He Shou Wu Ingredients & Drug Interactions
by Herb Pharm
What is this page for?
First and foremost: checking He Shou Wu 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
He Shou Wu is a dietary supplement by Herb Pharm with 1 active ingredient. Its ingredients are commonly taken for anti-aging and longevity, hair graying and hair loss, general tonic for vitality.Based on those ingredients, 1,257 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are He Shou Wu root (Reynoutria multiflora) extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against He Shou Wu by Herb Pharm
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HelloPharmacist Scorecard of He Shou Wu by Herb Pharm
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.
What’s inside
Full disclosure
He Shou Wu contains one active ingredient: fo-ti root extract from Reynoutria multiflora. The liquid also includes certified organic cane alcohol and distilled water as inactive ingredients to deliver the extract.
Does it work?
Couldn't assess
The evidence on fo-ti for its traditional uses isn't established in our data. Claims about age-related cognitive decline, hair loss (androgenic alopecia), Alzheimer disease, osteoporosis, and cardiovascular health all carry insufficient reliable evidence to rate.
How safe is it?
Well-documented data
Fo-ti carries real safety concerns. It's been linked to liver injury in around 450 documented cases in medical literature, affecting people of all ages and occurring across a wide range of doses and durations.
The damage has ranged from mild hepatitis to cirrhosis and liver failure. More commonly, unprocessed fo-ti causes abdominal pain, diarrhea, nausea, and vomiting.
The data advises against use in pregnancy and while breastfeeding due to insufficient safety information.
Meds to double-check
Moderate interaction found
Check before starting if you take blood thinners (like warfarin), heart medications (especially digoxin), water pills, pain relievers like sulindac, stimulant laxatives, or drugs that are processed by your liver's CYP2C8 or CYP2B6 enzymes. The interaction severity is Moderate across all these types.
The bottom line
Scorecard at a glanceFully disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
If you're on a blood thinner or heart medication, or take water pills, you'll need to check with your pharmacist before starting this product. Liver safety is a real concern with fo-ti, and the evidence for what it actually does is thin.
Talk to your pharmacist about whether this makes sense for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Dec 22, 2019.
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
General information
Key facts about He Shou Wu, straight from the product label.
| Brand | Herb Pharm |
|---|---|
| Barcode (UPC) | 090700001650 |
| Net contents | 4 fl. Oz.; 120 mL |
| Market status | On market |
| Date entered into DSLD | Dec 22, 2019 |
| DSLD ID | 210189 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free |
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 He Shou Wu by Herb Pharm, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| He Shou Wu root (Reynoutria multiflora) extract | 658 mg | -- |
Other ingredients: certified organic Cane Alcohol, distilled Water
Tap any ingredient to jump to its full detail below.
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.
Suggested/Recommended/Usage/Directions
Suggested use Shake well before using Add 1 full squeeze of the dropper bulb to 2 oz. of water or juice, 2 to 4 times per day. Best taken between meals.
Precautions
Caution: Not for use in persons with diarrhea.
Keep out of the reach of children
Storage
Store away from heat & light
Formula
Reynoutria multiflora
He Shou Wu Liquid Extract
We prepare our He Shou Wu Extract from the dried root of Reynoutria multiflora plants which are processed with Black Beans (Phaseolus vulgaris) according to traditional Chinese methods.
Formulation
Musculoskeletal
Gluten-free
Dry herb/mentruum ratio: 1:5
FDA Statement of Identity
Herbal Supplement
FDA Disclaimer Statement
This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
He Shou Wu by Herb Pharm label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
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)The Ingredients in He Shou Wu by Herb Pharm
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size0.7 mL Dosage formLiquid Servings per container168 Amounts shown are per serving.
He Shou Wu root (Reynoutria multiflora) extract
Interacts with1,257 drugs
Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these be...
