet, J. M. Allergic contact dermatitis to costus: removal of haptens with polymers. Acta Derm.Venereol. 1981;61(6):525-529. DOI

See these in context on the Costus monograph →

Bupleurum 17 references
  1. Kobashi Y, Nakajima M, Niki Y, Matsushima T. [A case of acute eosinophilic pneumonia due to Sho-saiko-to]. Nippon Kyobu Shikkan Gakkai Zasshi 1997;35:1372-7.
  2. Wada Y, Kubo M. [Acute lymphoblastic leukemia complicated by type C hepatitis during treatment and further by acute interstitial pneumonia due to sho-saiko-to in 7-year-old]. Arerugi 1997;46:1148-55.
  3. Sato A, Toyoshima M, Kondo A, et al. [Pneumonitis induced by the herbal medicine Sho-saiko-to in Japan]. Nippon Kyobu Shikkan Gakkai Zasshi 1997;35:391-5.
  4. Daibo A, Yoshida Y, Kitazawa S, et al. [A case of pneumonitis and hepatic injury caused by a herbal drug (sho-saiko-to)]. Nippon Kyobu Shikkan Gakkai Zasshi 1992;30:1583-8.
  5. Sugiyama H, Nagai M, Kotajima F, et al. [A case of interstitial pneumonia with chronic hepatitis C following interferon-alfa and sho-saiko-to therapy]. Arerugi 1995;44:711-4.
  6. Ishizaki T, Sasaki F, Ameshima S, et al. Pneumonitis during interferon and/or herbal drug therapy in patients with chronic active hepatitis. Eur Respir J 1996;9:2691-6. PubMed
  7. Nakagawa A, Yamaguchi T, Takao T, Amano H. [Five cases of drug induced pneumonitis due to Sho-saiko-to or interferon-alpha or both]. Nippon Kyobu Shikkan Gakkai Zasshi 1995;33:1361-6.
  8. Miyazaki E, Ando M, Ih K, et al. [Pulmonary edema associated with the Chinese medicine shosaikoto]. Nihon Kokyuki Gakkai Zasshi 1998;36:776-80.
  9. Matsumoto T, Yamada H. Regulation of immune complexes binding of macrophages by pectic polysaccharide from Bupleurum falcatum L.: pharmacological evidence for the requirement of intracellular calcium/calmodulin on Fc receptor up-regulation by bupleuran 2
  10. Hattori T, Ito M, Suzuki Y. [Studies on antinephritic effects of plant components in rats (1). Effects of saikosaponins original-type anti-GBM nephritis in rats and its mechanisms]. Nippon Yakurigaku Zasshi 1991;97:13-21. PubMed
  11. Chang WC, Hsu FL. Inhibition of platelet activation and endothelial cell injury by flavan-3-ol and saikosaponin compounds. Prostaglandins Leukot Essent Fatty Acids 1991;44:51-6. PubMed
  12. Kato M, Pu MY, Isobe K, et al. Characterization of the immunoregulatory action of saikosaponin-d. Cell Immunol 1994;159:15-25. PubMed
  13. Ushio Y, Oda Y, Abe H. Effect of saikosaponin on the immune responses in mice. Int J Immunopharmacol 1991;13:501-8. PubMed
  14. Hirayama, C., Okumura, M., Tanikawa, K., and et al. A multicenter randomized controlled clinical trial of Shosaiko-to in chronic active hepatitis. Gastroenterol Jpn 1989;24(6):715-719. PubMed
  15. Hiai S, Yokoyama H, Nagasawa T, and et al. Stimulation of the pituitary-adrenocortical axis by saikosaponin of Bupleuri radix. Chemical and Pharmaceutical Bulletin (Tokyo) 1981;29(2):495-499. PubMed
  16. Yokoyama H, Hiai S, and Oura H. Chemical structures and corticosterone secretion-inducing activities of saikosaponins. Chem Pharm Bull (Tokyo) 1981;29(2):500-504. PubMed
  17. Sugiyama H, Nagai M, Kotajima F, and et al. [A case of interstitial pneumonia with chronic hepatitis C following interferon-alfa and sho-saiko-to therapy]. Arerugi 1995;44(7):711-714.

See these in context on the Bupleurum monograph →

Corydalis Yanhusuo 21 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201-8. PubMed
  3. Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
  4. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  5. Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab 2008;93:2559-65. PubMed
  6. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  7. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
  8. Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
  9. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  10. Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
  11. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  12. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.
  13. Yin, J., Xing, H., and Ye, J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism 2008;57(5):712-717. PubMed
  14. Zhang, H., Wei, J., Xue, R., Wu, J. D., Zhao, W., Wang, Z. Z., Wang, S. K., Zhou, Z. X., Song, D. Q., Wang, Y. M., Pan, H. N., Kong, W. J., and Jiang, J. D. Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin re
  15. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  16. Wei, W., Zhao, H., Wang, A., Sui, M., Liang, K., Deng, H., Ma, Y., Zhang, Y., Zhang, H., and Guan, Y. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndro
  17. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
  18. Chun YT, Yip TT, Lau KL, and et al. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmac 1979;10:177-182. PubMed
  19. Hou Q, Han W, Fu X. Pharmacokinetic interaction between tacrolimus and berberine in a child with idiopathic nephrotic syndrome. Eur J Clin Pharmacol 2013;69(10):1861-2. PubMed
  20. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. PubMed
  21. Lyu Y, Zhang Y, Yang M, et al. Pharmacokinetic interactions between metformin and berberine in rats: Role of oral administration sequences and microbiota. Life Sci. 2019;235:116818. PubMed

See these in context on the Corydalis Yanhusuo monograph →

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