Schisandra Ingredients & Drug Interactions
by Hawaii Pharm
What is this page for?
First and foremost: checking Schisandra 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
Schisandra is a dietary supplement by Hawaii Pharm with 1 active ingredient. Its ingredients are commonly taken for fatigue and low energy, stress and adaptogen support, liver health.Based on those ingredients, 803 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are certified organic Schisandra extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Schisandra by Hawaii Pharm
Ask about any prescription or over-the-counter medication and we check it for interactions with Schisandra by Hawaii Pharm — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Schisandra by Hawaii Pharm
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This product contains one active ingredient: certified organic Schisandra extract. Schisandra is a berry used in traditional Chinese medicine, and this liquid form comes in vegetable palm glycerin and pharmaceutical-grade alcohol as inactive ingredients.
Does it work?
Couldn't assess
The evidence for schisandra isn't established in the data we hold. The product facts list six conditions — asthma, athletic performance, cough, diabetes, diarrhea, and hepatitis — but all are rated insufficient reliable evidence to rate.
That means there isn't enough high-quality research to say whether schisandra actually works for any of them. Before you use this for a specific health goal, it's worth talking to your doctor or pharmacist about whether the evidence supports it.
How safe is it?
Well-documented data
Schisandra is generally well tolerated in the short term in healthy adults, though high-quality safety data are limited. The most common side effects are decreased appetite, heartburn, stomach upset, and urticaria (a rash-like reaction).
The safety data advises against schisandra during pregnancy — traditional sources suggest it may stimulate the uterus — and there isn't enough reliable information to recommend it while breastfeeding, so avoid it in both situations.
Meds to double-check
Moderate interaction found
Check with your doctor or pharmacist before taking this if you use tacrolimus, or any drug metabolized by CYP3A4 (a huge category that includes many sedatives, statins, and antifungals), CYP2C19, CYP2C9, or transported by P-glycoprotein. Warfarin and other blood thinners need special attention because schisandra may reduce their effectiveness.
Because 804 medications are affected across all these pathways, your own healthcare provider is the best person to sort whether schisandra is safe alongside your specific drugs.
The bottom line
Scorecard at a glanceFully disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
Schisandra might appeal to you if you're exploring traditional remedies and have no prescription medications, but given its broad effects on drug metabolism, it's not a straightforward choice if you take any regular prescriptions. Anyone on an immunosuppressant like tacrolimus, a blood thinner like warfarin, or sedatives should definitely check with their doctor or pharmacist before adding this.
Pregnant and breastfeeding people should avoid it.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Oct 23, 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
General information
Key facts about Schisandra, straight from the product label.
| Brand | Hawaii Pharm |
|---|---|
| Barcode (UPC) | 650905467523 |
| Net contents | 4 Fluid Ounce(s); 120 mL |
| Market status | On market |
| Date entered into DSLD | Oct 23, 2020 |
| DSLD ID | 237596 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Schisandra by Hawaii Pharm, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| certified organic Schisandra extract | 970 mg | -- |
Other ingredients: Vegetable Palm Glycerin, pharmaceutical grade Alcohol
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
Hawaii Pharm Herbal Extract Highest quality since 2008
Made with Aloha!
Formulation
Contains no GMO, gluten, artificial colors, heavy metals, preservatives, pesticides, fertilizers.
Super concentrated liquid herbal extract. Dry herb/menstruum ratio: 1:3.
Manufactured in an FDA registered facility.
Non GMO Gluten free
Made in USA, Hawaii
Suggested/Recommended/Usage/Directions
Directions for use: Shake well before using. Take about 20-30 drops (0.7-1 ml, one full squeeze of the dropper bulb) to 2-4 oz of juice or water up to 4 times per day.
Precautions
Warning: Keep out of the reach of children.
May have contraindications. We recommend to seek expert medical advice before taking.
Do not use if you are allergic to any ingredients.
Consult a physician before using during pregnancy, if nursing or taking any medications.
Do not use if seal is broken or missing.
Storage
Store in a cool dry place.
Formula
(Schisandra chinensis)
FDA Statement of Identity
Herbal Dietary Supplement
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Seals/Symbols
FDA Registered Facility Made in United States of America USA
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Schisandra by Hawaii Pharm label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Schisandra by Hawaii Pharm
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size0.7 mL Dosage formLiquid Servings per container120 Amounts shown are per serving.
Certified organic Schisandra extract
Interacts with803 drugs
Schisandra is a traditional Chinese medicine berry used as an adaptogen for stress, fatigue, and liver support. Human evidence is limited and most cla...
