Lycium barbarum · PhytoNexus

01 Identity and provenance

Accepted binomial: Lycium barbarum
Common names: Goji Berry
Family (APG IV): Solanaceae
Part used: Fruit
Verification tier: Tier 2 · Verified Clinical columns reviewed and a source is on record.
Reviewer note (2026 audit): Lam AY & Elmer GW. Ann Pharmacother 2001;35:1199-201. PubMed 11675844 | Leung H & El-Kadiki S. Am J Health Syst Pharm 2009;66:2225-7 | PMC5598317 (gouqizi wine case) | VERIFIED 2026 (batch 7) - synthetic analogue, application, interactions, side effects and references populated from retrieved primary/regulatory sources. Interactions labelled CLINICAL vs THEORETICAL. Marketed-formulation column intentionally blank. | INTERACTION

02 Constituent chemistry

Chemical class	Marker compound	Synthetic analogue in use
Polysaccharides, carotenoids	Zeaxanthin dipalmitate Fruit	No analogue. Lycium barbarum polysaccharides and zeaxanthin dipalmitate are the marker constituents.

The analogue column is what makes the interaction reasoning tractable: where a constituent has a marketed structural counterpart, the counterpart's interaction profile is the starting hypothesis for the plant.

Looking up structures and physicochemical properties from PubChem…

03 Stated application

Reported activity: Chinese Pharmacopoeia drug (Gouqizi) at 6-12 g daily; traditional tonic for vision, immunity and liver. Widely sold as juice and dried fruit outside Asia, where consumers do not regard it as a medicine.
Reported adverse effects: Generally well tolerated as food. The risk profile is dominated by the warfarin interaction rather than intrinsic toxicity.

04 Interaction matrix

Source column, verbatim: WARFARIN - FOUR INDEPENDENT PUBLISHED CASES, WHICH IS UNUSUALLY STRONG FOR A FOOD. A 71-year-old on warfarin after knee surgery drank goji juice for four days and presented with epistaxis, bruising and rectal bleeding at an indeterminate INR (PT > 120 s), resolving to 2.6 with phytonadione; Naranjo score 6 (probable). A 61-year-old woman reached INR 4.1 after four days of concentrated L. barbarum tea. A 65-year-old man bled after gouqizi wine at more than 6-12 g. MECHANISM IS NOT SETTLED: in-vitro CYP2C9 inhibition of S-warfarin metabolism is WEAK (Ki 3.4 mg/mL), so something other than CYP450 is probably contributing. Treat as a real clinical interaction with an unexplained mechanism - increase INR monitoring, and ask about goji explicitly, since patients classify juice as food, not herbal medicine.
Normalised onto 1 canonical drug class below.

Curated from the reviewed source

Drug class	Severity	Mechanism type	Provenance	Expected effect
Anticoagulants (vitamin-K antagonists, DOACs) Haemostasis	3Major	PD-additive + PK-CYP2C9	curated A	INR destabilisation in either direction; ecchymosis, epistaxis, gum bleed…	why ▾
Class mechanism. Coumarin-, salicylate- and coumestan-bearing botanicals add to vitamin-K-antagonist effect; several also compete for CYP2C9 and CYP3A4, raising S-warfarin exposure. Botanicals rich in vitamin K1 act in the opposite direction and blunt anticoagulation. Expected INR destabilisation in either direction; ecchymosis, epistaxis, gum bleeding, GI or intracranial haemorrhage. Management Do not start or stop the botanical without INR cover. Check INR at 3-5 days and again at 2 weeks. Document the product, batch and dose in the anticoagulation record. Onset rapid Evidence A - human data with a cited source Matched on “warfarin” Find evidence for this pair Map this mechanism

Predicted from constituent chemistry

These edges are not clinical findings. Each one is a rule inference: a constituent class in this plant is known to act on a target that the drug class also acts on. They are shown because a blank cell reads as “safe”, and for a Tier 1 entry a blank cell only means “not yet looked at”. Treat them as a literature-search agenda, not as a warning.

