Supplement · Grade B/C

Cordyceps and medications.

Every documented pair, every citation. Below: 6 documented pairs grouped by mechanism.

Cordyceps is in the Distil supplement database, evidence Grade B/C. The page below lists every medication we have explicitly assessed it against.

Cordyceps, best taken as the Cordyceps militaris extract, is a medicinal fungus studied for athletic performance and energy. The evidence is Grade B to C: it may support VO2max, endurance, and fatigue through effects on mitochondrial ATP production, and it acts as a mild adaptogen with emerging signals for libido and immune function. The honest limit is that results are inconsistent. One RCT found militaris improved VO2max and exercise duration over three weeks, but a well-designed trial of the sinensis form found no benefit at all, which is part of why the militaris form is preferred over sinensis, alongside supply and standardisation problems with the latter. Typical dosing is 1,000 to 3,000mg a day. On interactions, cordyceps modulates the immune system, so it should be excluded in autoimmune conditions, is not appropriate in HIV or AIDS, and it carries a potential mild effect with anticoagulants. Organ transplant is a different picture: cordyceps has actually been studied as a supervised add-on to anti-rejection medication, where it can change how much of those drugs you need, so it should only be used with your transplant team and never added on your own to a settled immunosuppressant dose. Taken late it can disturb sleep. A reasonable trial for endurance work if you choose the militaris form and keep expectations measured.

Below are the 6 documented pairs we have explicitly assessed for Cordyceps: 6 amber. The pairs cluster around 2 mechanisms: Additive anticoagulation and Immunosuppression caution. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.

Documented interactions

Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.

Additive anticoagulation

Amber Does interact with Acenocoumarol?

Cordyceps may add to acenocoumarol's blood-thinning effect through a mild anti-clotting action of its own. This is based on laboratory work on human platelets rather than studies in people taking acenocoumarol, so the real-world size of the effect is unknown. If you take acenocoumarol, mention cordyceps to your anticoagulation clinic and ask whether an INR check is worth doing after you start.

Evidence: Based on an established mechanism, with no direct study of this exact combination yet.

PMID 17229422 · PMID 25593645 · BNF: Acenocoumarol