Herb & supplement monograph

Ashwagandha Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Ashwagandha interacts with medications. The heart of this page is the interaction list — every drug Ashwagandha is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Ashwagandha is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Ashwagandha Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Ashwagandha drug interaction appears low for most people, though a few medication types deserve care. None of the listed interactions are rated major, and most are theoretical rather than proven in people.

Interactions deserving the most attention

The best-documented concern is with thyroid hormone, since human studies suggest ashwagandha can raise thyroid hormone levels and could add to the effects and side effects of thyroid treatment. Early clinical evidence also hints it may lower blood sugar, so people taking diabetes medications should watch for signs of low blood sugar. Because ashwagandha can be sedating and has been linked to rare cases of liver injury, we also pay attention when it is combined with sedatives or medicines known to stress the liver.

What the rest of the list means

Ashwagandha appears alongside a long list of medications largely because it may affect enzymes the body uses to clear certain drugs, an effect seen mainly in lab research. Most of these pairings are theoretical, and several predicted effects, such as serotonin-related problems, have not produced meaningful changes in people. A long list reflects caution, not proof that every combination is harmful.

Check your medications against Ashwagandha

Based on HelloPharmacist’s Ashwagandha interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Ashwagandha

1372 medications have a known interaction with Ashwagandha, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
6-mercaptopurinePurinethol
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + 6-mercaptopurine interaction 6-mercaptopurine drug page: uses, dosage & side effects
Abacavir Sulfate, Dolutegravir, LamivudineTriumeq
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Abacavir Sulfate, Dolutegravir, Lamivudine interaction Abacavir Sulfate, Dolutegravir, Lamivudine drug page: uses, dosage & side effects
Abacavir, LamivudineEpzicom
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Abacavir, Lamivudine interaction
Abiraterone
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Abiraterone interaction Abiraterone drug page: uses, dosage & side effects
Abiraterone AcetateYonsa, Zytiga
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Abiraterone Acetate interaction Abiraterone Acetate drug page: uses, dosage & side effects
AbrocitinibCibinqo
Moderate Immunosuppressants

Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.

Read the full Ashwagandha + Abrocitinib interaction Abrocitinib drug page: uses, dosage & side effects
AcarboseGlucobay, Prandase, Precose
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acarbose interaction Acarbose drug page: uses, dosage & side effects
AcebutololRhotral, Sectral
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acebutolol interaction Acebutolol drug page: uses, dosage & side effects
AcepromazineAtravet
Moderate Cns Depressants

Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.

Read the full Ashwagandha + Acepromazine interaction
AcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen interaction Acetaminophen drug page: uses, dosage & side effects
Acetaminophen, AspirinGemnisyn
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Brompheniramine, Phenylpropanolamine interaction
Acetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Butalbital interaction
Acetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Butalbital, Caffeine interaction Acetaminophen, Butalbital, Caffeine drug page: uses, dosage & side effects
Acetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
Moderate Cns Depressants

Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.

Read the full Ashwagandha + Acetaminophen, Butalbital, Caffeine, Codeine interaction
Acetaminophen, Butalbital, CodeineBancap w/ Codeine
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Butalbital, Codeine interaction
Acetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Butalbital, Codeine Phosphate interaction
Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
Moderate Cns Depressants

Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.

Read the full Ashwagandha + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interaction
Acetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Caffeine, Codeine interaction
Acetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
Moderate Cns Depressants

Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.

Read the full Ashwagandha + Acetaminophen, Caffeine, Codeine, Salicylamide interaction
Acetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Caffeine, Dihydrocodeine interaction
Acetaminophen, Caffeine, IsomethepteneMigralam
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Caffeine, Isometheptene interaction
Acetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Caffeine, Pyrilamine interaction
Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interaction
Acetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
Moderate Cns Depressants

Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.

