Drug & supplement interaction

Hops + Amitriptyline, Chlordiazepoxide

Amitriptyline, Chlordiazepoxide brand name: Limbitrol DS.

Moderate Interaction
The bottom line Moderate

Amitriptyline, Chlordiazepoxide falls into 3 drug categories that Hops can interact with; the most serious is rated moderate. Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hops and Amitriptyline, Chlordiazepoxide

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Hops interacts with whole categories of medication. Amitriptyline, Chlordiazepoxide falls into 3 of those categories, so it can interact with Hops in 3 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 3

Why this applies to Amitriptyline, Chlordiazepoxide

Amitriptyline, Chlordiazepoxide falls under CNS DEPRESSANTS — the group Hops interacts with.

Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Some animal research shows that hops has sedative 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 thing to keep in mind with this combo. Limbitrol DS pairs amitriptyline (a sedating antidepressant) with chlordiazepoxide (a benzodiazepine), and both already tend to make people drowsy. Hops are taken for sleep and relaxation, so stacking them on top could add to that calming effect. You might notice extra grogginess, deeper drowsiness, dizziness, trouble concentrating, or feeling unsteady on your feet.

I want to be honest that this concern is theoretical, based mostly on how hops behave in animal studies, not strong human proof. Still, since this medication is already sedating, it's worth a quick chat with your pharmacist or doctor before adding hops, especially if you drive or feel sleepy during the day.

References
  1. Schiller, H., Forster, A., Vonhoff, C., Hegger, M., Biller, A., and Winterhoff, H. Sedating effects of Humulus lupulus L. extracts. Phytomedicine. 2006;13(8):535-541. PubMed
  2. Lee KM, Jung JS, Song DK, and et al. Effects of Humulus lupulus extract on the central nervous system in mice. Planta Med 1993;59(Suppl):A691.
  3. Assessment report on Humulus lupulus L., flos. European Medicines Agency, 2014. Available at: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-humulus-lupulus-l-flos_en.pdf. Accessed September 29, 2021.
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 3

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

Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
In vitro research suggests that flavonoid constituents of hops inhibit CYP1A2 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, does not affect levels of caffeine, a CYP1A2 probe substrate.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the good news about pairing hops with Limbitrol DS (the amitriptyline and chlordiazepoxide combo): the enzyme angle people worry about doesn't really pan out. In a test tube, certain hops flavonoids appeared to slow the CYP1A2 enzyme, which helps process amitriptyline. But when researchers actually gave people a standardized hops extract, it didn't change how their bodies handled a CYP1A2 marker. So in real life, this is a minor and unlikely concern.

The thing I'd actually watch isn't the enzyme, it's the overlap in effects. Hops are used to promote sleep, and both amitriptyline and chlordiazepoxide already cause drowsiness. Together they could leave you extra groggy, foggy, or unsteady. Go easy, and check with your pharmacist before adding hops.

References
  1. Henderson MC, Miranda CL, Stevens JF, et al. In vitro inhibition of human P450 enzymes by prenylated flavonoids from hops, Humulus lupulus. Xenobiotica 2000;30:235-51.. PubMed
  2. van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. 2020;68(18):5212-5220. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

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

Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Animal research suggests that specific constituents of hops, called lupulones, can induce hepatic CYP3A4 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients with normal metabolism shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, decreases the concentration of alprazolam, a CYP3A4 probe substrate, by 7.6%. This reduction is unlikely to be clinically relevant.
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 with Limbitrol DS (which combines amitriptyline, an antidepressant, and chlordiazepoxide, a benzodiazepine). Both of these are broken down in part by a liver enzyme called CYP3A4. Lab and animal studies hint that certain hops compounds (lupulones) might gently speed up that enzyme, which could in theory clear these medicines slightly faster and make them a touch less effective. But honestly, the real-world evidence is thin. In people, hops lowered levels of a similar drug by under 8 percent, which is too small to matter.

The more practical concern is overlap: hops are taken for sleep and can cause drowsiness, and so do both ingredients in Limbitrol. Stacking them may leave you extra groggy or foggy. Check with your pharmacist before combining them.

References
  1. Mannering, G. J., Shoeman, J. A., and Deloria, L. B. Identification of the antibiotic hops component, colupulone, as an inducer of hepatic cytochrome P-4503A in the mouse. Drug Metab Dispos 1992;20(2):142-147. DOI
  2. van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. 2020;68(18):5212-5220. 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

Hops Also Interacts With Other Medications

Hops has 288 moderate, 574 minor known drug interactions in our database — the Amitriptyline, Chlordiazepoxide 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 Hops

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

Everything else you take

See Every Supplement That Interacts With Amitriptyline, Chlordiazepoxide

This page covers Hops only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline, Chlordiazepoxide page lists 298 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 · 231 moderate · 50 minor.

From our pharmacist’s overview on the Amitriptyline, Chlordiazepoxide page

“Alcohol is the first thing to know about here. Beer and wine both carry major, well-documented interactions with Amitriptyline and Chlordiazepoxide (Limbitrol DS), because both drugs already slow the central nervous system, and anything sedating layered on top can deepen ordinary drowsiness into something dangerous.”

Reviewed by 2 · Jul 18, 2026

Open the Amitriptyline, Chlordiazepoxide interaction page

One more smart check

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

We hold 1,325 real supplement products containing Hops, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hops. Your product may carry other ingredients that interact with Amitriptyline, Chlordiazepoxide too, on top of Hops — 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 Hops and Amitriptyline, Chlordiazepoxide 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 Hops
Top 25%

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

29 days ago today
Medication Amitriptyline, Chlordiazepoxide
Steady interest

#1,673 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 Hops

What is Hops?

Hops
  • Sleep problems and insomnia
  • Anxiety and restlessness
  • Menopausal symptoms
  • Mild digestive complaints
  • Flavoring in beer and food

Hops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They are generally well tolerated when used short-term, though they may cause drowsiness, and should be avoided during pregnancy and breastfeeding because their safety is unknown.

Read the full Hops monograph & all interactions
Keep checking

Other Drugs & Hops

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

0Major
288Moderate
574Minor
1,967No known interaction
Moderate

288 interactions

Showing 60 of 288 moderate interactions — see all 288 on the Hops page.

Minor

574 interactions

Showing 60 of 574 minor interactions — see all 574 on the Hops page.

No interaction 1,967 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 Hops and Amitriptyline, Chlordiazepoxide Together: Common Questions

Can you take Hops with Amitriptyline, Chlordiazepoxide?
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 3 interactions listed for Hops and Amitriptyline, Chlordiazepoxide?
Amitriptyline, Chlordiazepoxide belongs to more than one drug category, and Hops 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 Hops and Amitriptyline, Chlordiazepoxide 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.