Drug & supplement interaction

Bacopa + Amitriptyline

Amitriptyline brand name: Elavil.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Amitriptyline falls into 5 drug categories that Bacopa can interact with; the most serious is rated moderate. Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions5
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bacopa and Amitriptyline

These two interact in 5 distinct ways. Each one is explained separately below.

Why Are There 5 Interactions?

Bacopa interacts with whole categories of medication. Amitriptyline falls into 5 of those categories, so it can interact with Bacopa in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 5

Why this applies to Amitriptyline

Amitriptyline falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Bacopa interacts with.

Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Research on the effects of bacopa extracts on CYP1A2 enzymes is conflicting. Some in vitro evidence shows that bacopa extract can moderately and non-competitively inhibit CYP1A2, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Severity Moderate 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 gist: your body relies partly on a liver enzyme called CYP1A2 to clear amitriptyline. In test-tube studies, bacopa has shown a mild ability to slow that enzyme down. If that happened in real life, amitriptyline could build up a bit more than usual, which might bump up its typical side effects, things like drowsiness, dry mouth, constipation, blurred vision, or feeling dizzy when you stand.

I want to be honest about the strength of this, though. This is only lab-dish and animal data, and even those studies disagree with each other, so it may not matter much in a real person. Amitriptyline isn't a prodrug, so the concern is too much drug, not too little. Still, I'd give your pharmacist or doctor a quick heads-up before pairing them, just to be safe.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
  2. Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

2 of 5

Amitriptyline also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.

Theoretically, bacopa might increase the levels and adverse effects of CYP2C19 substrates.
In vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C19 enzymes. It is not known whether this is clinically significant.
Severity Moderate 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 gist of it. Your body uses an enzyme called CYP2C19 to help break down amitriptyline. In test tube studies, bacopa appears to slow that enzyme down a bit. If that holds true in real people, less of the drug would get cleared and the amount in your blood could creep up. Amitriptyline isn't a prodrug, so more drug hanging around means stronger effects and a higher chance of side effects like drowsiness, dry mouth, constipation, blurry vision, dizziness when standing, or a faster heartbeat.

That said, this is based only on lab work, not on actual patients, so we genuinely don't know if it matters in everyday life. I wouldn't lose sleep over it, but do mention the bacopa to your pharmacist or doctor so they can keep an eye on how you're feeling.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

3 of 5

Amitriptyline also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, bacopa might increase the levels and adverse effects of CYP2C9 substrates.
Research on the effect of bacopa extracts on CYP2C9 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C9, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Severity Moderate 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 basic idea with bacopa and your amitriptyline (Elavil). Your liver uses an enzyme called CYP2C9 as one way to help break this medication down. In lab dishes, bacopa may slow that enzyme a bit, which in theory could let more amitriptyline build up in your body. If that happened, you might notice the usual tricyclic side effects more strongly, things like drowsiness, dry mouth, constipation, blurry vision, dizziness when standing, or a faster heartbeat.

I want to be honest, though: this is theoretical and comes only from test-tube studies, and even those disagree. For most people it likely won't cause real trouble. Still, since amitriptyline can be sensitive to changes, it's worth a quick chat with your pharmacist or doctor before adding bacopa.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
  2. Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

4 of 5

Amitriptyline also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Research on the effects of bacopa extracts on CYP3A4 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and competitively inhibit CYP3A4, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Severity Moderate 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 basic idea: your body uses a liver enzyme called CYP3A4 to help clear amitriptyline. Lab studies hint that bacopa might slow that enzyme down a little. If that happened in real life, more amitriptyline could linger in your system, which could nudge up its usual side effects, things like drowsiness, dry mouth, constipation, blurry vision, dizziness when you stand, or a faster heartbeat.

I want to be honest, though: this is a theoretical concern based only on test-tube and animal work, and even those studies disagree with each other. For most people it likely won't cause trouble. Still, since amitriptyline already carries plenty of side effects, it's worth a quick chat with your pharmacist or doctor before pairing them, especially if you notice extra grogginess.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
  2. Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
Moderate

ANTICHOLINERGIC DRUGS

5 of 5

Amitriptyline also falls under ANTICHOLINERGIC DRUGS.