Read the full Ashwagandha + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interaction
Acetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Chlorpheniramine, Dextromethorphan interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
Moderate Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full Ashwagandha + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Ashwagandha combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Ashwagandha affects

Every type of medication (drug category) Ashwagandha is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 10 drug categories Ashwagandha interacts with
Antidiabetes DrugsAntihypertensive DrugsBenzodiazepinesCns DepressantsHepatotoxic DrugsImmunosuppressantsThyroid HormoneCytochrome P450 1a2 (cyp1a2) SubstratesCytochrome P450 3a4 (cyp3a4) SubstratesSerotonergic Drugs
Antidiabetes Drugs

Theoretically, taking ashwagandha with antidiabetes drugs might increase the risk of hypoglycemia.
There is preliminary clinical evidence suggesting that ashwagandha might lower blood glucose levels. Theoretically, ashwagandha might have additive effects when used with antidiabetes drugs and increase the risk of hypoglycemia.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Animal research suggests that ashwagandha might lower systolic and diastolic blood pressure. Theoretically, ashwagandha might have additive effects when used with antihypertensive drugs and increase the risk of hypotension.

Likelihood Possible Evidence D
Benzodiazepines

Theoretically, taking ashwagandha might increase the sedative effects of benzodiazepines.
There is preliminary evidence that ashwagandha might have an additive effect with diazepam (Valium) and clonazepam (Klonopin). This may also occur with other benzodiazepines.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Ashwagandha seems to have sedative effects. Theoretically, this may potentiate the effects of barbiturates, other sedatives, and anxiolytics.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Ashwagandha has been linked to cases of acute hepatitis, liver failure, hepatic encephalopathy, autoimmune hepatitis, the need for liver transplantation, and death due to liver failure.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Ashwagandha has demonstrated immunostimulant effects in humans. Animal research has shown that ashwagandha can attenuate the immunosuppression caused by cyclophosphamide.

Likelihood Possible Evidence D
Thyroid Hormone

Ashwagandha might increase the effects and adverse effects of thyroid hormone.
Concomitant use of ashwagandha with thyroid hormones may cause additive therapeutic and adverse effects. Preliminary clinical research and animal studies suggest that ashwagandha boosts thyroid hormone synthesis and secretion. In one clinical study, ashwagandha increased triiodothyronine (T3) and thyroxine (T4) levels by 41.5% and 19.6%, respectively, and reduced serum TSH levels by 17.4% from baseline in adults with subclinical hypothyroidism.

Likelihood Probable Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that ashwagandha extract induces CYP1A2 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that ashwagandha extract induces CYP3A4 enzymes.

Likelihood Possible Evidence D
Serotonergic Drugs

Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors. However, there is no evidence to suggest that ashwagandha increases the risk of serotonin-related effects, and there have been no published case reports of serotonin syndrome when combined with other serotonergic drugs. Nevertheless, due to the lack of extensive studies on the matter and the fact that ashwagandha appears to affect serotonergic pathways, it would be prudent to exercise caution when combining it with drugs that affect serotonin. [References: - Effects of Withania somnifera (Ashwaga ndha) on Stress and the Stress-Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia. Curr Neuropharmacol. 2021 Sep 14; 19: 1468–1495. - A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/]

Likelihood Possible Evidence C
Monograph

Ashwagandha: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Ashwagandha is an Ayurvedic herb most often taken to help with stress, anxiety, and sleep, and some small studies suggest it may help, though the evidence is still limited. It is generally well tolerated for short-term use in healthy adults, but it should be avoided in pregnancy and used cautiously by people with thyroid or liver problems. Talk with your pharmacist or doctor before starting it.

Ashwagandha
Scientific name
Withania somnifera
Family
Solanaceae
Part used
Root (and sometimes leaves)
Common forms
Capsules, tablets, powder, liquid extracts, teas
People commonly use it for
  • Stress and anxiety
  • Sleep problems
  • Fatigue and low energy
  • Athletic performance
  • General well-being (adaptogen)

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Generally well tolerated short-term in healthy adults, but quality and long-term safety data are limited.

PregnancyLikely Unsafe

When used orally. Ashwagandha has abortifacient effects.

Read the full pregnancy detail
BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Ashwagandha (Withania somnifera) is a small shrub used for centuries in Ayurvedic medicine, the traditional healing system of India. It grows in India, the Middle East, and parts of Africa. The root is the part most often used, though the leaves are sometimes used too.

It is widely sold as a dietary supplement in capsules, tablets, powders, and liquid extracts. People most often take it as an adaptogen — an herb believed to help the body cope with stress. Many products use standardized root extracts.

How it works

Ashwagandha contains active compounds called withanolides, which are thought to be responsible for many of its effects. The exact way it works in the body is not fully understood.

