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Fo-ti (Polygonum multiflorum)



Interactions

Fo-ti/Drug Interactions:
  • AntibioticsAntibiotics: According to in vitro evidence, fo-ti exerted antibacterial effects against methicillin-resistant Staphylococcus aureus (MRSA) (1).
  • AntidiabeticsAntidiabetics: According to secondary sources, concomitant use of fo-ti with antidiabetic agents may increase the risk of hypoglycemia. Theoretically, fo-ti may decrease blood glucose levels and affect test results (7).
  • AntifibroticsAntifibrotics: In human research, a mixed-ingredient decoction containing Polygonum multiflorum decreased serum levels of hyaluronic acid, laminin, procollagen III, and collagen IV (27).
  • Anti-inflammatoriesAnti-inflammatories: According to in vitro evidence, an ethanol extract of the stem of fo-ti inhibited at least one panel of enzymes often associated with inflammation (28).
  • AntilipemicsAntilipemics: In animal research, Polygonum multiflorum stilbene glycoside, a water-soluble fraction of fo-ti, reduced the severity of atherosclerosis in hypercholesterolemic rabbits by attenuating the increase in plasma cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, and plasma triglyceride (29).
  • AntineoplasticsAntineoplastics: In animal research, fo-ti extract reduced tumor incidence in rats (30).
  • AntipruriticsAntipruritics: In human research, fo-ti administered in combination with localized plum-blossom needle tapping and as part of a modified Yangxue Dingfeng Tang decoction (also comprising radix Rehmanniae, radix Angelicae sinensis, radix Paeoniae rubra, radix Asparagi, radix Ophiopogonis, bombyx Batryticatus, cortex Moutan, rhizoma Chuanxiong, and scorpion) improved treatment effects in patients with neurodermatitis, compared to Yangxue Dingfeng Tang decoction alone and a conventional Western medicine combination of 10% urea ointment, Benadryl, and vitamin C (31).
  • Calcium channel blockersCalcium channel blockers: Since fo-ti contains compounds that were found to inhibit the calcium channel, theoretically it may produce a synergistic effect when taken with these drugs. The effect may be beneficial in some cases, but studies need to be done to further investigate this effect.
  • Cardiac glycosidesCardiac glycosides: Theoretically, fo-ti may cause hypokalemia and increase the risk of side effects from the use of herbs such as foxglove and oleander that contain cardiac glycosides and behave similarly to digoxin.
  • Cardiovascular agentsCardiovascular agents: According to secondary sources, due to fo-ti's potential to cause hypokalemia, dangerous changes in heart rhythms are theoretically plausible.
  • Cytochrome P450-modifying agentsCytochrome P450-modifying agents: According to in vitro evidence, fo-ti inhibited six major cytochrome P450 enzymes (CYP 1A2, CYP 2C8, CYP 2C9, CYP 2C19, CYP 2D6, and CYP 3A4) (20).
  • Dermatologic agentsDermatologic agents: A fine maculopapular rash has been reported in case reports, with symptoms resolving within three weeks after discontinuing an herbal product that contained fo-ti (12).
  • DigoxinDigoxin: Fo-ti may cause hypokalemia, which may increase the risk of side effects from the use of digoxin (anecdotally). Documented cases of this interaction are lacking in the available literature.
  • DiureticsDiuretics: Theoretically, the effects of potassium loss may be enhanced if diuretics are used with fo-ti. This may lead to worsening of the symptoms of hypokalemia. Documented cases of this interaction are lacking in the available literature.
  • EstrogensEstrogens: According to in vitro evidence, fo-ti may contain estrogen (17; 4; 18).
  • Gastrointestinal agentsGastrointestinal agents: In human case reports, incidences of liver damage (26) and acute or recurrent hepatitis (24; 8; 9; 10; 11; 12; 13; 14; 15; 16) have been reported following the use of fo-ti. Unprocessed fo-ti has also been associated with reports of abdominal cramping, diarrhea, vomiting, and nausea with unprocessed fo-ti (19).
  • HematologicsHematologics: Mild eosinophilia has been reported in case reports, with symptoms resolving within three weeks after discontinuing an herbal product that contained (12).
  • HepatotoxinsHepatotoxins: In human research, a mixed-ingredient decoction containing Polygonum multiflorum improved various serum markers of liver function and liver biochemistry, including alanine aminotransferase, total bilirubin, the albumin:globulin ratio, cholylglycine, prealbumin, and serum ferritin (27). Acute or recurrent hepatitis, due to use of Chinese medications containing fo-ti, has been reported in numerous case reports (24; 8; 9; 10; 11; 12; 13; 14; 15; 16).
  • Hormonal agentsHormonal agents: According to in vitro evidence, fo-ti may contain estrogen (17; 4; 18).
  • HypoglycemicsHypoglycemics: According to secondary sources, concomitant use of fo-ti with antidiabetic agents may increase the risk of hypoglycemia. Theoretically, fo-ti may decrease blood glucose levels and affect test results (7).
  • ImmunosuppressantsImmunosuppressants: According to in vitro evidence, emodin, an active principle component of fo-ti, may suppress the mixed lymphocyte reaction in a dose-dependent fashion (21).
  • LaxativesLaxatives: Theoretically, concomitant use of fo-ti with other laxatives may increase the risk of fluid and electrolyte depletion.
  • VasodilatorsVasodilators: According to in vitro evidence, emodin, an active principle component of fo-ti, may relax rat aortic rings precontracted with phenylephrine and may suppress the response of human mononuclear cells to phytohemagglutinin (21).

