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Peony (Paeonia lactiflora) is an herb. The roots are commonly used in Traditional Chinese Medicine (TCM) for many purposes.

Peony might block chemicals that can cause pain and swelling. It might also prevent blood clotting, kill cancer cells, and act as an antioxidant. Peony is sometimes called red peony and white peony. This refers to the color of the processed root, not the color of the flowers.

People use peony for menstrual cramps, aging skin, cough, epilepsy, psoriasis, and many other conditions, but there is no good scientific evidence to support these uses.

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When taken by mouth: Peony is possibly safe when used for up to 6 months. It can cause stomach upset in some people. There isn't enough reliable information to know if peony is safe to use long-term.

When applied to the skin: There isn't enough reliable information to know if peony is safe. It can cause rash in some people.

Special Precautions & Warnings:

Pregnancy: Peony is possibly unsafe when taken by mouth during pregnancy. It might cause uterine contractions. Until more is known, don't use peony during pregnancy.

Breast-feeding: There isn't enough reliable information to know if peony is safe to use while breast-feeding. Stay on the safe side and avoid use.

Children: Peony is possibly safe when taken by mouth for up to 12 months by children at least 1 year old.

Bleeding disorders: Peony might slow blood clotting. Don't use it if you have a bleeding disorder.

Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Peony extract might act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don't use peony.

Surgery: Peony might slow blood clotting. This might increase the chance of bleeding during and after surgery. Stop using peony at least 2 weeks before a scheduled surgery.

Birth control pills (Contraceptive drugs)

Interaction Rating=Moderate Be cautious with this combination.

Some birth control pills contain estrogen. Peony might have some of the same effects as estrogen. Taking peony along with birth control pills might increase the risk of side effects. It might also decrease the effects of birth control pills. If you take birth control pills along with peony, use an additional form of birth control such as a condom.

Clozapine (Clozaril)

Interaction Rating=Moderate Be cautious with this combination.

Peony might increase the amount of clozapine in the body. Taking peony along with clozapine might increase the effects and side effects from clozapine.

Estrogens

Interaction Rating=Moderate Be cautious with this combination.

Peony might have some of the same effects as estrogen. Taking peony along with estrogen might increase the effects and side effects from estrogen.

Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Peony might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Peony might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Interaction Rating=Moderate Be cautious with this combination.

Peony might slow blood clotting. Taking peony along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Phenytoin (Dilantin)

Interaction Rating=Moderate Be cautious with this combination.

Peony root might decrease the amount of phenytoin in the body. Taking peony root along with phenytoin might decrease the effects of phenytoin and increase the risk of seizures.

Herbs and supplements that might slow blood clotting: Peony might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.
Herbs that might act like estrogen: Peony might have the same effects as estrogen. Using it along with other supplements with similar effects might increase estrogen-like effects and side effects. Examples of supplements with this effect include black cohosh, hops, kudzu, and red clover.

There are no known interactions with foods.

A specific type of peony product, total glucosides of peony (TGP), has most often been used by adults in doses of 600 mg by mouth three times daily for up to 24 weeks. Speak with a healthcare provider to find out what dose might be best for a specific condition.

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