Major interaction on record — check this product against your medications before combining. Based on 11 of 14 ingredients. Check your meds →
Dietary supplement

MelasmaRF Ingredients & Drug Interactions

by Merry Clinic

MelasmaRF label
See full label image
Tablet Or Pill Category: Other Combinations
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 MelasmaRF 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

MelasmaRF is a dietary supplement by Merry Clinic with 14 active ingredients. Its ingredients are commonly taken for general wellness and longevity, antioxidant support, heart and cholesterol health.Based on those ingredients, 1,427 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Chinese Salvia extract, Chinese White Peony extract, Bai-Zhu Atractylodes 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 MelasmaRF by Merry Clinic

Ask about any prescription or over-the-counter medication and we check it for interactions with MelasmaRF by Merry Clinic — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of MelasmaRF by Merry Clinic

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 Aug 20, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

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

Why this rating?
  • The label discloses an exact amount for 0 of its 14 active ingredients.
  • “Proprietary Herbal Extract Blend” is a proprietary blend — the label gives one combined amount (3,000 mg) without saying how much of each component you get.

MelasmaRF contains 14 ingredients, of which we focus on the active ones: Angelica root extract, Ligustrum extract, Bupleurum extract, Bai-Zhu Atractylodes extract, Chinese White Peony extract, Dong quai extract, Rehmannia extract, Chinese Salvia (danshen) extract, Cyperus extract, Poria sclerotium (mushroom) extract, Eclipta extract, Cnidium extract, Peach extract, and Safflower extract. These are drawn from a proprietary herbal blend.

The product also contains three inactive ingredients — microcrystalline cellulose, croscarmellose sodium, and magnesium stearate — which serve as binders, disintegrants, and flow agents in the tablet.

Does it work?

Not established
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
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: decreasing hyperpigmentation on the face.
  • We looked for evidence on: Aging skin, melasma, facial pigmentation, skin hyperpigmentation.
  • The closest evidence on file: Peony is rated "Insufficient Reliable Evidence To Rate" for Aging skin (Natural Medicines).

The evidence we hold does not establish that any ingredient in MelasmaRF is effective for any condition. Most ingredients are rated as having insufficient reliable evidence.

One exception is rehmannia, which is rated possibly effective for chronic kidney disease. If you're considering this product for a skin or health condition, the scientific support is not yet solid enough to predict whether it will help.

The evidence, ingredient by ingredient Ashitaba Bupleurum Atractylodes Peony Dong Quai Rehmannia Danshen Adrue

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 7 of the 11 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 11 of 11.
  • General safety write-ups exist for 11 of 11.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Several ingredients carry cautions or warnings for safety. Angelica root extract is likely safe as a food but its use as a concentrated supplement has not been well studied.

Bupleurum has been linked to rare lung and liver problems and should be avoided in pregnancy and while breastfeeding; it is generally used short-term. Atractylodes has limited human safety data and should be avoided in pregnancy; safety while breastfeeding is unknown.

Peony is generally well tolerated for short-term use but has limited high-quality safety data; it should be avoided in pregnancy and while breastfeeding. Common side effects with peony in trials included diarrhea, nausea, and gastrointestinal discomfort.

Dong quai may increase bleeding risk and cause skin sensitivity to sunlight; it should be avoided in pregnancy and while breastfeeding. Rehmannia has limited human data and quality varies; avoid in pregnancy and while breastfeeding.

Danshen affects blood clotting and quality varies between products; avoid in pregnancy and while breastfeeding. Cyperus has very limited human safety data; avoid in pregnancy and while breastfeeding.

Poria mushroom is generally well tolerated in traditional use but human data are limited; allergic reactions have been reported rarely. Avoid in pregnancy and while breastfeeding.

Cnidium safety data are limited; avoid in pregnancy and while breastfeeding. Safflower oil in food is well tolerated, but concentrated extracts and high-dose supplements have less safety data.

Safflower has been linked to rare liver failure in case reports of over-use, usually for weight loss. Medicinal safflower should be avoided in pregnancy; caution is advised while breastfeeding beyond normal food use.

