NutriStack
Dexamethasone and Schisandra, a caution.
Schisandra extract can inhibit CYP3A in humans, and dexamethasone exposure rises markedly when CYP3A4 is inhibited. Adding Schisandra could increase dexamethasone effects, including insomnia, mood changes, glucose elevation, and adrenal suppression.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Dexamethasone and Schisandra
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Schisandra extract can inhibit CYP3A in humans, and dexamethasone exposure rises markedly when CYP3A4 is inhibited. Adding Schisandra could increase dexamethasone effects, including insomnia, mood changes, glucose elevation, and adrenal suppression.
Mechanism. Schisandra increased oral midazolam exposure in healthy volunteers, consistent with CYP3A inhibition. Dexamethasone is a CYP3A4 substrate, and itraconazole increased dexamethasone AUC and prolonged adrenal suppression in a controlled human study.
Recommendation. Avoid adding Schisandra during dexamethasone therapy unless your prescriber is aware, especially with repeated or high-dose courses. Watch for stronger steroid side effects and ask about dose adjustment if Schisandra is continued.
Sources (2)
- Xin HW, Wu XC, Li Q, Yu AR, Xiong L. Effects of Schisandra sphenanthera extract on the pharmacokinetics of midazolam in healthy volunteers. Br J Clin Pharmacol. 2009;67(5):541-546. PMID 19552749
- Varis T, Kivisto KT, Backman JT, Neuvonen PJ. The cytochrome P450 3A4 inhibitor itraconazole markedly increases the plasma concentrations of dexamethasone and enhances its adrenal-suppressant effect. Clin Pharmacol Ther. 2000;68(5):487-494. PMID 11103751
Stack Score
How this pair moves the number.
Effect on the composite score
If both Dexamethasone and Schisandra are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
Check your full routine
One pair was the worked example. NutriStack runs every pair in your stack at once.
Drop in your supplements and prescriptions and the public database surfaces every interaction, synergy, timing rule, and contraindication, every one linked to its primary source.