Drug & supplement interaction

Eurycoma Longifolia + Esketamine

Esketamine brand name: Spravato.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Eurycoma Longifolia and Esketamine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Eurycoma Longifolia and Esketamine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Esketamine and Eurycoma Longifolia in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Eurycoma Longifolia safety at a glance

Eurycoma Longifoli... overall Use caution Generally tolerated short-term in studies, but long-term safety and product quality are uncertain.
Pregnancy Avoid Not enough safety data and possible hormonal effects, so avoid during pregnancy.
Breastfeeding Avoid No reliable safety information, so it is best to avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Pharmacist analysis

Although there is no known interaction in this case, Eurycoma longifolia, most commonly known as Tongkat Ali, does have some potential interactions that are important to be aware of.

For example, it may interact with the following:

  • CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
  • CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
  • CYTOCHROME P450 2A6 (CYP2A6) SUBSTRATES
  • Propranolol
  • Testosterone

Tongkat Ali has been reported to inhibit certain metabolizing enzymes in the liver (the ones mentioned above) and therefore, may increase the levels of substances metabolized by those enzymes. This could potentially affect the way these substances work or how long they stay in your system.

In regard to propranolol, some studies show that Tongkat Ali decreases how well propranolol is absorbed in the gut and could reduce its effects. It is not known if separating administration will prevent this interaction/

Lastly, testosterone, Tongkat Ali may theoretically further increase levels of testosterone, a hormone responsible for various functions in the body. You should be cautious combining the two.

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Still wondering about combining Esketamine and Eurycoma Longifolia? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Esketamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Esketamine is filed under 2 classifications — tricyclic antidepressants (tcas), antidepressant drugs. Eurycoma Longifolia has documented interactions with 5 drug classes — the most serious being propranolol (inderal) (moderate), cytochrome p450 1a2 (cyp1a2) substrates (minor) and cytochrome p450 2a6 (cyp2a6) substrates (minor) — and none of Esketamine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Eurycoma Longifolia Does Interact With Other Medications

Eurycoma Longifolia has 3 moderate, 245 minor known drug interactions in our database — Esketamine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 3 Minor 245 No known interaction 2,582 (incl. Esketamine)
Taking anything else?

Check Another of Your Medications Against Eurycoma Longifolia

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

What to actually watch for

What Eurycoma Longifolia Itself Has Been Linked To

This is not an interaction — nothing below involves Esketamine. It is the side-effect record for Eurycoma Longifolia on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Eurycoma Longifolia, this list is the first place to look. One entry is worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    “Some research in both humans and animals suggests that Eurycoma longifolia might increase testosterone levels. If testosterone levels are increased beyond the normal range, there is risk of testosterone-related side effects which could include acne, insulin resistance, hepatotoxicity, and others.”

    Eurycoma Longifolia · Natural Medicines adverse-effect record, reported in acne.

    1 source cited
    1. 17924. Tambi MI, Imran MK, Henkel RR. Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Andrologia 2011 Jun 15. doi: 10.1111/j.1439-0272.2011.01168.x. [Epub ahead of pri PubMed
  • Acne Additional detail

    Recorded for Eurycoma Longifolia in the same Natural Medicines adverse-effect record shown under Liver problems above.

Everything above comes from the Natural Medicines adverse-effect record for Eurycoma Longifolia — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Esketamine’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Esketamine column appears here.

Everything else you take

See Every Supplement That Interacts With Esketamine

This page covers Eurycoma Longifolia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esketamine page lists 11 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Scopolia (major), Cowhage (moderate), Dhea (moderate), Griffonia Simplicifolia (moderate) and Indian Snakeroot (moderate).

By severity: 1 major · 6 moderate · 4 minor.

From our pharmacist’s overview on the Esketamine page

“Esketamine (Spravato) is the nasal spray for depression that hasn't responded to standard treatment, and its supplement list deserves genuine respect. Scopolia carries the only major rating and is the entry to understand before any other; pairing it with the medication can raise the risk of anticholinergic effects, meaning dry mouth, b…”

Reviewed by 2 · Jul 18, 2026

Open the Esketamine interaction page

One more smart check

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

We hold 1,122 real supplement products containing Eurycoma Longifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eurycoma Longifolia. Even though Eurycoma Longifolia itself has no known interaction with Esketamine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Eurycoma Longifolia and Esketamine 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 Eurycoma Longifolia
Top 10%

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

29 days ago today
Medication Esketamine
Steady interest

#2,264 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Eurycoma Longifolia reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Eurycoma Longifolia and Esketamine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Eurycoma Longifolia

What is Eurycoma Longifolia?

