Kidney Support Tonic Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Kidney Support Tonic 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
Kidney Support Tonic is a dietary supplement by Wise Woman Herbals with 6 active ingredients. Its ingredients are commonly taken for boosting energy and fighting fatigue, improving mental focus and memory, coping with stress (adaptogen).Based on those ingredients, 1,690 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Ginkgo, Asian Ginseng, Dan Shen. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Kidney Support Tonic by Wise Woman Herbals
Ask about any prescription or over-the-counter medication and we check it for interactions with Kidney Support Tonic by Wise Woman Herbals — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Kidney Support Tonic by Wise Woman Herbals
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
Low disclosure
Kidney Support Tonic contains 6 ingredients, four of which we can identify: ginkgo, astragalus, Chinese rhubarb, and Asian ginseng. The product also lists cornsilk and Dan Shen, plus a proprietary blend (meaning the exact amounts aren't disclosed).
The inactive ingredients are water, alcohol, and vegetable glycerine. Ginkgo is used traditionally to support circulation and cognitive function.
Astragalus has a history in herbal medicine for immune support. Chinese rhubarb root is used as a digestive aid, though it's a strong laxative.
Asian ginseng, cornsilk, and Dan Shen round out the formula, though the amounts in the blend are not specified on the label.
Does it work?
Moderate evidence
The evidence for these ingredients is mixed. Ginkgo has possibly effective ratings for hearing loss, stroke recovery, schizophrenia, premenstrual syndrome, dementia, and anxiety — meaning some clinical data supports these uses but more research is still needed.
For astragalus and the other ingredients in this product, the effectiveness evidence we hold is rated as insufficient — meaning we don't have enough reliable data to say whether they work for the conditions they're traditionally used for. Talk with your pharmacist if you're taking this product for a specific health concern.
How safe is it?
Well-documented data
Ginkgo is generally well tolerated in adults but carries a notable concern: it can increase bleeding risk, so caution is warranted if you're prone to bleeding or have a history of blood clots. The most common side effects are dizziness and mild stomach upset.
Rare but serious side effects include cardiac arrhythmias (irregular heartbeat) and spontaneous bleeding — case reports exist, though in most, other bleeding risk factors were also present. Astragalus is also generally well tolerated short-term, though human safety data is limited.
The main side effects reported are dizziness and, with intravenous forms, rash or itching. Chinese rhubarb root is safe in food amounts but as a supplement can cause cramping, diarrhea, nausea, and (with long-term use) electrolyte loss and kidney problems.
Do not use rhubarb long-term. Pregnancy: the safety data advises against ginkgo and rhubarb in pregnancy; astragalus data is insufficient.
Breastfeeding: ginkgo and rhubarb are best avoided; astragalus data is insufficient. Talk with your doctor or pharmacist before use if you're pregnant or nursing.
Meds to double-check
Major interaction found
Before taking this product, check your current medications against the tool on this page — especially if you take talinolol or other heart rhythm drugs (Major risk with ginkgo), blood thinners like warfarin, cholesterol or diabetes medications, immunosuppressants, lithium, corticosteroids, diuretics, digoxin, or chemotherapy agents. No interactions are documented for Asian ginseng, cornsilk, or Dan Shen, but those ingredients weren't checked because we hold no data for them.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.
This product contains ingredients with real interactions — especially with heart medications, blood thinners, and diabetes drugs. If you take any prescription medications, check them against the interaction tool on this page first.
Ginkgo is the main concern here; the others add to the picture. Talk with your pharmacist about whether this tonic fits your personal health situation.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 24, 2023.
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 Kidney Support Tonic, straight from the product label.
| Brand | Wise Woman Herbals |
|---|---|
| Barcode (UPC) | 748840046375 |
| Net contents | 2 Fluid oz.; 60 mL |
| Market status | On market |
| Date entered into DSLD | May 24, 2023 |
| DSLD ID | 284856 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Kidney Support Tonic by Wise Woman Herbals, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Asian Ginseng | 0 NP | -- |
| Ginkgo | 0 NP | -- |
| Astragalus | 0 NP | -- |
| Proprietary Blend | 3 mL | -- |
| Cornsilk | 0 NP | -- |
| Dan Shen | 0 NP | -- |
| Chinese Rhubarb | 0 NP | -- |
Other ingredients: Water, Alcohol, Vegetable Glycerine
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: Add 60 drops to water, 3 times per day.
Formulation
The presence of particulate matter in this product is normal.
Precautions
Caution: Keep out of the reach of children.
General Statements
Botanical formula
FDA Statement of Identity
Dietary Supplement
Storage
Store in a cool, dry area away from direct sunlight with the lid tightly sealed.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Kidney Support Tonic by Wise Woman Herbals 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 Kidney Support Tonic by Wise Woman Herbals
These are the 6 active ingredients this product is made of. Select any to open its full monograph.
Serving size60 Drop(s) Dosage formLiquid Servings per container20 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.
Proprietary Blend
- › Asian Ginseng
- › Ginkgo
- › Astragalus
- › Cornsilk
- › Dan Shen
- › Chinese Rhubarb
Other (inactive) ingredients: Water, Alcohol, Vegetable Glycerine. These complete the product’s ingredient list but are not active constituents.
Kidney Support Tonic by Wise Woman Herbals Drug Interactions
HelloPharmacist Interaction Report
Kidney Support Tonic by Wise Woman Herbals contains several ingredients with documented interactions.
The most serious is ginkgo, which causes a Major interaction with talinolol — a cardiac medication — by raising its blood levels by up to 36% when the extract is taken regularly, potentially causing overdose effects.
Read the full breakdown — every affected drug type, severity by severity
Ginkgo also interacts at Moderate severity with blood thinners like warfarin (raising bleeding risk), the cholesterol drug simvastatin (reducing its effect), anxiety medication alprazolam (lowering its levels), the antidepressant trazodone (potentially raising its levels), the HIV drug efavirenz (lowering its effect), the diabetes medication rosiglitazone (lowering its effect), and the immunosuppressant tacrolimus (raising its levels).