Side effects, ingredient by ingredient Ashitaba Bupleurum Atractylodes Peony Dong Quai Rehmannia Danshen Adrue

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?
  • 11 of the 11 matched ingredients can interact with medications — Peony, Adrue, Safflower, Poria Mushroom, Bupleurum, 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.
  • For scale: 1,428 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 MelasmaRF, check with your doctor or pharmacist if you take warfarin or other blood thinners (anticoagulants) and antiplatelet drugs — several ingredients may increase bleeding risk. Also check if you take digoxin (a heart medication), antihypertensive drugs (blood pressure medications), antidiabetes drugs (blood sugar medications), estrogens or contraceptive drugs, CNS depressants (sedatives and sleep aids), benzodiazepines, barbiturates, or anticholinergic drugs.

Your exact medications matter, so use the search tool on this page or speak with your doctor or pharmacist before combining them with this product.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.

MelasmaRF is a traditional herbal blend with multiple documented interactions — particularly with blood thinners, blood pressure medications, and blood sugar medications — and the most serious concern is with warfarin and other anticoagulants. Most ingredients have not been proven effective in humans, and several carry pregnancy and breastfeeding cautions.

If you take any prescription medications, blood thinners, heart medications, or blood sugar drugs, talk with your doctor or pharmacist before starting this product. This is an individual decision that depends on your full health picture.

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

Assessment coverage: 11 of 14 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 24, 2020.

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 MelasmaRF, straight from the product label.

Brand Merry Clinic
Net contents 150 Tablet(s)
Market status On market
Date entered into DSLD Mar 24, 2020
DSLD ID 215812
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for MelasmaRF by Merry Clinic, 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:
5 Tablet(s)
Maximum serving Sizes:
5 Tablet(s)
Servings per container
30
IngredientAmount% DV
Proprietary Herbal Extract Blend3000 mg--
Angelica root extract0 NP--
Ligustrum extract0 NP--
Bupleurum extract0 NP--
Bai-Zhu Atractylodes extract0 NP--
Chinese White Peony extract0 NP--
Dong quai extract0 NP--
Rehmannia extract0 NP--
Chinese Salvia extract0 NP--
Cyperus extract0 NP--
Poria sclerotium extract0 NP--
Eclipta extract0 NP--
Cnidium extract0 NP--
Peach extract0 NP--
Safflower extract0 NP--

Other ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, Magnesium Stearate

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.
Suggested/Recommended/Usage/Directions

Directions for use: For adults, take 5 tablets each time, twice daily, preferably after meals, or as directed by a health care professional.

Formula

This product is a safe and effective blend of Chinese herbal extracts.

Formulation

It helps in balancing the hormones and in decreasing hyperpigmentation on the face.

Precautions

Warning: If you are pregnant or lactating, or taking prescription medication, consult a physician prior to use.

Keep out of reach of children.

FDA Disclaimer Statement

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

FDA Statement of Identity

Herbal Dietary Supplement

General Statements

Made in U.S.A

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

See for yourself

MelasmaRF by Merry Clinic label

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

MelasmaRF 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 MelasmaRF by Merry Clinic

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

Serving size5 Tablet(s) Dosage formTablet Or Pill Servings per container30 Amounts shown are per serving.

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

Proprietary Herbal Extract Blend

3000 mg per serving

Other (inactive) ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

MelasmaRF by Merry Clinic Drug Interactions

Want to check YOUR meds against MelasmaRF?

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
1,427Drugs
123 Major 1,304 Moderate

Ingredients driving the most interactions

Chinese Salvia extract 1,059
Chinese White Peony extract 811
Bai-Zhu Atractylodes extract 801
Poria sclerotium extract 417
Cnidium extract 351

Individual Drug Interactions

The ingredients in MelasmaRF interact with 1,427 drugs. Click any drug to see the details.

11 of the 14 ingredients in MelasmaRF interact with drugs. Each result below shows which ingredient is responsible. Chinese Salvia extract Chinese White Peony extract Bai-Zhu Atractylodes extract Poria sclerotium extract Cnidium extract Bupleurum extract Rehmannia extract Cyperus extract Safflower extract Angelica root extract Dong quai extract

Each ingredient & the kinds of drugs it affects

For each ingredient in MelasmaRF 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.

Chinese Salvia extract16 drug types · 1,059 drugs

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.

