Major interaction on record — check this product against your medications before combining. Based on 7 of 12 ingredients. Check your meds →
Dietary supplement

Qian Lie Xian Wan Ingredients & Drug Interactions

by E-Fong

Qian Lie Xian Wan 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 Qian Lie Xian Wan 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

Qian Lie Xian Wan is a dietary supplement by E-Fong with 12 active ingredients. Its ingredients are commonly taken for digestive complaints and diarrhea, inflammation and joint discomfort, stress and weight management (in combination products).Based on those ingredients, 1,559 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Polygonum multiflorum, Phellodendron chinense, Citrus aurantium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Qian Lie Xian Wan by E-Fong

Ask about any prescription or over-the-counter medication and we check it for interactions with Qian Lie Xian Wan by E-Fong — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Qian Lie Xian Wan by E-Fong

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 12 active ingredients.

Qian Lie Xian Wan contains 12 ingredients, 11 of which are herbal extracts. The active ingredients include Phellodendron chinense, Rehmannia glutinosa, Salvia miltiorrhiza, Panax notoginseng, Taraxacum mongolicum, Prunella vulgaris, Lophatherum gracile, Hedyotis diffusa, Polygonum multiflorum (fo-ti), Coix lacryma-jobi (Job's tears), Polyporus umbellatus (poria mushroom), and Citrus aurantium (bitter orange).

There are no inactive ingredients listed.

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: Angina — rated "Possibly Effective" (Panax Notoginseng) (Natural Medicines).
  • On file: Intracranial hemorrhage — rated "Possibly Effective" (Panax Notoginseng) (Natural Medicines).
  • On file: Stroke — rated "Possibly Effective" (Panax Notoginseng) (Natural Medicines).
  • On file: Chronic kidney disease (CKD) — rated "Possibly Effective" (Rehmannia) (Natural Medicines).

The evidence for this product's claimed uses is limited. Rehmannia is rated Possibly Effective for chronic kidney disease; Panax notoginseng is rated Possibly Effective for angina and stroke; and Citrus aurantium has insufficient evidence for all listed conditions.

Most other ingredients—including Phellodendron, fo-ti, Job's tears, and poria mushroom—have insufficient reliable evidence to rate their effectiveness for their traditional uses. The data we hold does not establish that this combination works for its intended purposes.

The evidence, ingredient by ingredient Phellodendron Rehmannia Panax Notoginseng Fo-ti Job's Tears Poria Mushroom Bitter Orange

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

This product carries several safety concerns. Fo-ti (Polygonum multiflorum) has been linked to approximately 450 documented cases of liver damage in the medical literature, ranging from hepatitis to cirrhosis, at various doses and durations—this is a serious risk.

Bitter orange can raise blood pressure and heart rate, especially when combined with caffeine or other stimulants. Panax notoginseng may cause nervousness, insomnia, dry mouth, nausea, and vomiting.

Phellodendron-containing products have been associated in one trial with reports of sexual dysfunction, shaking hands, numbness around the mouth, fatigue, headache, and heartburn, though it's unclear if phellodendron was responsible. Overall, human safety data for most of these herbs are limited, and this product is generally used short-term in traditional medicine only.

Side effects, ingredient by ingredient Phellodendron Rehmannia Panax Notoginseng Fo-ti Job's Tears Poria Mushroom Bitter Orange

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?
  • 7 of the 7 matched ingredients can interact with medications — Poria Mushroom, Fo-ti, Panax Notoginseng, Bitter Orange, Phellodendron, 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: 1,560 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.

Check with your pharmacist if you take any of the following: MAOIs (antidepressants), sedatives like midazolam, blood thinners (anticoagulants) or aspirin, blood pressure medications, diabetes drugs, drugs that slow heart rhythm (QT-prolonging medications), stimulant drugs, cough suppressants (dextromethorphan), or any drug processed by your liver's CYP enzymes. No interactions are documented for five of the twelve ingredients we could not check.

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 herbal formula with multiple serious drug interactions and limited evidence of effectiveness. If you take any prescription medications—particularly blood thinners, blood pressure drugs, diabetes medications, or sedatives—talk to your pharmacist before using it.

Pregnant women and those breastfeeding should avoid it; fo-ti in particular carries documented risk of liver injury. Use only under professional guidance.

