Drug & supplement interaction

Cowhage + Etomidate

Etomidate brand name: Amidate.

Moderate Interaction
The bottom line Moderate

Cowhage has a moderate interaction with Etomidate. Theoretically, concomitant use of cowhage and anesthesia might increase the risk of arrhythmias.

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

Cowhage and Etomidate

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

Moderate

ANESTHESIA

Why this applies to Etomidate

Etomidate falls under ANESTHESIA — the group Cowhage interacts with.

Theoretically, concomitant use of cowhage and anesthesia might increase the risk of arrhythmias.
Cowhage contains levodopa. Use of levodopa with cyclopropane or halogenated hydrocarbon anesthesia has led to arrhythmias. Other anesthetics have not been implicated. Use other anesthetics in patients taking cowhage or tell patients to stop taking cowhage at least 2 weeks before surgery.
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

Etomidate is a fast-acting medication used to put you to sleep at the start of anesthesia, usually given in the hospital or operating room. Cowhage is a natural source of levodopa, and there is a theoretical concern that mixing levodopa with certain anesthesia could nudge the heart toward an irregular rhythm (an arrhythmia).

Here is the honest picture: this worry comes mainly from older anesthetics like cyclopropane and some halogenated gases, not etomidate itself. Etomidate has not been linked to this problem, and the evidence overall is weak and anecdotal. Still, the safe habit is simple. If you take cowhage and have surgery coming up, tell your anesthesiologist and pharmacist ahead of time. They may ask you to pause cowhage for about two weeks before your procedure.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. 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
  3. 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
  4. 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.
  5. 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
  6. Creapure (Creatine Monohydrate). Toxicological Datasheet. Degussa BioActives. Available at: https://www.fda.gov/ohrms/DOCKETS/.../95s-0316-rpt0154-54-Ref-50-vol112.pdf.
  7. 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 17 major, 175 moderate known drug interactions in our database — the Etomidate 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 Etomidate

This page covers Cowhage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Etomidate page lists 5 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Fever Bark (major), Cannabis (moderate), Datura Wrightii (moderate) and Delta-9-tetrahydrocannabinol (thc) (moderate).

By severity: 1 major · 4 moderate.

From our pharmacist’s overview on the Etomidate page

“Etomidate is not a pill you take at home. It is an intravenous drug used to put you under quickly for surgery or emergency procedures, and that shapes what this short list of five interacting supplements means.”

Reviewed by 2 · Jul 18, 2026

Open the Etomidate 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 Etomidate 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 Etomidate 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%

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

29 days ago today
Medication Etomidate
Steady interest

#1,515 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 Etomidate

What Is Etomidate Used For?

Brand name: Amidate

Etomidate — available as Amidate and under the generic name Etomidate — is given by intravenous (IV) injection to induce general anesthesia before surgery or other procedures. It brings on unconsciousness rapidly, usually within about one minute.

Amidate and etomidate injection products are also used to supplement weaker anesthetic agents, such as nitrous oxide in oxygen, during short operative procedures — for example, dilation and curettage (D&C) or cervical conization. This supplemental use is supported only for adult patients in short procedures; it is not recommended for longer procedures or for pediatric patients.

See full Etomidate 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.

17Major
175Moderate
0Minor
2,637No known interaction
Major

17 interactions

Moderate

175 interactions

Showing 60 of 175 moderate interactions — see all 175 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 Etomidate Together: Common Questions

Can you take Cowhage with Etomidate?
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.
How serious is the Cowhage and Etomidate 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.