Fo-ti/Herb/Supplement Interactions:
  • AntibacterialsAntibacterials: According to in vitro evidence, fo-ti exerted antibacterial effects against methicillin-resistant Staphylococcus aureus (MRSA) (1).
  • AntidiabeticsAntidiabetics: According to secondary sources, concomitant use of fo-ti with antidiabetic herbs and supplements may increase the risk of hypoglycemia. Theoretically, fo-ti may decrease blood glucose levels and affect test results (7).
  • AntifibroticsAntifibrotics: In human research, a mixed-ingredient decoction containing Polygonum multiflorum decreased serum levels of hyaluronic acid, laminin procollagen III, and collagen IV (27).
  • Anti-inflammatoriesAnti-inflammatories: According to in vitro evidence, an ethanol extract of the stem of fo-ti inhibited at least one panel of enzymes often associated with inflammation (28).
  • AntilipemicsAntilipemics: In animal research, Polygonum multiflorum stilbene glycoside, a water-soluble fraction of fo-ti, reduced the severity of atherosclerosis in hypercholesterolemic rabbits by attenuating the increase in plasma cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, and plasma triglyceride (29).
  • AntineoplasticsAntineoplastics: In animal research, fo-ti extract reduced tumor incidence in rats (30).
  • AntioxidantsAntioxidants: According to in vitro evidence, fo-ti extracts may exert antioxidant effects (32).
  • AntipruriticsAntipruritics: In human research, fo-ti administered in combination with localized plum-blossom needle tapping and as part of a modified Yangxue Dingfeng Tang decoction (also comprising radix Rehmanniae, radix Angelicae sinensis, radix Paeoniae rubra, radix Asparagi, radix Ophiopogonis, bombyx Batryticatus, cortex Moutan, rhizoma Chuanxiong, and scorpion) improved treatment effects in patients with neurodermatitis, compared to Yangxue Dingfeng Tang decoction alone and a conventional Western medicine combination of 10% urea ointment, Benadryl, and vitamin C (31).
  • Cardiac glycosidesCardiac glycosides: Theoretically, fo-ti may cause hypokalemia and increase the risk of side effects from the use of herbs such as foxglove and oleander that contain cardiac glycosides and behave similarly to digoxin.
  • Cardiovascular agentsCardiovascular agents: According to secondary sources, due to fo-ti's potential to cause hypokalemia, dangerous changes in heart rhythms are theoretically plausible.
  • CytochromeP450-modifying agentsCytochromeP450-modifying agents: According to in vitro evidence, fo-ti inhibited six major cytochrome P450 enzymes (CYP 1A2, CYP 2C8, CYP 2C9, CYP 2C19, CYP 2D6, and CYP 3A4) (20).
  • DiureticDiuretics: Theoretically, the effects of potassium loss may be enhanced if diuretics are used with fo-ti. This may lead to worsening of the symptoms of hypokalemia. However, there are no reports available in literature.
  • FoxgloveFoxglove: Theoretically, fo-ti may cause hypokalemia and increase the risk of side effects from the use of herbs such as foxglove and oleander that contain cardiac glycosides and behave similarly to digoxin.
  • Gastrointestinal agentsGastrointestinal agents: In human case reports, incidences of liver damage (26) and acute or recurrent hepatitis (24; 8; 9; 10; 11; 12; 13; 14; 15; 16) have been reported following the use of fo-ti. Unprocessed fo-ti has also been associated with reports of abdominal cramping, diarrhea, vomiting, and nausea with unprocessed fo-ti (19).
  • HematologicsHematologics: Mild eosinophilia has been reported in case reports, with symptoms resolving within three weeks after discontinuing an herbal product that contained fo-ti (12).
  • HepatotoxinsHepatotoxins: In human research, a mixed-ingredient decoction containing Polygonum multiflorum improved various serum markers of liver function and liver biochemistry, including alanine aminotransferase, total bilirubin, the albumin:globulin ratio, cholylglycine, prealbumin, and serum ferritin (27).
  • Hormonal agentsHormonal agents: According to in vitro evidence, fo-ti may contain estrogen (17; 4; 18).
  • HypoglycemicsHypoglycemics: According to secondary sources, concomitant use of fo-ti with antidiabetic agents may increase the risk of hypoglycemia. Theoretically, fo-ti may decrease blood glucose levels and affect test results (7).
  • ImmunosuppressantsImmunosuppressants: According to in vitro evidence, emodin, an active principle component of fo-ti, may suppress the mixed lymphocyte reaction in a dose-dependent fashion (21).
  • LaxativesLaxatives: Theoretically, the use of other laxative herbs, including alder buckthorn, aloe, cascara, rhubarb, senna, and yellow dock, may contribute additive laxative effects to fo-ti.
  • LicoriceLicorice: Licorice and fo-ti both have potassium-depleting properties and theoretically may increase the risk of hypokalemia.
  • OleanderOleander: Theoretically, fo-ti may cause hypokalemia and increase the risk of side effects from the use of herbs such as foxglove and oleander that contain cardiac glycosides and behave similarly to digoxin.
  • PhytoestrogensPhytoestrogens: According to in vitro evidence, fo-ti may contain estrogen (17; 4; 18).
  • VasodilatorsVasodilators: According to in vitro evidence, emodin, an active principle component of fo-ti, may relax rat aortic rings precontracted with phenylephrine and may suppress the response of human mononuclear cells to phytohemagglutinin (21).