Likelihood Probable Evidence D
Digoxin (Lanoxin)

Theoretically, using danshen with digoxin might increase the risk of adverse effects.
Danshen has structural and pharmacological similarities to cardiac glycosides.

Likelihood Probable Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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%.

Likelihood Possible Evidence B
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%.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence D
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%.

Likelihood Probable Evidence B
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%.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence B
Chinese Salvia extract full monograph & interactions

Chinese White Peony extract7 drug types · 811 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Clozapine (Clozaril)

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

Likelihood Possible Evidence D
Contraceptive Drugs

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

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

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

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

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

Likelihood Possible Evidence D
Estrogens

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

Likelihood Possible Evidence D
Phenytoin (Dilantin)

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

Likelihood Probable Evidence D
Chinese White Peony extract full monograph & interactions

Bai-Zhu Atractylodes extract5 drug types · 801 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, atractylodes might increase the risk of bleeding when used concomitantly with anticoagulant and antiplatelet drugs.
Laboratory research suggests that atractylenolides II and III, constituents of atractylodes, reduce platelet activation. So far, this has not been shown in humans.

Likelihood Possible Evidence D
Aromatase Inhibitors

Theoretically, atractylodes may have an additive effect when used with other aromatase inhibitors.
Laboratory research suggests that atractylodes and its constituents exhibit aromatase inhibitor effects.

Likelihood Possible Evidence D
Hexobarbital

Theoretically, taking atractylodes may prolong the therapeutic and adverse effects of hexobarbital.
In animals, atractylodes has been shown to prolong the effects of hexobarbital. These effects have not been shown in humans.

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

Theoretically, atractylodes might decrease the levels of CYP1A2 substrates.
In animals, atractylodes administered at high doses has been shown to induce CYP1A2 activity. This effect has not been shown in humans.

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

Theoretically, atractylodes might increase the levels of CYP3A4 substrates.
In animals, atractylodes administered at high doses has been shown to inhibit CYP3A1 activity, which is a homolog to the human CYP3A4 enzyme. This effect has not been shown in humans.

Likelihood Possible Evidence D
Bai-Zhu Atractylodes extract full monograph & interactions

Poria sclerotium extract3 drug types · 417 drugs

Anticholinergic Drugs

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

Likelihood Possible Evidence D
Cholinergic Drugs

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

Likelihood Possible Evidence D
Cns Depressants

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

Likelihood Possible Evidence D
Poria sclerotium extract full monograph & interactions

Cnidium extract2 drug types · 351 drugs

Anticoagulant/Antiplatelet Drugs

Laboratory research shows that osthol, a constituent of cnidium, inhibits blood clotting and the activity of platelets. Theoretically, cnidium might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Likelihood Possible Evidence D
Cns Depressants

In laboratory research, cnidium has been shown to have sedative and hypnotic effects, possibly related to constituent coumarins. Theoretically, cnidium may potentiate the effects of barbiturates, other sedatives, and anxiolytics.

Likelihood Possible Evidence D
Cnidium extract full monograph & interactions

Bupleurum 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 extract full monograph & interactions

Rehmannia extract2 drug types · 258 drugs

Antidiabetes Drugs

Theoretically, rehmannia might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that rehmannia may have hypoglycemic effects.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, rehmannia might increase the risk of hypotension when taken with antihypertensive drugs.
Animal research shows that rehmannia may have hypotensive effects. Laboratory research shows that formulations of dried and processed rehmannia root inhibit angiotensin-converting enzyme (ACE).

Likelihood Possible Evidence D
Rehmannia extract full monograph & interactions

Cyperus extract3 drug types · 256 drugs

Barbiturates

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

Likelihood Possible Evidence D
Benzodiazepines

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

Likelihood Possible Evidence D
Cns Depressants

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

Likelihood Possible Evidence D
Cyperus extract full monograph & interactions

Safflower extract3 drug types · 208 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence B
Antidiabetes Drugs

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

Likelihood Possible Evidence B
Warfarin

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

Likelihood Possible Evidence D
Safflower extract full monograph & interactions

Angelica root extract1 drug type · 186 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

In vitro research shows that ashitaba extract inhibits cytochrome P450 (CYP) 1A2. Theoretically, concomitant use of ashitaba with CYP1A2 substrates might decrease the clearance of these substrates and increase the risk for adverse effects. However, this interaction has yet to be reported in humans. Until more is known, use with caution.