Certified organic Schisandra extract monograph & interactionsOther (inactive) ingredients: Vegetable Palm Glycerin, Pharmaceutical grade Alcohol. These complete the product’s ingredient list but are not active constituents.
Schisandra by Hawaii Pharm Drug Interactions
HelloPharmacist Interaction Report
Schisandra by Hawaii Pharm interacts with a large number of medications through its effects on several drug-processing systems in your body.
The most serious documented interaction is with tacrolimus (an immunosuppressant used after transplants): schisandra can raise tacrolimus levels by 183% to 268%, which could cause toxicity and requires close monitoring if you take both.
Read the full breakdown — every affected drug type, severity by severity
Schisandra inhibits CYP3A4 and CYP2C19 enzymes, which means it can increase levels of many drugs metabolized by those pathways — including midazolam, voriconazole, and a broad category of CYP3A4 substrates. It also appears to inhibit P-glycoprotein transporters, potentially raising levels of drugs that depend on that pathway for clearance.
On the flip side, schisandra can induce CYP2C9 enzymes, which may decrease the effectiveness of warfarin and other CYP2C9 substrates. All of these effects carry Moderate severity.
Altogether, these interactions span 804 individual medications. Because this product affects multiple drug-processing systems, it's crucial to run your exact medications through the interaction checker on this page before you start, and to discuss it with your doctor or pharmacist if you take any prescription drugs — especially immunosuppressants, blood thinners (anticoagulants), sedatives, or antifungals.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Schisandra?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Schisandra interact with 803 drugs. Click any drug to see the details.
1 of the 1 ingredient in Schisandra interact with drugs. Each result below shows which ingredient is responsible. certified organic Schisandra extract
Amlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Amlodipine Besylate, Benazepril interactionAmlodipine, CelecoxibConsensi
How Amlodipine, Celecoxib interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
Read the full Certified Organic Schisandra Extract + Amlodipine, Celecoxib interactionAmoxicillin, Omeprazole Magnesium, RifabutinTalicia
How Amoxicillin, Omeprazole Magnesium, Rifabutin interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Certified Organic Schisandra Extract + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Certified Organic Schisandra Extract + Amphotericin, Tetracycline interactionAmprenavirAgenerase
How Amprenavir interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Certified Organic Schisandra Extract + Amprenavir interactionAntidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi
How Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Certified Organic Schisandra Extract + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interactionApalutamideErleada
How Apalutamide interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Apalutamide interactionApixabanEliquis
How Apixaban interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Apixaban interactionApomorphineAPO-go, APO-go Pen, APO-go PFS, Apokyn, Uprima
How Apomorphine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Certified Organic Schisandra Extract + Apomorphine interactionApomorphine HydrochlorideKynmobi
How Apomorphine Hydrochloride interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Certified Organic Schisandra Extract + Apomorphine Hydrochloride interactionApremilastOtezla
How Apremilast interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Apremilast interactionAprepitantCinvanti, Emend
How Aprepitant interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aprepitant interactionAripiprazoleAbilify, Abilify Maintena, Abilify Mycite
How Aripiprazole interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aripiprazole interactionAripiprazole LauroxilAristada, Aristada Initio Kit
How Aripiprazole Lauroxil interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aripiprazole Lauroxil interactionArmodafinilNuvigil
How Armodafinil interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Certified Organic Schisandra Extract + Armodafinil interactionAspirin, Butalbital, CaffeineFiorinal
How Aspirin, Butalbital, Caffeine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Butalbital, Caffeine interactionAspirin, Butalbital, Caffeine, Codeine PhosphateFiorinal w/ Codeine
How Aspirin, Butalbital, Caffeine, Codeine Phosphate interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionAspirin, Butalbital, Caffeine, PhenacetinMarnal
How Aspirin, Butalbital, Caffeine, Phenacetin interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Butalbital, Caffeine, Phenacetin interactionAspirin, CaffeineAnacin
How Aspirin, Caffeine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Caffeine interactionAspirin, Caffeine, Codeine PhosphateAnacin w/ Codeine
How Aspirin, Caffeine, Codeine Phosphate interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Caffeine, Codeine Phosphate interactionAspirin, Caffeine, Dihydrocodeine BitartrateSynalgos DC
How Aspirin, Caffeine, Dihydrocodeine Bitartrate interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionAspirin, Caffeine, Dover's PwdAcedoval, Dovacet
How Aspirin, Caffeine, Dover's Pwd interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Caffeine, Dover's Pwd interactionAspirin, Caffeine, HydrocodoneDamason-P
How Aspirin, Caffeine, Hydrocodone interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Caffeine, Hydrocodone interactionAspirin, Caffeine, Isobutylallylbarbituric Acid, PhenacetinLanorinal
How Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Caffeine, Isobutylallylbarbituric Acid, Phenacetin interactionAspirin, Caffeine, OrphenadrineInvagesic, Invagesic Forte, Norgesic, Norgesic Forte, Orphengesic, Orphengesic Forte
How Aspirin, Caffeine, Orphenadrine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Caffeine, Orphenadrine interactionAspirin, Caffeine, Phenacetin, PropoxypheneMargesic Comp. 65
How Aspirin, Caffeine, Phenacetin, Propoxyphene interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Caffeine, Phenacetin, Propoxyphene interactionAspirin, CarisoprodolSoma Compound
How Aspirin, Carisoprodol interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Certified Organic Schisandra Extract + Aspirin, Carisoprodol interactionAspirin, Carisoprodol, Codeine PhosphateSoma Compound w/ Codeine
How Aspirin, Carisoprodol, Codeine Phosphate interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Certified Organic Schisandra Extract + Aspirin, Carisoprodol, Codeine Phosphate interactionAspirin, Chlorpheniramine, PhenylpropanolamineAlka-Seltzer Plus Cold
How Aspirin, Chlorpheniramine, Phenylpropanolamine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Chlorpheniramine, Phenylpropanolamine interactionAspirin, HydrocodoneAlor 5 500, Lortab ASA
How Aspirin, Hydrocodone interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Certified Organic Schisandra ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Certified Organic Schisandra Extract + Aspirin, Hydrocodone interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Schisandra with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
certified organic Schisandra extract
Cyclophosphamide
Theoretically, schisandra might increase the levels and clinical effects of cyclophosphamide.
In vitro research shows that schisandra increases the concentration of cyclophosphamide, likely through inhibition of cytochrome P450 3A4. After multiple doses of the schisandra constituents schisandrin A and schisantherin A, the maximum concentration of cyclophosphamide was increased by 7% and 75%, respectively, while the overall exposure to cyclophosphamide was increased by 29% and 301%, respectively.
Cyclosporine (Neoral, Sandimmune)
Schisandra can increase the levels and clinical effects of cyclosporine.
A small observational study in children with aplastic anemia found that taking schisandra with cyclosporine increased cyclosporine trough levels by 93% without increasing the risk of adverse events. However, the dose of cyclosporine was reduced in 9% of children to maintain appropriate cyclosporine blood concentrations.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
In vitro research shows that schisandra inhibits CYP2C19, and animal research shows that schisandra increases the concentration of voriconazole, a CYP2C19 substrate. Theoretically, schisandra may also inhibit the metabolism of other CYP2C19 substrates. This effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
In vitro and animal research suggests that schisandra induces CYP2C9 enzymes. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Most clinical and laboratory research shows that schisandra, administered either as a single dose or up to twice daily for 14 days, inhibits CYP3A4 and increases the concentration of CYP3A4 substrates such as cyclophosphamide, midazolam, tacrolimus, and talinolol. Although one in vitro and animal study shows that schisandra may induce CYP3A4 metabolism, this effect appears to be overpowered by schisandra's CYP3A4 inhibitory activity and has not been reported in humans.
Midazolam (Versed)
Schisandra can increase the levels and clinical effects of midazolam.
A small pharmacokinetic study in healthy adults shows that taking schisandra extract (Hezheng Pharmaceutical Co.) containing deoxyschizandrin 33.75 mg twice daily for 8 days and a single dose of midazolam 15 mg on day 8 increases the overall exposure to midazolam by about 119%, increases the peak plasma level of midazolam by 86%, and decreases midazolam clearance by about 52%. This effect has been attributed to inhibition of CYP3A4 by schisandra.
P-Glycoprotein Substrates
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that schisandra extracts and constituents such as schisandrin B inhibit P-glycoprotein mediated efflux in intestinal cells and in P-glycoprotein over-expressing cell lines. Additionally, a small clinical study shows that schisandra increases the peak concentration and overall exposure to talinolol, a P-glycoprotein probe substrate. Theoretically, schisandra might inhibit the efflux of other P-glycoprotein substrates.
Sirolimus (Rapamune)
Schisandra can increase the levels and clinical effects of sirolimus.
A small pharmacokinetic study in healthy volunteers shows that taking 3 capsules of schisandra (Hezheng Pharmaceutical Company) containing a total of 33.75 mg deoxyschizandrin twice daily for 13 days and then taking a single dose of sirolimus 2 mg increases the overall exposure and peak level of sirolimus by two-fold. This effect is thought to be due to inhibition of cytochrome P450 3A4 by schisandra, as well as possible inhibition of the P-glycoprotein drug transporter.
Tacrolimus (Prograf)
Schisandra can increase the levels and clinical effects of tacrolimus.
Clinical research in healthy children and adults, transplant patients, and patients with nephrotic syndrome and various rheumatic immunologic disorders shows that taking schisandra with tacrolimus increases tacrolimus peak levels by 183% to 268%, prolongs or delays time to peak tacrolimus concentrations, increases overall exposure to tacrolimus by 126% to 343%, and decreases tacrolimus clearance by 19% to 73%. This effect is thought to be due to inhibition of P-glycoprotein drug transporter and CYP3A4 and CYP3A5 by schisandra. Some clinical and observational studies suggest that schisandra increases tacrolimus levels similarly in both expressors and non-expressors of CYP3A5, while other studies suggest it does so to a greater degree in CYP3A5 expressors than non-expressors. Animal research suggests that the greatest increase in tacrolimus levels occurs when schisandra is taken either concomitantly or up to 2 hours before tacrolimus, and clinical and observational research in humans suggests that schisandra may increase whole blood levels of tacrolimus and decrease clearance of tacrolimus in a dose-dependent manner.
Talinolol
Schisandra can increase the levels and clinical effects of talinolol.
A small pharmacokinetic study in healthy volunteers shows that taking schisandra extract 300 mg twice daily for 14 days with a single dose of talinolol 100 mg on day 14 increases the peak talinolol level by 51% and the overall exposure to talinolol by 47%. This effect is thought to be due to the possible inhibition of cytochrome P450 3A4 and P-glycoprotein by schisandra.
tly.
Voriconazole (Vfend)
Theoretically, schisandra might increase the levels and clinical effects of voriconazole.
Animal research shows that oral schisandra given daily for 1 or 14 days increases levels of intravenously administered voriconazole, a cytochrome P450 (CYP) 2C19 substrate. This effect is thought to be due to inhibition of CYP2C19 by schisandra. However, this interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, schisandra might decrease the levels and clinical effects of warfarin.
Animal research suggests that oral schisandra extract, given daily for 6 days, reduces levels of intravenously administered warfarin. This effect might be due to the induction of cytochrome P450 (CYP) 2C9 metabolism by schisandra. However, this interaction has not been reported in humans.
Brand information
Manufacturer and brand details for Schisandra, from the product label.
Hawaii Pharm
See all Hawaii Pharm products- Name
- Hawaii Pharm LLC
- City
- Honolulu
- State
- HI
- ZipCode
- 96815
- Web Address
- www.hawaiipharm.com
Schisandra by Hawaii Pharm: Common Questions
Does Schisandra by Hawaii Pharm interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
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What are the common side effects?
Does this actually work for asthma, cough, diabetes, or the other conditions listed?
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Schisandra is safe with your meds?
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Schisandra’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Schisandra's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 26 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.
Schisandra 26 references
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Iwata H, Tezuka Y, Kadota S, et al. Identification and characterization of potent CYP3A4 inhibitors in Schisandra fruit extract. Drug Metab Dispos 2004;32:1351-8. PubMed
- Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
- Xin HW, Wu XC, Li Q, et al. Effects of Schisandra sphenanthera extract on the pharmacokinetics of tacrolimus in healthy volunteers. Br J Clin Pharmacol 2007;64:469-75.
- Qin XL, Bi HC, Wang XD, et al. Mechanistic understanding of the different effects of Wuhzi Tablet (Schisandra sphenanthera extract) on the absorption and first-pass intestinal and hepatic metabolism of tacrolimus (FK506). Int J Pharm 2010;389:114-21.
- Makino, T., Mizuno, F., and Mizukami, H. Does a kampo medicine containing schisandra fruit affect pharmacokinetics of nifedipine like grapefruit juice? Biol.Pharm.Bull. 2006;29(10):2065-2069. PubMed
- Fan L, Mao XQ, Tao GY, Wang G, Jiang F, Chen Y, Li Q, Zhang W, Lei HP, Hu DL, Huang YF, Wang D, Zhou HH. Effect of Schisandra chinensis extract and Ginkgo biloba extract on the pharmacokinetics of talinolol in healthy volunteers. Xenobiotica. 2009 Mar;39(
- Jiang W, Wang X, Xu X, Kong L. Effect of Schisandra sphenanthera extract on the concentration of tacrolimus in the blood of liver transplant patients. Int J Clin Pharmacol Ther. 2010 Mar;48(3):224-9. PubMed
- Xin HW, Wu XC, Li Q, Yu AR, Xiong L. Effects of Schisandra sphenanthera extract on the pharmacokinetics of midazolam in healthy volunteers. Br J Clin Pharmacol. 2009 May;67(5):541-6.
- Li J, Chen S, Qin X, et at. Wuzhi Tablet (<i>Schisandra sphenanthera</i> Extract) is a Promising Tacrolimus-Sparing Agent for Renal Transplant Recipients Who are CYP3A5 Expressers: a Two-Phase Prospective Study. Drug Metab Dispos. 2017;45(11):1114-1119.
- Qin XL, Li JL, Wang SH, Chen X, Huang M, Bi HC. Co-administration of Wuzhi tablet (Schisandra sphenanthera extract) alters tacrolimus pharmacokinetics in a dose- and time-dependent manner in rats. J Ethnopharmacol. 2020;263:113233. PubMed
- Yuan F, Liang X, Chen X, Qin X, Tan C, Wang L. CYP2C19 is involved in the effect of Wuzhi tablet (Schisandra sphenanthera extract) and its constituents on the pharmacokinetics of intravenous voriconazole. Pharmazie. 2020;75(11):559-564. DOI
- Zhang Z, Lu X, Dong L, Ma J, Fan X. Clinical observation on the effect of Wuzhi soft capsule on FK506 concentration in membranous nephropathy patients. Medicine (Baltimore). 2019;98(48):e18150. PubMed
- Yoo HH, Lee M, Lee MW, Lim SY, Shin J, Kim DH. Effects of Schisandra lignans on P-glycoprotein-mediated drug efflux in human intestinal Caco-2. Planta Med. 2007;73(5):444-50.
- Qiangrong P, Wang T, Lu Q, Hu X. Schisandrin B--a novel inhibitor of P-glycoprotein. Biochem Biophys Res Commun. 2005;335(2):406-11. PubMed
- Chen L, Ji N, Zhang M, Chen W. The influence of Wuzhi capsule on the pharmacokinetics of cyclophosphamide. Recent Pat Anticancer Drug Discov 2021. PubMed
- Cheng X, Ma J, Xu X, Zhang L, Wang X, Wu R. Effect of Wuzhi capsules on cyclosporine A concentration in children with aplastic anemia immunotherapy: a single-center observational study. Expert Rev Clin Pharmacol 2022:1-5. PubMed
- Cheng F, Li Q, Wang J, Zeng F, Zhang Y. Effects and safety evaluation of Wuzhi capsules combined with tacrolimus for the treatment of kidney transplantation recipients. J Clin Pharm Ther 2021;46(6):1636-49. PubMed
- Teng F, Wang W, Zhang W, et al. Effect of hepar-protecting Wuzhi capsule on pharmacokinetics and dose-effect character of tacrolimus in healthy volunteers. Biopharm Drug Dispos 2022.
- Kou K, Sun X, Li M, et al. Beneficial effects of Wuzhi capsule on tacrolimus blood concentrations in liver transplant patients with different donor-recipient CYP3A5 genotypes. J Clin Pharm Ther 2022;47(2):200-10. PubMed
- Peng Y, Jiang F, Zhou R, et al. Clinical evaluation of the efficacy and safety of co-administration of Wuzhi capsule and tacrolimus in adult Chinese patients with myasthenia gravis. Neuropsychiatr Dis Treat 2021;17:2281-9. PubMed
- Chen P, Dai R, She Y, et al. Prediction of tacrolimus and Wuzhi tablet pharmacokinetic interaction magnitude in renal transplant recipients. Clin Transplant 2022;36(12):e14807. PubMed
- Qu J, Bian R, Liu B, et al. The pharmacokinetic study of tacrolimus and Wuzhi capsule in Chinese liver transplant patients. Front Pharmacol 2022;13:956166. PubMed
- Zhou Y, Huang X, Liu L, et al. Effect of Wuzhi preparations on tacrolimus in CYP3A5 expressers during the early period after transplantation: A real-life experience from heart transplant recipients. Transpl Immunol 2023;76:101748. PubMed
- Huang Q, Lin X, Wang Y, et al. Tacrolimus pharmacokinetics in pediatric nephrotic syndrome: A combination of population pharmacokinetic modelling and machine learning approaches to improve individual prediction. Front Pharmacol 2022;13:942129. PubMed
- Wang CB, Zhang YJ, Zhao MM, Zhao LM. Population pharmacokinetic analyses of tacrolimus in non-transplant patients: a systematic review. Eur J Clin Pharmacol 2023;79(7):897-913. PubMed
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC