Drug & supplement interaction

Cowhage + Tranylcypromine

Tranylcypromine brand name: Parnate.

Major Interaction
The bottom line Major

Cowhage has a major interaction with Tranylcypromine. Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.

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

Cowhage and Tranylcypromine

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

Major

MONOAMINE OXIDASE INHIBITORS (MAOIs)

Why this applies to Tranylcypromine

Tranylcypromine falls under MONOAMINE OXIDASE INHIBITORS (MAOIs) — the group Cowhage interacts with.

Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Cowhage contains levodopa. Use of levodopa with non-selective MAOIs might cause hypertensive crisis. However, this interaction has not been reported with MAO-B selective inhibitors such as selegiline.
Severity Major Likelihood Probable Evidence D

Interaction 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..

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

Here's the concern with this pairing. Cowhage seeds are loaded with natural L-dopa, which your body turns into dopamine and related chemicals. Tranylcypromine (Parnate) is a non-selective MAOI, meaning it blocks the enzyme that normally breaks those chemicals back down. Put the two together and that dopamine activity can pile up instead of being cleared, which is what raises the worry for a hypertensive crisis, a sudden dangerous spike in blood pressure with pounding headache, chest pain, sweating, or a racing heart.

I want to be honest that this is a theoretical caution based on how these drugs work, not a flood of real-world reports. Still, because MAOIs already come with strict food and supplement rules, this is one I'd take seriously. Please don't start cowhage without first checking with your doctor or pharmacist.

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 16 major, 176 moderate known drug interactions in our database — the Tranylcypromine 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 Tranylcypromine

This page covers Cowhage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tranylcypromine page lists 81 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Bitter Orange (major), Brewer's Yeast (major) and Fever Bark (major).

By severity: 14 major · 55 moderate · 12 minor.

From our pharmacist’s overview on the Tranylcypromine page

“Tranylcypromine (Parnate) belongs to the MAOI class of antidepressants, and I read its supplement list with real seriousness, since the highest-rated entries can turn dangerous quickly. The drug blocks the enzyme that normally clears tyramine, so tyramine-rich items like brewer's yeast, fermented soy, and even beer or wine can push blo…”

Reviewed by 2 · Jul 18, 2026

Open the Tranylcypromine 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 Tranylcypromine 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 Tranylcypromine 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%

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

29 days ago today
Medication Tranylcypromine
Top half

#1,395 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 Tranylcypromine

What Is Tranylcypromine Used For?

Brand name: Parnate

Tranylcypromine tablets — sold as Parnate, Tranylcypromine, and Tranylcypromine Sulfate — are used to treat major depressive disorder (MDD) in adults. It is not a first-choice antidepressant; it is specifically for people who have already tried other antidepressants and have not gotten adequate relief.

Because of its serious potential side effects, strict dietary requirements, and many drug interactions, tranylcypromine is reserved for cases where other treatments have not worked. It is not approved for use in children.

See full Tranylcypromine 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 Tranylcypromine Together: Common Questions

Can you take Cowhage with Tranylcypromine?
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 Tranylcypromine 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.