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Limited evidenceGeneral health

Schisandra

An adaptogen with a large Soviet-era literature and almost no modern controlled evidence. One small menopause RCT is positive; more importantly, schisandra is a potent CYP3A4 and P-glycoprotein modulator, making it one of the most interaction-prone herbs on the shelf.

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What the science says

  • Menopausal symptoms Limited evidence

    In a randomized, double-blind, placebo-controlled trial, 36 women aged 40-70 took a Schisandra chinensis extract (BMO-30) or placebo for 6 weeks with follow-up to week 12. Total Kupperman Index scores were significantly lower than placebo (p = 0.042), driven mainly by hot flushes, sweating and palpitations. With 18 women per arm this is a pilot-scale result, not proof.

  • Stamina, concentration and stress tolerance Limited evidence

    The Russian literature reviewed by Panossian and Wikman describes numerous studies of schisandra in soldiers, athletes, sailors and shift workers reporting improved work capacity, attention and stress resistance. Almost all of it predates modern trial standards, was uncontrolled or unblinded, and has never been replicated under double-blind conditions.

  • Liver protection Limited evidence

    Schisandrin-derived compounds such as bifendate are used in China to lower ALT in chronic hepatitis, but falling transaminases may partly reflect enzyme-level effects rather than genuine hepatoprotection. There are no good placebo-controlled trials of whole-berry supplements for liver outcomes.

Dosage & safety

Studied doseCommonly 500-2000 mg/day of dried berry or berry extract standardized to schisandrins/lignans; traditional decoctions use 1.5-6 g/day of dried fruit. The menopause trial used a proprietary extract daily for 6 weeks. There is no established optimal dose.
SafetyCommon complaints are heartburn, acid reflux, nausea and reduced appetite. The critical issue is drug interactions: schisandra lignans strongly modulate CYP3A4 and P-glycoprotein, and human pharmacokinetic studies show large increases in exposure to tacrolimus, midazolam and talinolol, enough to be clinically dangerous with immunosuppressants, statins, calcium channel blockers, some anticoagulants and many other drugs. Do not use it if you take a narrow-therapeutic-index medication. Avoid in pregnancy (traditional uterine stimulant), in epilepsy, and in severe reflux or peptic ulcer disease.

How to take it

TimingTiming does not matter.
With food?Take it with food - heartburn and reflux are the most common complaints.
Worth knowingRun your full medication list past a pharmacist first; schisandra is one of the few supplements that reliably raises prescription drug levels.

Interactions

With medications

  • tacrolimus and ciclosporin

    Schisandra sphenanthera raises tacrolimus exposure several-fold in human pharmacokinetic studies, enough to cause toxicity. do not combine without transplant-team supervision and level monitoring

  • statins, calcium channel blockers, midazolam and other CYP3A4 substrates

    Schisandra lignans inhibit CYP3A4 and raise blood levels of these drugs. check with your pharmacist before combining

  • digoxin, talinolol and other P-glycoprotein substrates

    Schisandra inhibits P-glycoprotein and increases drug absorption. do not combine with narrow-therapeutic-index drugs

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

What is schisandra good for?

Schisandra has limited evidence for any use: one small trial in 36 women found a schisandra extract eased menopausal hot flushes and sweating over 6 weeks, and the stamina and focus claims come from old, uncontrolled Russian studies. None of it has been replicated under modern trial standards.

Does schisandra interact with medications?

Yes, strongly: schisandra lignans inhibit CYP3A4 and P-glycoprotein and can raise tacrolimus exposure several-fold, along with statins, calcium channel blockers and midazolam. Do not use schisandra with narrow-therapeutic-index medication, and run your medication list past a pharmacist first.

Does schisandra protect the liver?

There are no good placebo-controlled trials of schisandra berry supplements for liver outcomes. Schisandrin-derived compounds lower ALT in chronic hepatitis in China, but that may reflect enzyme-level effects rather than true liver protection.

How much schisandra should I take?

Schisandra is commonly taken at 500-2000 mg/day of dried berry or standardised extract, but there is no established optimal dose. Take it with food, since heartburn and reflux are the most common complaints.

Scientific references

Where to buy

Swanson Vitamins, Schizandra Extract, Standardized, 500 mg, 60 Capsules

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