Astragalus carries Moderate interactions with immunosuppressant drugs (potentially weakening them), lithium (a mood stabilizer that may accumulate), cancer chemotherapy agents like cyclophosphamide (potentially weakening it), and diabetes medications (raising the risk of low blood sugar). Chinese rhubarb interacts at Moderate severity with kidney-damaging drugs, liver-damaging drugs, corticosteroids, diuretics, other laxatives, warfarin, digoxin (a heart medication), and cyclosporine (an immunosuppressant).
We could not check Asian ginseng, cornsilk, or Dan Shen for interactions — no data is on file for these. Altogether, these interactions span 1,540 individual medications.
Use the medication checker on this page to see if any of your drugs are affected.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Kidney Support Tonic?
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 Kidney Support Tonic interact with 1,690 drugs. Click any drug to see the details.
5 of the 6 ingredients in Kidney Support Tonic interact with drugs. Each result below shows which ingredient is responsible. Ginkgo Asian Ginseng Dan Shen Chinese Rhubarb Astragalus
AbciximabReoPro
How Abciximab interacts with Kidney Support Tonic — through 3 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Abciximab interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Abciximab interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Abciximab interactionAbrocitinibCibinqo
How Abrocitinib interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Abrocitinib interactionGinkgoCytochrome P450 2c19 (cyp2c19) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Read the full Ginkgo + Abrocitinib interactionAsian GinsengAnticoagulant/antiplatelet Drugs, Immunosuppressants Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Abrocitinib interactionAstragalusImmunosuppressants Moderate
Interaction Summary
Theoretically, astragalus might interfere with immunosuppressive therapy.
Read the full Astragalus + Abrocitinib interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Kidney Support Tonic — through 3 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Acenocoumarol interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Acenocoumarol interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Acenocoumarol interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAspirin, Glucuronidated Drugs +3 Major
Interaction Summary
Theoretically, danshen may increase the levels of aspirin and the risk of bleeding.
Read the full Dan Shen + Acetaminophen, Aspirin interactionGinkgoAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Acetaminophen, Aspirin interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Acetaminophen, Aspirin interactionChinese RhubarbHepatotoxic Drugs, Nephrotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Read the full Chinese Rhubarb + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +4 Major
Interaction Summary
Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Dan Shen + Acetaminophen, Aspirin, Caffeine interactionGinkgoCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo + Acetaminophen, Aspirin, Caffeine interactionChinese RhubarbNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Acetaminophen, Aspirin, Caffeine interactionAsian GinsengAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, IbuprofenCombogesic
How Acetaminophen, Ibuprofen interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs +3 Major
Interaction Summary
Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Dan Shen + Acetaminophen, Ibuprofen interactionGinkgoCytochrome P450 2c9 (cyp2c9) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP2C9.
Read the full Ginkgo + Acetaminophen, Ibuprofen interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Acetaminophen, Ibuprofen interactionChinese RhubarbNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Acetaminophen, Ibuprofen interactionAcetylsalicylic AcidEntrophen
How Acetylsalicylic Acid interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Aspirin Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Acetylsalicylic Acid interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Acetylsalicylic Acid interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Acetylsalicylic Acid interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Acetylsalicylic Acid interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with Kidney Support Tonic — through 3 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Alteplase, Tpa interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Alteplase, Tpa interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Alteplase, Tpa interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Aspirin Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAsian GinsengCytochrome P450 2d6 (cyp2d6) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full Asian Ginseng + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionGinkgoSeizure Threshold Lowering Drugs, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Aspirin Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAnacaulase-bcdbNexoBrid
How Anacaulase-bcdb interacts with Kidney Support Tonic — through 3 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Anacaulase-bcdb interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Anacaulase-bcdb interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Anacaulase-bcdb interactionAnagrelideAgrylin
How Anagrelide interacts with Kidney Support Tonic — through 3 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Anagrelide interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Anagrelide interactionGinkgoCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo + Anagrelide interactionAnisindioneMiradon
How Anisindione interacts with Kidney Support Tonic — through 3 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Anisindione interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Anisindione interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Anisindione interactionAntithrombin IiiThrombate III
How Antithrombin Iii interacts with Kidney Support Tonic — through 3 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Antithrombin Iii interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Antithrombin Iii interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Antithrombin Iii interactionApixabanEliquis
How Apixaban interacts with Kidney Support Tonic — through 3 ingredients. Tap an ingredient for the detail:
Dan ShenP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Major
Interaction Summary
Danshen might alter the levels of drugs cleared by p-glycoprotein.
Read the full Dan Shen + Apixaban interactionAsian GinsengAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Apixaban interactionGinkgoAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Apixaban interactionArgatrobanArgatroban
How Argatroban interacts with Kidney Support Tonic — through 3 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Argatroban interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Argatroban interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Argatroban interactionAspirinAngettes 75, ASA, Asaphen, Aspirin, Caprin, Cartia +8 more
How Aspirin interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Aspirin Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Aspirin interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Aspirin interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Aspirin interactionAspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
How Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAspirin, Anticoagulant/antiplatelet Drugs Major
Interaction Summary
Theoretically, danshen may increase the levels of aspirin and the risk of bleeding.
Read the full Dan Shen + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionGinkgoAnticoagulant/antiplatelet Drugs, Seizure Threshold Lowering Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionAsian GinsengAnticoagulant/antiplatelet Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionAspirin, ButalbitalAxotal
How Aspirin, Butalbital interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Aspirin Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Aspirin, Butalbital interactionAsian GinsengAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Aspirin, Butalbital interactionGinkgoAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Aspirin, Butalbital interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Butalbital interactionAspirin, Butalbital, CaffeineFiorinal
How Aspirin, Butalbital, Caffeine interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAspirin, Anticoagulant/antiplatelet Drugs +2 Major
Interaction Summary
Theoretically, danshen may increase the levels of aspirin and the risk of bleeding.
