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📰Read the full Dong Quai evidence review on GMJ News →Complete clinical article, references and updates on news.gmj.ge. This page is the structured safety summary.⚠ Patient taking dong quai alone for hot flashes — negative RCT; TCM uses it in formulas [2]
⚠ Patient on warfarin using dong quai — coumarin anticoagulant interaction [1]
⚠ Patient on photosensitizing drugs + dong quai — additive UV sensitivity [1]
⚠ Pregnant patient using dong quai — uterotonic; contraindicated [1]
🥗 Food first — build your daily Typical 500–2,000 mg
Check the foods you regularly eat — the bar fills toward your daily target.
Dong quai chicken soup (traditional)500 mg dong quai root (approximate per serving)
Dong quai wine (traditional)200 mg dong quai root (approximate per serving)
Check your regular foods above
🔬 Lab interpreter
Recommended test
INR (if on warfarin)
INR (if on warfarin)
Reference range / target
Therapeutic range
Therapeutic range
Coumarin content — significant interaction [1].
Full lab monitoring ↓⚕ For professionals — confirm ranges against your local laboratory.
Clinical verdict
Dong quai is TCM's most prescribed gynecological herb, but a well-designed RCT found it NO better than placebo for hot flashes as a single agent. The TCM teaching is critical: dong quai works in formulas (Si Wu Tang), not alone. Two safety essentials: (1) warfarin interaction from coumarins (case reports of bleeding); (2) photosensitivity from furanocoumarins. Contraindicated in pregnancy [1] [2].
1 How much do I need?
👤 Adults: Specific dosage data under clinical review
👴 Elderly: Specific dosage data under clinical review
🤰 Pregnancy: See guidance
AVOID. Uterotonic effects (traditional labor-inducing herb). Furanocoumarins additional concern [1].
👦 Pediatric: See guidance
Not indicated for children [1].
🏃 Athletes: Standard dose
⚖️ Obesity: Standard dose
Fat-soluble compounds may require dose adjustment in obesity.
🩺 Renal: Consult specialist
Dose adjustment may be needed in renal impairment.
🌱 Vegan: Standard dose
How to take
🍽 Timing: As directed in TCM formula. BID–TID with food [1].
💊 With food: Traditional: in soup or with other herbs [1].
2 Which form?
| Form | Bioavailability | Vegan | Cost |
|---|---|---|---|
| ['Dong quai root extract', 'common', '500 mg 2–3×/day standardized to ferulic acid or ligustilide [1].'] | Standard | Check label | |
| ['Dong quai root powder', 'traditional', '1–3 g/day. Used in TCM decoctions and soups [1].'] | Standard | Check label | |
| ['Dong quai in TCM formulas', 'traditional', 'Most commonly combined with other herbs (Si Wu Tang, Dang Gui Bu Xue Tang) [1].'] | Standard | Check label | |
| ['Dong quai slices (for soup)', 'food', "Added to chicken soup in Chinese cuisine. Traditional 'blood-building' food [1]."] | Standard | Check label |
3 Common questions
Does dong quai help hot flashes? ▼
When used alone: NO. The only well-designed RCT (n=71, 24 weeks) found no benefit over placebo. In TCM, dong quai is ALWAYS used in multi-herb formulas, never as a single agent. Taking dong quai alone for hot flashes contradicts traditional use AND modern evidence [2].
Is dong quai estrogenic? ▼
Debated. In vitro studies show conflicting results — some suggest weak estrogen receptor binding, others show no estrogenic activity. The landmark RCT found no change in estrogen levels, endometrial thickness, or vaginal maturation. The traditional TCM classification as a 'blood tonic' does not equate to estrogenic activity [1] [2].
Why does TCM use dong quai in formulas? ▼
TCM philosophy holds that herbs work synergistically — dong quai is the 'chief herb' (Jun) in blood-building formulas like Si Wu Tang, with other herbs providing supporting, assisting, and envoy roles. This combination approach may explain why single-agent studies are negative while TCM practitioners report clinical benefit [1].
Can dong quai thin blood? ▼
Yes. Dong quai contains coumarins and furanocoumarins with documented anticoagulant activity. Multiple case reports of warfarin interaction (elevated INR, bleeding). Always disclose dong quai use to physicians, especially before surgery [1].
