Selected Sensitive CYP3A4 Substrates/Schisandra Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Schisandra may increase the amount of your other medicine in your blood by slowing down how quickly your liver processes the medicine.

What might happen:

The blood levels of your other medicine may increase and could cause toxic effects.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Keep all of your appointments with the doctor and laboratory. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and- drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
  • 2.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
  • 3.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.
  • 4.Li R, Guo W, Fu Z, Ding G, Wang Z, Fu H. A study about drug combination therapy of Schisandra sphenanthera extract and Rapamycin in healthy subjects. Can J Physiol Pharmacol 2012 Jul;90(7):941-5.
  • 5.Li J, Chen S, Qin X, Fu Q, Bi H, Zhang Y, Wang X, Liu L, Wang C, Huang M. Wuzhi Tablet (Schisandra sphenanthera Extract) is a Promising Tacrolimus-Sparing Agent for Renal Transplant Recipients Who are CYP3A5 Expressers: a Two-Phase Prospective Study. Drug Metab Dispos 2017 Nov; 45(11):1114-1119.
  • 6.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.
  • 7.Xin HW, Wu XC, Li Q, Yu AR, Zhu M, Shen Y, Su D, Xiong L. Effects of Schisandra sphenanthera extract on the pharmacokinetics of tacrolimus in healthy volunteers. Br J Clin Pharmacol 2007 Oct;64(4):469-75.
  • 8.American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2023 Jul;71(7):2052-2081.
  • 9.Fyarro (sirolimus protein-bound particles for injectable susspension) US prescribing information. Aadi Bioscience, Inc. November, 2021.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.