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Dietary supplement

Major Bupleurum Teapills Ingredients & Drug Interactions

by Plum Flower

Major Bupleurum Teapills label
See full label image
Tablet Or Pill Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

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

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

The interaction bottom line Most serious interaction: Major

Major Bupleurum Teapills is a dietary supplement by Plum Flower with 8 active ingredients. Its ingredients are commonly taken for nausea and vomiting, cough with phlegm, morning sickness (traditional use).Based on those ingredients, 1,655 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Zingiber officinale Rhizome Extract, Citrus aurantium Fruit Extract, Scutellaria baicalensis Root Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Major Bupleurum Teapills by Plum Flower

Ask about any prescription or over-the-counter medication and we check it for interactions with Major Bupleurum Teapills by Plum Flower — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Major Bupleurum Teapills by Plum Flower

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

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 8 active ingredients.
  • “Proprietary Extract Blend” is a proprietary blend — the label gives one combined amount (1,360 mg) without saying how much of each component you get.

Major Bupleurum Teapills contains eight active ingredients in a proprietary extract blend. The formula includes pinellia ternata rhizome, ziziphus jujuba fruit, ginger rhizome, bitter orange fruit, bupleurum root, baikal skullcap root, peony root, and rhubarb rhizome and root.

The product also contains inactive ingredients — maltose, hydrated magnesium silicate, activated carbon, and china wax — which serve as fillers and binders.

Does it work?

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

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Moderate

Some clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Menopausal symptoms — rated "Possibly Effective" (Rhubarb) (Natural Medicines).
  • On file: Osteoarthritis — rated "Possibly Effective" (Ginger) (Natural Medicines).
  • On file: Pregnancy-induced nausea and vomiting — rated "Possibly Effective" (Ginger) (Natural Medicines).
  • On file: Dysmenorrhea — rated "Possibly Effective" (Ginger) (Natural Medicines).
  • On file: Pancreatitis — rated "Possibly Effective" (Rhubarb) (Natural Medicines).

The evidence for how well this product works is not established in the data we hold. Individual ingredients have varying levels of evidence.

Ginger is possibly effective for pregnancy-related nausea and vomiting, dysmenorrhea, and osteoarthritis, though possibly ineffective for exercise-related muscle soreness and chemotherapy-related nausea. The other active ingredients — pinellia, ziziphus, bitter orange, bupleurum, baikal skullcap, peony, and rhubarb — lack sufficient reliable evidence to rate for their traditional uses.

The evidence, ingredient by ingredient Pinellia Ternata Zizyphus Ginger Bitter Orange Bupleurum Baikal Skullcap Peony Rhubarb

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 8 of the 8 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 8 of 8.
  • General safety write-ups exist for 8 of 8.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Ginger and peony are generally well tolerated at typical amounts. However, pinellia ternata carries important cautions: the raw plant is toxic and irritating, and only properly processed material should be used.

Bitter orange may be unsafe at medicinal doses and can raise heart rate and blood pressure, especially when combined with caffeine or stimulants. Rhubarb root can cause cramping and should not be used long-term; chronic use risks potassium loss and kidney problems.

Bupleurum has been linked to rare lung and liver issues, though quality varies. Baikal skullcap is generally well tolerated but human safety data are limited.

Pinellia, bitter orange, bupleurum, baikal skullcap, peony, and rhubarb all lack sufficient safety information for pregnancy and breastfeeding — discuss with your doctor or pharmacist before use if you are pregnant or nursing.

Side effects, ingredient by ingredient Pinellia Ternata Zizyphus Ginger Bitter Orange Bupleurum Baikal Skullcap Peony Rhubarb

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

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

Why this rating?
  • 8 of the 8 matched ingredients can interact with medications — Peony, Zizyphus, Rhubarb, Bupleurum, Baikal Skullcap, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 1,656 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Major Bupleurum Teapills, double-check with your pharmacist if you take monoamine oxidase inhibitors (antidepressants), midazolam or other benzodiazepines (sedatives for anxiety), blood thinners or antiplatelet drugs, diabetes medications, corticosteroids, diuretics, or heart medications like digoxin or nifedipine. Bitter orange can also interact with CYP3A4-metabolized drugs, some blood pressure medications, and stimulants including caffeine.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence behind its ingredients' uses. Major medication interactions have been identified, and safety information is well characterized.

This is a traditional Chinese herbal formula with multiple ingredients that interact with common medications, particularly blood thinners, sedatives, diabetes drugs, and antidepressants. If you take any prescription medications — especially MAOIs, benzodiazepines, blood thinners, or diabetes medications — check with your pharmacist before starting.

Pregnant or nursing? Talk to your doctor first, as safety data are limited for several ingredients.