He Shou Wu root (Reynoutria multiflora) extract monograph & interactionsOther (inactive) ingredients: Certified organic Cane Alcohol, Distilled Water. These complete the product’s ingredient list but are not active constituents.
He Shou Wu by Herb Pharm Drug Interactions
HelloPharmacist Interaction Report
He Shou Wu by Herb Pharm contains fo-ti root extract, which carries documented interaction risks with a number of medications.
The most serious concern is with blood thinners (anticoagulants) like warfarin—fo-ti has been linked to cases of acute liver failure that can worsen bleeding risk, and in one documented case a patient stable on warfarin developed severely elevated INR levels after 90 days of fo-ti use.
Read the full breakdown — every affected drug type, severity by severity
Beyond blood thinners, fo-ti may interact with several other drug types. It could theoretically increase the effects of drugs metabolized by your liver's CYP2C8 and CYP2B6 enzymes, and it may alter levels of sulindac (Clinoril), a pain reliever.
Raw fo-ti root in particular can act like a stimulant laxative, which raises risks when combined with digoxin (a heart medication), water pills (diuretics), or other stimulant laxatives—diarrhea can worsen bleeding on blood thinners and cause dangerous drops in potassium.
Altogether, these interactions span 1,236 individual medications. Before you start this product, run your exact medications through the interaction checker below.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against He Shou Wu?
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in He Shou Wu interact with 1,257 drugs. Click any drug to see the details.
1 of the 1 ingredient in He Shou Wu interact with drugs. Each result below shows which ingredient is responsible. He Shou Wu root (Reynoutria multiflora) extract
AlogliptinNesina
How Alogliptin interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 2c8 (cyp2c8) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2C8.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractAntidiabetes Drugs, Cytochrome P450 2c8 (cyp2c8) Substrates +2 Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Alteplase, Tpa interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Ambrisentan interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amiloride, Hydrochlorothiazide interactionAminosalicylic AcidPaser
How Aminosalicylic Acid interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Aminosalicylic Acid interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +3 Moderate
Interaction Summary
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C19.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 2c19 (cyp2c19) Substrates +3 Moderate
Interaction Summary
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C9.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +3 Moderate
Interaction Summary
Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amitriptyline, Perphenazine interactionAmlodipineNorliqva
How Amlodipine interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amlodipine Besylate interactionAmlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amlodipine Besylate, Benazepril interactionAmlodipine, CelecoxibConsensi
How Amlodipine, Celecoxib interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amlodipine, Celecoxib interactionAmmonium ChlorideAmmonium Chloride
How Ammonium Chloride interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Ammonium Chloride interactionAmobarbital, SecobarbitalTuinal
How Amobarbital, Secobarbital interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 2b6 (cyp2b6) Substrates Moderate
Interaction Summary
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2B6.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amobarbital, Secobarbital interactionAmoxicillinAmix, Amoram, Amoxident, Amoxil Capsules, Amoxil Injection, Galenamox +3 more
How Amoxicillin interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amoxicillin interactionAmoxicillin VeterinaryBiomox
How Amoxicillin Veterinary interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amoxicillin Veterinary interactionAmoxicillin, Clavulanate PotassiumAugmentin, Augmentin '125/31 SF', Augmentin '250/62 SF', Augmentin XR, Augmentin-Duo 400/57, Clavulin
How Amoxicillin, Clavulanate Potassium interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amoxicillin, Clavulanate Potassium interactionAmoxicillin, Omeprazole Magnesium, RifabutinTalicia
How Amoxicillin, Omeprazole Magnesium, Rifabutin interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractHepatotoxic Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates +2 Moderate
Interaction Summary
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionAmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amphetamine interactionAmphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine SulfateAdderall, Adderall XR
How Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate interactionAmphetamine SulfateBenzedrine, Evekeo ODT
How Amphetamine Sulfate interacts with He Shou Wu — through 1 ingredient. Tap an ingredient for the detail:
He Shou Wu Root (reynoutria Multiflora) ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full He Shou Wu Root (reynoutria Multiflora) Extract + Amphetamine Sulfate interactionEach ingredient & the kinds of drugs it affects
For each ingredient in He Shou Wu with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
He Shou Wu root (Reynoutria multiflora) extract
Anticoagulant/Antiplatelet Drugs
Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery. Theoretically, concomitant use of fo-ti with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients. Until more is known, monitor patients taking fo-ti and drugs that affect bleeding.
Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Antidiabetes Drugs
Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Fo-ti reportedly has hypoglycemic effects.
Contraceptive Drugs
Theoretically, taking large amounts of fo-ti might interfere with contraceptive drugs due to competition for estrogen receptors.
In vitro research suggests that fo-ti extract has estrogenic activity.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2B6.
Animal research suggests that fo-ti might inhibit CYP2B6. One in vitro study suggests that the degree of CYP2B6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C19.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C19. An in vitro study suggests that the degree of CYP2C19 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2C8.
In vitro research suggests that fo-ti might inhibit CYP2C8. However, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C9.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C9. However, this interaction has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Animal research suggests that fo-ti might inhibit CYP2D6. Additionally, an in vitro study suggests that the degree of CYP2D6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction has not been reported in humans.
Digoxin (Lanoxin)
Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia and cardiotoxicity when taken with digoxin.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects. In vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.
Diuretic Drugs
Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia when taken with diuretic drugs.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects and compound diuretic-induced potassium loss. In vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.
Estrogens
Theoretically, taking large amounts of fo-ti might interfere with hormone replacement therapy through competition for estrogen receptors.
In vitro research suggests that fo-ti extract has estrogenic activity.
Hepatotoxic Drugs
Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Fo-ti has been linked to liver damage in many reports.
Stimulant Laxatives
Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of fluid and electrolyte depletion when taken with stimulant laxatives.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects. However, in vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.
Sulindac (Clinoril)
Theoretically, fo-ti might increase or decrease the levels and clinical effects of sulindac.
Animal research suggests that the type of fo-ti extract might affect the levels of sulindac differently; the raw plant may increase levels, but processed parts may decrease levels. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.
Warfarin (Coumadin)
Theoretically, fo-ti might increase the effects and adverse effects of warfarin.
Fo-ti may have stimulant laxative effects and cause diarrhea, especially when the raw or unprocessed fo-ti root is used. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Also, fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of warfarin. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery.
Brand information
Manufacturer and brand details for He Shou Wu, from the product label.
Herb Pharm
See all Herb Pharm products- Name
- Herb Pharm
- City
- Williams
- State
- OR
- ZipCode
- 97544
- Phone Number
- 800-348-4372
- Web Address
- www.herb-pharm.com
He Shou Wu by Herb Pharm: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.
The Full Monographs Behind He Shou Wu’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
He Shou Wu'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.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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 28 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.
Fo-ti 28 references
- Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
- Park GJ, Mann SP, Ngu MC. Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum. J Gastroenterol Hepatol 2001;16:115-7.
- But PP, Tomlinson B, Lee KL. Hepatitis related to the Chinese medicine Shou-wu-pian manufactured from Polygonum multiflorum. Vet Hum Toxicol 1996;38:280-2.
- Oerter Klein KO, Janfaza M, Wong JA, Chang RJ. Estrogen bioactivity in Fo-Ti and other herbs used for their estrogen-like effects as determined by a recombinant cell bioassay. J Clin Endocrinol Metab 2003;88:4077-9.. PubMed
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- UK Medicines and Healthcare Products Regulatory Agency. Polygonum multiflorum and liver reactions. April 2006. Available at: www.mhra.gov.uk/home/idcplg?IdcService= SS_GET_PAGE&useSecondary=true&ssDocName= CON2023590&ssTargetNodeId= 833 (Accessed 10 May 2
- Panis B, Wong DR, Hooymans PM, De Smet PA, Rosias PP. Recurrent toxic hepatitis in a Caucasian girl related to the use of Shou-Wu-Pian, a Chinese herbal preparation. J Pediatr Gastroenterol Nutr 2005;41:256-8. PubMed
- Mazzanti G, Battinelli L, Daniele C, et al. New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese herbal product derived from Polygonum multiflorum. Ann Intern Med 2004;140:E589-90.