Likelihood Possible Evidence D
Angelica root extract full monograph & interactions

Dong quai extract3 drug types · 163 drugs

Warfarin (Coumadin)

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

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Estrogens

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

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

Brand information

Manufacturer and brand details for MelasmaRF, from the product label.

Merry Clinic

See all Merry Clinic products
Name
Merry Clinic
City
San Bruno
State
CA
ZipCode
94066
Web Address
www.merryclinic.com
Pharmacist Counseling Corner

MelasmaRF by Merry Clinic: Common Questions

Does MelasmaRF by Merry Clinic interact with any medications?
Yes. Based on its ingredients, MelasmaRF has a known interaction with 1,427 medications, including 123 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
MelasmaRF contains 14 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is it safe to take MelasmaRF if I'm pregnant or breastfeeding?
No. Several ingredients — bupleurum, atractylodes, peony, dong quai, rehmannia, danshen, cyperus, poria mushroom, cnidium, and safflower — either have not been studied enough in pregnancy and lactation or are rated possibly unsafe. Talk with your doctor or pharmacist about whether this product is right for you if you're pregnant or nursing.
What does dong quai do in this formula?
Dong quai is a traditional herbal ingredient, but the evidence we hold shows insufficient reliable evidence for any specific condition it's meant to treat in this product. It's included in the blend for traditional use.
Can danshen really interact with my heart medication?
Yes. Danshen (Chinese Salvia) has structural and pharmacological similarities to digoxin, a heart medication, and theoretically could increase the risk of adverse effects. If you take digoxin or any cardiac drug, ask your doctor or pharmacist before starting this product.
What if I'm on a blood thinner like warfarin?
This product carries a Major-severity interaction with warfarin due to dong quai, and Moderate interactions with other blood thinners from several other ingredients. Do not take MelasmaRF without discussing it first with your doctor or pharmacist — the bleeding risk is serious.
Are there any common side effects I should know about?
Peony may cause diarrhea, nausea, abdominal distension, and loss of appetite. Bupleurum and poria mushroom can cause nausea. Safflower has been rarely linked to liver failure in cases of over-use. If you experience unusual bleeding, bruising, stomach upset, or changes in how your medications work, stop and speak with your pharmacist.
Does this product actually work for skin or melasma?
The evidence we hold does not establish that any ingredient in MelasmaRF is effective for melasma or skin conditions. Most ingredients are rated as having insufficient reliable evidence. Talk with your doctor about proven treatments if you're looking for skin-condition support.

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

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

MelasmaRF label
Go deeper

The Full Monographs Behind MelasmaRF’s Ingredients

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

Herb & supplement monograph

Ashitaba

Interacts with 186 drugs

Ashitaba is a leafy plant from Japan that is eaten as a vegetable and taken as a supplement for general health, antioxidant, and heart benefits. Most of the supporting research comes from la...

Read the full Ashitaba 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

Atractylodes

Interacts with 801 drugs

Atractylodes is a root used for centuries in traditional Chinese, Japanese, and Thai medicine, mostly for digestive complaints and fatigue, often as part of multi-herb formulas. Modern resea...

Read the full Atractylodes 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

Dong Quai

Interacts with 163 drugs

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

Read the full Dong Quai monograph → Herb & supplement monograph

Rehmannia

Interacts with 258 drugs

Rehmannia is a root used for centuries in Traditional Chinese Medicine, often to 'tonify' the kidneys and support energy or blood health. Human evidence for most modern uses is limited, so i...

Read the full Rehmannia monograph → Herb & supplement monograph

Danshen

Interacts with 1,059 drugs

Danshen 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 monograph

Adrue

Interacts with 256 drugs

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

Read the full Adrue monograph → Herb & supplement monograph

Poria Mushroom

Interacts with 417 drugs

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

Read the full Poria Mushroom monograph → Herb & supplement monograph

Cnidium

Interacts with 351 drugs

Cnidium is the dried fruit of an Asian plant long used in traditional Chinese medicine, mostly for skin problems and sexual health. Modern human evidence for these uses is very limited, with...

