Drug & supplement interaction

German Chamomile + Amitriptyline

Amitriptyline brand name: Elavil.

Moderate Interaction
The bottom line Moderate

Amitriptyline falls into 5 drug categories that German Chamomile can interact with; the most serious is rated moderate. Theoretically, German chamomile might have additive effects when used with CNS depressants.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions5
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

German Chamomile and Amitriptyline

These two interact in 5 distinct ways. Each one is explained separately below.

Why Are There 5 Interactions?

German Chamomile interacts with whole categories of medication. Amitriptyline falls into 5 of those categories, so it can interact with German Chamomile in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 5

Why this applies to Amitriptyline

Amitriptyline falls under CNS DEPRESSANTS — the group German Chamomile interacts with.

Theoretically, German chamomile might have additive effects when used with CNS depressants.
German chamomile has mild sedative effects. Theoretically, concomitant use with drugs with sedative properties can cause additive effects and side effects.
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 simple version: amitriptyline already tends to make people drowsy, especially when you first start it or take it at night. German chamomile, usually sipped as a tea, has its own mild calming, sleepy effect. Put the two together and those effects can stack, so you might feel more groggy, foggy, or sluggish than usual the next day.

I want to be honest about the evidence here. This concern comes mainly from lab and animal data, so it's more of a theoretical heads-up than a proven problem, and a cup of chamomile tea is unlikely to cause trouble for most folks. Stronger concentrated supplement doses are where I'd be a bit more careful. If you notice extra drowsiness or feel unsteady, check in with your pharmacist or doctor before changing anything.

References
  1. Viola H, Wasowski C, Levi de Stein M, et al. Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Med 1995;61:213-6.
  2. Avallone R, Zanoli P, Puia G, et al. Pharmacological profile of apigenin, a flavonoid isolated from Matricaria chamomilla. Biochem Pharmacol 2000;59:1387-94. PubMed
  3. Loggia RD, Traversa U, Scarcia V, et al. Depressive effects of Chamomilla recutita (L.) Rausch, tubular flowers, on central nervous system in mice. Pharmacol Res Commun 1982;14(2):153-162. PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 5

Amitriptyline also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2D6. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2D6 in patients taking German chamomile.
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 short version: your body uses an enzyme called CYP2D6 to help break down amitriptyline and clear it out. Lab studies suggest German chamomile may slow that enzyme down a bit. If that happens, amitriptyline could build up more than usual, which can mean stronger side effects like drowsiness, dry mouth, constipation, blurry vision, dizziness when standing, or a faster heartbeat.

The important thing to know is that this is theoretical. It has only been seen in test-tube research, not in real people, so an occasional cup of chamomile tea is unlikely to cause trouble. Still, since amitriptyline already causes plenty of these effects on its own, it's worth mentioning to your pharmacist or doctor, especially if you use concentrated chamomile supplements daily.

References
  1. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

3 of 5

Amitriptyline also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2C9. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2C9 in patients taking German chamomile.
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 gist: amitriptyline is partly broken down by a liver enzyme called CYP2C9. German chamomile, in lab studies, seems able to slow that enzyme down. If that happened in your body, amitriptyline could clear out a little more slowly and build up, which may mean stronger effects and more of its usual side effects, things like drowsiness, dry mouth, constipation, blurry vision, or feeling lightheaded when you stand up.

The important part to keep in perspective: this is only seen in test-tube research and hasn't actually been reported in people. An occasional cup of chamomile tea is unlikely to cause trouble. Still, if you take concentrated chamomile supplements regularly, it's worth a quick chat with your pharmacist or doctor before mixing them.

References
  1. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

4 of 5

Amitriptyline also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.
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 gist for amitriptyline (Elavil): your body uses a liver enzyme called CYP3A4 to help break it down. In test-tube studies, German chamomile appears to slow that enzyme down a bit. If that happened in real life, amitriptyline could clear more slowly and build up, which might bump up its usual side effects like drowsiness, dry mouth, constipation, blurred vision, or feeling lightheaded when you stand.

