Drug & supplement interaction

Cowhage + Sevoflurane

Sevoflurane brand name: Ultane.

Moderate Interaction
The bottom line Moderate

Cowhage has a moderate interaction with Sevoflurane. 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 Sevoflurane

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

Moderate

ANESTHESIA

Why this applies to Sevoflurane

Sevoflurane 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

Here's the concern with cowhage and sevoflurane, the gas anesthetic used to keep you asleep during surgery. Cowhage seeds naturally contain L-dopa, the same compound the body turns into dopamine. Extra dopamine activity can make the heart more electrically jumpy, and certain inhaled anesthetics (the older halogenated ones) have been tied to irregular heartbeats (arrhythmias) when L-dopa is on board. Sevoflurane is a modern halogenated agent, so the theoretical worry carries over to it.

Keep in mind this is based only on scattered, anecdotal reports, not strong studies, and other anesthetics haven't shown the same problem. Still, surgery is no time to guess. Tell your anesthesiologist and surgeon you take cowhage. They often have patients stop it about two weeks before surgery, but let your care team make that call.

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 Sevoflurane 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 Sevoflurane

This page covers Cowhage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sevoflurane page lists 22 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Fever Bark (major), Cannabis (moderate), Coffee Charcoal (moderate) and Datura Wrightii (moderate).

By severity: 2 major · 11 moderate · 9 minor.

From our pharmacist’s overview on the Sevoflurane page

“Fever bark is the supplement I would want disclosed first before anyone receives sevoflurane (Ultane), the inhaled anesthetic used during surgery. Its reserpine content has been tied to unstable heart function and circulation under general anesthesia, earning one of two major ratings among the 22 ingredients on this page.”

Reviewed by 2 · Jul 18, 2026

Open the Sevoflurane 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 Sevoflurane 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 Sevoflurane 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 Sevoflurane
Steady interest

#1,554 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
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 Sevoflurane Together: Common Questions

Can you take Cowhage with Sevoflurane?
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 Sevoflurane 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.