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

Assessment coverage: 7 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 25, 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 Qian Lie Xian Wan, straight from the product label.

Brand E-Fong
Barcode (UPC) 6925496339134
Net contents 200 Pill(s)
Market status On market
Date entered into DSLD Jun 25, 2025
DSLD ID 331226
Product type Botanical
Supplement form Tablet Or Pill
Dietary claims / uses All Other
Intended target group(s) Children 4 or More Years of Age, 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 Qian Lie Xian Wan by E-Fong, 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
6925496339134
IngredientAmount% DV
Phellodendron chinense0 NP--
Rehmannia glutinosa0 NP--
Salvia miltiorrhiza0 NP--
Panax notoginseng0 NP--
Taraxacum mongolicum0 NP--
Prunella vulgaris0 NP--
Lophatherum gracile0 NP--
Hedyotis diffusa0 NP--
Polygonum multiflorum0 NP--
Coix lacryma-jobi0 NP--
Polyporus umbellatus0 NP--
Citrus aurantium0 NP--

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 Adult and children 12 years and over: Take 8 pills 3 times daily, 30 minutes to 1 hour away from meals with 250ml of water.

Precautions

Do not take if inner cap seal is missing or broken.

Keep out of reach of children.

Formulation

GMP Certified

Traditional Chinese Formula

Storage

Storage: Store below 30 degrees C

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

See for yourself

Qian Lie Xian Wan by E-Fong label

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

Qian Lie Xian Wan 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 Qian Lie Xian Wan by E-Fong

These are the 12 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.

Phellodendron chinense

Interacts with
1,160 drugs
0 NP per serving

Phellodendron is a traditional Chinese medicine bark (Huang Bai) that contains berberine and other plant compounds with antimicrobial and anti-inflamm...

Phellodendron chinense monograph & interactions

Rehmannia glutinosa

Interacts with
258 drugs
0 NP per serving

Rehmannia is a root used for centuries in Traditional Chinese Medicine, often to 'tonify' the kidneys and support energy or blood health. Human eviden...

Rehmannia glutinosa monograph & interactions

Salvia miltiorrhiza

0 NP per serving Form: Salvia miltiorrhiza, Salvia miltiorrhiza

Panax notoginseng

Interacts with
207 drugs
0 NP per serving Form: Panax notoginseng, Panax notoginseng

Panax notoginseng (sanqi or tienchi ginseng) is a traditional Chinese herb most often used to help with bleeding, bruising, and circulation. Human evi...

Panax notoginseng monograph & interactions

Taraxacum mongolicum

0 NP per serving

Prunella vulgaris

0 NP per serving

Lophatherum gracile

0 NP per serving Form: Lophatherum gracile, Lophatherum gracile

Hedyotis diffusa

0 NP per serving

Polygonum multiflorum

Interacts with
1,257 drugs
0 NP per serving

Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these be...

Polygonum multiflorum monograph & interactions

Coix lacryma-jobi

Interacts with
128 drugs
0 NP per serving

Job's Tears is a grain-like seed long used as a food and in traditional medicine, especially in East Asia. While it is generally safe as a food and is...

Coix lacryma-jobi monograph & interactions

Polyporus umbellatus

Interacts with
417 drugs
0 NP per serving

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

Polyporus umbellatus monograph & interactions

Citrus aurantium

Interacts with
957 drugs
0 NP per serving

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

Citrus aurantium monograph & interactions
Interaction report

Qian Lie Xian Wan by E-Fong Drug Interactions

Want to check YOUR meds against Qian Lie Xian Wan?

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
1,559Drugs
10 Major 1,549 Moderate

Ingredients driving the most interactions

Polygonum multiflorum 1,257
Phellodendron chinense 1,160
Citrus aurantium 957
Polyporus umbellatus 417
Rehmannia glutinosa 258

Individual Drug Interactions

The ingredients in Qian Lie Xian Wan interact with 1,559 drugs. Click any drug to see the details.

7 of the 12 ingredients in Qian Lie Xian Wan interact with drugs. Each result below shows which ingredient is responsible. Polygonum multiflorum Phellodendron chinense Citrus aurantium Polyporus umbellatus Rehmannia glutinosa Panax notoginseng Coix lacryma-jobi

Each ingredient & the kinds of drugs it affects

For each ingredient in Qian Lie Xian Wan 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.