- Cardenas A, Restrepo JC, Sierra F, Correa G. Acute hepatitis due to shen-min: a herbal product derived from Polygonum multiflorum. J Clin Gastroenterol 2006;40:629-32. PubMed
- Zhang CZ, Wang SX, Zhang Y, et al. In vitro estrogenic activities of Chinese medicinal plants traditionally used for the management of menopausal symptoms. J Ethnopharmacol 2005;98:295-300. PubMed
- Laird AR, Ramchandani N, deGoma EM, et al. Acute hepatitis associated with the use of an herbal supplement (Polygonum multiflorum) mimicking iron-overload syndrome. J Clin Gastroenterol 2008;42:861-2. PubMed
- Jung KA, Min HJ, Yoo SS, et al. Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb. Gut Liver 2011;5(4):493-9. PubMed
- Kang, S. C., Lee, C. M., Choi, H., Lee, J. H., Oh, J. S., Kwak, J. H., and Zee, O. P. Evaluation of oriental medicinal herbs for estrogenic and antiproliferative activities. Phytother Res 2006;20(11):1017-1019. PubMed
- Yuen, M. F., Tam, S., Fung, J., Wong, D. K., Wong, B. C., and Lai, C. L. Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1-year prospective study. Aliment.Pharmacol.Ther 10-15-2006;24(8):1179-1186. PubMed
- Zhang, L., Yang, X., Sun, Z., and Qu, Y. [Retrospective study of adverse events of Polygonum multiflorum and risk control]. Zhongguo Zhong.Yao Za Zhi. 2009;34(13):1724-1729.
- Bae, S. H., Kim, D. H., Bae, Y. S., Lee, K. J., Kim, D. W., Yoon, J. B., Hong, J. H., and Kim, S. H. [Toxic hepatitis associated with Polygoni multiflori]. Korean J.Hepatol. 2010;16(2):182-186. PubMed
- Furukawa, M., Kasajima, S., Nakamura, Y., Shouzushima, M., Nagatani, N., Takinishi, A., Taguchi, A., Fujita, M., Niimi, A., Misaka, R., and Nagahara, H. Toxic hepatitis induced by show-wu-pian, a Chinese herbal preparation. Intern.Med. 2010;49(15):1537-1 PubMed
- McGuffin, M., Hobbs, C., Upton, R., and Goldberg, A. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC;1997.
- Dong H, Slain D, Cheng J, Ma W, Liang W. Eighteen cases of liver injury following ingestion of Polygonum multiflorum. Complement Ther Med 2014;22(1):70-4. PubMed
- Lei X, Chen J, Ren J, et al. Liver damage associated with Polygonum multiflorum Thunb.: a systematic review of case reports and case series. Evid Based Complement Alternat Med 2015;2015:459749.
- Ma KF, Zhang XG, Jia HY. CYP1A2 polymorphism in Chinese patients with acute liver injury induced by Polygonum multiflorum. Genet Mol Res 2014;13(3):5637-43. PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Yu J, Xie J, Mao XJ, et al. Comparison of laxative and antioxidant activities of raw, processed and fermented Polygoni multiflori radix. Chin J Nat Med 2012;10(1):63-7. DOI
- Shao YL, Ma CM, Wu JM, Guo FC, Zhang SC. Concurrent severe hepatotoxicity and agranulocytosis induced by Polygonum multiflorum: A case report. World J Clin Cases 2022;10(27):9921-9928.
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC