Schisandra Ingredients & Drug Interactions
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 Herbalist & Alchemist 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 Schisandra Berry Extract, Dry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Schisandra by Herbalist & Alchemist
Ask about any prescription or over-the-counter medication and we check it for interactions with Schisandra by Herbalist & Alchemist — 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 Herbalist & Alchemist
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: schisandra berry extract in dried form. Schisandra has been used in traditional herbal practice, though modern clinical evidence for most of its traditional uses remains limited.
The liquid also contains ethyl alcohol, distilled water, and glycerin as inactive ingredients.
Does it work?
Not established
The evidence for schisandra's effectiveness on the conditions listed — asthma, athletic performance, cough, diabetes, diarrhea, and hepatitis — is not established in the data we hold. For each of these uses, the evidence is rated as insufficient to make a reliable recommendation.
How safe is it?
Well-documented data
Schisandra is generally well tolerated in the short term in healthy adults, though high-quality safety studies are limited. The most common side effects reported are decreased appetite, heartburn, stomach upset, and a rash (urticaria).
Schisandra's safety data for pregnancy suggests it may stimulate the uterus, so it's best avoided during pregnancy. There isn't enough reliable information on safety during breastfeeding, so it should be avoided then as well.
Meds to double-check
Moderate interaction found
Before starting schisandra, check with your pharmacist or doctor if you take tacrolimus (Prograf) or midazolam (Versed) — schisandra can significantly raise their levels. Also double-check any CYP3A4 substrates, CYP2C19 substrates, blood thinners like warfarin, antifungals like voriconazole, and P-glycoprotein substrates, as schisandra may affect how your body processes these medications.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
Schisandra is a single-herb supplement that interacts with a wide range of medications by affecting how your liver and intestines process drugs. It's particularly important to check with your pharmacist or doctor before starting it if you take tacrolimus, warfarin, midazolam, voriconazole, or any other prescription medications — especially immunosuppressants, blood thinners, sedatives, or antifungals.
If you're pregnant or breastfeeding, talk with your healthcare provider before considering this product.
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 24, 2023.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Schisandra, straight from the product label.
| Brand | Herbalist & Alchemist |
|---|---|
| Barcode (UPC) | 667056108052 |
| Net contents | 2 Fluid Ounce(s); 60 mL |
| Market status | On market |
| Date entered into DSLD | Oct 24, 2023 |
| DSLD ID | 297470 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Kosher |
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 Herbalist & Alchemist, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Schisandra Berry Extract, Dry | 3 mL | -- |
Other ingredients: Ethyl Alcohol, Water, Distilled, Glycerin
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.
Formula
Schisandra chinensis
OK (Kosher)
Formulation
Adaptogenic support for stress
FDA Statement of Identity
Herbal Supplement
Suggested/Recommended/Usage/Directions
Suggested use: 30-40 drops (1.5-2 mL) in juice or water. Take 3 times per day. Shake well before using.
Precautions
Keep out of children's reach
FDA Disclaimer Statement
This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
Seals/Symbols
OK (Kosher)
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Schisandra by Herbalist & Alchemist 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 Herbalist & Alchemist
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1.5 mL Dosage formLiquid Servings per container30 Amounts shown are per serving.
Schisandra Berry Extract, Dry
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...
Schisandra Berry Extract, Dry monograph & interactionsOther (inactive) ingredients: Ethyl Alcohol, Water, Distilled, Glycerin. These complete the product’s ingredient list but are not active constituents.
Schisandra by Herbalist & Alchemist Drug Interactions
HelloPharmacist Interaction Report
Schisandra by Herbalist & Alchemist has documented interactions with a substantial number of medications.
The main concern is through its schisandra berry extract content, which affects how your body metabolizes certain drugs — most notably increasing levels of tacrolimus (an immunosuppressant used after transplants) and midazolam (a sedative), and potentially affecting blood thinners like warfarin. Altogether, these interactions span 804 individual medications.
Read the full breakdown — every affected drug type, severity by severity
Schisandra inhibits several of your liver's drug-processing enzymes (CYP3A4 and CYP2C19), which means it can raise the levels and effects of medications that depend on those pathways — including antifungals like voriconazole and many others metabolized this way. At the same time, it may speed up processing of some drugs through CYP2C9, which could make those medications less effective.
It also affects how your intestines transport certain drugs (P-glycoprotein substrates), potentially boosting their levels.
Because the number of affected medication types is broad, checking your exact prescriptions before starting schisandra is important. Use the search tool on this page with each of your current medications, or run through them with your pharmacist before you begin.
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. Schisandra Berry Extract, Dry
Acetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionAcetaminophen, Dextromethorphan, PseudoephedrineAlka-Seltzer PLUS Flu Liquid Gels, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Daytime Ex Strength, Tylenol Flu Ex Strength
How Acetaminophen, Dextromethorphan, Pseudoephedrine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Acetaminophen, Hydrocodone interactionAcetaminophen, IbuprofenCombogesic
How Acetaminophen, Ibuprofen interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
Read the full Schisandra Berry Extract, Dry + Acetaminophen, Ibuprofen interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAdagrasibKrazati
How Adagrasib interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Adagrasib interactionAerosphere Budesonide, Formoterol Fumarate, GlycopyrrolateBreztri
How Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Schisandra Berry Extract, Dry + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionAfatinib DimaleateGilotrif
How Afatinib Dimaleate interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryP-glycoprotein Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Schisandra Berry Extract, Dry + Afatinib Dimaleate interactionAgomelatineValdoxan
How Agomelatine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Schisandra Berry Extract, Dry + Agomelatine interactionAlfentanilAlfenta
How Alfentanil interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Alprazolam interactionAlvimopanEntereg
How Alvimopan interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryP-glycoprotein Substrates Moderate
Interaction Summary
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
Read the full Schisandra Berry Extract, Dry + Alvimopan interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryP-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 Schisandra Berry Extract, Dry + Ambrisentan interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome 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 Schisandra Berry Extract, Dry + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2c19 (cyp2c19) Substrates +1 Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome 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 Schisandra Berry Extract, Dry + Amitriptyline, Perphenazine interactionAmlodipineNorliqva
How Amlodipine interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with Schisandra — through 1 ingredient. Tap an ingredient for the detail:
Schisandra Berry Extract, DryCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra Berry Extract, Dry + Amlodipine Besylate 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.
Schisandra Berry Extract, Dry
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.
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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.
Herbalist & Alchemist
See all Herbalist & Alchemist products- Name
- Herbalist & Alchemist, Inc.
- City
- Washington
- State
- NJ
- ZipCode
- 07882
- Phone Number
- 800-611-8235
- Web Address
- www.herbalist-alchemist.com
Schisandra by Herbalist & Alchemist: Common Questions
Does Schisandra by Herbalist & Alchemist interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
What is schisandra, and what is it used for?
Can I take this if I'm pregnant or breastfeeding?
What are the most common side effects?
Does this product have fillers or other inactive ingredients?
Why does schisandra interact with so many medications?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Schisandra is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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.
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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
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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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