Drug & supplement interaction

Cowhage + Carbidopa, Levodopa

Carbidopa, Levodopa brand names: Sinemet CR, Sinemet, Rytary, Dhivy.

Major Interaction
The bottom line Major

Cowhage has a major interaction with Carbidopa, Levodopa. Concomitant use can increase the risk of levodopa-related adverse effects.

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

Cowhage and Carbidopa, Levodopa

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

Major

LEVODOPA

Why this applies to Carbidopa, Levodopa

Carbidopa, Levodopa falls under LEVODOPA — the group Cowhage interacts with.

Concomitant use can increase the risk of levodopa-related adverse effects.
Cowhage contains levodopa. Some cowhage products have been standardized to contain 75-400 mg of levodopa per dose.
Severity Major Likelihood Likely Evidence D

Well-controlled human studies have demonstrated the likely existence of this interaction.

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

Here's the simple version: cowhage seeds naturally contain L-dopa, which is the same active ingredient as the levodopa in your Sinemet or Rytary. So taking cowhage alongside your medicine is a bit like quietly adding an extra, unmeasured dose on top of what your doctor prescribed. Standardized cowhage products can pack anywhere from 75 to 400 mg of levodopa per dose, which is not trivial.

Because you're stacking two sources of the same drug, the worry is too much levodopa effect. That can mean nausea, dizziness or lightheadedness when standing, a fast or irregular heartbeat, and involuntary jerky movements (dyskinesias). This concern is based on pharmacology rather than a pile of studies, but it makes good sense. Please don't add cowhage without checking with your doctor or pharmacist first.

References
  1. HP-200 in Parkinson's Disease study group. An alternative medicine treatment for Parkinson's disease: Results of a multicenter clinical trial. J Alt Comp Med 1995;1:249-55. DOI
  2. Vadivel V, Janardhanan K. Nutritional and anti-nutritional composition of velvet bean: an under-utilized food legume in south India. Int J Food Sci Nutr 2000;51:279-87. PubMed
  3. Prakash, D., Niranjan, A., and Tewari, S. K. Some nutritional properties of the seeds of three Mucuna species. Int.J.Food Sci.Nutr. 2001;52(1):79-82.
  4. Vadivel, V. and Janardhanan, K. Nutritional and antinutritional characteristics of seven South Indian wild legumes. Plant Foods Hum.Nutr 2005;60(2):69-75. PubMed
  5. Creapure (Creatine Monohydrate). Toxicological Datasheet. Degussa BioActives. Available at: https://www.fda.gov/ohrms/DOCKETS/.../95s-0316-rpt0154-54-Ref-50-vol112.pdf.
  6. Pulikkalpura H, Kurup R, Mathew PJ, Baby S. Levodopa in Mucuna pruriens and its degradation. Sci Rep 2015;5:11078. 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

Cowhage Also Interacts With Other Medications

Cowhage has 16 major, 176 moderate known drug interactions in our database — the Carbidopa, Levodopa 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 Cowhage

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

Everything else you take

See Every Supplement That Interacts With Carbidopa, Levodopa

This page covers Cowhage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Carbidopa, Levodopa page lists 43 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Branched-chain Amino Acids (bcaa) (major), Indian Snakeroot (major), Magnesium (major) and Phenylalanine (major).

By severity: 8 major · 24 moderate · 11 minor.

From our pharmacist’s overview on the Carbidopa, Levodopa page

“Carbidopa/levodopa (Sinemet, Rytary) anchors Parkinson's treatment, and because symptom control hinges on how much levodopa actually reaches the brain, the 43 supplements and herbs on this list deserve real respect before you add any of them. Eight carry a major rating, and almost all of the serious entries weaken the drug rather than…”

Reviewed by 2 · Jul 18, 2026

Open the Carbidopa, Levodopa interaction page

One more smart check

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

We hold 1,218 real supplement products containing Cowhage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cowhage. Your product may carry other ingredients that interact with Carbidopa, Levodopa too, on top of Cowhage — 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 Cowhage and Carbidopa, Levodopa 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 Cowhage
Top 10%

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

29 days ago today
Medication Carbidopa, Levodopa
Top 5%

#77 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 Cowhage

What is Cowhage?

  • Parkinson's disease symptoms
  • Male fertility and libido
  • Mood and stress support
  • Traditional aphrodisiac
  • General energy and vitality

Cowhage (Mucuna pruriens) is a tropical legume best known as a natural source of L-dopa, the compound the body turns into dopamine. It is most studied for Parkinson's disease symptoms and male fertility, but evidence is still limited and the L-dopa content makes it potentially powerful and risky—talk to your doctor or pharmacist before using it.

Read the full Cowhage monograph & all interactions
Medication

About Levodopa and Carbidopa

What Is Levodopa and Carbidopa Used For?

Brand names: Sinemet CR, Sinemet, Rytary, Dhivy

Levodopa and carbidopa is used to treat Parkinson's disease, post-encephalitic parkinsonism (parkinsonism that develops after a brain infection), and symptomatic parkinsonism that can follow carbon monoxide or manganese poisoning. These indications are shared across the oral tablet, orally disintegrating tablet, extended-release tablet, and extended-release capsule formulations (including Sinemet, Rytary, Crexont, and generic products).

DUOPA — a carbidopa/levodopa suspension given through a tube directly into the small intestine — is specifically indicated for the treatment of motor fluctuations in patients with advanced Parkinson's disease. This is a product-specific indication and does not apply to the oral forms.

See full Levodopa and Carbidopa drug information
Keep checking

Other Drugs & Cowhage

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

16Major
176Moderate
0Minor
2,637No known interaction
Major

16 interactions

Moderate

176 interactions

Showing 60 of 176 moderate interactions — see all 176 on the Cowhage page.

No interaction 2,637 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 Cowhage and Carbidopa, Levodopa Together: Common Questions

Can you take Cowhage with Carbidopa, Levodopa?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Cowhage and Carbidopa, Levodopa interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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.