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

Assessment coverage: 8 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2025.

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

At a glance

General information

Key facts about Major Bupleurum Teapills, straight from the product label.

Brand Plum Flower
Barcode (UPC) 739934833230
Net contents 1.2 Ounce(s); 34 Gram(s); 200 Pill(s)
Market status On market
Date entered into DSLD Aug 22, 2025
DSLD ID 336482
Product type Botanical
Supplement form Tablet Or Pill
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years), Women (not pregnant or lactating)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Major Bupleurum Teapills by Plum Flower, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
8 Pill(s)
Maximum serving Sizes:
8 Pill(s)
Servings per container
25
UPC/BARCODE
739934833230
IngredientAmount% DV
Proprietary Extract Blend1360 mg--
Pinellia ternata Rhizome Extract0 NP--
Ziziphus jujuba Fruit Extract0 NP--
Zingiber officinale Rhizome Extract0 NP--
Citrus aurantium Fruit Extract0 NP--
Bupleurum chinense Root Extract0 NP--
Scutellaria baicalensis Root Extract0 NP--
Paeonia lactiflora Root Extract0 NP--
Rheum palmatum Rhizome, Root Extract0 NP--

Other ingredients: Maltose, Magnesium Silicate, Hydrated, Carbon, Activated, China Wax

Tap any ingredient to jump to its full detail below.

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

Da Chai Hu Wan

FDA Statement of Identity

Herbal Supplement

Suggested/Recommended/Usage/Directions

Take 8 pills 3 times daily or as directed by your health care practitioner

Precautions

Not for use during pregnancy Caution when nursing

Keep out of reach of children

Seals/Symbols

Plum Flower Guarantee Sourced Sustainably FDA Registered cGMP Compliant Made at a cGMP Certified Facility Lab Tested Quality Verified Species Verified

General Statements

Foci Pharmceutical 1929

Formulation

US owned & operated since 1969. Made in China in partnership with the award winning Lanzhou Foci Pharmaceutical Co. Ltd.

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

See for yourself

Major Bupleurum Teapills by Plum Flower label

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

Major Bupleurum Teapills label

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

View the full label (PDF)
What’s inside

The Ingredients in Major Bupleurum Teapills by Plum Flower

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size8 Pill(s) Dosage formTablet Or Pill Servings per container25 Amounts shown are per serving.

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

Other (inactive) ingredients: Maltose, Magnesium Silicate, Hydrated, Carbon, Activated, China Wax. These complete the product’s ingredient list but are not active constituents.

Interaction report

Major Bupleurum Teapills by Plum Flower Drug Interactions

Want to check YOUR meds against Major Bupleurum Teapills?

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

 Go to the checker
1,655Drugs
10 Major 1,620 Moderate 25 Minor

Ingredients driving the most interactions

Zingiber officinale Rhizome Extract 1,007
Citrus aurantium Fruit Extract 957
Scutellaria baicalensis Root Extract 946
Paeonia lactiflora Root Extract 811
Rheum palmatum Rhizome, Root Extract 658

Individual Drug Interactions

The ingredients in Major Bupleurum Teapills interact with 1,655 drugs. Click any drug to see the details.

8 of the 8 ingredients in Major Bupleurum Teapills interact with drugs. Each result below shows which ingredient is responsible. Zingiber officinale Rhizome Extract Citrus aurantium Fruit Extract Scutellaria baicalensis Root Extract Paeonia lactiflora Root Extract Rheum palmatum Rhizome, Root Extract Ziziphus jujuba Fruit Extract Bupleurum chinense Root Extract Pinellia ternata Rhizome Extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Major Bupleurum Teapills 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.

Zingiber officinale Rhizome Extract14 drug types · 1,007 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence B
Antidiabetes Drugs

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

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

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

Likelihood Possible Evidence D
Losartan (Cozaar)

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

Likelihood Possible Evidence D
Nifedipine (Procardia)

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

Likelihood Possible Evidence B
P-Glycoprotein Substrates

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

Likelihood Possible Evidence D
Phenprocoumon (Marcoumar, Others)

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

Likelihood Possible Evidence D
Warfarin (Coumadin)

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

Likelihood Possible Evidence B
Calcium Channel Blockers

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

Likelihood Unlikely Evidence D
Cyclosporine (Neoral, Sandimmune)

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

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

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

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

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

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

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

Likelihood Possible Evidence D
Metronidazole (Flagyl)

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

Likelihood Possible Evidence D
Zingiber officinale Rhizome Extract full monograph & interactions

Citrus aurantium Fruit Extract13 drug types · 957 drugs

Midazolam (Versed)

Bitter orange might increase blood levels of midazolam.
One small clinical study shows that bitter orange juice can increase midazolam levels, likely through inhibition of cytochrome P450 3A4 (CYP3A4). Theoretically, bitter orange might increase the risk of midazolam-related adverse effects.