Drug class	Severity	Mechanism type	Provenance	Expected effect
Cardiac glycosides (digoxin, digitoxin) Cardiovascular	4Contraindicated	PD-additive + PK-transporter + assay interference	predicted D	Nausea, xanthopsia, bradyarrhythmia, AV block, ventricular tachycardia an…	why ▾
Chemistry of this pair. Hydrocolloids raise luminal viscosity and physically entrap co-administered drug molecules, delaying and reducing absorption. Class mechanism. Cardenolide- and bufadienolide-bearing plants are themselves Na+/K+-ATPase inhibitors, so co-administration is pharmacological overdose. Several also inhibit intestinal P-glycoprotein, raising digoxin exposure, and cross-react with digoxin immunoassays so that serum levels become uninterpretable. Expected Nausea, xanthopsia, bradyarrhythmia, AV block, ventricular tachycardia and death; falsely reassuring or falsely high assay results. Management Treat as an absolute contraindication. If exposure has occurred, manage on ECG and clinical grounds, not on assay values, and consult toxicology about digoxin-specific Fab. Onset rapid Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Antidiabetic drugs (insulin, sulfonylureas, biguanides, GLP-1, SGLT2) Endocrine	3Major	PD-additive	predicted D	Symptomatic hypoglycaemia, sweating, tremor, confusion; severe events rep…	why ▾
Chemistry of this pair. Hydrocolloids raise luminal viscosity and physically entrap co-administered drug molecules, delaying and reducing absorption. Class mechanism. Hypoglycaemic botanicals act through insulin secretagogue, insulin-sensitising, alpha-glucosidase-inhibiting or glucose-transport routes. Added to a titrated pharmacological regimen the effects summate rather than plateau. Expected Symptomatic hypoglycaemia, sweating, tremor, confusion; severe events reported with insulin and sulfonylureas. Management Increase self-monitoring frequency for 2 weeks after starting or stopping. Anticipate a downward dose adjustment of insulin or sulfonylurea. Onset rapid Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Antibacterials and anthelmintics Infection	2Moderate	PK-chelation + PK-CYP	predicted D	Treatment failure from subtherapeutic antibiotic concentrations, or raise…	why ▾
Chemistry of this pair. Hydrocolloids raise luminal viscosity and physically entrap co-administered drug molecules, delaying and reducing absorption. Class mechanism. Cation- and tannin-rich botanicals chelate tetracyclines and fluoroquinolones; efflux-pump-inhibiting and CYP-modulating constituents alter macrolide, rifamycin and azole exposure. Anthelmintic botanicals add to praziquantel and albendazole effect. Expected Treatment failure from subtherapeutic antibiotic concentrations, or raised toxicity of azoles and macrolides. Management Separate doses by 2-3 hours. Do not rely on botanical antimicrobials in place of an indicated antibiotic. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Iron, calcium and mineral supplements Nutrition	2Moderate	PK-chelation	predicted D	Failure of iron-deficiency correction, unexplained non-response to oral i…	why ▾
Chemistry of this pair. Hydrocolloids raise luminal viscosity and physically entrap co-administered drug molecules, delaying and reducing absorption. Class mechanism. Tannins, phytates, oxalates and mucilage form insoluble complexes with divalent and trivalent cations in the gut lumen, reducing absorption of both the mineral and any co-administered chelating drug. Expected Failure of iron-deficiency correction, unexplained non-response to oral iron or calcium. Management Separate mineral doses from tannin- and fibre-rich botanicals by at least 2 hours; take iron with ascorbate instead. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Thyroid hormones and antithyroid drugs Endocrine	2Moderate	PK-absorption + PD-modulation	predicted D	Iatrogenic hyper- or hypothyroidism, unexplained TSH drift, loss of euthy…	why ▾
Chemistry of this pair. Hydrocolloids raise luminal viscosity and physically entrap co-administered drug molecules, delaying and reducing absorption. Class mechanism. Guggulsterone stimulates thyroid function and T4-to-T3 conversion; goitrogenic glucosinolates and lithospermic acid suppress it; high-fibre and cation-rich botanicals bind levothyroxine in the gut and reduce absorption. Expected Iatrogenic hyper- or hypothyroidism, unexplained TSH drift, loss of euthyroid control. Management Separate levothyroxine from fibre and mineral products by 4 hours. Recheck TSH 6-8 weeks after any botanical change. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism

05 Hazard register

direction disputed - Four published warfarin cases with bleeding

06 Confusable material

These entries could be mistaken for this one in trade, in the herbarium, or in a prescription. Powdered material is often indistinguishable, so the check is macroscopic, microscopic and chromatographic rather than nominal.

Vaccinium macrocarpon Cranberry	Ericaceae	Shares the common name "berry"
Vaccinium myrtillus Bilberry	Ericaceae	Shares the common name "berry"
Morus alba Mulberry	Moraceae	Shares the common name "berry"
Berberis vulgaris Barberry	Berberidaceae	Shares the common name "berry"
Anamirta cocculus Fish Berry	Menispermaceae	Shares the common name "berry"
Sambucus nigra Elderberry	Adoxaceae	Shares the common name "berry"

07 Mechanism map

Chemistry sorts to the left, pharmacology to the right. Dashed edges are predicted. Drag nodes, scroll to zoom, export at 3× for a figure.

species

chemical class

marker compound

drug class

expected effect

hazard

08 Open literature

Abstract-scoped query built from this binomial, its common names and its marker compounds, run live against Europe PMC, PubMed and OpenAlex, then ranked locally against an evidence hierarchy.

Checking openFDA spontaneous reports…

09 Isomechanistic neighbours

Species whose interaction profile overlaps this one, ranked by shared severity weight rather than by count — a shared contraindication counts for more than a shared minor signal. Practical use: these are the plants you should not stack with this one, because the mechanisms summate.

Species	Family	Shared classes	Jaccard
Panax ginseng Ginseng	Araliaceae	6	0.60
Plantago ovata Isabgol	Plantaginaceae	5	0.71
Senegalia senegal Gum Acacia	Fabaceae	5	0.83
Salvia hispanica Chia	Lamiaceae	5	0.83
Cyamopsis tetragonoloba Guar	Fabaceae	5	0.83
Astragalus gummifer Tragacanth	Fabaceae	5	0.83

10 References and notes

Source column: Rivera CA et al. Pharmacotherapy 2012;32:e50-3. PubMed 22392461

Rivera CA et al. Pharmacotherapy 2012

Rivera CA et al. Pharmacotherapy 2012 manual

32:e50-3. PubMed 22392461

manual

BibTeX for all 2 records

@article{RiveraCAet2012,
  title = {Rivera CA et al. Pharmacotherapy 2012},
  author = {Rivera CA et al.},
  journal = {Pharmacotherapy},
  year = {2012},
}

@article{anon,
  title = {32:e50-3. PubMed 22392461},
}

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