Read the full Dan Shen + Aspirin, Butalbital, Caffeine interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Butalbital, Caffeine interactionGinkgoCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo + Aspirin, Butalbital, Caffeine interactionAsian GinsengAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Aspirin, Butalbital, Caffeine interactionAspirin, Butalbital, Caffeine, Codeine PhosphateFiorinal w/ Codeine
How Aspirin, Butalbital, Caffeine, Codeine Phosphate interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Major
Interaction Summary
Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Dan Shen + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionGinkgoCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionAsian GinsengStimulant Drugs, Anticoagulant/antiplatelet Drugs +3 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Asian Ginseng + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionAspirin, Butalbital, Caffeine, PhenacetinMarnal
How Aspirin, Butalbital, Caffeine, Phenacetin interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Aspirin, Butalbital, Caffeine, Phenacetin interactionAsian GinsengCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Asian Ginseng + Aspirin, Butalbital, Caffeine, Phenacetin interactionGinkgoAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Aspirin, Butalbital, Caffeine, Phenacetin interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Butalbital, Caffeine, Phenacetin interactionAspirin, CaffeineAnacin
How Aspirin, Caffeine interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Aspirin +2 Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Aspirin, Caffeine interactionGinkgoCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo + Aspirin, Caffeine interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Caffeine interactionAsian GinsengAnticoagulant/antiplatelet Drugs, Stimulant Drugs +2 Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Aspirin, Caffeine interactionAspirin, Caffeine, Codeine PhosphateAnacin w/ Codeine
How Aspirin, Caffeine, Codeine Phosphate interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Major
Interaction Summary
Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Dan Shen + Aspirin, Caffeine, Codeine Phosphate interactionGinkgoAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Aspirin, Caffeine, Codeine Phosphate interactionAsian GinsengCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +3 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Asian Ginseng + Aspirin, Caffeine, Codeine Phosphate interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Caffeine, Codeine Phosphate interactionAspirin, Caffeine, Dihydrocodeine BitartrateSynalgos DC
How Aspirin, Caffeine, Dihydrocodeine Bitartrate interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionAsian GinsengCytochrome P450 2d6 (cyp2d6) Substrates, Stimulant Drugs +3 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full Asian Ginseng + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionGinkgoCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionAspirin, Caffeine, Dover's PwdAcedoval, Dovacet
How Aspirin, Caffeine, Dover's Pwd interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +2 Major
Interaction Summary
Danshen might alter the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Dan Shen + Aspirin, Caffeine, Dover's Pwd interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Caffeine, Dover's Pwd interactionGinkgoCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo + Aspirin, Caffeine, Dover's Pwd interactionAsian GinsengAnticoagulant/antiplatelet Drugs, Stimulant Drugs +2 Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Aspirin, Caffeine, Dover's Pwd interactionAspirin, Caffeine, HydrocodoneDamason-P
How Aspirin, Caffeine, Hydrocodone interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenCytochrome P450 1a2 (cyp1a2) Substrates, Aspirin +2 Major
Interaction Summary
Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Dan Shen + Aspirin, Caffeine, Hydrocodone interactionGinkgoCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo + Aspirin, Caffeine, Hydrocodone interactionAsian GinsengCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +3 Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Asian Ginseng + Aspirin, Caffeine, Hydrocodone interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Caffeine, Hydrocodone interactionAspirin, Caffeine, Isobutylallylbarbituric Acid, PhenacetinLanorinal
How Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Aspirin +2 Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionAsian GinsengAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Asian Ginseng + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionGinkgoAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionAspirin, Caffeine, OrphenadrineInvagesic, Invagesic Forte, Norgesic, Norgesic Forte, Orphengesic, Orphengesic Forte
How Aspirin, Caffeine, Orphenadrine interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenAnticoagulant/antiplatelet Drugs, Aspirin +2 Major
Interaction Summary
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Dan Shen + Aspirin, Caffeine, Orphenadrine interactionGinkgoCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Read the full Ginkgo + Aspirin, Caffeine, Orphenadrine interactionChinese RhubarbNephrotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Caffeine, Orphenadrine interactionAsian GinsengCaffeine, Anticoagulant/antiplatelet Drugs +2 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Read the full Asian Ginseng + Aspirin, Caffeine, Orphenadrine interactionAspirin, Caffeine, Phenacetin, PropoxypheneMargesic Comp. 65
How Aspirin, Caffeine, Phenacetin, Propoxyphene interacts with Kidney Support Tonic — through 4 ingredients. Tap an ingredient for the detail:
Dan ShenCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Major
Interaction Summary
Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Dan Shen + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionGinkgoAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionAsian GinsengStimulant Drugs, Caffeine +3 Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Asian Ginseng + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionChinese RhubarbNephrotoxic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
Read the full Chinese Rhubarb + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Kidney Support Tonic 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.
Ginkgo
Talinolol
Taking ginkgo with talinolol seems to increase blood levels of talinolol.
There is some evidence that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of talinolol by 36% in healthy male individuals. However, single doses of ginkgo do not seem to affect talinolol pharmacokinetics.
Alprazolam (Xanax)
Theoretically, ginkgo might decrease the levels and clinical effects of alprazolam.
In clinical research, ginkgo extract (Ginkgold) 120 mg twice daily seems to decrease alprazolam levels by about 17%. However, ginkgo does not appear to decrease the elimination half-life of alprazolam. This suggests that ginkgo is more likely to decrease absorption of alprazolam rather than induce hepatic metabolism of alprazolam.