Likelihood Probable Evidence B
Monoamine Oxidase Inhibitors (Maois)

Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Bitter orange contains tyramine, octopamine, and synephrine, which are MAO substrates.

Likelihood Probable Evidence D
Antidiabetes Drugs

Theoretically, bitter orange might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Some clinical research shows that drinking a tea containing bitter orange and Indian snakeroot reduces fasting and postprandial glucose levels in patients with type 2 diabetes who are using antidiabetes drugs. However, it is unclear if these effects are due to bitter orange, Indian snakeroot, or the combination. An animal study also shows that p-synephrine in combination with gliclazide , a sulfonylurea, causes an additional 20% to 44% decrease in glucose levels when compared with gliclazide alone.

Likelihood Possible Evidence B
Caffeine

Bitter orange might increase blood pressure and heart rate when taken with caffeine.
Small clinical studies show that taking bitter orange in combination with caffeine can increase blood pressure and heart rate in otherwise healthy normotensive adults. Theoretically, this might increase the risk of serious cardiovascular adverse effects.

Likelihood Possible Evidence B
Colchicine

Bitter orange might affect colchicine levels.
Colchicine is a substrate of P-glycoprotein and cytochrome P450 3A4 (CYP3A4). Bitter orange has been reported to inhibit CYP3A4 and increase levels of CYP3A4 substrates. However, one small clinical study in healthy adults shows that drinking bitter orange juice 240 mL twice daily for 4 days and taking a single dose of colchicine 0.6 mg on the 4th day decreases colchicine peak serum levels by 24%, time to peak serum level by 1 hour, and overall exposure to colchicine by 20%. The clinical significance of this finding is unclear.

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

Bitter orange might increase levels of drugs metabolized by CYP3A4.
Small clinical studies suggest that single or multiple doses of freshly squeezed bitter orange juice 200-240 mL can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. However, the extent of the effect of bitter orange on CYP3A4-mediated drug interactions is unknown. Some evidence suggests that bitter orange selectively inhibits intestinal CYP3A4, but not hepatic CYP3A4. Its effect on P-glycoprotein, which strongly overlaps with CYP3A4 interactions, is unclear. One small clinical study shows that drinking 8 ounces of freshly squeezed bitter orange juice has no effect on cyclosporine, which seems to be more dependent on hepatic CYP3A4 and P-glycoprotein than intestinal CYP3A4.

Likelihood Possible Evidence B
Dextromethorphan (Robitussin Dm, Others)

Bitter orange might increase blood levels of dextromethorphan.
One small clinical study shows that bitter orange juice increases dextromethorphan levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for dextromethorphan-related adverse effects.

Likelihood Possible Evidence B
Felodipine (Plendil)

Bitter orange might increase blood levels of felodipine.
One small clinical study shows that bitter orange juice increases felodipine levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for felodipine-related adverse effects.

Likelihood Probable Evidence B
Indinavir (Crixivan)

Bitter orange might increase blood levels of indinavir.
One small clinical study shows that bitter orange juice slightly increases indinavir levels, but this effect is likely to be clinically insignificant. Bitter orange selectively inhibits intestinal cytochrome P450 3A4 (CYP3A4); however, the metabolism of indinavir seems to be more dependent on hepatic CYP3A4. The effect of bitter orange on other protease inhibitors has not been studied.

Likelihood Possible Evidence B
Qt Interval-Prolonging Drugs

Theoretically, bitter orange might have an additive effect when combined with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
One case report suggests that taking bitter orange in combination with other stimulants such as caffeine might prolong the QT interval in some patients.

Likelihood Possible Evidence D
Sildenafil (Viagra)

Bitter orange juice might increase blood levels of sildenafil.
A small clinical study in healthy adult males shows that drinking freshly squeezed bitter orange juice 250 mL daily for 3 days and taking a single dose of sildenafil 50 mg on the 3rd day increases the peak plasma concentration of sildenafil by 18% and the overall exposure to sildenafil by 44%. Theoretically, this may be due to inhibition of cytochrome P450 3A4 by bitter orange.

Likelihood Probable Evidence B
Stimulant Drugs

Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Bitter orange appears to have stimulant effects.

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

Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
In vitro research shows that octopamine, a constituent of bitter orange, weakly inhibits CYP2D6 enzymes. This effect has not been reported in humans.