Theoretically, concurrent use might decrease the effectiveness of both agents.
Bacopa seems to inhibit acetylcholinesterase and might increase acetylcholine levels, which could counteract the effects of anticholinergic drugs. Similarly, anticholinergic drugs might counteract the cholinergic effects of bacopa.
Severity Moderate 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 simple version: amitriptyline (Elavil) has strong anticholinergic activity, meaning it dials down a brain and body messenger called acetylcholine. Bacopa seems to nudge things the opposite way, gently raising acetylcholine levels. So in theory, the two could partly cancel each other out, and you might not get the full benefit you're hoping for from either one.

I want to be honest about the strength of this, though. It's a theoretical concern based on how these work in the lab, not something well documented in people. Realistically, if any tug-of-war did happen, it would more likely show up as your amitriptyline simply working less well rather than new symptoms. Don't change anything on your own, but do give your pharmacist or prescriber a heads-up before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Morgan A, Stevens J. Does Bacopa monnieri improve memory performance in older persons? Results of a randomized, placebo-controlled, double-blind trial. J Altern Complement Med 2010;16:753-9.

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

Bacopa Also Interacts With Other Medications

Bacopa has 916 moderate, 13 minor known drug interactions in our database — the Amitriptyline one above is among them. If you take anything else, check it against the full list below.

Moderate 916 Minor 13 No known interaction 1,901 (incl. Amitriptyline)
Taking anything else?

Check Another of Your Medications Against Bacopa

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

From our Q&A

Questions About Bacopa or Amitriptyline

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Bacopa or Amitriptyline, 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 Amitriptyline

This page covers Bacopa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline page lists 296 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).

By severity: 17 major · 228 moderate · 51 minor.

From our pharmacist’s overview on the Amitriptyline page

“Amitriptyline (Elavil), an older antidepressant now often prescribed for nerve pain, migraines, and sleep, is one of the drugs I genuinely want patients to be careful with, and 17 of the 296 supplement and herbal ingredients on this list carry a major rating. Most of the serious ones deepen the drowsiness amitriptyline already causes,…”

Reviewed by 2 · Jul 18, 2026

Open the Amitriptyline interaction page

One more smart check

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

We hold 1,420 real supplement products containing Bacopa, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bacopa. Your product may carry other ingredients that interact with Amitriptyline too, on top of Bacopa — 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 Bacopa and Amitriptyline 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 Bacopa
Top 10%

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

29 days ago today
Medication Amitriptyline
Top 5%

#30 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 Bacopa

What is Bacopa?

Bacopa
  • Memory and cognitive support
  • Anxiety and stress
  • ADHD symptoms
  • Age-related memory decline
  • General brain health

Bacopa is an Ayurvedic herb most often used for memory and thinking. Some small studies suggest it may modestly help memory when taken regularly for several weeks, but the evidence is limited and quality varies. It is generally well tolerated but can cause stomach upset, and it should be avoided in pregnancy and breastfeeding due to a lack of safety data.

Read the full Bacopa monograph & all interactions
Medication

About Amitriptyline

What Is Amitriptyline Used For?

Brand name: Elavil

Amitriptyline tablets (sold as Amitriptyline HCL and Amitriptyline Hydrochloride) are used to relieve the symptoms of depression.

Endogenous depression is more likely to improve with this medicine than other types of depression.

See full Amitriptyline drug information
Keep checking

Other Drugs & Bacopa

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

0Major
916Moderate
13Minor
1,900No known interaction
916 Moderate 13 Minor 1,900 No interaction
Moderate

916 interactions

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

Minor

13 interactions

No interaction 1,900 drugs checked — show the list

We also checked Bacopa against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,900 medications checked with no known interaction — see the full Bacopa list.

See the full Bacopa interactions page
See every supplement checked against Amitriptyline, ranked by severity
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
Bacopa monograph › Uses, safety, and every drug interaction in one place Amitriptyline supplement interactions › Every supplement checked against Amitriptyline, ranked by severity Amitriptyline drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Bacopa and Amitriptyline Together: Common Questions

Can you take Bacopa with Amitriptyline?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 5 interactions listed for Bacopa and Amitriptyline?
Amitriptyline belongs to more than one drug category, and Bacopa interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Bacopa and Amitriptyline interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Amitriptyline and Bacopa?

Our pharmacists answer your medication & supplement questions — free.

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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.