Anticoagulant/Antiplatelet Drugs
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin. Theoretically, ginkgo might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. However, population and clinical studies have produced mixed results. Some evidence shows that short-term use of ginkgo leaf does not significantly reduce platelet aggregation and blood clotting. A study in healthy males who took a specific ginkgo leaf extract (EGb 761) 160 mg twice daily for 7 days found no change in prothrombin time. An analysis of a large medical record database suggests that ginkgo increases the risk of a bleeding adverse event by 38% when taken concurrently with warfarin. It has been suggested that ginkgo has to be taken for at least 2-3 weeks to have a significant effect on platelet aggregation. However, a meta-analysis of 18 studies using standardized ginkgo extracts, 80-480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. In addition, a single dose of ginkgo plus clopidogrel or ticlopidine does not seem to significantly increase bleeding time or platelet aggregation. Also, taking ginkgo leaf extract daily for 8 days in conjunction with rivaroxaban does not affect anti-factor Xa activity; however, this study did not evaluate bleeding time.
Anticonvulsants
Theoretically, ginkgo might reduce the effectiveness of anticonvulsants.
Ginkgo seeds contain ginkgotoxin. Large amounts of ginkgotoxin can cause neurotoxicity and seizure. Ginkgotoxin is present in much larger amounts in ginkgo seeds than leaves. Ginkgo leaf extract contains trace amounts of ginkgotoxin. The amount of ginkgotoxin in ginkgo leaf and leaf extract seems unlikely to cause toxicity. However, there are anecdotal reports of seizure occurring after use of ginkgo leaf both in patients without a history of seizure disorder and in those with previously well-controlled epilepsy.
Antidiabetes Drugs
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Ginkgo leaf extract seems to alter insulin secretion and metabolism, and might affect blood glucose levels in people with type 2 diabetes. The effect of ginkgo seems to differ depending on the insulin and treatment status of the patient. In diet-controlled diabetes patients with hyperinsulinemia, taking ginkgo does not seem to significantly affect insulin or blood glucose levels. In patients with hyperinsulinemia who are treated with oral hypoglycemic agents, taking ginkgo seems to decrease insulin levels and increase blood glucose following an oral glucose tolerance test. Researchers speculate that this could be due to ginkgo-enhanced hepatic metabolism of insulin. In patients with pancreatic exhaustion, taking ginkgo seems to stimulate pancreatic beta-cells, resulting in increased insulin and C-peptide levels, but with no significant change in blood glucose levels in response to an oral glucose tolerance test.
Atorvastatin (Lipitor)
Theoretically, ginkgo might decrease the levels and clinical effects of atorvastatin.
In humans, intake of ginkgo extract appears to increase atorvastatin clearance, reducing the area under the curve of atorvastatin by 10% to 14% and the maximum concentration by 29%. However, this interaction does not appear to affect cholesterol synthesis and absorption. Further, a model in rats with hyperlipidemia suggests that administering ginkgo extract does not impact blood levels of atorvastatin and leads to lower total cholesterol, low-density lipoprotein cholesterol, and triglycerides when compared with rats given atorvastatin alone.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that ginkgo leaf extract can mildly inhibit CYP1A2 enzymes. However, clinical research suggests ginkgo might not affect CYP1A2. Until more is known, use ginkgo cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Some clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce CYP2C19 enzymes and potentially decrease levels of drugs metabolized by these enzymes. However, other clinical research shows that taking ginkgo 120 mg twice daily for 12 days has no effect on levels of drugs metabolized by CYP2C19.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, ginkgo might increase levels of drugs metabolized by CYP2C9.
In vitro, a specific standardized extract of ginkgo leaf (EGb 761) inhibits CYP2C9 activity . The terpenoid (ginkgolides) and flavonoid (quercetin, kaempferol, etc.) constituents seem to be responsible for this effect. Most ginkgo extracts contain some amount of these constituents. Therefore, other ginkgo leaf extracts might also inhibit the CYP2C9 enzyme. However, clinical research suggests that ginkgo might not have a significant effect on CYP2C9 in humans. Ginkgo does not seem to significantly affect the pharmacokinetics of CYP2C9 substrates diclofenac or tolbutamide.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
There is conflicting evidence about whether ginkgo induces or inhibits CYP3A4. Ginkgo does not appear to affect hepatic CYP3A4. However, it is not known if ginkgo affects intestinal CYP3A4. Preliminary clinical research suggests that taking ginkgo does not significantly affect levels of donepezil, lopinavir, or ritonavir, which are all CYP3A4 substrates. Other clinical research also suggests ginkgo does not significantly affect CYP3A4 activity. However, there are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4).
Efavirenz (Sustiva)
Theoretically, ginkgo might decrease the levels and clinical effects of efavirenz.
There are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. In one case, an HIV-positive male experienced over a 50% decrease in efavirenz levels over the course of 14 months while taking ginkgo extract. HIV-1 RNA copies also increased substantially, from less than 50 to more than 1500. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4). In another case report, a patient stable on antiviral therapy including efavirenz for 10 years, had an increase in viral load from <50 copies/mL to 1350 copies/mL after 2 months of taking a combination of supplements including ginkgo. After stopping ginkgo, the viral load was again controlled with the same antiviral therapy regimen.
Ibuprofen (Advil, Others)
Theoretically, ginkgo might increase the risk of bleeding when used with ibuprofen.
Ginkgo might have antiplatelet effects and has been associated with several case reports of spontaneous bleeding. In one case, a 71-year-old male had taken a specific ginkgo extract (Gingium, Biocur) 40 mg twice daily for 2.5 years. About 4 weeks after starting ibuprofen 600 mg daily he experienced a fatal intracerebral hemorrhage. However, the antiplatelet effects of ginkgo have been questioned. A meta-analysis and other studies have not found a significant antiplatelet effect with standardized ginkgo extracts, 80 mg to 480 mg taken daily for up to 32 weeks.