Likelihood Possible Evidence D
Citrus aurantium Fruit Extract full monograph & interactions

Scutellaria baicalensis Root Extract12 drug types · 946 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, Baikal skullcap might increase the risk of bleeding when used concomitantly with anticoagulant and antiplatelet drugs.
Preliminary clinical research suggests that taking capsules containing a combination of astragalus, goldthread, and Baikal skullcap daily for 4 weeks inhibits platelet aggregation; the effect seems to be similar to that of aspirin 50 mg daily. It is unclear if this effect is due to Baikal skullcap, other ingredients, or the combination.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, concomitant use of Baikal skullcap with antidiabetes drugs might enhance blood glucose lowering effects.
Baicalein, a constituent of Baikal skullcap, has alpha-glucosidase inhibitory activity in vitro. Animal research also suggests that Baikal skullcap enhances the antidiabetic effects of metformin. However, in a small human study, taking Baikal skullcap extract did not enhance the antidiabetic effects of metformin, although it did modestly lower glucose levels during an oral glucose tolerance test (OGTT). Until more is known, use cautiously.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, concomitant use of Baikal skullcap with antihypertensive drugs might have additive effects and increase the risk of hypotension.
Animal research suggests that baicalein, a constituent of Baikal skullcap, might lower blood pressure.

Likelihood Possible Evidence D
Antithyroid Drugs

Theoretically, concomitant use of Baikal skullcap and antithyroid drugs may result in additive activity and increase the risk of hypothyroidism.
In an animal hyperthyroid model, Baikal skullcap improved levels of triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH). The clinical significance of this effect is unclear.

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

Theoretically, Baikal skullcap may increase levels of drugs metabolized by CYP1A2 enzymes.
In vitro evidence suggests that constituents of Baikal skullcap inhibit the activity of CYP1A2. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, Baikal skullcap might increase levels of drugs metabolized by CYP2C19 enzymes.
In vitro evidence suggest that wogonin, a constituent of Baikal skullcap, modestly inhibits the activity of CYP2C19 enzymes. This effect has not been reported in humans.

Likelihood Possible Evidence D
Estrogens

Theoretically, concomitant use of large amounts of Baikal skullcap might interfere with hormone replacement therapy, due to competition for estrogen receptors.
In vitro evidence suggests that Baikal skullcap has estrogenic activity.

Likelihood Possible Evidence D
Lithium

Theoretically, Baikal skullcap might reduce lithium excretion and increase serum levels of lithium.
Baikal skullcap is thought to have diuretic properties, which may reduce lithium excretion. The dose of lithium might need to be decreased.

Likelihood Possible Evidence D
Alcohol (Ethanol)

Theoretically, Baikal skullcap might potentiate the sedative effects of alcohol.
In vitro and animal research suggests that Baikal skullcap binds to GABA-A receptors and causes sedation. Theoretically, Baikal skullcap might potentiate the sedative effects of alcohol. Preliminary clinical research has not identified clinically relevant sedation after use of Baikal skullcap; however, a thorough evaluation of safety outcomes has not been conducted.

Likelihood Unlikely Evidence D
Cns Depressants

Theoretically, Baikal skullcap might cause additive therapeutic and adverse effects when used concomitantly with drugs with sedative properties.
In vitro and animal research suggests that Baikal skullcap binds to GABA-A receptors and causes sedation. Theoretically, Baikal skullcap might cause additive therapeutic and adverse effects when used concomitantly with drugs with sedative properties. Preliminary clinical research has not identified clinically relevant sedation after use of Baikal skullcap; however, a thorough evaluation of safety outcomes has not been conducted.

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

Theoretically, Baikal skullcap might alter the levels and clinical effects of OATP substrates.
Some pharmacokinetic research shows that baicalin, a constituent of Baikal skullcap, can decrease plasma levels of rosuvastatin. The mechanism is thought to involve stimulation of the activity of the organic anion-transporting polypeptide 1B1 (OATP1B1), which transports rosuvastatin into the liver. This decreases plasma levels of the drug, but increases levels at the site of action in the liver. The degree to which rosuvastatin levels are affected depends on the OATP1B1 haplotype of the individual. Baikal skullcap might also affect other OATP1B1 substrates.

Likelihood Possible Evidence B
P-Glycoprotein Substrates

Theoretically, Baikal skullcap might increase levels of drugs transported by P-glycoprotein.
In vitro and animal research suggests that baicalein, oroxylin A, and wogonin, constituents of Baikal skullcap, can inhibit P-glycoprotein. This effect has not been reported in humans.