Researchers believe it may act on the body's stress system, possibly helping to lower levels of the stress hormone cortisol. It may also have antioxidant and anti-inflammatory effects. Much of this is based on laboratory and animal research, so how well it translates to people is still unclear.

Effectiveness

Does Ashwagandha work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 40 uses evaluated
4 Possibly effective 36 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.
Possibly Effective Anxiety
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral ashwagandha might reduce anxiety.

Possibly Effective Generalized anxiety disorder (GAD)
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha may modestly improve symptoms of anxiety in patients with GAD.

Possibly Effective Insomnia
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha may modestly improve sleep in patients with insomnia or non-restorative sleep.

Possibly Effective Stress
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha seems to help reduce stress and may also reduce stress-related weight gain.

Also studied for 36 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Aging
Rating & evidence shown verbatim from Natural Medicines

A small clinical study suggests that oral ashwagandha may modestly improve well-being, sleep, and alertness in elderly patients.

Insufficient Reliable Evidence To Rate Androgenic alopecia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical ashwagandha is beneficial for androgenic alopecia.

Insufficient Reliable Evidence To Rate Antipsychotic-induced metabolic side effects
Rating & evidence shown verbatim from Natural Medicines

It is unclear if ashwagandha is beneficial for attenuating the metabolic side effects of antipsychotic agents.

Insufficient Reliable Evidence To Rate Asthma
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral ashwagandha for asthma, there is insufficient reliable information about the clinical effects of ashwagandha for this condition.

Insufficient Reliable Evidence To Rate Athletic performance
Rating & evidence shown verbatim from Natural Medicines

It is unclear if ashwagandha is beneficial for improving athletic performance.

Insufficient Reliable Evidence To Rate Attention deficit-hyperactivity disorder (ADHD)
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Back pain
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Bipolar disorder
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral ashwagandha is beneficial for improving cognitive function in adults with bipolar disorder.

Insufficient Reliable Evidence To Rate Bronchitis
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral ashwagandha for bronchitis, there is insufficient reliable information about the clinical effects of ashwagandha for this condition.

Insufficient Reliable Evidence To Rate Cerebellar ataxia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral ashwagandha is beneficial for improving balance in patients with cerebellar ataxia.

Insufficient Reliable Evidence To Rate Chemotherapy-related fatigue
Rating & evidence shown verbatim from Natural Medicines

Evidence is limited to one small clinical study in patients with breast cancer.

Insufficient Reliable Evidence To Rate Chronic obstructive pulmonary disease (COPD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral ashwagandha is beneficial in patients with COPD.

Insufficient Reliable Evidence To Rate Cognitive function
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral ashwagandha for cognitive function, there is insufficient reliable information about the clinical effects of ashwagandha for this condition.

Insufficient Reliable Evidence To Rate Constipation
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Coronavirus disease 2019 (COVID-19)
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Depression
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral ashwagandha is beneficial for depression.

Insufficient Reliable Evidence To Rate Diabetes
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral ashwagandha is beneficial for type 2 diabetes.

Insufficient Reliable Evidence To Rate Fatigue
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral ashwagandha is beneficial for fatigue.

Insufficient Reliable Evidence To Rate Fibromyalgia
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral ashwagandha for fibromyalgia, there is insufficient reliable information about the clinical effects of ashwagandha for this condition.

Insufficient Reliable Evidence To Rate Hiccups
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral ashwagandha for hiccups, there is insufficient reliable information about the clinical effects of ashwagandha for this condition.

Insufficient Reliable Evidence To Rate Hypercholesterolemia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if ashwagandha is beneficial for hypercholesterolemia.

Insufficient Reliable Evidence To Rate Hypothyroidism
Rating & evidence shown verbatim from Natural Medicines

It is unclear if ashwagandha is beneficial for hypothyroidism.

Insufficient Reliable Evidence To Rate Infertility
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral ashwagandha for infertility in females, there is insufficient reliable information about the clinical effects of ashwagandha for this condition.

Insufficient Reliable Evidence To Rate Lichen planus
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical ashwagandha is beneficial for oral lichen planus.

Insufficient Reliable Evidence To Rate Menopausal symptoms
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha may be beneficial for menopausal symptoms.

Insufficient Reliable Evidence To Rate Obsessive-compulsive disorder (OCD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if ashwagandha is beneficial for OCD.

