Properties: Bitter, astringent, neutral

Meridans Entered:
Primary: Liver

1. Clears Heat, resolves Toxicity and reduces swellings
   Carbuncles and sores
   Snake and bug bites
   Urinary tract infections
   Red eyes
   Tonsillitis
2. Stops Bleeding
   Haemoptysis
   Haematemsis
   Bleeding due to trauma
3. Dispels Wind Damp
   Relieves muscle aches and pains
4. Calms Shen and Soothes Liver Qi
   Regulates Liver Qi to treat depression

Suggested Daily Dosage: 6-9g in decoction.

Cautions: Many interactions with medicines been reported.

Interactions:

• SSRIs: May have additive effect causing serotonin syndrome with heart problems, shivering, nausea, headache, and anxiety. These include fluoxetine (Prozac), sertraline (Zoloft), amitriptyline, paroxetine, clomipramine, imipramine and others.
• Contraceptive drugs: May increase the breakdown of oestrogen decreasing the effect of oestrogen based birth control pills.
• Cyclosporine: Immunosuppressant. Increases the rate of breakdown, decreasing the effect.
• Medications changed by Cytochrome P450 3A4 in the liver: May decrease effect of lovastatin, ketoconazole, itraconazole, fexofenadine, triazolam and others. For a complete list see the Cytochrome P450 Substrates.
• Nonnucleoside Reverse Transcriptase Inhibitors: Used for treating HIV/AIDS. Increases the rate of breakdown, decreasing the effect, including nevirapine, delavirdine and efavirenz.
• Protease Inhibitors: Used for treating HIV/AIDS. Increases the rate of breakdown, decreases the effect, including amprenavir, nelfinavir, ritonavir, and saquinavir.
• Pain medications: Increases the rate of breakdown, decreasing the effect, including meperidine, hydrocodone, morphine, OxyContin, and many others.
• P-Glycoprotein Substrates: May increase the activity of the cellular pumps used to move these drugs, decreasing their effect, including etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride, fexofenadine, cyclosporine, loperamide, quinidine, and others.
• Photosensensitising drugs: May have additive effect causing increased risk of sunburn, blistering or rashes on skin exposed to sunlight. These include aminolevulinic acid, amitriptyline, ciprofloxacin, norfloxacin, lomefloxacin, ofloxacin, levofloxacin, sparfloxacin, gatifloxacin, moxifloxacin, trimethoprim/sulfamethoxazole, tetracycline, methoxsalen and Trioxsalen.
• Alprazolam: increases rate of breakdown, decreasing effect.
• Amitriptyline: increases rate of breakdown, decreasing effect.
• Digoxin: May decease how much the body absorbs, decreasing the effect.
• Fenfluramine: May have additive effect causing serotonin syndrome with heart problems, shivering, nausea, headache, and anxiety.
• Imatinib: Increases the rate of breakdown, decreasing the effect.
• Irinotecan: Increases the rate of breakdown, decreasing the effect.
• Recommended to stop 5 days before surgery due to risk of serotoninism, drug interaction with cyclosporine, digitalis, MAO-I, warfarin, oral contraceptives, throphylline, midazolam, lignocaine, increased sedative effect, risk of organ rejection and increased uterine tone (Ang-Lee, Moss & Yuan, 2001; Yilmaz & Çifci, 2018).