Read the full Cnidium monograph → Herb & supplement monograph

Safflower

Interacts with 208 drugs

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

Read the full Safflower monograph →
Sources

Sources & How We Checked

MelasmaRF'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 109 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.

Ashitaba 2 references
  1. Kwon D, Yoon S, Carter O, Bailey GS, Dashwood RH. Antioxidant and antigenotoxic activities of Angelica keiskei, Oenanthe javanica and Brassica oleracea in the Salmonella mutagenicity assay and in HCT116 human colon cancer cells. Biofactors. 2006;26(4):231
  2. Noh HM, Ahn EM, Yun JM, Cho BL, Paek YJ. Angelica keiskei Koidzumi extracts improve some markers of liver function in habitual alcohol drinkers: a randomized double-blind clinical trial. J Med Food. 2015;18(2):166-72.

See these in context on the Ashitaba monograph →

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

See these in context on the Bupleurum monograph →

Atractylodes 6 references
  1. Liu Y, Jia Z, Dong L, et al. A randomized pilot study of atractylenolide I on gastric cancer cachexia patients. Evid Based Complement Alternat Med 2008;5:337-44. PubMed
  2. Chen Y, Yang W, Guo L, Wu X, Zhang T, Liu J, Zhang J. Atractylodes lactone compounds inhibit platelet activation. Platelets. 2017 Mar;28(2):194-202. PubMed
  3. Jiang H, Shi J, Li Y. Screening for compounds with aromatase inhibiting activities from Atractylodes macrocephala Koidz. Molecules. 2011 Apr 14;16(4):3146-51. PubMed
  4. Koonrungsesomboon N, Na-Bangchang K, Karbwang J. Therapeutic potential and pharmacological activities of Atractylodes lancea (Thunb.) DC. Asian Pac J Trop Med. 2014 Jun;7(6):421-8. PubMed
  5. Li L, Tang LY, Man GC, Yeung BH, Lau CB, Leung PC, Wang CC. Potential reproductive toxicity of Largehead Atractylodes Rhizome, the most commonly used Chinese medicine for threatened miscarriage. Hum Reprod. 2011 Dec;26(12):3280-8. PubMed
  6. Muhamad N, Plengsuriyakarn T, Na-Bangchang K. Atractylodes lancea for cholangiocarcinoma: Modulatory effects on CYP1A2 and CYP3A1 and pharmacokinetics in rats and biodistribution in mice. PLoS One 2022;17(11):e0277614. PubMed

See these in context on the Atractylodes monograph →

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

See these in context on the Peony monograph →

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

See these in context on the Dong Quai monograph →

Rehmannia 3 references
  1. Zhang R, Zhou J, Jia Z, et al. Hypoglycemic effect of Rehmannia glutinosa oligosaccharide in hyperglycemic and alloxan-induced diabetic rats and its mechanism. J Ethnopharmacol 2004;90:39-43. PubMed
  2. Zhang RX, Li MX, Jia ZP. Rehmannia glutinosa: review of botany, chemistry and pharmacology. J Ethnopharmacol 2008;117(2):199-214. PubMed
  3. Chao CH, Hsu JL, Chen MF, et al. Anti-hypertensive effects of Radix Rehmanniae and its active ingredients. Nat Prod Res. 2020;34(11):1547-1552.