Insufficient Reliable Evidence To Rate Osteoarthritis
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Parkinson disease
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Psychological well-being
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral ashwagandha is beneficial for improving psychological well-being in college students.

Insufficient Reliable Evidence To Rate Rheumatoid arthritis (RA)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral ashwagandha is beneficial for improving symptoms of RA.

Insufficient Reliable Evidence To Rate Sexual dysfunction
Rating & evidence shown verbatim from Natural Medicines

Small clinical studies suggest that oral ashwagandha root extract may help improve sexual arousal and sexual desire in some females and males with sexual dysfunction.

Insufficient Reliable Evidence To Rate Smoking cessation
Rating & evidence shown verbatim from Natural Medicines

Oral ashwagandha has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Tuberculosis
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral ashwagandha for tuberculosis, there is insufficient reliable information about the clinical effects of ashwagandha for this condition.

Insufficient Reliable Evidence To Rate Vitiligo
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral ashwagandha for vitiligo, there is insufficient reliable information about the clinical effects of ashwagandha for this condition.

Insufficient Reliable Evidence To Rate Wound healing
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using topical ashwagandha for healing of skin ulcers and skin sores, there is insufficient reliable information about the clinical effects of ashwagandha for this condition.

Insufficient Reliable Evidence To Rate Wrinkled skin
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical ashwagandha is beneficial in individuals with wrinkled skin.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

For most healthy adults, ashwagandha appears to be reasonably well tolerated when used short-term. However, long-term safety has not been well studied, and supplement quality can vary between brands.

There have been rare reports of liver injury linked to ashwagandha products. Stop using it and contact your doctor if you notice yellowing of the skin or eyes, dark urine, or stomach pain.

Use caution if you have a thyroid condition, since ashwagandha may affect thyroid hormone levels. People with autoimmune conditions or those scheduled for surgery should also check with their doctor first.

Pregnancy: Avoid ashwagandha during pregnancy, as it has traditionally been linked to a risk of miscarriage. Breastfeeding: There is not enough safety information, so it is best to avoid it while breastfeeding.

Side effects

Ashwagandha is usually well tolerated, but some people experience side effects, especially at higher doses. These can include:

  • Upset stomach, nausea, or diarrhea
  • Drowsiness or sleepiness
  • Headache

Rare but serious effects include liver problems and possible changes in thyroid function. Stop taking it and seek medical care if you have signs of an allergic reaction or symptoms of liver trouble.

Ashwagandha: Reported Adverse Effects

Documented safety reports on Ashwagandha from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, ashwagandha seems to be well-tolerated. Topically, no adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted.

Most Common Adverse Effects:

Orally: Diarrhea, gastrointestinal upset, nausea, and vomiting. However, these adverse effects do not commonly occur with typical doses.

Serious Adverse Effects (Rare):

Orally: Some case reports raise concerns about acute hepatitis, acute liver failure, hepatic encephalopathy, the need for liver transplantation, and death due to liver failure with ashwagandha treatment.

Reports by condition
Adrenal insufficiency Endocrine

A case report describes a 73-year-old female who had taken an ashwagandha root extract (unspecified dose) for 2 years to treat hypothyroidism which had been previously managed with levothyroxine. The patient was diagnosed with hyperthyroidism after presenting with supraventricular tachycardia, chest pain, tremor, dizziness, fatigue, irritability, hair thinning, and low thyroid stimulating hormone (TSH) levels. Hyperthyroidism resolved after discontinuing ashwagandha. Additionally, an otherwise healthy adult who was taking ashwagandha extract orally for 2 months experienced clinical and laboratory-confirmed thyrotoxicosis. Thyrotoxicosis resolved 50 days after discontinuing ashwagandha, without other treatment. Another case report describes a 37-year-old female who presented with moderate symptomatic hyponatremia secondary to adrenal insufficiency after chronic consumption of ashwagandha for 2 years. This subject was effectively managed with oral hydrocortisone.

