Drug & supplement interaction

Calamus + Zolpidem Tartrate

Zolpidem Tartrate brand name: Ambien.

Moderate Interaction
The bottom line Moderate

Zolpidem Tartrate falls into 2 drug categories that Calamus can interact with; the most serious is rated moderate. Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.

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

Calamus and Zolpidem Tartrate

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

Why Are There 2 Interactions?

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

Moderate

CNS DEPRESSANTS

1 of 2

Why this applies to Zolpidem Tartrate

Zolpidem Tartrate falls under CNS DEPRESSANTS — the group Calamus interacts with.

Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Animal research shows that calamus is a CNS depressant and increases gamma-aminobutyric acid levels.
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: zolpidem (Ambien) already works by quieting down your brain so you can fall asleep. Calamus appears to do something similar in animal studies, where it acts like a calming agent and bumps up GABA, the same brain chemical zolpidem leans on. Stack the two and you may get more sedation than you bargained for, things like next-morning grogginess, dizziness, poor coordination, or feeling foggy and unsteady on your feet.

I'll be honest with you, this concern is theoretical and based mostly on lab and animal work, not human studies. Still, calamus has its own safety baggage (it's banned from foods in the U.S.), so I'd avoid it. Please check with your pharmacist or doctor before combining anything with your sleep medicine.

References
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Koo, B. S., Park, K. S., Ha, J. H., Park, J. H., Lim, J. C., and Lee, D. U. Inhibitory effects of the fragrance inhalation of essential oil from Acorus gramineus on central nervous system. Biol Pharm.Bull. 2003;26(7):978-982. PubMed
  3. Panchal, G. M., Venkatakrishna-Bhatt, H., Doctor, R. B., and Vajpayee, S. Pharmacology of Acorus calamus L. Indian J Exp.Biol 1989;27(6):561-567.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

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

Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
In vitro research shows that calamus extract inhibits CYP3A4 enzyme.
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

Your body relies on a liver enzyme called CYP3A4 to clear zolpidem (Ambien) out of your system. In lab studies, calamus appears to slow this same enzyme down. If that held true in people, your body would break zolpidem down more slowly, so more of it could linger in your bloodstream. That could mean a stronger or longer-lasting effect, with things like next-morning grogginess, dizziness, poor coordination, or feeling unusually sedated.

I want to be honest about the evidence here: this is only a theoretical concern based on test-tube research, not human studies. On top of that, calamus has real safety worries of its own and is best avoided. Please check with your pharmacist or doctor before combining them.

References
  1. Pandit S, Mukherjee PK, Ponnusankar S, Venkatesh M, Srikanth N. Metabolism mediated interaction of a-asarone and Acorus calamus with CYP3A4 and CYP2D6. Fitoterapia 2011;82(3):369-74.

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

Calamus Also Interacts With Other Medications

Calamus has 1,097 moderate, 19 minor known drug interactions in our database — the Zolpidem Tartrate one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Calamus

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

From our Q&A

Questions About Calamus or Zolpidem Tartrate

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

This page covers Calamus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Zolpidem Tartrate page lists 195 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), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

Open the Zolpidem Tartrate interaction page

One more smart check

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

We hold 71 real supplement products containing Calamus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Calamus. Your product may carry other ingredients that interact with Zolpidem Tartrate too, on top of Calamus — 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 Calamus and Zolpidem Tartrate 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 Calamus
Top half

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

29 days ago today
Medication Zolpidem Tartrate
Steady interest

#1,648 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 Calamus

What is Calamus?

Calamus
  • Digestive upset and gas
  • Loss of appetite
  • Memory and focus (traditional)
  • Coughs and colds
  • Calming or sedative effect (traditional)

Calamus is a swamp plant with a long history in Ayurvedic and traditional Chinese medicine, mostly for digestive and nervous-system complaints. However, it contains beta-asarone, a compound linked to cancer and other toxic effects in animal studies, which is why the U.S. FDA banned it from foods. Because of these safety concerns and a lack of solid human evidence, it is generally best avoided.

Read the full Calamus monograph & all interactions
Medication

About Zolpidem

What Is Zolpidem Used For?

Brand name: Ambien

Zolpidem is used short-term for insomnia. Most formulations — including Ambien, oral tablets, and Zolpidem Tartrate Capsules — are approved to help people who have trouble falling asleep at bedtime. Zolpidem Tartrate Capsules are specifically indicated for adults under 65.

The extended-release formulations (including Zolpidem Tartrate Extended-Release Tablets) help with both falling asleep and staying asleep through the night. Sublingual tablets (Edluar, Zolpidem Tartrate Sublingual Tablet, and Zolpidem tartrate sublingual) are taken as needed when you wake up in the middle of the night and cannot get back to sleep — but only if at least 4 hours of sleep time remain before you need to be up.

See full Zolpidem drug information
Keep checking

Other Drugs & Calamus

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

0Major
1,097Moderate
19Minor
1,713No known interaction
Moderate

1,097 interactions

Showing 60 of 1,097 moderate interactions — see all 1,097 on the Calamus page.

Minor

19 interactions

No interaction 1,713 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

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Pharmacist Counseling Corner

Taking Calamus and Zolpidem Tartrate Together: Common Questions

Can you take Calamus with Zolpidem Tartrate?
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 Calamus and Zolpidem Tartrate?
Zolpidem Tartrate belongs to more than one drug category, and Calamus 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 Calamus and Zolpidem Tartrate 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

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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.