P-Glycoprotein Substrates
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
A small clinical study in healthy volunteers shows that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of the P-glycoprotein substrate, talinolol, by 36% in healthy male individuals. However, single doses of ginkgo do not have the same effect.
Risperidone (Risperdal)
Theoretically, taking ginkgo with risperidone might increase the levels and adverse effects of risperidone.
A single case of priapism has been reported for a 26-year-old male with schizophrenia who used risperidone 3 mg daily along with ginkgo extract 160 mg daily. Risperidone is metabolized by cytochrome P450 (CYP) 2D6 and CYP3A4. CYP3A4 activity might be affected by ginkgo. Theoretically, ginkgo may inhibit the metabolism of risperidone and increase the risk of adverse effects.
Rosiglitazone (Avandia)
Theoretically, ginkgo might decrease the levels and clinical effects of rosiglitazone.
Animal research shows that ginkgo leaf extract orally 100 or 200 mg/kg daily for 10 days alters the pharmacodynamics of rosiglitazone in a dose-dependent manner. The 100 mg/kg and 200 mg/kg doses reduce the area under the concentration time curve (AUC) of rosiglitazone by 39% and 52%, respectively, and the half-life by 28% and 39%, respectively. It is hypothesized that these changes may be due to induction of cytochrome P450 2C8 by ginkgo.
Seizure Threshold Lowering Drugs
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Ginkgo seeds contain ginkgotoxin. Large amounts of ginkgotoxin can cause neurotoxicity and seizure. Ginkgotoxin is present in much larger amounts in ginkgo seeds than leaves. Ginkgo leaf extract contains trace amounts of ginkgotoxin. The amount of ginkgotoxin in ginkgo leaf and leaf extract seems unlikely to cause toxicity. However, there are anecdotal reports of seizure occurring after use of ginkgo leaf both in patients without a history of seizure disorder and in those with previously well-controlled epilepsy.
Simvastatin (Zocor)
Theoretically, ginkgo might decrease the levels and clinical effects of simvastatin.
Clinical research shows that taking ginkgo extract can reduce the area under the curve and maximum concentration of simvastatin by 32% to 39%. However, ginkgo extract does not seem to affect the cholesterol-lowering ability of simvastatin.
Sofosbuvir (Sovaldi)
Theoretically, ginkgo might increase the levels and clinical effects of sofosbuvir.
Animal research in rats shows that giving a ginkgo extract 25 mg/kg orally daily for 14 days increases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 11%, increases the half-life by 60%, and increases the plasma concentration at 4 hours by 38%. This interaction appears to be related to the inhibition of intestinal P-glycoprotein by ginkgo.
Tacrolimus (Prograf)
Theoretically, ginkgo might increase the blood levels of tacrolimus.
In vitro evidence suggests that certain biflavonoids in ginkgo leaves (i.e. amentoflavone, ginkgetin, bilobetin) may inhibit the metabolism of tacrolimus by up to 50%. This interaction appears to be time-dependent and due to inhibition of cytochrome P450 (CYP) 3A4 by these bioflavonoids. In rats given tacrolimus 1 mg/kg orally, amentoflavone was shown to increase the area under the concentration time curve (AUC) of tacrolimus by 3.8-fold.
Trazodone (Desyrel)
Theoretically, ginkgo might increase the levels and clinical effects of trazodone.
In a case report, an Alzheimer patient taking trazodone 20 mg twice daily and ginkgo leaf extract 80 mg twice daily for four doses became comatose. The coma was reversed by administration of flumazenil (Romazicon). Coma might have been induced by excessive GABA-ergic activity. Ginkgo flavonoids are thought to have GABA-ergic activity and act directly on benzodiazepine receptors. Ginkgo might also increase metabolism of trazodone to active GABA-ergic metabolites, possibly by inducing cytochrome P450 3A4 (CYP3A4) metabolism.
Warfarin (Coumadin)
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. Information from a medical database suggests that when taken concurrently with warfarin, ginkgo increases the risk of a bleeding adverse event by 38%. There is also some evidence that ginkgo leaf extract can inhibit cytochrome P450 2C9, an enzyme that metabolizes warfarin. This could result in increased warfarin levels. However, population and clinical research has produced mixed results. Clinical research in healthy people suggests that ginkgo has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. A meta-analysis of 18 studies using standardized ginkgo extracts, 80 mg to 480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. There is also some preliminary clinical research that suggests ginkgo might not significantly increase the effects of warfarin in patients that have a stable INR.
Nifedipine (Procardia)
Theoretically, taking ginkgo with oral, but not intravenous, nifedipine might increase levels and adverse effects of nifedipine.
Animal research and some clinical evidence suggests that taking ginkgo leaf extract orally in combination with oral nifedipine might increase nifedipine levels and cause increased side effects, such as headaches, dizziness, and hot flushes. However, taking ginkgo orally does not seem to affect the pharmacokinetics of intravenous nifedipine.
Omeprazole (Prilosec)
Theoretically, taking ginkgo with omeprazole might decrease the levels and clinical effects of omeprazole.
Clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce cytochrome P450 (CYP) 2C19 enzymes and decrease levels of omeprazole by about 27% to 42%.
Asian Ginseng
Anticoagulant/Antiplatelet Drugs
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that ginsenoside constituents in Panax ginseng might decrease platelet aggregation. However, research in humans suggests that ginseng does not affect platelet aggregation. Animal research indicates low oral bioavailability of Rb1 and rapid elimination of Rg1, which might explain the discrepancy between in vitro and human research. Until more is known, use with caution in patients concurrently taking anticoagulant or antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Monitor blood glucose levels closely.
Caffeine
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects. Theoretically, caffeine might have an additive effect on the stimulant effects of Panax ginseng.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6. However, research is conflicting.