Eurycoma Longifolia
  • Low testosterone or low libido in men
  • Male fertility support
  • Athletic performance and muscle strength
  • Energy and fatigue
  • Stress and mood
  • General male enhancement

Eurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small human studies suggesting possible benefits. However, the overall evidence is still limited and product quality varies widely, so talk with your pharmacist or doctor before using it, and avoid it if you are pregnant or breastfeeding.

Eurycoma longifolia · Simaroubaceae · Root (and root extracts) · Capsules, tablets, powder, extracts, teas, and blended supplement products

An interaction check asks whether these two react with each other — it does not ask whether Eurycoma Longifolia is a good idea for someone in your situation. Here is what our Eurycoma Longifolia record says about it on its own.

Eurycoma Longifolia: dosing

There is no official or universally agreed-upon dose for Eurycoma longifolia. Studies have used different standardized extracts at different strengths, which makes it hard to recommend one specific amount.The best approach is to follow the directions on the product label and not exceed them.

From our Eurycoma Longifolia monograph — the full record covers uses, side effects and every documented interaction.

Read the full Eurycoma Longifolia monograph & all interactions
Medication

About Esketamine Nasal Spray

What Is Esketamine Nasal Spray Used For?

Brand name: Spravato

Spravato (esketamine) nasal spray is approved for two uses in adults. First, it treats treatment-resistant depression (TRD) — depression that has not responded to other antidepressants — either on its own or alongside an oral antidepressant. Second, it treats depressive symptoms in adults with major depressive disorder (MDD) who have acute suicidal ideation or behavior, always used together with an oral antidepressant.

Important limitations: Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behavior directly. Even if you feel better after an early dose, hospitalization may still be needed if your doctor determines it's necessary. Spravato is not approved for use in children or as an anesthetic.

Most-Reported Side Effects for Esketamine

From FAERS, the FDA’s public side-effect reporting system (17,728 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dissociation 3,733 reports
Sedation 2,706 reports
Suicidal ideation 1,351 reports
Nausea 957 reports
Depression 873 reports
See full Esketamine Nasal Spray drug information
Keep checking

Other Drugs & Eurycoma Longifolia

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

0Major
3Moderate
245Minor
2,581No known interaction
3 Moderate 245 Minor 2,581 No interaction
Moderate

3 interactions

Minor

245 interactions

Showing 60 of 245 minor interactions — see all 245 on the Eurycoma Longifolia page.

No interaction 2,581 drugs checked — show the list

We also checked Eurycoma Longifolia against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,581 medications checked with no known interaction — see the full Eurycoma Longifolia list.

See the full Eurycoma Longifolia interactions page
See every supplement checked against Esketamine, ranked by severity
Evidence & sources

Eurycoma Longifolia References

The 4 references that drive our Eurycoma Longifolia monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Salman SA, Amrah S, Wahab MS, et al. Modification of propranolol's bioavailability by Eurycoma longifolia water-based extract. J Clin Pharm Ther 2010;35:691-6. PubMed
  2. Tambi MI, Imran MK, Henkel RR. Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Andrologia 2011 Jun 15. doi: 10.1111/j.1439-0272.2011.01168.x. [Epub ahead of pri PubMed
  3. Han YM, Kim IS, Rehman SU, Choe K, Yoo HH. In vitro evaluation of the effects of Eurycoma longifolia extract on CYP-mediated drug metabolism. Evid Based Complement Alternat Med 2015;2015:631329.
  4. Chinnappan SM, George A, Pandey P, Narke G, Choudhary YK. Effect of Eurycoma longifolia standardised aqueous root extract-Physta ® on testosterone levels and quality of life in ageing male subjects: a randomised, double-blind, placebo-controlled multicent

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Eurycoma Longifolia and Esketamine Together: Common Questions

Is it safe to take Eurycoma Longifolia with Esketamine?
We do not list a known interaction between Eurycoma Longifolia and Esketamine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
How was the Eurycoma Longifolia and Esketamine combination checked?
Interactions in our licensed database are recorded against drug classes. Esketamine is filed under 2 classifications, and Eurycoma Longifolia has documented interactions with 5 drug classes — none of Esketamine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Eurycoma Longifolia interact with any other medications?
Yes. Eurycoma Longifolia has 248 documented drug interactions in our database — Esketamine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Esketamine interact with any supplements?
Yes. Esketamine has documented interactions with 11 supplements in our database — Eurycoma Longifolia is not one of them. The Esketamine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Eurycoma Longifolia monograph Uses, safety profile, and every drug interaction in one place Esketamine Nasal Spray drug information The full plain-English guide to this medication Esketamine supplement interactions Every supplement checked against Esketamine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 4 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Esketamine and Eurycoma Longifolia?

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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.