That said, I want to keep this in perspective. This is theoretical, based only on lab work, and it has not actually been reported in people. An occasional cup of chamomile tea is unlikely to cause trouble for most folks. Concentrated chamomile supplements are a bigger unknown. Before adding either one regularly, it's worth a quick chat with your pharmacist or doctor.

References
  1. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  2. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

5 of 5

Amitriptyline also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
In vitro and animal research shows that German chamomile might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP1A2 in patients taking German chamomile.
Severity Minor 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 gist: your body uses several liver enzymes, including one called CYP1A2, to break down amitriptyline. Lab and animal studies hint that German chamomile might slow CYP1A2 down a little. If that happened in people, amitriptyline could clear out a bit more slowly and build up, which might make its usual side effects more noticeable, things like drowsiness, dry mouth, constipation, blurry vision, or feeling lightheaded when you stand up.

The honest part: this is only a theoretical concern based on test-tube and animal work, and it hasn't actually been seen in humans. A cup or two of chamomile tea is unlikely to cause trouble for most folks. Still, since amitriptyline can cause heavy sedation, it's worth a quick chat with your pharmacist or doctor, especially with concentrated chamomile supplements.

References
  1. Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
  2. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. 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

German Chamomile Also Interacts With Other Medications

German Chamomile has 924 moderate, 35 minor known drug interactions in our database — the Amitriptyline one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against German Chamomile

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

From our Q&A

Questions About German Chamomile or Amitriptyline

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers German Chamomile or Amitriptyline, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Amitriptyline

This page covers German Chamomile only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline page lists 296 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).

By severity: 17 major · 228 moderate · 51 minor.

From our pharmacist’s overview on the Amitriptyline page

“Amitriptyline (Elavil), an older antidepressant now often prescribed for nerve pain, migraines, and sleep, is one of the drugs I genuinely want patients to be careful with, and 17 of the 296 supplement and herbal ingredients on this list carry a major rating. Most of the serious ones deepen the drowsiness amitriptyline already causes,…”

Reviewed by 2 · Jul 18, 2026

Open the Amitriptyline interaction page

One more smart check

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

We hold 782 real supplement products containing German Chamomile, each one broken down to its full ingredient list — and combination products often carry several ingredients besides German Chamomile. Your product may carry other ingredients that interact with Amitriptyline too, on top of German Chamomile — 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 German Chamomile and Amitriptyline 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 German Chamomile
Top 25%

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

29 days ago today
Medication Amitriptyline
Top 5%

#49 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 German Chamomile

What is German Chamomile?

German Chamomile
  • Anxiety and stress
  • Sleep and relaxation
  • Digestive upset
  • Skin irritation and inflammation
  • Mouth sores and gum irritation

German chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin or digestive issues, but the evidence is limited and most uses are based on tradition rather than strong proof. It is generally well tolerated, but people allergic to ragweed or related plants and those who are pregnant should be cautious.

Read the full German Chamomile monograph & all interactions
Medication

About Amitriptyline

What Is Amitriptyline Used For?

Brand name: Elavil

Amitriptyline HCL and Amitriptyline Hydrochloride tablets are used to relieve symptoms of depression. Depression that originates from within the body (called endogenous depression) tends to respond better than other types of depression.

See full Amitriptyline drug information
Keep checking

Other Drugs & German Chamomile

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

0Major
924Moderate
35Minor
1,870No known interaction
Moderate

924 interactions

Showing 60 of 924 moderate interactions — see all 924 on the German Chamomile page.

Minor

35 interactions

No interaction 1,870 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 German Chamomile and Amitriptyline Together: Common Questions

Can you take German Chamomile with Amitriptyline?
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.
Why are there 5 interactions listed for German Chamomile and Amitriptyline?
Amitriptyline belongs to more than one drug category, and German Chamomile interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the German Chamomile and Amitriptyline 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

Still Have a Question About Amitriptyline and German Chamomile?

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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.