Fo-ti/Food Interactions:
  • Diuretic foods (e.g., celery, watermelon, asparagus, and parsley)Diuretic foods (e.g., celery, watermelon, asparagus, and parsley): Theoretically, any foods that may have diuretic effects may interact with fo-ti and reduce electrolytes.

Fo-ti/Lab Interactions:
  • CholesterolCholesterol: In animal research, Polygonum multiflorum stilbene glycoside, a water-soluble fraction of fo-ti, reduced the severity of atherosclerosis in hypercholesterolemic rabbits by attenuating the increase in plasma cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, and plasma triglyceride (29).
  • Colorimetric testingColorimetric testing: According to secondary sources, fo-ti may cause discoloration of urine (pink, red, orange, rust) and may therefore interfere with diagnostic tests that depend on a color change, due to its anthraquinone content.
  • GlucoseGlucose: Theoretically, fo-ti may decrease blood glucose levels and affect test results (7).
  • HormonesHormones: According to in vitro evidence, fo-ti may contain estrogen (17; 4; 18).
  • Liver panelLiver panel: In human research, a mixed-ingredient decoction containing Polygonum multiflorum improved various serum markers of liver function and liver biochemistry, including alanine aminotransferase, total bilirubin, the albumin:globulin ratio, cholylglycine, prealbumin, and serum ferritin (27). Theoretically, laboratory tests of liver function may be affected by the use of Chinese herbal preparations containing fo-ti.
  • LymphocytesLymphocytes: According to in vitro evidence, emodin, an active principle component of fo-ti, may suppress the mixed lymphocyte reaction in a dose-dependent fashion (21).
  • PotassiumPotassium: According to secondary sources, chronic use of fo-ti may cause hypokalemia, reducing serum potassium concentrations and test results due to its anthraquinone contents.
  • TriglyceridesTriglycerides: In animals, Polygonum multiflorum stilbene glycoside, a water-soluble fraction of fo-ti, reduced the severity of atherosclerosis in hypercholesterolemic rabbits by attenuating the increase in plasma cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, and plasma triglyceride (29).

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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