Corydalis (Yanhusuo) 450 mg by TerraVita Premium Collection

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Constipation. Oral Corydalis yanhusuo has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in patients with functional constipation shows that taking a specific supplement (Motilitone, Dong-A ST) containing 30 mg of Corydalis yanhusuo and Pharbitis seed extracts three times daily before meals for 24 days improves colonic transit time, stool frequency, and symptoms of abdominal discomfort and pain when compared to baseline. At the start of the study, 63% of patients reported less than one stool per week. At the end of the study, 78% of patients were experiencing one or more stools per week, with 11% of patients reporting more than three stools per week (97159). The validity of these findings is limited by a lack of placebo control group.
• Depression. Although there has been interest in using oral Corydalis yanhusuo for depression, there is insufficient reliable information about the clinical effects of Corydalis yanhusuo for this purpose.
• Dysmenorrhea. Although there has been interest in using oral Corydalis yanhusuo for dysmenorrhea, there is insufficient reliable information about the clinical effects of Corydalis yanhusuo for this purpose.
• Dyspepsia. Oral Corydalis yanhusuo has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: One clinical trial in patients with functional dyspepsia shows that taking a specific supplement (Motilitone, Dong-A ST) containing 30 mg of Corydalis yanhusuo and Pharbitis seed extracts three times daily before meals for 4 weeks improves dyspepsia to a similar degree as pantoprazole 40 mg (97158).
• Gastroesophageal reflux disease (GERD). Oral Corydalis yanhusuo has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in patients with GERD shows that taking a specific supplement (Motilitone, Dong-A ST) containing 30 mg of Corydalis yanhusuo and Pharbitis seed extracts three times daily before meals for 4 weeks does not improve symptoms of dyspepsia or quality of life when compared with placebo (97160).
• Headache. Although there has been interest in using oral Corydalis yanhusuo for headache, there is insufficient reliable information about the clinical effects of Corydalis yanhusuo for this purpose.
• Helicobacter pylori. Although there has been interest in using oral Corydalis yanhusuo for Helicobacter pylori, there is insufficient reliable information about the clinical effects of Corydalis yanhusuo for this purpose. More evidence is needed to rate Corydalis yanhusuo for these uses.

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POSSIBLY SAFE ...when used orally, short-term. A specific supplement (Motilitone, Dong-A ST) containing Corydalis yanhusuo extract in combination with Pharbitis seed extract has been used with apparent safety in a dose of 90 mg daily for up to 4 weeks in clinical research (97158,97159,97160). There is insufficient reliable information available about the safety of Corydalis yanhusuo when used orally as a single ingredient.

CHILDREN: LIKELY UNSAFE
when used orally in newborns. The berberine constituent of Corydalis yanhusuo can cause kernicterus in newborns, particularly preterm neonates with hyperbilirubinemia (2589).

PREGNANCY: LIKELY UNSAFE
when used orally. Corydalis yanhusuo might promote menstrual flow and stimulate uterine contractions (12). The berberine constituent of Corydalis yanhusuo is thought to cross the placenta and may cause harm to the fetus. Kernicterus has developed in newborn infants exposed to berberine (2589).

LACTATION: LIKELY UNSAFE
when used orally. The berberine constituent of Corydalis yanhusuo and other harmful constituents can be transferred to the infant through breast milk (2589).

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ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.  Details Corydalis yanhusuo contains berberine. In vitro and in vivo research suggest that berberine can inhibit platelet aggregation (33660,33694). Theoretically, Corydalis yanhusuo might also inhibit platelet aggregation.

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo may increase the risk of hypoglycemia when taken with antidiabetes drugs.  Details Corydalis yanhusuo contains berberine. Clinical research shows that berberine may lower blood glucose levels (20579,34247,34265,34282). Theoretically, Corydalis yanhusuo might also lower blood glucose levels.

ANTIHYPERTENSIVE DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might have additive effects with antihypertensive drugs.  Details Corydalis yanhusuo contains berberine. Animal research suggests that berberine can have hypotensive effects (33692,34308). Also, a clinical study suggests that taking berberine in combination with amlodipine can lower systolic and diastolic blood pressure when compared with amlodipine alone (91956). Theoretically, Corydalis yanhusuo might also reduce blood pressure.

