Supplement · Grade B/C

Schisandra and medications.

Every documented pair, every citation. Below: 4 documented pairs grouped by mechanism.

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

Schisandra is a berry used in traditional Chinese medicine, taken as a standardised extract for stress resilience, fatigue, liver protection and cognitive performance under load. The adaptogen evidence is modest, mostly Grade C, with some Grade B signal for stress and fatigue when it sits alongside ashwagandha and rhodiola. Liver support is plausible but weaker than silymarin, and the menopause and cognitive claims are early. Treat it as emerging rather than established. The dose runs 500 to 2,000mg a day, and morning or early afternoon timing tends to work best because schisandrin can cause restlessness or insomnia late in the day. On interactions, schisandra may induce CYP3A4, which can speed the clearance of statins, immunosuppressants, calcium channel blockers and hormonal contraceptives, so it is worth flagging for anyone on multiple medications. It can also raise gastric acid, so use it cautiously with active reflux or peptic ulcer. Avoid in pregnancy given uterine-stimulating activity in animal work and thin human safety data.

Below are the 4 documented pairs we have explicitly assessed for Schisandra: 4 red. The pairs cluster around 1 mechanism: CYP3A4 inhibition. 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

CYP3A4 inhibition

Red Ciclosporin

Schisandra can slow how the body clears ciclosporin and push ciclosporin blood levels higher than intended, which risks toxicity. Do not combine the two outside direct transplant-team supervision.

PMID 22996305 · PMID 17506780 · PMID 22686837 · BNF: Ciclosporin

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Red Everolimus

Schisandra can slow how the body clears everolimus and push everolimus blood levels higher than intended, which risks toxicity. Do not combine the two outside direct transplant-team supervision.

PMID 22686837 · BNF: Everolimus

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Red Sirolimus

Schisandra slows how the body clears sirolimus and can roughly double sirolimus blood levels, which risks toxicity. Do not combine the two outside direct transplant-team supervision.

PMID 22686837 · BNF: Sirolimus

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Red Tacrolimus

Schisandra slows how the body clears tacrolimus and can raise tacrolimus blood levels several times over, which risks toxicity. Do not combine the two outside direct transplant-team supervision.

PMID 17506780 · PMID 20197017 · PMID 21656210 · BNF: Tacrolimus

Reviewer-flagged: awaiting clinical-reviewer sign-off.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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