Likelihood Possible Evidence D
Scutellaria baicalensis Root Extract full monograph & interactions

Paeonia lactiflora Root Extract7 drug types · 811 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Clozapine (Clozaril)

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

Likelihood Possible Evidence D
Contraceptive Drugs

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

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

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

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

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

Likelihood Possible Evidence D
Estrogens

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

Likelihood Possible Evidence D
Phenytoin (Dilantin)

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

Likelihood Probable Evidence D
Paeonia lactiflora Root Extract full monograph & interactions

Rheum palmatum Rhizome, Root Extract8 drug types · 658 drugs

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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
Rheum palmatum Rhizome, Root Extract full monograph & interactions

Ziziphus jujuba Fruit Extract3 drug types · 469 drugs

Antidiabetes Drugs

Theoretically, zizyphus might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that zizyphus has hypoglycemic activity. However, a small clinical study shows that zizyphus fruit powder does not reduce fasting blood glucose levels in patients with type 2 diabetes.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, zizyphus might cause additive sedative effects when taken with CNS depressants.
Some animal research has found that various parts of zizyphus have sedative effects. However, other animal research shows that zizyphus plant extract does not alter sleep parameters when used in combination with pentobarbital.

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

Theoretically, zizyphus might decrease the levels and clinical effects of drugs metabolized by CYP1A2.
Animal research shows that zizyphus induces CYP1A2 enzymes. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Ziziphus jujuba Fruit Extract full monograph & interactions

Bupleurum chinense Root Extract3 drug types · 327 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Antidiabetes Drugs

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

Likelihood Possible Evidence D
Immunosuppressants

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

Likelihood Possible Evidence D
Bupleurum chinense Root Extract full monograph & interactions

Pinellia ternata Rhizome Extract3 drug types · 256 drugs

Barbiturates

Evidence from animal research shows that a Pinellia ternata preparation decreases activity and increases sleeping time. Theoretically, Pinellia ternata can potentiate the therapeutic effect of barbiturates. Some of these sedative medications include pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), and others.

Likelihood Possible Evidence D
Benzodiazepines

Evidence from animal research shows that a Pinellia ternata preparation decreases activity and increases sleeping time. Theoretically, Pinellia ternata can potentiate the therapeutic effect of benzodiazepines. Some benzodiazepines include lorazepam (Ativan), alprazolam (Xanax), diazepam (Valium), midazolam (Versed), and others.

Likelihood Possible Evidence D
Cns Depressants

Evidence from animal research shows that a Pinellia ternata preparation decreases activity and increases sleeping time. Theoretically, Pinellia ternata can potentiate the therapeutic effect of CNS depressants. Some of these medications include antihistamines, barbiturates, benzodiazepines, tricyclic antidepressants, and others.

Likelihood Possible Evidence D
Pinellia ternata Rhizome Extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Major Bupleurum Teapills, from the product label.

Plum Flower

Name
Mayway Herbs
City
Oakland
State
CA
Web Address
www.plumflowerherbs.com
Pharmacist Counseling Corner

Major Bupleurum Teapills by Plum Flower: Common Questions

Does Major Bupleurum Teapills by Plum Flower interact with any medications?
Yes. Based on its ingredients, Major Bupleurum Teapills has a known interaction with 1,655 medications, including 10 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Major Bupleurum Teapills contains 8 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm pregnant or breastfeeding?
Several ingredients — pinellia, bitter orange, bupleurum, baikal skullcap, peony, and rhubarb — lack enough safety data for pregnancy or lactation. Rhubarb is possibly unsafe during pregnancy due to its effects on the uterus and bowels. Talk to your doctor or pharmacist for personalized advice; don't start this product on your own.
What's pinellia ternata in here for?
Pinellia is a traditional ingredient used in Chinese herbal formulas, but we don't have reliable evidence on how well it works. The raw form is toxic, so only properly processed material is safe. It can make you sleepy by enhancing the effects of sedating medications.
Does ginger in this product have any proven benefits?
Ginger is possibly effective for pregnancy-related nausea, period cramps, and osteoarthritis pain. However, it's one ingredient in a blend, so the overall effect of the formula isn't established. At higher doses (5 grams daily or more), ginger can cause heartburn, diarrhea, and stomach discomfort.
Why is bitter orange a concern in this formula?
Bitter orange contains stimulant compounds that can raise blood pressure and heart rate, especially with caffeine or other stimulants. It also blocks a liver enzyme that clears many medications, raising their blood levels and side effects. Most seriously, it can trigger a dangerous blood pressure spike with certain antidepressants.
What are the inactive ingredients in this product?
The teapills contain maltose, hydrated magnesium silicate, activated carbon, and china wax as binders and fillers to hold the blend together and allow for easy swallowing.
Can I use this long-term?
Rhubarb — one of the active ingredients — should not be used long-term because it can cause potassium loss and kidney problems with chronic use. Several other ingredients also have limited long-term safety data. This is traditionally used as a short-term formula; talk to your herbalist or pharmacist about duration.

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

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Major Bupleurum Teapills label
Go deeper

The Full Monographs Behind Major Bupleurum Teapills’s Ingredients

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

Herb & supplement monograph

Pinellia Ternata

Interacts with 256 drugs

Pinellia ternata is a tuber used in traditional Chinese medicine, most often for nausea, vomiting, and phlegmy coughs, and almost always as part of multi-herb formulas. The raw plant is toxi...

Read the full Pinellia Ternata monograph → Herb & supplement monograph

Zizyphus

Interacts with 469 drugs

Zizyphus (jujube) is an edible fruit and traditional remedy used mainly for sleep, anxiety, and digestion. The fruit is a nutritious food, but human evidence for its medicinal benefits is li...

Read the full Zizyphus monograph → Herb & supplement monograph

Ginger

Interacts with 1,007 drugs

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

Read the full Ginger monograph → Herb & supplement monograph

Bitter Orange

Interacts with 957 drugs

Bitter orange is a citrus fruit whose extracts contain synephrine, a mild stimulant often added to weight-loss and energy supplements. Evidence that it works for weight loss or performance i...

Read the full Bitter Orange monograph → Herb & supplement monograph

Bupleurum

Interacts with 327 drugs

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

Read the full Bupleurum monograph → Herb & supplement monograph

Baikal Skullcap

Interacts with 946 drugs

Baikal skullcap is a traditional Chinese herb (Huang Qin) used for inflammation, allergies, and infections, with active compounds like baicalin and baicalein studied mostly in the lab. Human...

Read the full Baikal Skullcap monograph → Herb & supplement monograph

Peony

Interacts with 811 drugs

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

Read the full Peony monograph → Herb & supplement monograph

Rhubarb

Interacts with 658 drugs

Rhubarb 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

Sources & How We Checked

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

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

The 216 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.

Pinellia Ternata 4 references
  1. Kim SH, Jeong H, Kim YK, et al. IgE-mediated occupational asthma induced by herbal medicine, Bahna (Pinellia ternata). Clin Exp Allergy 2000;31:779-81.
  2. FDA, HHS. Final rule declaring dietary supplements containing ephedrine alkaloids adulterated because they present an unreasonable risk. Fed Regist 2004;69:6787-6854.
  3. Lin S, Nie B, Yao G, Yang H, Ye R, Yuan Z. Pinellia ternata (Thunb.) makino preparation promotes sleep by increasing REM sleep. Nat Prod Res. 2019;33(22):3326-3329. PubMed
  4. Lin YH, Chen C, Zhao X, et al. Efficacy and Safety of Banxia Formulae for Insomnia: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials. Evid Based Complement Alternat Med 2021;2021:8833168. PubMed

See these in context on the Pinellia Ternata monograph →

Zizyphus 15 references
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  2. Cisse, A., Ndiaye, A., Lopez-Sall, P., Seck, F., Faye, B., and Faye, B. [Antidiabetic activity of Zizyphus mauritiana Lam (Rhamnaceae)]. Dakar Med 2000;45(2):105-107.
  3. Abdel-Zaher, A. O., Salim, S. Y., Assaf, M. H., and Abdel-Hady, R. H. Antidiabetic activity and toxicity of Zizyphus spina-christi leaves. J Ethnopharmacol. 10-3-2005;101(1-3):129-138. PubMed
  4. Nesseem, D. I., Michel, C. G., Sleem, A. A., and El-Alfy, T. S. Formulation and evaluation of antihyperglycemic leaf extracts of Zizyphus spina-christi (L.) Willd. Pharmazie 2009;64(2):104-109. DOI
  5. Anand, K. K., Singh, B., Chand, D., Chandan, B. K., and Gupta, V. N. Effect of Zizyphus sativa leaves on blood glucose levels in normal and alloxan-diabetic rats. J Ethnopharmacol. 1989;27(1-2):121-127. PubMed
  6. Morishita, S., Mishima, Y., Hirai, Y., Saito, T., and Shoji, M. Pharmacological studies of water extract of the Zizyphus seed and the Zizyphus seed containing drug. Gen Pharmacol 1987;18(6):637-641. PubMed
  7. Watanabe, I., Saito, H., and Takagi, K. Pharmacological studies of Zizyphus seeds. Jpn J Pharmacol 1973;23(4):563-571. DOI
  8. Wu, S. X., Zhang, J. X., Xu, T., Li, L. F., Zhao, S. Y., and Lan, M. Y. [Effects of seeds, leaves and fruits of Ziziphus spinosa and jujuboside A on central nervous system function]. Zhongguo Zhong Yao Za Zhi 1993;18(11):685-4.
  9. Glombitza, K. W., Mahran, G. H., Mirhom, Y. W., Michel, K. G., and Motawi, T. K. Hypoglycemic and antihyperglycemic effects of Zizyphus spina-christi in rats. Planta Med 1994;60(3):244-247.
  10. Jarald, E. E., Joshi, S. B., and Jain, D. C. Antidiabetic activity of extracts and fraction of <it>Zizyphus mauritiana. Pharmaceutical Biology 2009;47:328-334.
  11. Ebrahimimd S, Ashkani-Esfahani S, Poormahmudibs A. Investigating the efficacy of zizyphus jujuba on neonatal jaundice. Iran J Pediatr. 2011 Sep;21(3):320-4.
  12. Hajhashemi V, Safaei A. Hypnotic effect of Coriandrum sativum, Ziziphus jujuba, Lavandula angustifolia and Melissa officinalis extracts in mice. Res Pharm Sci. 2015 Nov-Dec;10(6):477-84.
  13. Jing XY, Peng YR, Wang XM, Duan JA. Effects of Ziziphus jujuba fruit extracts on cytochrome P450 (CYP1A2) activity in rats. Chin J Nat Med. 2015 Aug;13(8):588-94. PubMed
  14. Irannejad Niri Z, Shidfar F, Jabbari M, et al. The effect of dried Ziziphus vulgaris on glycemic control, lipid profile, apo-proteins and hs-CRP in patients with type 2 diabetes mellitus: a randomized controlled clinical trial. J Food Biochem 2020; Mar 30
  15. Shergis JL, Hyde A, Meaklim H, Varma P, Da Costa C, Jackson ML. Medicinal seeds Ziziphus spinosa for insomnia: a randomized, placebo-controlled, cross-over, feasibility clinical trial. Complement Ther Med 2021;57:102657. PubMed