Polygonum multiflorum17 drug types · 1,257 drugs

Anticoagulant/Antiplatelet Drugs

Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery. Theoretically, concomitant use of fo-ti with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients. Until more is known, monitor patients taking fo-ti and drugs that affect bleeding.
Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Fo-ti reportedly has hypoglycemic effects.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, taking large amounts of fo-ti might interfere with contraceptive drugs due to competition for estrogen receptors.
In vitro research suggests that fo-ti extract has estrogenic activity.

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

Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.

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

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2B6.
Animal research suggests that fo-ti might inhibit CYP2B6. One in vitro study suggests that the degree of CYP2B6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.

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

Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C19.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C19. An in vitro study suggests that the degree of CYP2C19 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C8 (Cyp2C8) Substrates

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2C8.
In vitro research suggests that fo-ti might inhibit CYP2C8. However, this interaction has not been reported in humans.

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

Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C9.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C9. However, this interaction has not been reported in humans.

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

Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Animal research suggests that fo-ti might inhibit CYP2D6. Additionally, an in vitro study suggests that the degree of CYP2D6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.

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

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia and cardiotoxicity when taken with digoxin.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects. In vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia when taken with diuretic drugs.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects and compound diuretic-induced potassium loss. In vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.

Likelihood Possible Evidence D
Estrogens

Theoretically, taking large amounts of fo-ti might interfere with hormone replacement therapy through competition for estrogen receptors.
In vitro research suggests that fo-ti extract has estrogenic activity.

Likelihood Probable Evidence D
Hepatotoxic Drugs

Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Fo-ti has been linked to liver damage in many reports.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of fluid and electrolyte depletion when taken with stimulant laxatives.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects. However, in vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.

Likelihood Possible Evidence D
Sulindac (Clinoril)

Theoretically, fo-ti might increase or decrease the levels and clinical effects of sulindac.
Animal research suggests that the type of fo-ti extract might affect the levels of sulindac differently; the raw plant may increase levels, but processed parts may decrease levels. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, fo-ti might increase the effects and adverse effects of warfarin.
Fo-ti may have stimulant laxative effects and cause diarrhea, especially when the raw or unprocessed fo-ti root is used. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Also, fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of warfarin. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery.

Likelihood Possible Evidence D
Polygonum multiflorum full monograph & interactions

Phellodendron chinense14 drug types · 1,160 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Antidiabetes Drugs

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

Likelihood Possible Evidence D
Antihypertensive Drugs

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

Likelihood Possible Evidence D
Cns Depressants

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

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

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

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

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

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

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

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

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

Likelihood Possible Evidence D
Dextromethorphan (Robitussin Dm, Others)

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

Likelihood Possible Evidence D
Losartan (Cozaar)

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

Likelihood Possible Evidence D
Metformin (Glucophage)

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

Likelihood Possible Evidence D
Midazolam (Versed)

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

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

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

Likelihood Possible Evidence D
Tacrolimus (Prograf)

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

Likelihood Possible Evidence D
Phellodendron chinense full monograph & interactions

Citrus aurantium13 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 full monograph & interactions

Polyporus umbellatus3 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
Polyporus umbellatus full monograph & interactions

Rehmannia glutinosa2 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 glutinosa full monograph & interactions

Panax notoginseng4 drug types · 207 drugs

Aspirin

Theoretically, taking Panax notoginseng concomitantly with aspirin may increase the risk of adverse effects from both products.
Animal research shows that taking Panax notoginseng extract with aspirin increases blood levels of salicylic acid by approximately 50% and blood levels of Panax notoginseng by 75% to 196%. This effect may be due to increased absorption of both products.

Likelihood Possible Evidence D
Caffeine

Theoretically, taking Panax notoginseng may decrease the levels and clinical effects of caffeine.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction is attributed to the ability of Panax notoginseng to increase the activity of cytochrome P450 1A2 (CYP1A2) enzymes.

