Drug & supplement interaction

Ashwagandha + Vibegron

Vibegron brand name: Gemtesa.

Minor Interaction
The bottom line Minor

Ashwagandha has a minor interaction with Vibegron. Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ashwagandha and Vibegron

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Vibegron

Vibegron falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Ashwagandha interacts with.

Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that ashwagandha extract induces CYP3A4 enzymes.
Severity Minor Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version on pairing ashwagandha with Vibegron (Gemtesa). Vibegron is partly handled by a liver enzyme called CYP3A4. Lab studies (test-tube, not people) hint that ashwagandha may speed that enzyme up a bit. If that happened in your body, it could in theory clear Vibegron a little faster and make it work less well, meaning your overactive bladder symptoms (frequent trips to the bathroom, sudden urges, leaks) might not be as well controlled.

I want to be honest that this is theoretical and rated minor. It comes from lab work, not real patients, so for most people it likely won't be a noticeable problem. Vibegron isn't a prodrug, so it doesn't get stronger from this. If you take both and feel your bladder symptoms creeping back, mention it to your pharmacist or doctor.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction 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.
  • PossibleInteraction 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ashwagandha Also Interacts With Other Medications

Ashwagandha has 916 moderate, 455 minor known drug interactions in our database — the Vibegron one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Ashwagandha

Covers the 2,830 medications we’ve checked against Ashwagandha. Pick one to open its full report.

From our Q&A

Questions About Ashwagandha or Vibegron

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ashwagandha or Vibegron, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Vibegron

This page covers Ashwagandha only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Vibegron page lists 157 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 117 moderate · 37 minor.

From our pharmacist’s overview on the Vibegron page

“Three items on this page deserve more attention than the other 154 combined for anyone taking vibegron (Gemtesa) for overactive bladder. Grapefruit can raise the drug's blood level by blocking the enzyme that clears it, St.”

Reviewed by 2 · Jul 18, 2026

Open the Vibegron interaction page

One more smart check

Taking Ashwagandha as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4,964 real supplement products containing Ashwagandha, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ashwagandha. Your product may carry other ingredients that interact with Vibegron too, on top of Ashwagandha — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ashwagandha and Vibegron Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ashwagandha
Top 5%

#30 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Vibegron
Steady interest

#2,443 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ashwagandha

What is Ashwagandha?

Ashwagandha
  • Stress and anxiety
  • Sleep problems
  • Fatigue and low energy
  • Athletic performance
  • General well-being (adaptogen)

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.

Read the full Ashwagandha monograph & all interactions
Medication

About Vibegron

What Is Vibegron Used For?

Brand name: Gemtesa

Gemtesa (vibegron) is used to treat overactive bladder (OAB) in adults. Specifically, it targets the three main OAB symptoms: sudden strong urges to urinate, leaking urine when you feel that urge (urge urinary incontinence), and needing to urinate too often.

Gemtesa is also approved for adult men who have OAB symptoms and are already taking medication for benign prostatic hyperplasia (BPH) — an enlarged prostate.

See full Vibegron drug information
Keep checking

Other Drugs & Ashwagandha

Browse every other medication we’ve checked against Ashwagandha — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
916Moderate
455Minor
1,458No known interaction
Moderate

916 interactions

Showing 60 of 916 moderate interactions — see all 916 on the Ashwagandha page.

Minor

455 interactions

Showing 60 of 455 minor interactions — see all 455 on the Ashwagandha page.

No interaction 1,458 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

Keep exploring
Pharmacist Counseling Corner

Taking Ashwagandha and Vibegron Together: Common Questions

Can you take Ashwagandha with Vibegron?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Ashwagandha and Vibegron interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Vibegron and Ashwagandha?

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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.