The short answer
No reliable human dose or timing rule is established for Chinese skullcap with cyclosporine. A root decoction sharply reduced oral cyclosporine exposure in rats, but isolated baicalin behaved differently and had no meaningful effect in a small single-dose human study. Review the exact botanical product with your prescribing team before use.
What this answer covers
Scutellaria baicalensis, Chinese skullcap, especially oral root decoctions, with systemic oral cyclosporine. Isolated baicalin, baicalein, other skullcap species and multi-herb formulas are different preparations and are not treated as direct substitutes for the root.
- Supplement or preparation
- Scutellaria baicalensis
- Medication ingredient
- cyclosporine
What was found with the root preparation?
In rats, a Scutellaria baicalensis root decoction substantially reduced the peak and overall exposure of oral microemulsion cyclosporine. The decoction did not change the handling of intravenous cyclosporine in that experiment. This points to an interaction during absorption, but an animal experiment cannot specify a patient’s risk or an appropriate dose change.
Why is baicalin a separate question?
The same animal work found increased exposure with isolated baicalin and baicalein, the opposite of the whole root decoction. A product’s individual constituents therefore cannot be assumed to reproduce the net effect of the plant preparation. A skullcap capsule, decoction and purified compound should not share one numerical interaction estimate.
What did the human study show?
Sixteen healthy volunteers took microemulsion cyclosporine alone and then with a single 500 mg dose of a baicalin capsule product. The study found no clinically important exposure change. It did not test whole skullcap root, repeated use or transplant recipients, so this reassuring result cannot establish that those other situations are safe.
Can dose spacing prevent a problem?
No tested separation interval for the root preparation was established. Show your clinician the species, plant part, full ingredient list and dose before starting or changing it. If use is continued under supervision, the team can decide whether additional cyclosporine levels are needed. Do not adjust the transplant medicine based on a rat study.
Evidence and practical considerations
Timing & monitoring
No reliable human dose or timing rule is established for Chinese skullcap with cyclosporine. A root decoction sharply reduced oral cyclosporine exposure in rats, but isolated baicalin behaved differently and had no meaningful effect in a small single-dose human study. Review the exact botanical product with your prescribing team before use.
- Exact scope
- Scutellaria baicalensis, Chinese skullcap, especially oral root decoctions, with systemic oral cyclosporine. Isolated baicalin, baicalein, other skullcap species and multi-herb formulas are different preparations and are not treated as direct substitutes for the root. with Cyclosporine, RxCUI 3008, IN, systemic oral use. Neoral modified microemulsion and conventional Sandimmune are distinguished; neither is automatically dose-equivalent to the other. The Neoral label identifies cyclosporine as the active ingredient and basis of strength. Intravenous reference experiments are identified separately; ophthalmic and topical use are excluded.
- Medication form and route
- oral
- Timing or duration
- Only the durations described in the sources are established; no untested persistence or dose-spacing interval is inferred.
What remains uncertain
- Root evidence is nonhuman; isolated constituents differ in effect and exposure. A single-dose healthy-volunteer baicalin study cannot settle chronic whole-root use or supplement requirements.
Factors that may matter: botanical species and plant part; root versus isolated constituent; extraction and dose; repeated versus single use; oral cyclosporine formulation.
Read the supporting source summaries
Source 1: regulatory prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Patients prescribed systemic oral cyclosporine, including transplant recipients.
Requires clinical and blood-level monitoring, recognizes nephrotoxicity and hyperkalemia, cautions with potassium-containing drugs and explicitly advises avoiding grapefruit and grapefruit juice. Neoral and Sandimmune are not bioequivalent.
How this applies: Direct exact-medication identity and oral monitoring guidance. Pair-specific applicability is restricted to the named food or potassium-containing products; other supplements require their own evidence.
A regulatory label does not quantify each supplement interaction. Botanical effects and absolute event rates cannot be inferred from cyclosporine toxicity alone. Formulation-specific findings must be retained.
Source 2: primary animal pharmacokinetic experiment
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Rats in crossover pharmacokinetic experiments.
Root decoction reduced oral cyclosporine peak by 62.9% or 79.6% and AUC by 55.2% or 82.0%; intravenous disposition was unchanged. Isolated baicalin and baicalein increased, rather than decreased, oral exposure.
How this applies: Exact S. baicalensis root preparation, but nonhuman. Does not establish a human dose adjustment or extend to other Scutellaria species.
Abstract only, high-dose animal experiment, no patients or human spacing comparison. Isolated constituents and whole root had opposite effects, so they cannot be substituted as evidence for one another.
Source 3: primary human pharmacokinetic study
pmc.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Sixteen healthy Chinese volunteers in an open-label, fixed-sequence, two-period study with a two-week washout.
No clinically relevant pharmacokinetic change; 90% confidence intervals for AUC and peak ratios were within conventional 80-125% bioequivalence bounds.
How this applies: Important preparation boundary and contrary mechanistic context; not direct evidence for the whole-botanical pair.
Isolated baicalin product, single exposure, healthy volunteers, not whole S. baicalensis root or chronic transplant treatment. This result cannot establish safety of root decoctions or multi-herb formulas.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Original studies and regulatory sources checked; a new article prepared with exact formulation and access limits. No independent clinical review is recorded. | |
| Research summary published |
Article revision: 75d1b8114ac78cbf
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
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Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.