See these in context on the Zizyphus monograph →

Ginger 64 references
  1. Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 1991;38:19-24. PubMed
  2. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2000;(2):CD000145. PubMed
  3. Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol 2001;97:577-82. DOI
  4. Backon J. Ginger in preventing nausea and vomiting of pregnancy; a caveat due to its thromboxane synthetase activity and effect on testosterone binding. Eur J Obstet Gynecol Reprod Biol 1991;42:163-4. PubMed
  5. Srivastava KC. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukot Essent Fatty Acids 1989;35:183-5. PubMed
  6. Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology 1991;42:111-20. PubMed
  7. Smith C, Crowther C, Willson K, et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
  8. Portnoi G, Chng LA, Karimi-Tabesh L, et al. Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Am J Obstet Gynecol 2003;189:1374-7.. PubMed
  9. Wigler I, Grotto I, Caspi D, Yaron M. The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis. Osteoarthritis Cartilage 2003;11:783-9. PubMed
  10. Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol 2005;45:74-80. PubMed
  11. Thomson M, Al-Qattan KK, Al-Sawan SM, et al. The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent. Prostaglandins Leukot Essent Fatty Acids 2002;67:475-8. PubMed
  12. Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis 1996;35:157-62. PubMed
  13. Akhani SP, Vishwakarma SL, Goyal RK. Anti-diabetic activity of Zingiber officinale in streptozotocin-induced type I diabetic rats. J Pharm Pharmacol 2004;56:101-5.
  14. Kruth P, Brosi E, Fux R, et al. Ginger-associated overanticoagulation by phenprocoumon. Ann Pharmacother 2004;38:257-60. PubMed
  15. Jiang X, Williams KM, Liauw WS, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32. PubMed
  16. Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005;105:849-56. PubMed
  17. Smith C, Crowther C, Wilson K et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol 2004;103:639-45. PubMed
  18. Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
  19. Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.
  20. Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 2009;15:129-32. PubMed
  21. Black CD, Herring MP, Hurley DJ, O'Connor PJ. Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise. J Pain 2010;11:894-903. PubMed
  22. Heitmann K, Nordeng H, Holst L. Safety of ginger use in pregnancy: results from a large population-based cohort study. Eur J Clin Pharmacol 2012 Jun 17. PubMed
  23. Ryan JL, Heckler CE, Roscoe JA, et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer. 2012;20:1479-89. PubMed
  24. Backon J. Ginger as an antiemetic: possible side effects due to its thromboxane synthetase activity. Anaesthesia. 1991;46(8):705-6.. PubMed
  25. Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27:391-401. PubMed
  26. Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants and medicinal plants. An emerging interaction]. Ann Ital Med Int. 2000;15:139-43.
  27. Young HY, Liao JC, Chang YS, et al. Synergistic effect of ginger and nifedipine on human platelet aggregation: a study in hypertensive patients and normal volunteers. Am J Chin Med. 2006;34:545-51. PubMed
  28. Greenway FL, Liu Z, Martin CK, et al. Safety and efficacy of NT, an herbal supplement, in treating human obesity. Int J Obes (Lond). 2006;30:1737-41. PubMed
  29. Shalansky S, Lynd L, Richardson K, et al. Risk of warfarin-related bleeding events and supratherapeutic international normalized ratios associated with complementary and alternative medicine: a longitudinal analysis. Pharmacotherapy. 2007;27:1237-47. PubMed
  30. Lesho EP, Saullo L, Udvari-Nagy S. A 76-year-old woman with erratic anticoagulation. Cleve Clin J Med. 2004;71:651-6. PubMed
  31. Okonta JM, Uboh M, Obonga WO. Herb-Drug Interaction: A Case Study of Effect of Ginger on the Pharmacokinetic of Metronidazole in Rabbit. Indian Journal of Pharmaceutical Sciences (India) 2008;70(230):232. PubMed
  32. Chiang HM, Chao PD, Hsiu SL, et al. Ginger significantly decreased the oral bioavailability of cyclosporine in rats. Am J Chin Med. 2006;34:845-55. PubMed
  33. Bhandari U, Kanojia R, Pillai KK. Effect of ethanolic extract of Zingiber officinale on dyslipidaemia in diabetic rats. J Ethnopharmacol. 2005;97:227-30. PubMed
  34. Ojewole JA. Analgesic, antiinflammatory and hypoglycaemic effects of ethanol extract of Zingiber officinale (Roscoe) rhizomes (Zingiberaceae) in mice and rats. Phytother Res. 2006;20:764-72.
  35. Al-Amin ZM, Thomson M, Al-Qattan KK, et al. Anti-diabetic and hypolipidaemic properties of ginger (Zingiber officinale) in streptozotocin-induced diabetic rats. Br J Nutr. 2006;96:660-6.
  36. Islam MS, Choi H. Comparative effects of dietary ginger (Zingiber officinale) and garlic (Allium sativum) investigated in a type 2 diabetes model of rats. J Med Food. 2008;11:152-9.
  37. Cady RK, Goldstein J, Nett R, et al. A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine. Headache 2011;51:1078-86.
  38. Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
  39. Sripramote, M. and Lekhyananda, N. A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc.Thai. 2003;86(9):846-853.
  40. Lohsiriwat, S., Rukkiat, M., Chaikomin, R., and Leelakusolvong, S. Effect of ginger on lower esophageal sphincter pressure. J.Med.Assoc.Thai. 2010;93(3):366-372.
  41. Liu, P. H. and Ho, H. L. Ginger and drug bezoar induced small bowel obstruction. J R.Coll.Surg.Edinb. 1983;28(6):397-398.
  42. Maghbooli M, Golipour F, Moghimi Esfandabadi A, Yousefi M. Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine. Phytother Res 2014;28(3):412-5. PubMed
  43. Mahluji S, Attari VE, Mobasseri M, Payahoo L, Ostadrahimi A, Golzari SE. Effects of ginger (Zingiber officinale) on plasma glucose level, HbA1c and insulin sensitivity in type 2 diabetic patients. Int J Food Sci Nutr 2013;64(6):682-6.
  44. Mozaffari-Khosravi H, Talaei B, Jalali BA, Najarzadeh A, Mozayan MR. The effect of ginger powder supplementation on insulin resistance and glycemic indices in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Complement PubMed
  45. Paramdeep G. Efficacy and tolerability of ginger (Zingiber officinale) in patients of osteoarthritis of knee. Indian J Physiol Pharmacol 2013;57(2):177-83.
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  48. Bartels EM, Folmer VN, Bliddal H, et al. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis Cartilage. 2015;23(1):13-21. PubMed
  49. Choi JS, Han JY, Ahn HK, et al. Assessment of fetal and neonatal outcomes in the offspring of women who had been treated with dried ginger (Zingiberis rhizoma siccus) for a variety of illnesses during pregnancy. J Obstet Gynaecol. 2015;35(2):125-30.
  50. Marx W, McKavanagh D, McCarthy AL, Bird R, Ried K, Chan A, Isenring L. The effect of ginger (Zingiber officinale) on platelet aggregation: A systematic literature review. PLoS One. 2015;10(10):e0141119. PubMed
  51. Crichton M, Marshall S, Marx W, McCarthy AL, Isenring E. Efficacy of ginger (Zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: A systematic review update and meta-analysis. J Acad Nutr Diet. 2 PubMed
  52. Martins LB, Rodrigues AMDS, Monteze NM, et al. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) in the prophylactic treatment of migraine. Cephalalgia. 2020;40(1):88-95.
  53. Martins LB, Rodrigues AMDS, Rodrigues DF, Dos Santos LC, Teixeira AL, Ferreira AVM. Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) addition in migraine acute treatment. Cephalalgia. 2019;39(1):68-76.
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See these in context on the Rhubarb monograph →

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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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