See these in context on the Rehmannia monograph →

Danshen 28 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Yu CM, Chan JC, Sanderson JE. Chinese herbs and warfarin potentiation by danshen. J Intern Med 1997;241:337-9. PubMed
  3. Tam LS, et al. Warfarin interacions with Chinese traditional medicines: danshen and methyl salicylate medicated oil. Aust N Z J Med 1995;25:258.
  4. Chan TY. Interaction between warfarin and danshen (Salvia miltiorrhiza). Ann Pharmacother 2001;35:501-4. DOI
  5. Chan TY. Drug interactions as a cause of overanticoagulation and bleedings in Chinese patients receiving warfarin. Int J Clin Pharmacol Ther 1998;36:403-5.
  6. Izzat MB, Yim APC, El-Zufari MH. A taste of Chinese medicine! Ann Thorac Surg 1998;66:941-2. PubMed
  7. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
  8. Wahed A, Dasgupta A. Positive and negative in vitro interference of Chinese medicine dan shen in serum digoxin measurement. Elimination of interference by monitoring free digoxin concentration. Am J Clin Pathol 2001;116:403-408. PubMed
  9. Wu B, Liu M, Zhang S. Dan Shen agents for acute ischaemic stroke. Cochrane Database Syst Rev 2007;(2):CD004295. PubMed
  10. Qiu F, Wang G, Zhang R, Sun J, et al. Effect of danshen extract on the activity of CYP3A4 in healthy volunteers. Br J Clin Pharmacol 2010;69:656-62. PubMed
  11. Li CP, Yung KH, and Chiu KW. Hypotensive action of Salvia miltiorrhiza cell culture extract. American Journal of Chinese Medicine 1990;18(3-4):157-166.
  12. Chu Y, Zhang L, Wang XY, Guo JH, Guo ZX, Ma XH. The effect of Compound Danshen Dripping Pills, a Chinese herb medicine, on the pharmacokinetics and pharmacodynamics of warfarin in rats. J Ethnopharmacol. 2011 Oct 11;137(3):1457-61. PubMed
  13. Ma S, Ju W, Dai G, Zhao W, Cheng X, Fang Z, Tan H, Wang X. Synergistic effects of clopidogrel and fufang danshen dripping pills by modulation of the metabolism target and pharmacokinetics. Evid Based Complement Alternat Med. 2014;2014:789142. PubMed
  14. Qiu F, Jiang J, Ma Y, Wang G, Gao C, Zhang X, Zhang L, Liu S, He M, Zhu L, Ye Y, Li Q, Miao P. Opposite Effects of Single-Dose and Multidose Administration of the Ethanol Extract of Danshen on CYP3A in Healthy Volunteers. Evid Based Complement Alternat Me PubMed
  15. Qiu F, Zeng J, Liu S, He M, Zhu L, Ye Y, Miao P, Shen S, Jiang J. Effects of danshen ethanol extract on the pharmacokinetics of fexofenadine in healthy volunteers. Evid Based Complement Alternat Med. 2014;2014:473213. PubMed
  16. Wang X, Cheung CM, Lee WY, Or PM, Yeung JH. Major tanshinones of Danshen (Salvia miltiorrhiza) exhibit different modes of inhibition on human CYP1A2, CYP2C9, CYP2E1 and CYP3A4 activities in vitro. Phytomedicine. 2010 Sep;17(11):868-75. PubMed
  17. Wang X, Yeung JH. Investigation of cytochrome P450 1A2 and 3A inhibitory properties of Danshen tincture. Phytomedicine. 2012 Feb 15;19(3-4):348-54. PubMed
  18. Wen JH, Xiong YQ. The effect of herbal medicine danshensu and ursolic acid on pharmacokinetics of rosuvastatin in rats. Eur J Drug Metab Pharmacokinet. 2011 Dec;36(4):205-11. PubMed
  19. Zhang Z, Ge B, Zhou L, Lam TN, Zuo Z. Induction of liver cytochrome P450s by Danshen-Gegen formula is the leading cause for its pharmacokinetic interactions with warfarin. J Ethnopharmacol. 2014 Jul 3;154(3):672-86. PubMed
  20. Zhou X, Chan K, Yeung JH. Herb-drug interactions with Danshen (Salvia miltiorrhiza): a review on the role of cytochrome P450 enzymes. Drug Metabol Drug Interact. 2012 Mar 2;27(1):9-18.
  21. Zhou L, Wang S, Zhang Z, Lau BS, Fung KP, Leung PC, Zuo Z. Pharmacokinetic and pharmacodynamic interaction of Danshen-Gegen extract with warfarin and aspirin. J Ethnopharmacol. 2012 Sep 28;143(2):648-55. PubMed
  22. Lv C, Liu C, Yao Z, et al. The clinical pharmacokinetics and pharmacodynamics of warfarin when combined with compound danshen: a case study for combined treatment of coronary heart diseases with atrial fibrillation. Front Pharmacol. 2017 Nov 21;8:826. PubMed
  23. Yin QS, Chen L, Mi RH, Ai H, Yin JJ, Liu XJ, Wei XD. Efficacy and safety of danshen compound tablets in preventing thalidomide-associated thromboembolism in patients with multiple myeloma: a multicenter retrospective study. Med Sci Monit. 2016 Oct 20;22:3 PubMed
  24. Zhang H, Han X, Li Y, Li H, Guo X. Effects of danshen tablets on pharmacokinetics of amlodipine in rats. Pharm Biol. 2019;57(1):306-309. PubMed
  25. Zhang Y, Yang M, Ho NJ, et al. Is it safe to take Radix Salvia Miltiorrhiza - Radix Pueraria Lobate product with warfarin and aspirin? A pilot study in healthy human subjects. J Ethnopharmacol. 2020 Nov 15;262:113151. PubMed
  26. Ma XJ, Duan WH, Zhang Y, et al. Combination of activating blood circulation and detoxifying Chinese medicines played an anti-inflammatory role in unstable angina patients after percutaneous coronary intervention: A multicenter, open-labeled, randomized co
  27. Liu J, Shi Y, Wu C, et al. Comparison of sweated and non-sweated ethanol extracts of Salvia miltiorrhiza Bge. (Danshen) effects on human and rat hepatic UDP-glucuronosyltransferase and preclinic herb-drug interaction potential evaluation. Curr Drug Metab
  28. Zheng D, Zhang W, Hou M, et al. Evaluation of herb-drug interactions between compound Danshen dripping pills and clopidogrel based on the pharmacokinetics and pharmacodynamics in rats. Biomed Chromatogr. 2023;37(9):e5684. PubMed