There is some evidence that Panax ginseng can inhibit the CYP2D6 enzyme by approximately 6%. In addition, in animal research, Panax ginseng inhibits the metabolism of dextromethorphan, a drug metabolized by CYP2D6, by a small amount. However, contradictory research suggests Panax ginseng might not inhibit CYP2D6. Until more is known, use Panax ginseng cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Panax ginseng may affect the clearance of drugs metabolized by CYP3A4. One such drug is imatinib. Inhibition of CYP3A4 was believed to be responsible for a case of imatinib-induced hepatotoxicity. In contrast, Panax ginseng has been shown to increase the clearance of midazolam, another drug metabolized by CYP3A4. Clinical research shows that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng. Until more is known, use Panax ginseng cautiously in combination with CYP3A4 substrates.
Estrogens
Theoretically, concomitant use of large amounts of Panax ginseng might interfere with hormone replacement therapy.
Laboratory research and some case reports suggest that Panax ginseng can have estrogenic effects due to competition for estrogen receptors. The estrogenic activity is attributed to the ginsenoside constituents of Panax ginseng.
Furosemide (Lasix)
Theoretically, Panax ginseng might reduce the effects of furosemide.
There is some concern that Panax ginseng might contribute to furosemide resistance. There is one case of resistance to furosemide diuresis in a patient taking a germanium-containing ginseng product.
Imatinib (Gleevec)
Theoretically, Panax ginseng might increase the effects and adverse effects of imatinib.
A case of imatinib-induced hepatotoxicity has been reported for a 26-year-old male with chronic myelogenous leukemia stabilized on imatinib for 7 years. The patient took imatinib 400 mg along with a Panax ginseng-containing energy drink daily for 3 months. Since imatinib-associated hepatotoxicity typically occurs within 2 years of initiating therapy, it is believed that Panax ginseng affected imatinib toxicity though inhibition of cytochrome P450 3A4. CYP3A4 is the primary enzyme involved in imatinib metabolism.
Immunosuppressants
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Panax ginseng might have immune system stimulating properties.
Insulin
Theoretically, taking Panax ginseng with insulin might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Insulin dose adjustments might be necessary in patients taking Panax ginseng; use with caution.
Midazolam (Versed)
Theoretically, Panax ginseng may increase the clearance of midazolam.
Midazolam is metabolized by cytochrome P450 3A4 (CYP3A4). Clinical research suggests that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, Panax ginseng can interfere with MAOI therapy.
Concomitant use of Panax ginseng with phenelzine (Nardil) is associated with insomnia, headache, tremors, and hypomania.
Nifedipine (Procardia)
Theoretically, taking Panax ginseng with nifedipine might increase serum levels of nifedipine and the risk of hypotension.
Preliminary clinical research shows that concomitant use can increase serum levels of nifedipine in healthy volunteers. This might cause the blood pressure lowering effects of nifedipine to be increased when taken concomitantly with Panax ginseng.
Qt Interval-Prolonging Drugs
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias. However, research is conflicting.
Clinical research shows that short-term use of Panax ginseng can increase the QT interval. However, no changes in QT interval have been identified with prolonged use.
Raltegravir (Isentress)
Theoretically, taking Panax ginseng with raltegravir might increase the risk of liver toxicity.
A case report suggests that concomitant use of Panax ginseng with raltegravir can increase serum levels of raltegravir, resulting in elevated liver enzymes levels.
Selegiline (Eldepryl)
Theoretically, Panax ginseng might increase or decrease levels of selegiline, possibly altering the effects and side effects of selegiline.
Animal research shows that taking selegiline with a low dose of Panax ginseng extract (1 gram/kg) reduces selegiline bioavailability, while taking a high dose of Panax ginseng extract (3 grams/kg) increases selegiline bioavailability. More research is needed to confirm these effects.
Stimulant Drugs
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects.
Warfarin (Coumadin)
Panax ginseng might affect the clearance of warfarin. However, this interaction appears to be unlikely.
There has been a single case report of decreased effectiveness of warfarin in a patient who also took Panax ginseng. However, it is questionable whether Panax ginseng was the cause of this decrease in warfarin effectiveness. Some research in humans and animals suggests that Panax ginseng does not affect the pharmacokinetics of warfarin. However, other research in humans suggests that Panax ginseng might modestly increase the clearance of the S-warfarin isomer. More evidence is needed to determine whether Panax ginseng causes a significant interaction with warfarin.
Fexofenadine (Allegra)
Theoretically, Panax ginseng might decrease blood levels of oral or intravenous fexofenadine.
Animal research suggests that taking Panax ginseng in combination with oral or intravenous fexofenadine may reduce the bioavailability of fexofenadine. Some scientists have attributed this effect to the ability of Panax ginseng to increase the expression of P-glycoprotein.
Lopinavir/Ritonavir (Kaletra)
Although Panax ginseng has demonstrated variable effects on cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir, Panax ginseng is unlikely to alter levels of lopinavir/ritonavir.
Lopinavir is metabolized by CYP3A4 and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Panax ginseng has shown variable effects on CYP3A4 activity in humans. However, taking Panax ginseng (Vitamer Laboratories) 500 mg twice daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in 12 healthy volunteers.
Dan Shen
Anticoagulant/Antiplatelet Drugs
Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Danshen has been reported to have antithrombotic effects. Animal research also suggests that taking a danshen combination formula with clopidogrel exhibits a synergistic increase in antiplatelet aggregation and prolongation of coagulation time when compared with either taken alone.
Digoxin (Lanoxin)
Theoretically, using danshen with digoxin might increase the risk of adverse effects.
Danshen has structural and pharmacological similarities to cardiac glycosides.
Amlodipine (Norvasc)
Theoretically, taking danshen in combination with amlodipine may decrease the clinical effects of amlodipine.