  1. Kamal HI, Patel K, Brdak A, Heffernan J, Ahmad N. Ashwagandha as a unique cause of thyrotoxicosis presenting with supraventricular tachycardia. Cureus. 2022 Mar 25;14(3):e23494.
  2. Hayashi M, Hamada H, Azuma SI, Hayashi K. Painless Thyroiditis by Withania somnifera (Ashwagandha). Cureus 2024;16(3):e55352.
  3. Patel M, Newell R, Hillier M, Ramalingam R. Herbal remedies as a potential cause of hypoadrenalism. Br J Hosp Med (Lond) 2024;85(6):1-4.
Cluster headache Neurologic/CNS

Orally, ashwagandha has been reported to cause drowsiness. Headache, neck pain, and blurry vision have been reported in a 47-year-old female taking ashwagandha, cannabis, and venlafaxine. Imaging over the course of multiple years and hospital admissions indicated numerous instances of intracranial hemorrhage and multifocal stenosis of intracranial arteries, likely secondary to reversible cerebral vasoconstriction syndrome (RCVS). It is unclear whether the RCVS and subsequent intracranial hemorrhages were precipitated by ashwagandha, cannabis, or venlafaxine.

  1. Ajgaonkar A, Jain M, Debnath K. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract for Improvement of Sexual Health in Healthy Women: A Prospective, Randomized, Placebo-Controlled Study. Cureus 2022;14(10):e30787.
  2. Majeed M, Nagabhushanam K, Murali A, Vishwanathan DT, Mamidala RV, Mundkur L. A Standardized Withania somniferra (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomize
  3. Patel PA, Sanborn E, Then R, Williams DM. Recurrent Reversible Cerebral Vasoconstriction Syndrome: A Report of Two Cases. Cureus 2023;15(8):e42992.
Dermatitis Dermatologic

Orally, dermatitis has been reported in three of 42 patients in a clinical trial.

  1. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5.
Diarrhea Hepatic

Orally, ashwagandha in doses of 154 mg to 20 grams daily has played a role in several case reports of cholestatic, hepatocellular, and mixed liver injuries. In most of these cases, other causes of liver injury were excluded, and liver failure did not occur. Symptoms included jaundice, pruritus, malaise, fatigue, lethargy, weight loss, nausea, diarrhea, abdominal pain and distension, stool discoloration, and dark urine. Symptom onset was typically 5-180 days from first intake, although in some cases onset occurred after more than 12 months of use. Laboratory findings include elevated aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase, serum bilirubin, and international normalized ratio (INR). In most cases, liver enzymes normalized within 1-5 months after discontinuation of ashwagandha. However, treatment with corticosteroids, lactulose, ornithine, ursodeoxycholic acid, and plasmapheresis, among other interventions, was required in one case. Rarely, use of oral ashwagandha has been reported to cause hepatic encephalopathy, liver failure requiring liver transplantation, and acute-on-chronic liver failure resulting in death.

  1. Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4):825-829.
  2. Ireland PJ, Hardy T, Burt AD, Donnelly MC. Drug-induced hepatocellular injury due to herbal supplement ashwagandha. J R Coll Physicians Edinb. 2021;51(4):363-365.
  3. Suryawanshi G, Abdallah M, Thomson M, Desai N, Chauhan A, Lim N. Ashwagandha-Associated Acute Liver Failure Requiring Liver Transplantation. Am J Ther 2023;30(1):e80-e83.
  4. Pusec CM, Wolsky R, Llerena C, Sura P. A Case of Supplement-Induced Hepatitis. Cureus 2022;14(10):e30433.
  5. Lubarska M, Halasinski P, Hryhorowicz S, et al. Liver Dangers of Herbal Products: A Case Report of Ashwagandha-Induced Liver Injury. Int J Environ Res Public Health 2023;20(5):3921.
  6. Tóth M, Benedek AE, Longerich T, Seitz HK. Ashwagandha-induced acute liver injury: A case report. Clin Case Rep 2023;11(3):e7078.
  7. Bokan G, Glamocanin T, Mavija Z, et al. Herb-Induced Liver Injury by Ayurvedic Ashwagandha as Assessed for Causality by the Updated RUCAM: An Emerging Cause. Pharmaceuticals (Basel) 2023;16(8):1129.
  8. Philips CA, Valsan A, Theruvath AH, et al. Ashwagandha-induced liver injury-A case series from India and literature review. Hepatol Commun 2023;7(10):e0270.
  9. Vazirani S, Kothari A, Fujimoto J, Gomez M. Supplements Are Not a Synonym for Safe: Suspected Liver Injury From Ashwagandha. Fed Pract 2023;40(9):315-319.
Diarrhea Gastrointestinal

Orally, large doses may cause gastrointestinal upset, diarrhea, and vomiting secondary to irritation of the mucous and serous membranes. When taken orally, nausea and abdominal pain and gastritis and flatulence have been reported.