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

Theoretically, taking Panax notoginseng might reduce the levels and clinical effects of CYP1A2 substrates.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction was attributed to the ability of Panax notoginseng to increase the activity of CYP1A2.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, taking Panax notoginseng concomitantly with warfarin may increase the risk of bleeding.
Animal research shows that taking Panax notoginseng concomitantly with warfarin increases plasma warfarin levels, prothrombin time, and international normalized ratio when compared with control. In vitro research also suggests that Panax notoginseng may downregulate expression of cytochrome P450 3A4 enzymes, which may affect warfarin metabolism.

Likelihood Possible Evidence D
Panax notoginseng full monograph & interactions

Coix lacryma-jobi5 drug types · 128 drugs

Antidiabetes Drugs

Preliminary evidence shows that constituents of Job's tears might have hypoglycemic effects. Theoretically, concomitant use with drugs that decrease blood glucose levels might increase the risk of hypoglycemia. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

Likelihood Possible Evidence D
Chlorzoxazone (Parafon Forte, Paraflex)

Animal research suggests that Job's tears might enhance absorption of chlorzoxazone in the small intestine. Single dose and short-term oral administration of Job's tears bran ethanolic extract along with oral administration of a five-drug cocktail containing chlorzoxazone increases chlorzoxazone peak plasma concentration and area under the plasma concentration-time curve (AUC) without altering major cytochrome P450 activities in the liver. This effect has not been reported in humans.

Likelihood Possible Evidence D
Dextromethorphan (Robitussin Dm, Others)

Animal research suggests that Job's tears might enhance absorption of dextromethorphan in the small intestine. Single dose oral administration of Job's tears bran ethanolic extract along with oral administration of a five-drug cocktail containing dextromethorphan increases dextromethorphan area under the plasma concentration-time curve (AUC) without altering major cytochrome P450 activities in the liver. This effect has not been reported in humans.

Likelihood Possible Evidence D
Diltiazem (Cardizem, Others)

Animal research suggests that Job's tears might enhance absorption of diltiazem in the small intestine. Single dose oral administration of Job's tears bran ethanolic extract along with oral administration of a five-drug cocktail containing diltiazem increases diltiazem peak plasma concentration and area under the plasma concentration-time curve (AUC) without altering major cytochrome P450 activities in the liver. This effect has not been reported in humans.

Likelihood Possible Evidence D
Theophylline

Animal research suggests that Job's tears might enhance absorption of theophylline in the small intestine. Single dose and short-term oral administration of Job's tears bran ethanolic extract along with oral administration of a five-drug cocktail containing theophylline increases theophylline peak plasma concentration and area under the plasma concentration-time curve (AUC) without altering major cytochrome P450 activities in the liver. This effect has not been reported in humans.

Likelihood Possible Evidence D
Coix lacryma-jobi full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Qian Lie Xian Wan, from the product label.

E-Fong

See all E-Fong products
Name
E-Fong Herbs, inc.
Pharmacist Counseling Corner

Qian Lie Xian Wan by E-Fong: Common Questions

Does Qian Lie Xian Wan by E-Fong interact with any medications?
Yes. Based on its ingredients, Qian Lie Xian Wan has a known interaction with 1,559 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?
Qian Lie Xian Wan contains 12 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 while pregnant?
No. Phellodendron and fo-ti should be avoided in pregnancy due to safety concerns. Panax notoginseng, Job's tears, poria mushroom, and Rehmannia also lack sufficient safety data and are best avoided. Talk to your doctor or pharmacist before considering use.
Can I take this while breastfeeding?
No. Phellodendron's berberine passes to infants and may be harmful. Fo-ti, Panax notoginseng, Job's tears, poria mushroom, and Rehmannia also lack adequate safety data for breastfeeding. Avoid this product.
What side effects have been reported?
In clinical trials with the phellodendron-magnolia combination, isolated cases of sexual dysfunction, hand shaking, numbness around the lips, fatigue, and headache were noted (though it's unclear if phellodendron caused them). Panax notoginseng can cause nervousness, insomnia, nausea, and vomiting. Bitter orange may raise blood pressure and heart rate. Fo-ti may cause abdominal pain and diarrhea.
Does this product actually work for what it claims?
The evidence is very limited. Only Rehmannia for chronic kidney disease and Panax notoginseng for angina and stroke are rated Possibly Effective. All other ingredients have insufficient evidence. We don't have data to say this combination is effective for its intended uses.
Why is fo-ti (Polygonum multiflorum) in this formula?
Fo-ti is a traditional herb used in Asian medicine, but it has been linked to around 450 documented cases of liver damage, ranging from hepatitis to cirrhosis. It carries real risk and should be used only under professional guidance, if at all.
Is bitter orange safe in this product?
Bitter orange can raise blood pressure and heart rate, particularly when combined with caffeine or stimulants. It interacts with sedatives and certain blood pressure drugs. If you have heart conditions, high blood pressure, or take relevant medications, this ingredient is a concern—check with your pharmacist first.