In animal research, taking danshen orally in combination with amlodipine reduced blood levels of amlodipine by about 52%. This may have been due to induction of cytochrome P450 3A4 (CYP3A4) by danshen, which has been demonstrated in vitro. So far, this interaction has not been reported in humans.
Antihypertensive Drugs
Theoretically, taking danshen with antihypertensive drugs might increase the risk of hypotension.
Animal research suggests that danshen can produce dose-dependent hypotensive effects. Furthermore, concomitant use with captopril appears to potentiate this effect.
Aspirin
Theoretically, danshen may increase the levels of aspirin and the risk of bleeding.
Research in healthy adult males shows that taking a combination of danshen and kudzu with aspirin increases plasma aspirin area under the curve by approximately 3.4-fold. Animal research also shows that taking a combination of danshen and kudzu (danshen-gegen formula) with aspirin increases maximal blood levels of aspirin and salicylic acid by approximately 4-fold and 3.7-fold, respectively, without impacting blood loss. Taking danshen increases the antiplatelet activity of aspirin and might increase the side effects of aspirin.
Clopidogrel (Plavix)
Theoretically, danshen may increase the risk of bleeding if taken with clopidogrel.
Clopidogrel is an antiplatelet prodrug that is metabolized by carboxyl esterase 1 (CES1) to an inactive metabolite. Animal research shows that a danshen combination formula decreases the activity of CES1, decreasing levels of the inactive metabolite in the blood and possibly increasing levels of the active metabolite. Animal research also suggests that taking a danshen combination formula with clopidogrel exhibits a synergistic increase in antiplatelet aggregation and prolongation of coagulation time when compared with either taken alone.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research shows that danshen tincture and various constituents of danshen inhibit the activity of CYP1A2. However, this activity has not been shown in humans when theophylline, a CYP1A2 substrate, was used as a target drug.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP2C9.
In vitro research shows that various constituents of danshen inhibit the activity of CYP2C9. So far, this interaction has not been reported in humans.
Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP2E1.
In vitro research shows that various constituents of danshen inhibit the activity of CYP2E1. So far, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Danshen might alter the levels and clinical effects of drugs metabolized by CYP3A4.
Preliminary clinical research in healthy males shows that the administration of danshen for 10-14 days induces intestinal CYP3A4 and increases the clearance of midazolam, a CYP3A4 substrate. The maximum concentration of midazolam was decreased by 31% to 67%, and drug levels were decreased by 27% to 80%. However, a single dose of danshen has the opposite effect, increasing maximum concentrations of midazolam by 87%.
Fexofenadine (Allegra)
Danshen might increase the levels and clinical effects of fexofenadine.
Pharmacokinetic research in healthy volunteers shows that taking danshen extract 1 gram three times daily for 10 days prior to receiving fexofenadine 60 mg increases peak levels of fexofenadine, a p-glycoprotein substrate, by 27.4% and area under the curve (AUC) by 37.2%.
Glucuronidated Drugs
Theoretically, danshen might affect the levels and clinical effects of drugs requiring glucuronidation.
In vitro research shows that danshen induces the expression of glucuronosyltransferases. However, it also inhibits the activity of glucuronosyltransferases, including various members of the 1A and 2B families. The extent of inhibition of a specific glucuronosyltransferase seems to be dependent on whether or not the danshen is processed via 'sweating'. This type of processing may affect the levels of constituents in danshen that alter glucuronosyltransferase activity. So far, this interaction has not been reported in humans.
Midazolam (Versed)
Danshen might alter the levels and clinical effects of midazolam.
Preliminary clinical research in healthy males shows that the administration of danshen for 10-14 days induces intestinal CYP3A4 and increases midazolam clearance. The maximum concentration was decreased by 31% to 67%, and drug levels were decreased by 27% to 80%. However, a single dose of danshen has the opposite effect, increasing maximum concentrations of midazolam by 87%.
P-Glycoprotein Substrates
Danshen might alter the levels of drugs cleared by p-glycoprotein.
Pharmacokinetic research in healthy volunteers suggests that danshen might affect p-glycoprotein activity. Taking danshen extract 1 gram three times daily for 10 days prior to receiving fexofenadine 60 mg increases peak levels of fexofenadine, a p-glycoprotein substrate, by 27.4% and area under the curve (AUC) by 37.2%.
Rosuvastatin (Crestor)
Theoretically, danshen might increase the levels and clinical effects of rosuvastatin.
Animal research shows that a single dose of danshen increases levels of rosuvastatin at least 2-fold, possibly by increasing absorption and/or decreasing elimination. So far, this interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, danshen may increase the risk of bleeding if used with warfarin.
There have been several case reports of increased international normalized ratio (INR) after concomitant use of danshen and warfarin. Elevations in INR have occurred as early as 3-5 days after start of danshen. However, a clinical trial in adults taking warfarin with stable INR found that the addition of compound danshen dripping pills, containing danshen extract, Panax notoginseng, and borneol, 270 mg three times daily for 4 weeks did not alter INR levels or the average required warfarin dose when compared to baseline. These findings are consistent with animal research, which found no change in warfarin pharmacokinetics with the use of danshen. Other research in healthy adult males also shows that taking a combination of danshen and kudzu with warfarin does not increases plasma warfarin area under the curve, but may reduce plasma soluble thrombomodulin levels. However, other research shows that danshen might increase the rate of absorption and decrease the elimination rate of warfarin. Also, research in healthy adult males shows that taking a combination of danshen and kudzu with warfarin increases plasma area under the curve of danshensu, a constituent of danshen, by approximately 29.5-fold. Danshen should be used cautiously in patients taking warfarin.
Chinese Rhubarb
Corticosteroids
Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia when taken with corticosteroids.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might compound corticosteroid-induced potassium loss.
Cyclosporine (Neoral, Sandimmune)
Theoretically, taking rhubarb with cyclosporine might reduce cyclosporine levels.