  1. Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.
  2. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5.
  3. Suryawanshi G, Abdallah M, Thomson M, Desai N, Chauhan A, Lim N. Ashwagandha-Associated Acute Liver Failure Requiring Liver Transplantation. Am J Ther 2023;30(1):e80-e83.
  4. Majeed M, Nagabhushanam K, Murali A, Vishwanathan DT, Mamidala RV, Mundkur L. A Standardized Withania somniferra (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomize
  5. Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Integr Cancer Ther. 2013;12(4):312-22.
Erythema Genitourinary

In one case report, a 28-year-old male with a decrease in libido who was taking ashwagandha 5 grams daily over 10 days subsequently experienced burning, itching, and skin and mucous membrane discoloration of the penis, as well as an oval, dusky, eroded plaque (3 cm) with erythema on the glans penis and prepuce.

  1. Sehgal, V. N., Verma, P., and Bhattacharya, S. N. Fixed-drug eruption caused by ashwagandha (Withania somnifera): a widely used Ayurvedic drug. Skinmed. 2012;10(1):48-49.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no official, well-established dose for ashwagandha. Studies have used a wide range of doses and different types of extracts, which makes it hard to recommend one standard amount.

The safest approach is to follow the directions on the product label and not exceed the recommended amount. Because supplements are not tightly regulated, choosing a product that has been independently tested for quality is a good idea. Check with your pharmacist or doctor before starting, especially if you take other medicines or have a health condition.

Pregnancy & Breastfeeding

Ashwagandha & Pregnancy

Likely Unsafe

When used orally. Ashwagandha has abortifacient effects.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

Ashwagandha & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 32 references that drive our Ashwagandha monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.
  3. Davis L, Kuttan G. Effect of Withania somnifera on cyclophosphamide-induced urotoxicity. Cancer Lett 2000;148:9-17. PubMed
  4. Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol 1998;62:209-14. PubMed
  5. Mishra LC, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): a review. Altern Med Rev 2000;5:334-46. DOI
  6. Andallu B, Radhika B. Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian J Exp Biol 2000;38:607-9.
  7. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5. PubMed
  8. Ahumada F, Aspee F, Wikman G, Hancke J. Withania somnifera exract. Its effects on arterial blood pressure in anaesthetized dogs. Phytother Res 1991;5:111-14.
  9. Panda S, Kar A. Withania somnifera and Bauhinia purpurea in the regulation of circulating thyroid hormone concentrations in female mice. J Ethnopharmacol 1999;67:233-39. PubMed
  10. Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol 1998;50:1065-68. PubMed
  11. Sehgal, V. N., Verma, P., and Bhattacharya, S. N. Fixed-drug eruption caused by ashwagandha (Withania somnifera): a widely used Ayurvedic drug. Skinmed. 2012;10(1):48-49.
  12. Agnihotri AP, Sontakke SD, Thawani VR, Saoji A, Goswami VS. Effects of Withania somnifera in patients of schizophrenia: a randomized, double blind, placebo controlled pilot trial study. Indian J Pharmacol. 2013;45(4):417-8. PubMed
  13. Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Integr Cancer Ther. 2013;12(4):312-22.
  14. Sharma AK, Basu I, Singh S. Efficacy and safety of Ashwagandha root extract in subclinical hypothyroid patients: a double-blind, randomized placebo-controlled trial. J Altern Complement Med. 2018 Mar;24(3):243-248. PubMed
  15. Durg S, Bavage S, Shivaram SB. Withania somnifera (Indian ginseng) in diabetes mellitus: A systematic review and meta-analysis of scientific evidence from experimental research to clinical application. Phytother Res. 2020;34(5):1041-1059.
Keep reading

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Brand directory

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1,073 brands in our database make a supplement containing Ashwagandha.

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5,000 products in our database contain Ashwagandha. Open any to see its full ingredient list and every drug interaction we check.