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.

Qian Lie Xian Wan label
Go deeper

The Full Monographs Behind Qian Lie Xian Wan’s Ingredients

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

Herb & supplement monograph

Phellodendron

Interacts with 1,160 drugs

Phellodendron is a traditional Chinese medicine bark (Huang Bai) that contains berberine and other plant compounds with antimicrobial and anti-inflammatory activity in lab studies. Human evi...

Read the full Phellodendron 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

Panax Notoginseng

Interacts with 207 drugs

Panax notoginseng (sanqi or tienchi ginseng) is a traditional Chinese herb most often used to help with bleeding, bruising, and circulation. Human evidence for these uses is limited and most...

Read the full Panax Notoginseng monograph → Herb & supplement monograph

Fo-ti

Interacts with 1,257 drugs

Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these benefits is limited, and processed Fo-ti h...

Read the full Fo-ti monograph → Herb & supplement monograph

Job's Tears

Interacts with 128 drugs

Job's Tears is a grain-like seed long used as a food and in traditional medicine, especially in East Asia. While it is generally safe as a food and is being studied for possible effects on m...

Read the full Job's Tears 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

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 →
Sources

Sources & How We Checked

Qian Lie Xian Wan'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 121 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.

Phellodendron 22 references
  1. Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201-8. PubMed
  2. Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
  3. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  4. Garrison R, Chambliss WG. Effect of a proprietary Magnolia and Phellodendron extract on weight management: a pilot, double-blind, placebo-controlled clinical trial. Altern Ther Health Med 2006;12:50-4.
  5. Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab 2008;93:2559-65. PubMed
  6. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  7. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
  8. Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
  9. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  10. Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
  11. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  12. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.
  13. Yin, J., Xing, H., and Ye, J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism 2008;57(5):712-717. PubMed
  14. Zhang, H., Wei, J., Xue, R., Wu, J. D., Zhao, W., Wang, Z. Z., Wang, S. K., Zhou, Z. X., Song, D. Q., Wang, Y. M., Pan, H. N., Kong, W. J., and Jiang, J. D. Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin re
  15. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  16. Wei, W., Zhao, H., Wang, A., Sui, M., Liang, K., Deng, H., Ma, Y., Zhang, Y., Zhang, H., and Guan, Y. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndro
  17. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
  18. Chun YT, Yip TT, Lau KL, and et al. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmac 1979;10:177-182. PubMed
  19. Hou Q, Han W, Fu X. Pharmacokinetic interaction between tacrolimus and berberine in a child with idiopathic nephrotic syndrome. Eur J Clin Pharmacol 2013;69(10):1861-2. PubMed
  20. Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. PubMed
  21. Kalman DS, Feldman S, Feldman R, et al. Effect of a proprietary magnolia and phellodendron extract on stress levels in healthy women: a pilot, double-blind, placebo-controlled clinical trial. Nutr J 2008;7:11.
  22. Lyu Y, Zhang Y, Yang M, et al. Pharmacokinetic interactions between metformin and berberine in rats: Role of oral administration sequences and microbiota. Life Sci. 2019;235:116818. PubMed

See these in context on the Phellodendron 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 →

Panax Notoginseng 15 references
  1. Huang KC. The Pharmacology of Chinese Herbs. 2nd ed. New York, NY: CRC Press, LLC 1999:101-102.
  2. Bensky D, Gamble A, Kaptchuk T. Chinese Herbal Medicine Materia Medica. Seattle, WA: Eastland Press, 1996:359-60.
  3. Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8..
  4. Du XF, Yin XP, Zhang GL, Shi HJ, Shao MH. Interstitial granulomatous drug reaction to a Chinese herb extract. Eur J Dermatol. 2012 May-Jun;22(3):419-20. PubMed
  5. Liu R, Qin M, Hang P, Liu Y, Zhang Z, Liu G. Effects of Panax notoginseng saponins on the activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in rats in vivo. Phytother Res. 2012 Aug;26(8):1113-8.
  6. Shang Q, Xu H, Liu Z, Chen K, Liu J. Oral Panax notoginseng Preparation for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013;2013:940125.
  7. Tian Z, Pang H, Du S, Lu Y, Zhang L, Wu H, Guo S, Wang M, Zhang Q. Effect of Panax notoginseng saponins on the pharmacokinetics of aspirin in rats. J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jan 1;1040:136-143. PubMed
  8. Xu D, Huang P, Yu Z, Xing DH, Ouyang S, Xing G. Efficacy and Safety of Panax notoginseng Saponin Therapy for Acute Intracerebral Hemorrhage, Meta-Analysis, and Mini Review of Potential Mechanisms of Action. Front Neurol. 2015 Jan 7;5:274. PubMed
  9. Yang X, Xiong X, Wang J. Sanqi panax notoginseng injection for angina pectoris. Evid Based Complement Alternat Med. 2014;2014:963208. PubMed
  10. Yin Z, Ma L, Xu J, Xia J, Luo D. Pustular drug eruption due to Panax notoginseng saponins. Drug Des Devel Ther. 2014 Jul 16;8:957-61. PubMed
  11. Song H, Wang P, Liu J, Wang C. Panax notoginseng Preparations for Unstable Angina Pectoris: A Systematic Review and Meta-Analysis. Phytother Res. 2017 Jun 20.
  12. Tian Z, Pang H, Zhang Q, et al. Effect of aspirin on the pharmacokinetics and absorption of panax notoginsengsaponins. J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Jan 2;1074-75.
  13. Li C, Xu T, Zhou P, et al. Post-marketing safety surveillance and re-evaluation of Xueshuantong injection. BMC Complement Altern Med. 2018;18(1):277. PubMed
  14. Liu L, Shen XJ, Xue LJ, Yao SK, Zhu JY. Submucosal hematoma with a wide range of lesions, severe condition and atypical clinical symptoms: A case report. World J Clin Cases 2021;9(20):5683-5688. PubMed
  15. Qian J, Chen W, Wu J, et al. Effects and Mechanism of Action of Panax notoginseng Saponins on the Pharmacokinetics of Warfarin. Eur J Drug Metab Pharmacokinet 2022;47(3):331-342. PubMed