CNS DEPRESSANTS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might increase the sedative effects of CNS depressants.  Details Corydalis yanhusuo contains berberine. Animal research suggests that berberine may have sedative effects (13519,33650,33664,33692). Theoretically, Corydalis yanhusuo might also have CNS depressants effects.

CYCLOSPORINE (Neoral, Sandimmune) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might increase blood levels of cyclosporine.  Details Corydalis yanhusuo contains berberine. Preliminary clinical research shows that berberine can reduce metabolism of cyclosporine and increase serum levels, likely through inhibition of cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporine (13524). Theoretically, Corydalis yanhusuo might also reduce the metabolism of cyclosporine.

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP2C9.  Details Corydalis yanhusuo contains berberine. Preliminary clinical research shows that berberine can inhibit CYP2C9 (34279). Theoretically, Corydalis yanhusuo might also inhibit CYP2C9.

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP2D6.  Details Corydalis yanhusuo contains berberine. In vitro research and preliminary clinical evidence show that berberine can inhibit CYP2D6 (21117,34279,34297). Theoretically, Corydalis yanhusuo might also inhibit CYP2D6.

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP3A4.  Details Corydalis yanhusuo contains berberine. In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4 (13524,21114,34279,34297). Theoretically, Corydalis yanhusuo might also inhibit CYP3A4.

DEXTROMETHORPHAN (Robitussin DM, others) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo may increase serum levels of dextromethorphan.  Details Corydalis yanhusuo contains berberine. Preliminary clinical research shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan (34279). Theoretically, Corydalis yanhusuo may also inhibit the metabolism of dextromethorphan.

LOSARTAN (Cozaar) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might reduce the therapeutic effects of losartan by decreasing its conversion to its active form.  Details Corydalis yanhusuo contains berberine. Preliminary clinical research suggests that berberine can inhibit cytochrome P450 2C9 (CYP2C9) activity and reduce metabolism of losartan (34279). Theoretically, Corydalis yanhusuo might also inhibit the metabolism of losartan.

METFORMIN (Glucophage) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might increase the therapeutic and adverse effects of metformin.  Details Corydalis yanhusuo contains berberine. In vitro and animal studies show that berberine can increase the systemic exposure and half-life of metformin, potentially increasing metformin's effects and side effects. This interaction seems to be most apparent when berberine is administered 2 hours prior to metformin. Taking berberine and metformin at the same time does not appear to increase systemic exposure to metformin (103195). It is unclear if Corydalis yanhusuo might have this same effect.

MIDAZOLAM (Versed) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might reduce metabolism of midazolam, which might increase the risk of severe adverse effects.  Details Corydalis yanhusuo contains berberine. Preliminary clinical research shows that berberine can inhibit cytochrome P450 3A4 (CYP3A4) activity and reduce metabolism of midazolam (34279). Theoretically, Corydalis yanhusuo might also inhibit the metabolism of midazolam.

PENTOBARBITAL (Nembutal) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might increase the sedative effect of pentobarbital.  Details Corydalis yanhusuo contains berberine. Animal research shows that berberine can prolong pentobarbital-induced sleeping time (13519). Theoretically, Corydalis yanhusuo might increase the sedative effects of pentobarbital.

TACROLIMUS (Prograf) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, Corydalis yanhusuo might increase blood levels of tacrolimus.  Details Corydalis yanhusuo contains berberine. In a 16-year-old patient with idiopathic nephrotic syndrome who was being treated with tacrolimus 6.5 mg twice daily, intake of berberine 200 mg three times daily increased the blood concentration of tacrolimus from 8 to 22 ng/mL. Following a reduction of the tacrolimus dose to 3 mg daily, blood levels of tacrolimus decreased to 12 ng/mL (91954). It is unclear if Corydalis yanhusuo might have this same effect.

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General ...Orally, Corydalis yanhusuo is generally well tolerated.
Serious Adverse Effects (Rare):
Orally: Clonic spasms and muscle tremors with high doses.

Musculoskeletal ...Orally, clonic spasms and muscle tremors may occur with overdoses of Corydalis yanhusuo (18).

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