See these in context on the Danshen monograph →

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

See these in context on the Adrue monograph →

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

See these in context on the Poria Mushroom monograph →

Cnidium 1 reference
  1. Sun Y, Yang AWH, Lenon GB. Phytochemistry, ethnopharmacology, pharmacokinetics and toxicology of Cnidium monnieri (L.) Cusson. Int J Mol Sci. 2020;21(3):1006. PubMed

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Safflower 14 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
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  4. Borkman M, Chisholm DJ, Furler SM, et al. Effects of fish oil supplementation on glucose and lipid metabolism in NIDDM. Diabetes 1989;38:1314-9.. PubMed
  5. Amato, P. and Quercia, R. A. A historical perspective and review of the safety of lipid emulsion in pregnancy. Nutr Clin Pract. 1991;6(5):189-192. PubMed
  6. Demke, D. M., Peters, G. R., Linet, O. I., Metzler, C. M., and Klott, K. A. Effects of a fish oil concentrate in patients with hypercholesterolemia. Atherosclerosis 1988;70(1-2):73-80. PubMed
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  8. Kwon, J. S., Snook, J. T., Wardlaw, G. M., and Hwang, D. H. Effects of diets high in saturated fatty acids, canola oil, or safflower oil on platelet function, thromboxane B2 formation, and fatty acid composition of platelet phospholipids. Am.J.Clin.Nutr. PubMed
  9. Lloyd-Still, J. D., Simon, S. H., Wessel, H. U., and Gibson, L. E. Negative effects of oral fatty acid supplementation on sweat chloride in cystic fibrosis. Pediatrics 1979;64(1):50-52. DOI
  10. Challen, A. D., Branch, W. J., and Cummings, J. H. The effect of aspirin and linoleic acid on platelet aggregation, platelet fatty acid composition and haemostasis in man. Hum Nutr Clin Nutr 1983;37(3):197-208.
  11. Asp ML, Collene AL, Norris LE, Cole RM, Stout MB, Tang SY, Hsu JC, Belury MA. Time-dependent effects of safflower oil to improve glycemia, inflammation and blood lipids in obese, post-menopausal women with type 2 diabetes: a randomized, double-masked, cro
  12. Liu Y, Liu S, Shi Y, et al. Effects of safflower injection on the pharmacodynamics and pharmacokinetics of warfarin in rats. Xenobiotica. 2017 Oct 25:1-6. [Epub ahead of print] PubMed
  13. de Ataide EC, Reges Perales S, de Oliveira Peres MA, et al. Acute liver failure induced by Carthamus tinctorius oil: Case reports and literature review. Transplant Proc. 2018;50(2):476-477. PubMed
  14. Ruyvaran M, Zamani A, Mohamadian A, et al. Safflower (Carthamus tinctorius L.) oil could improve abdominal obesity, blood pressure, and insulin resistance in patients with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial. PubMed

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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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