4 Clinical evidence
Strong
TCM pharmacopoeia: dong quai is the most prescribed gynecological herb in TCM, documented for >2,000 years [1]. HIGH
Moderate
Dysmenorrhea: dong quai-containing TCM formulas (Si Wu Tang, Dang Gui Shao Yao San) improved dysmenorrhea in several Chinese RCTs — but these are multi-herb formulas; dong quai's isolated contribution is unclear [1]. Blood-building: ferulic acid stimulates erythropoietin production in vitro and improved hemoglobin in 1 small trial [1]. Uterine smooth muscle: ligustilide relaxes uterine smooth muscle in vitro — supporting the dysmenorrhea mechanism [1]. MODERATE
Insufficient
Menopausal hot flashes (as single agent): a well-designed 24-week RCT (n=71) found NO significant difference between dong quai and placebo for hot flash frequency, intensity, or estrogen levels. This is the most important single negative finding [2]. Fertility: traditional use for implantation support; no RCTs [1]. Anemia: blood-tonic reputation; limited to 1 small study [1]. Neuroprotection: ferulic acid data is preclinical [1]. LOW
5 Safety, toxicity & adverse events
Absolute contraindications
✕ Pregnancy — uterine-stimulant and anticoagulant effects
Relative
⚠ Anticoagulants/antiplatelets — bleeding risk
⚠ Photosensitivity (furocoumarins)
⚠ Hormone-sensitive conditions — possible estrogenic activity
⚠ (Same herb as 'Dang Gui (Dong Quai)')
🚩 Red flags
● Patient on warfarin — coumarin interaction; INR elevation [1]
● Patient with excessive sun exposure + dong quai — phototoxicity [1]
● Pregnant patient — uterotonic, contraindicated [1]
6 Interactions
Drug interactions
Warfarin Major
Mechanism: Coumarin/furanocoumarin anticoagulant activity [1].
Effect: Elevated INR, bleeding [1].
Action: Avoid combination. Monitor INR if unavoidable [1].
Photosensitizing drugs (tetracyclines, quinolones, thiazides) Moderate
Mechanism: Additive furanocoumarin-mediated photosensitivity [1].
Effect: Severe sunburn/phototoxicity [1].
Action: Sun protection if combining [1].
Supplement synergies
White Peony Root (Bai Shao) · As in traditional Si Wu Tang formula
Classic TCM blood-tonic pair (Si Wu Tang). Dong quai (moving) + peony (nourishing) [1].
Classic TCM blood-tonic pair (Si Wu Tang). Dong quai (moving) + peony (nourishing) [1].
Rehmannia (Shu Di Huang) · As in formula
Another Si Wu Tang component. Blood-nourishing synergy [1].
Another Si Wu Tang component. Blood-nourishing synergy [1].
7 Regulatory
China (Chinese Pharmacopoeia): Official TCM medicine. One of the most commonly prescribed herbs in Chinese medicine [1].
United States (FDA): Available as dietary supplement. No FDA-approved claims [1].
European Union (EMA): No EMA monograph for Angelica sinensis [1].
8 US supplement products
146
on-market products containing Dong Quai (NIH DSLD)
Brands carrying Dong Quai (79)
Click a brand to see its Dong Quai products.
9 Frequently paired with
10 Cite this page
Vancouver: Pkhakadze G. Dong Quai — safety profile [Internet]. Tbilisi: PHIG; 2026 [cited 2026 Oct 16]. Available from: https://supplement.ge/ingredients/dong-quai/
APA 7th: Pkhakadze, G. (2026). Dong Quai — Safety profile. Public Health Institute of Georgia. https://supplement.ge/ingredients/dong-quai/
📋 Editorial information
Author: Prof. G. Pkhakadze, MD, MPH, PhD
Institution: Public Health Institute of Georgia (PHIG)
Affiliation: David Tvildiani Medical University (DTMU)
First published: January 2026
Last reviewed: 2026-05-29
Next review: April 2027
References: 4 cited sources
COI: SupplementIndex receives no funding from supplement manufacturers. All content independently authored by PHIG.
Process: Systematic literature review
📄 License & reuse
Published under Creative Commons Attribution 4.0 International (CC BY 4.0). You may share and adapt for any purpose with attribution.
Pkhakadze G. "Dong Quai — Safety Profile." SupplementIndex, PHIG, 2026. https://supplement.ge/ingredients/dong-quai/ CC BY 4.0.
GP
Prof. G. Pkhakadze, MD, MPH, PhD
Professor of Public Health · Head of Department, DTMU
Editor-in-Chief, Georgian Medical Journal (ISSN 3088-4322)
Chair, Public Health Institute of Georgia · UEMS Public Health Section
Educational and public health purposes. CC BY 4.0. Consult your healthcare provider before starting any supplement. Corrections: info@accreditation.ge. Publisher: PHIG