Drug & supplement interaction

Bael + Donepezil (patch)

Donepezil (patch) brand name: Adlarity.

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

Donepezil (patch) falls into 2 drug categories that Bael can interact with; the most serious is rated moderate. Bael leaf extract shows acetylcholinesterase (AChE) inhibitory activity in vitro.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bael and Donepezil (patch)

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Bael interacts with whole categories of medication. Donepezil (patch) falls into 2 of those categories, so it can interact with Bael in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CHOLINERGIC DRUGS

1 of 2

Why this applies to Donepezil (patch)

Donepezil (patch) falls under CHOLINERGIC DRUGS — the group Bael interacts with.

Bael leaf extract shows acetylcholinesterase (AChE) inhibitory activity in vitro. Theoretically, bael might have additive effects with cholinergic drugs and increase the risk of cholinergic side effects.
Cholinergic drugs include bethanechol (Urecholine), donepezil (Aricept), echothiophate (Phospholine Iodide), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmin), physostigmine (Antilirium), pyridostigmine (Mestinon, Regonol), succinylcholine (Anectine, Quelicin), and tacrine (Cognex).
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 donepezil patch (Adlarity) works by blocking an enzyme called acetylcholinesterase, which boosts a brain chemical that helps with memory in Alzheimer's disease. In lab tests, bael leaf extract seems to block that same enzyme. So on paper, pairing them could stack up their effects and push you toward too much cholinergic activity.

What that might feel like: more nausea, diarrhea, stomach cramps, extra drooling or sweating, a slower heartbeat, or muscle twitching. Now, the honest part: this is only a theoretical concern based on test-tube work, not real patient reports, and everyday culinary amounts of bael fruit are unlikely to matter. Still, before adding a concentrated bael supplement, please check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Asaduzzaman M, Uddin MJ, Kader MA, et al. In vitro acetylcholinesterase inhibitory activity and the antioxidant properties of Aegle marmelos leaf extract: implications for the treatment of Alzheimer's disease. Psychogeriatrics. 2014;14(1):1-10.
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

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

Bael and its constituents marmelosin and marmesinin inhibited cytochrome P450 3A4 (CYP3A4) activity in vitro. So far, this interaction has not been reported in humans. Theoretically, bael might increase levels of drugs metabolized by CYP3A4.
Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others. Use bael cautiously or avoid in patients taking these drugs.
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 for your donepezil patch (Adlarity). Your body clears donepezil partly through a liver enzyme called CYP3A4. In lab studies, bael and a couple of its compounds seemed to slow that enzyme down. If that also happened in people, donepezil could build up a bit more than expected, which might mean stronger side effects like nausea, diarrhea, stomach upset, a slower heartbeat, dizziness, or trouble sleeping.

Now the reassuring part: this is only test-tube evidence, it has never actually been reported in humans, and the interaction is rated minor. Donepezil is a regular drug (not a prodrug), so the direction here would be more effect, not less. Occasional bael as a food is unlikely to matter, but before using concentrated bael supplements, please check with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Manda VK, Avula B, Chittiboyina AG, Khan IA, Walker LA, Khan SI. Inhibition of CYP3A4 and CYP1A2 by Aegle marmelos and its constituents. Xenobiotica. 2016;46(2):117-25.

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

Bael Also Interacts With Other Medications

Bael has 110 moderate, 710 minor known drug interactions in our database — the Donepezil (patch) one above is among them. If you take anything else, check it against the full list below.

Moderate 110 Minor 710 No known interaction 2,010 (incl. Donepezil (patch))
Taking anything else?

Check Another of Your Medications Against Bael

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

Everything else you take

See Every Supplement That Interacts With Donepezil (patch)

This page covers Bael only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Donepezil (patch) page lists 156 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Grapefruit (major), St. John's Wort (major), 1,3-dmaa (moderate), Acacia Rigidula (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 2 major · 120 moderate · 34 minor.

From our pharmacist’s overview on the Donepezil (patch) page

“If someone you care for wears the donepezil patch (Adlarity) for Alzheimer's disease, take a hard look at this list before adding any supplement, starting with the two rated major. Grapefruit can push donepezil levels up and St.”

Reviewed by 2 · Jul 18, 2026

Open the Donepezil (patch) interaction page

One more smart check

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

We hold 94 real supplement products containing Bael, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bael. Your product may carry other ingredients that interact with Donepezil (patch) too, on top of Bael — 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 Bael and Donepezil (patch) 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 Bael
Top half

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

29 days ago today
Medication Donepezil (patch)
Steady interest

#1,508 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 Bael

What is Bael?

Bael
  • Diarrhea and dysentery
  • Indigestion and other digestive complaints
  • Constipation
  • Blood sugar support
  • General wellness in traditional medicine

Bael is a fruit-bearing tree long used in traditional Indian (Ayurvedic) medicine, mostly for digestive problems like diarrhea and indigestion. Modern human evidence for its medicinal benefits is very limited, so it should be viewed mainly as a food and traditional remedy rather than a proven treatment. Talk to your pharmacist or doctor before using bael as a supplement, especially if you are pregnant, breastfeeding, or have a health condition.

Read the full Bael monograph & all interactions
Keep checking

Other Drugs & Bael

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

0Major
110Moderate
710Minor
2,009No known interaction
110 Moderate 710 Minor 2,009 No interaction
Moderate

110 interactions

Showing 60 of 110 moderate interactions — see all 110 on the Bael page.

Minor

710 interactions

Showing 60 of 710 minor interactions — see all 710 on the Bael page.

No interaction 2,009 drugs checked — show the list

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

Showing the 60 most looked-up of 2,009 medications checked with no known interaction — see the full Bael list.

See the full Bael interactions page
See every supplement checked against Donepezil (patch), 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
Bael monograph › Uses, safety, and every drug interaction in one place Donepezil (patch) supplement interactions › Every supplement checked against Donepezil (patch), ranked by severity 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 Bael and Donepezil (patch) Together: Common Questions

Can you take Bael with Donepezil (patch)?
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 2 interactions listed for Bael and Donepezil (patch)?
Donepezil (patch) belongs to more than one drug category, and Bael 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 Bael and Donepezil (patch) 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 Donepezil (patch) and Bael?

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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.