+Stress Relief Stress Relief Complex by Shaklee Other (e.g. Tea Bag) 30 Caplet(s) View ingredients & interactions 100% Ashwagandha Powder by Vedic Care Powder 100 Gram(s) · 3.5 Ounce(s) View ingredients & interactions 100% Natural Stress Regress by Whole Body Research Capsule 60 Vegetarian Capsule(s) View ingredients & interactions 10x Pure-Gold Sleep All Night by CTFO Changing The Future Outcome Capsule 60 Capsule(s) View ingredients & interactions 17-Beta by iSatori Capsule 90 Capsule(s) View ingredients & interactions 2 Reduce Desire by Renew Life Tablet Or Pill 60 Chewable Orange Tablet(s) View ingredients & interactions 213 for Her by Carbon Fire Capsule 80 Capsule(s) View ingredients & interactions 24K by Reliv Powder 10.6 Ounce(s) View ingredients & interactions 24K Mixed Berry Flavor by Reliv Powder 10.6 Ounce(s) View ingredients & interactions 28 Days Later by Insane Labz Capsule 90 Capsule(s) View ingredients & interactions 4-Stress by Flora Capsule 60 Vegetarian Capsule(s) View ingredients & interactions 5 Ginseng by Global Healing Liquid 2 Fluid Ounce(s) · 59.2 mL View ingredients & interactions 5-HTP Power by Nature's Sunshine Capsule 60 Capsule(s) View ingredients & interactions 5-HTP+Complex with Ashwagandha & L-Taurine by Purely Optimal Capsule 60 Veggie Capsule(s) View ingredients & interactions 50+ Men Multivitamin + Supporting Herbs Iron Free by Super Nutrition SimplyOne Tablet Or Pill 30 Tablet(s) View ingredients & interactions 50+ Men Multivitamin + Supporting Herbs Iron Free by Super Nutrition SimplyOne Tablet Or Pill 90 Tablet(s) View ingredients & interactions 7-Herb Energy by Banyan Botanicals Liquid 1 fl. Oz. · 30 mL View ingredients & interactions 8Hr Sleep with Melatonin by 8 Hour Sleep Capsule 60 Capsule(s) View ingredients & interactions a Drenal by RLC Labs Capsule 120 Capsule(s) View ingredients & interactions A.J.'s Super Energy by Altrum Nutrition Capsule 60 Capsule(s) View ingredients & interactions A.M. Activator by ProCaps Laboratories Capsule 180 Easy-To-Swallow Capsule(s) View ingredients & interactions A.M. Activator by ProCaps Laboratories Capsule 180 Easy-To-Swallow Capsule(s) View ingredients & interactions ACG3 Supercharged+ Flex On The Beach by PMD Powder 13.2 Ounce(s) · 375 Gram(s) View ingredients & interactions ACG3 Supercharged+ Gummy Bear Blast by PMD Powder 13.2 Ounce(s) · 375 Gram(s) View ingredients & interactions
Pharmacist Counseling Corner

Ashwagandha: Common Questions

What is Ashwagandha used for, and does it work?
People use Ashwagandha for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting Ashwagandha for Anxiety, Generalized anxiety disorder (GAD), Insomnia and Stress. For most other uses it has been studied for, the evidence is currently insufficient to rate. See the graded list on this page, and always confirm with your pharmacist or doctor.
Does Ashwagandha interact with prescription medications?
Yes. We list 1372 medications with a known interaction with Ashwagandha. Use the checker above to see how Ashwagandha interacts with a specific drug.
How are Ashwagandha interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Ashwagandha with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Ashwagandha interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Ashwagandha used for?
People most commonly use it as an adaptogen to help with stress, anxiety, and sleep. It is also tried for fatigue and athletic performance, though the evidence for most uses is limited.
Is Ashwagandha safe to take?
It is generally well tolerated by healthy adults for short-term use, but long-term safety isn't well studied. People with thyroid or liver conditions, and anyone who is pregnant or breastfeeding, should avoid it or check with a doctor first.
Can I take Ashwagandha while pregnant or breastfeeding?
No. It is best to avoid Ashwagandha during pregnancy because of a traditional concern about miscarriage, and there is not enough safety information to use it while breastfeeding.
How long does Ashwagandha take to work?
In studies looking at stress and sleep, people often took it for several weeks before noticing effects. Results vary from person to person, and it does not work for everyone.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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