See these in context on the Panax Notoginseng monograph →

Fo-ti 28 references
  1. Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  5. Park GJ, Mann SP, Ngu MC. Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum. J Gastroenterol Hepatol 2001;16:115-7.
  6. But PP, Tomlinson B, Lee KL. Hepatitis related to the Chinese medicine Shou-wu-pian manufactured from Polygonum multiflorum. Vet Hum Toxicol 1996;38:280-2.
  7. Oerter Klein KO, Janfaza M, Wong JA, Chang RJ. Estrogen bioactivity in Fo-Ti and other herbs used for their estrogen-like effects as determined by a recombinant cell bioassay. J Clin Endocrinol Metab 2003;88:4077-9.. PubMed
  8. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  9. UK Medicines and Healthcare Products Regulatory Agency. Polygonum multiflorum and liver reactions. April 2006. Available at: www.mhra.gov.uk/home/idcplg?IdcService= SS_GET_PAGE&useSecondary=true&ssDocName= CON2023590&ssTargetNodeId= 833 (Accessed 10 May 2
  10. Panis B, Wong DR, Hooymans PM, De Smet PA, Rosias PP. Recurrent toxic hepatitis in a Caucasian girl related to the use of Shou-Wu-Pian, a Chinese herbal preparation. J Pediatr Gastroenterol Nutr 2005;41:256-8. PubMed
  11. Mazzanti G, Battinelli L, Daniele C, et al. New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese herbal product derived from Polygonum multiflorum. Ann Intern Med 2004;140:E589-90.
  12. Cardenas A, Restrepo JC, Sierra F, Correa G. Acute hepatitis due to shen-min: a herbal product derived from Polygonum multiflorum. J Clin Gastroenterol 2006;40:629-32. PubMed
  13. Zhang CZ, Wang SX, Zhang Y, et al. In vitro estrogenic activities of Chinese medicinal plants traditionally used for the management of menopausal symptoms. J Ethnopharmacol 2005;98:295-300. PubMed
  14. Laird AR, Ramchandani N, deGoma EM, et al. Acute hepatitis associated with the use of an herbal supplement (Polygonum multiflorum) mimicking iron-overload syndrome. J Clin Gastroenterol 2008;42:861-2. PubMed
  15. Jung KA, Min HJ, Yoo SS, et al. Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb. Gut Liver 2011;5(4):493-9. PubMed
  16. Kang, S. C., Lee, C. M., Choi, H., Lee, J. H., Oh, J. S., Kwak, J. H., and Zee, O. P. Evaluation of oriental medicinal herbs for estrogenic and antiproliferative activities. Phytother Res 2006;20(11):1017-1019. PubMed
  17. Yuen, M. F., Tam, S., Fung, J., Wong, D. K., Wong, B. C., and Lai, C. L. Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1-year prospective study. Aliment.Pharmacol.Ther 10-15-2006;24(8):1179-1186. PubMed
  18. Zhang, L., Yang, X., Sun, Z., and Qu, Y. [Retrospective study of adverse events of Polygonum multiflorum and risk control]. Zhongguo Zhong.Yao Za Zhi. 2009;34(13):1724-1729.
  19. Bae, S. H., Kim, D. H., Bae, Y. S., Lee, K. J., Kim, D. W., Yoon, J. B., Hong, J. H., and Kim, S. H. [Toxic hepatitis associated with Polygoni multiflori]. Korean J.Hepatol. 2010;16(2):182-186. PubMed
  20. Furukawa, M., Kasajima, S., Nakamura, Y., Shouzushima, M., Nagatani, N., Takinishi, A., Taguchi, A., Fujita, M., Niimi, A., Misaka, R., and Nagahara, H. Toxic hepatitis induced by show-wu-pian, a Chinese herbal preparation. Intern.Med. 2010;49(15):1537-1 PubMed
  21. McGuffin, M., Hobbs, C., Upton, R., and Goldberg, A. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC;1997.
  22. Dong H, Slain D, Cheng J, Ma W, Liang W. Eighteen cases of liver injury following ingestion of Polygonum multiflorum. Complement Ther Med 2014;22(1):70-4. PubMed
  23. Lei X, Chen J, Ren J, et al. Liver damage associated with Polygonum multiflorum Thunb.: a systematic review of case reports and case series. Evid Based Complement Alternat Med 2015;2015:459749.
  24. Ma KF, Zhang XG, Jia HY. CYP1A2 polymorphism in Chinese patients with acute liver injury induced by Polygonum multiflorum. Genet Mol Res 2014;13(3):5637-43. PubMed
  25. Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
  26. Yu J, Xie J, Mao XJ, et al. Comparison of laxative and antioxidant activities of raw, processed and fermented Polygoni multiflori radix. Chin J Nat Med 2012;10(1):63-7. DOI
  27. Shao YL, Ma CM, Wu JM, Guo FC, Zhang SC. Concurrent severe hepatotoxicity and agranulocytosis induced by Polygonum multiflorum: A case report. World J Clin Cases 2022;10(27):9921-9928.
  28. Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed

See these in context on the Fo-ti monograph →

Job's Tears 3 references
  1. Chiang W, Cheng C, Chiang M, Chung KT. Effects of dehulled adlay on the culture count of some microbiota and their metabolism in the gastrointestinal tract of rats. J Agric Food Chem 2000;48:829-32. PubMed
  2. Yu YM, Chang WC, Liu CS, Tsai CM. Effect of young barley leaf extract and adlay on plasma lipids and LDL oxidation in hyperlipidemic smokers. Biol Pharm Bull 2004;27:802-5. PubMed
  3. Yao HT, Lin JH, Liu YT, Li ML, Chiang W. Food-Drug Interaction between the Adlay Bran Oil and Drugs in Rats. Nutrients 2019;11(10):2473. PubMed

See these in context on the Job's Tears 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 →

Bitter Orange 47 references
  1. Penzak SR, Jann MW, Cold JA, et al. Seville (sour) orange juice: synephrine content and cardiovascular effects in normotensive adults. J Clin Pharmacol 2001;41:1059-63. 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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