Scutellaria baicalensis

01 Identity and provenance

Accepted binomial: Scutellaria baicalensis
Common names: Huang Qin
Family (APG IV): Lamiaceae
Part used: Root
Verification tier: Tier 2 · Verified Clinical columns reviewed and a source is on record.
Reviewer note (2026 audit): Lin LZ et al. Phytochem Anal 2009;20:298-306 (distinguishing skullcap from germander) | Foster S. HerbalGram 2012;93:34-41 (adulteration review) | Larrey D et al. (germander hepatitis, France 1992) | VERIFIED 2026 (batch 4) - synthetic analogue, application, interactions, side effects and references populated from retrieved primary/regulatory sources. Interactions labelled CLINICAL vs THEORETICAL. Marketed-formulation column intentionally blank. | IDENTITY

02 Constituent chemistry

Chemical class	Marker compound	Synthetic analogue in use
Flavones	Baicalin, Baicalein Root	No direct analogue. Baicalin and baicalein are flavones with anti-inflammatory activity.

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: Widely used in Chinese practice for inflammatory and infectious conditions; increasingly in Western supplements.
Reported adverse effects: EVIDENCE CONTESTED - RECORD BOTH SIDES. LiverTox carries case reports and small series of acute liver injury with jaundice arising 1-3 months after starting Chinese skullcap; one 51-year-old developed jaundice 10 days in (bilirubin 2.6 rising to 24.0 mg/dL, ALT 147 U/L) and resolved within 12 weeks of stopping. Other authors reviewing the same literature conclude there is NO convincing evidence S. baicalensis itself causes liver injury. THE CONFOUND IS ADULTERATION: skullcap products are a known target for substitution with hepatotoxic germander (Teucrium chamaedrys, T. canadense), and germander was the proven cause of the 1990s liver-injury cluster originally blamed on skullcap. In a USDA analysis of 13 internet-purchased skullcap supplements, only 5 contained measurable true skullcap; 4 contained germander. Attribution therefore requires product authentication.

04 Interaction matrix

Source column, verbatim: THEORETICAL: additive hepatotoxicity with other hepatotoxic agents. Flavone-mediated CYP interactions are plausible but not well characterised clinically.
Normalised onto 1 canonical drug class below.

Curated from the reviewed source

Drug class	Severity	Mechanism type	Provenance	Expected effect
Hepatotoxic drugs Organ toxicity	3Major	Organ-toxicity additive	curated A	Transaminase elevation, cholestasis, sinusoidal obstruction syndrome, acu…	why ▾
Class mechanism. Pyrrolizidine alkaloids, high-dose anthraquinones, kava constituents and germander-type diterpenes cause hepatocellular or sinusoidal injury that adds to the risk from paracetamol, isoniazid, methotrexate, azoles and statins. Expected Transaminase elevation, cholestasis, sinusoidal obstruction syndrome, acute liver failure. Management Baseline and 4-weekly ALT and bilirubin. Stop the botanical at any transaminase rise above three times the upper reference limit. Onset unspecified Evidence A - human data with a cited source Matched on “hepatotoxic” 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
Cytotoxic and targeted anticancer drugs Oncology	4Contraindicated	PK-CYP3A4/UGT + PD-antagonistic	predicted D	Neutropenic sepsis and severe diarrhoea from over-exposure, or reduced an…	why ▾
Chemistry of this pair. Flavonoids inhibit CYP3A4, CYP1A2, OATP1B1 and UGT to a variable extent and have measurable antiplatelet activity. Class mechanism. Botanical CYP3A4 and UGT1A1 modulation alters exposure to irinotecan, taxanes, vinca alkaloids and kinase inhibitors. High-dose antioxidant botanicals may also oppose the oxidative mechanism of some cytotoxics and of proteasome inhibitors. Expected Neutropenic sepsis and severe diarrhoea from over-exposure, or reduced antitumour effect; boronic-acid proteasome inhibitors are directly antagonised by polyphenols. Management No botanical should be taken during active cytotoxic therapy without oncology sign-off. Record all supplements in the chemotherapy chart. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Narrow-therapeutic-index CYP3A4 substrates Pharmacokinetic	4Contraindicated	PK-CYP3A4	predicted D	Toxic accumulation or subtherapeutic failure of the co-prescribed drug, s…	why ▾
Chemistry of this pair. Flavonoids inhibit CYP3A4, CYP1A2, OATP1B1 and UGT to a variable extent and have measurable antiplatelet activity. Class mechanism. Furanocoumarins, bergamottin, piperine, glabridin and berberine inhibit CYP3A4; hyperforin, andrographolide and several diterpenes induce it through PXR. Because CYP3A4 handles roughly half of marketed drugs, the affected list is broad and the direction is product-specific. Expected Toxic accumulation or subtherapeutic failure of the co-prescribed drug, sometimes fatal for antiarrhythmics, immunosuppressants and oncology agents. Management Screen the full regimen for 3A4 substrates. Where the substrate has a narrow index, avoid rather than monitor. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Antiplatelet agents Haemostasis	3Major	PD-additive	predicted D	Prolonged bleeding time, surgical and post-procedural bleeding, bruising,…	why ▾
Chemistry of this pair. Flavonoids inhibit CYP3A4, CYP1A2, OATP1B1 and UGT to a variable extent and have measurable antiplatelet activity. Class mechanism. Organosulfur compounds, gingerols, salicylates, ginkgolides and eugenol inhibit thromboxane A2 synthesis, platelet aggregation and PAF-mediated activation, duplicating the pharmacology of aspirin and P2Y12 blockers. Expected Prolonged bleeding time, surgical and post-procedural bleeding, bruising, haematuria. Management Stop the botanical 7-14 days before elective surgery or neuraxial anaesthesia. Record it on the pre-operative medicines list. Onset rapid Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Statins and lipid-lowering drugs Cardiovascular	2Moderate	PK-CYP3A4/OATP	predicted D	Myalgia, raised creatine kinase, rhabdomyolysis, hepatic transaminase ele…	why ▾
Chemistry of this pair. Flavonoids inhibit CYP3A4, CYP1A2, OATP1B1 and UGT to a variable extent and have measurable antiplatelet activity. Class mechanism. CYP3A4 and OATP1B1 inhibition by furanocoumarin- and flavonoid-rich botanicals raises simvastatin, atorvastatin and lovastatin exposure. Some botanicals themselves contain monacolin K, which is chemically lovastatin. Expected Myalgia, raised creatine kinase, rhabdomyolysis, hepatic transaminase elevation. Management Ask specifically about red-yeast-rice type products. Check CK and ALT if muscle symptoms appear; prefer a non-3A4 statin. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism

05 Hazard register

substitution - germander (Teucrium) adulteration confounds every

06 Confusable material

No same-genus or shared-common-name entry in the corpus.

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
Centella asiatica Mandukaparni	Apiaceae	5	0.56
Hypericum perforatum St. John's Wort	Hypericaceae	5	0.45
Achillea millefolium Yarrow	Asteraceae	5	0.42
Actaea racemosa Black Cohosh	Ranunculaceae	5	0.63
Echinacea purpurea Echinacea	Asteraceae	5	0.42
Pterocarpus marsupium Vijaysar	Fabaceae	4	0.80

10 References and notes

Source column: LiverTox NBK548757 (Skullcap)

LiverTox NBK548757 (Skullcap)

manual

BibTeX for all 1 records

@article{anon,
  title = {LiverTox NBK548757 (Skullcap)},
}

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