Animal research shows that co-administration of rhubarb decoction 0.25 or 1 gram/kg with cyclosporine 2.5 mg/kg, decreases cyclosporine maximum plasma concentration and overall exposure levels when compared with taking cyclosporine alone. The authors theorize that rhubarb might reduce cyclosporine bioavailability by inducing of P-glycoprotein and/or cytochrome P450 3A4. However, since rhubarb was administered as a single oral dose and enzyme induction usually occurs after multiple doses, it is possible that cyclosporine absorption was actually reduced via rhubarb's stimulant laxative effects. Also, the composition of the rhubarb decoction was not described.
Digoxin (Lanoxin)
Theoretically, overuse of rhubarb might increase the risk of adverse effects when taken with digoxin.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion, increasing the risk of digoxin toxicity.
Diuretic Drugs
Theoretically, frequent and high doses of rhubarb might increase the risk of hypokalemia.
Rhubarb has stimulant laxative effects. Overuse of rhubarb might cause potassium depletion and compound diuretic-induced potassium loss.
Hepatotoxic Drugs
Theoretically, concomitant use of rhubarb with potentially hepatotoxic drugs might increase the risk of developing liver damage.
Some animal research suggests that anthraquinones in rhubarb might have hepatotoxic effects. Also, rhubarb use has been linked to at least 24 cases of liver injury, although details on the dose of rhubarb and duration of use in these cases is unclear.
Nephrotoxic Drugs
Theoretically, long-term use of anthraquinones from rhubarb might increase the risk of nephrotoxicity when used with nephrotoxic drugs.
The anthraquinone constituents of rhubarb have been shown to induce nephrotoxicity in animal research. Additionally, in a case report, a 23-year old female presented with kidney failure after taking 6 tablets of a proprietary slimming agent (found to contain the anthraquinones emodin and aloe-emodin from rhubarb) daily for 6 weeks and then adding diclofenac 25 mg 4 times daily for 2 days. The authors postulate that the anthraquinone constituents of rhubarb contributed to the renal dysfunction, and the addition of diclofenac, a nephrotoxic drug, led to renal failure. Until more is known, advise patients to avoid taking rhubarb if they are taking other potentially nephrotoxic drugs.
Stimulant Laxatives
Theoretically, rhubarb might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Rhubarb has stimulant laxative effects. Concomitant use with stimulant laxatives might compound fluid and electrolyte loss.
Warfarin (Coumadin)
Theoretically, excessive use of rhubarb might increase the risk of bleeding when taken with warfarin.
Rhubarb has stimulant laxative effects and can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of rhubarb.
Astragalus
Antidiabetes Drugs
Theoretically, taking astragalus with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research in humans shows that astragalus might have hypoglycemic effects. Theoretically, taking astragalus, especially in combination with other hypoglycemic agents, might increase the risk of hypoglycemia.
Cyclophosphamide
Theoretically, astragalus might interfere with cyclophosphamide therapy.
Evidence regarding the effect of astragalus on immunosuppression caused by cyclophosphamide is conflicting. Some animal research suggests that astragalus reverses cyclophosphamide-induced immunosuppression. However, other animal research shows no effect.
Immunosuppressants
Theoretically, astragalus might interfere with immunosuppressive therapy.
Astragalus seems to stimulate immune function. Theoretically, taking astragalus might decrease the effects of immunosuppressive therapy.
Lithium
Theoretically, astragalus might increase levels and adverse effects of lithium.
Animal research suggests that astragalus has diuretic properties. Theoretically, due to this diuretic effect, astragalus might reduce excretion and increase levels of lithium.
Brand information
Manufacturer and brand details for Kidney Support Tonic, from the product label.
Wise Woman Herbals
See all Wise Woman Herbals products- Name
- Wise Woman Herbals
- City
- Creswell
- State
- OR
- ZipCode
- 97426
- Phone Number
- 541.895.5152
- Web Address
- wisewomanherbals.com
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The Full Monographs Behind Kidney Support Tonic’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Panax Ginseng
Interacts with 1,130 drugsPanax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and mostly preliminary. It is generally well...
Read the full Panax Ginseng monograph → Herb & supplement monographGinkgo
Interacts with 1,266 drugsGinkgo is one of the world's most popular herbal supplements, mostly taken to support memory and circulation. The evidence for these uses is mixed and generally weak, and it is not proven to...
Read the full Ginkgo monograph → Herb & supplement monographAstragalus
Interacts with 208 drugsAstragalus is a root used for centuries in traditional Chinese medicine, mainly to support the immune system and help the body cope with stress. While early studies are interesting, strong h...
Read the full Astragalus monograph → Herb & supplement monographDanshen
Interacts with 1,059 drugsDanshen is a root used in traditional Chinese medicine, mainly for heart and circulation problems. Some early research is promising, but the evidence is not strong enough to confirm it works...
Read the full Danshen monograph → Herb & supplement monographRhubarb
Interacts with 658 drugsRhubarb root has a long history of use as a laxative and in traditional Chinese medicine, and its edible stalks are a common food. Most medicinal claims are backed by limited or low-quality...
Read the full Rhubarb monograph →Sources & How We Checked
Kidney Support Tonic'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 224 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.
Panax Ginseng 66 references
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- Lee, Y. H., Lee, B. K., Choi, Y. J., Yoon, I. K., Chang, B. C., and Gwak, H. S. Interaction between warfarin and Korean red ginseng in patients with cardiac valve replacement. Int J Cardiol. 11-19-2010;145(2):275-276. PubMed
- Liu, P., Yin, H., Xu, Y., Zhang, Z., Chen, K., and Li, Y. Effects of ginsenoside Rg1 on postimplantation rat and mouse embryos cultured in vitro. Toxicol In Vitro 2006;20(2):234-238. PubMed
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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.
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