Drug & supplement interaction

Ilex Guayusa + Ganaxolone

Ganaxolone brand name: Ztalmy.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 20, 2026

The bottom line No known interaction

We found no known interaction between Ilex Guayusa and Ganaxolone 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. Additionally, although there is no interaction, the label for Ganaxolone states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Ilex Guayusa and Ganaxolone

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 Ganaxolone and Ilex Guayusa 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.

Ilex Guayusa safety at a glance

Ilex Guayusa overall Use caution Generally well tolerated in tea amounts, but it contains caffeine that can cause stimulant side effects.

Pregnancy Use caution Limit or avoid because of its caffeine content and a lack of safety studies in pregnancy.

Breastfeeding Use caution Caffeine passes into breast milk, so limit intake or avoid until more is known.

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

Still wondering about combining Ganaxolone and Ilex Guayusa? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Ganaxolone

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ganaxolone is filed under 3 classifications — cns depressants, cytochrome p450 3a4 (cyp3a4) substrates, oral drugs. Ilex Guayusa has documented interactions with 37 drug classes — the most serious being ephedrine (major), adenosine (adenocard) (moderate) and anticoagulant/antiplatelet drugs (moderate) — and none of Ganaxolone’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

Ilex Guayusa Does Interact With Other Medications

Ilex Guayusa has 8 major, 470 moderate, 127 minor known drug interactions in our database — Ganaxolone isn’t one of them. If you take anything else, check it against the full list below.

Major 8 Moderate 470 Minor 127 No known interaction 2,225 (incl. Ganaxolone)

Taking anything else?

Check Another of Your Medications Against Ilex Guayusa

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

What to actually watch for

No Interaction Found — But Data Suggests Ilex Guayusa and Ganaxolone May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

Drowsiness / Tiredness Additional detail
Ilex Guayusa
“Chronic use of caffeine, especially in large amounts, may produce tolerance, habituation, and psychological dependence. There is some concern that stopping regular use of caffeine may cause withdrawal symptoms such as headache, tiredness and fatigue, decreased energy, alertness, and attentiveness, drowsiness, decreased contentedness, depressed mood, difficulty concentrating, irritability, and lack of clear-headedness…”

Ilex Guayusa · Natural Medicines adverse-effect record, reported in anxiety.
5 sources cited

3719. Boozer CN, Nasser JA, Heymsfield SB, et al. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Relat Metab Disord 2001;25:316-24. PubMed

13738. Juliano LM, Griffiths RR. A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features. Psychopharmacology (Berl) 2004;176:1-29. PubMed

2723. Dews PB, Curtis GL, Hanford KJ, O'Brien CP. The frequency of caffeine withdrawal in a population-based survey and in a controlled, blinded pilot experiment. J Clin Pharmacol 1999;39:1221-32. PubMed

11839. Dews PB, O'Brien CP, Bergman J. Caffeine: behavioral effects of withdrawal and related issues. Food Chem Toxicol 2002;40:1257-61. PubMed

13736. Anderson BJ, Gunn TR, Holford NH, Johnson R. Caffeine overdose in a premature infant: clinical course and pharmacokinetics. Anaesth Intensive Care 1999;27:307-11. PubMed
Ganaxolone

Listed in the ADVERSE REACTIONS section of the FDA label for Ganaxolone. Read the label on DailyMed ›

Reported for Ilex Guayusa but not commonly for Ganaxolone: trouble concentrating, dependence or withdrawal symptoms, raised blood pressure and low mood.

Effects for Ganaxolone come from the ADVERSE REACTIONS section of its FDA label; effects for Ilex Guayusa come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Ganaxolone Products Have a Food Rule — Ilex Guayusa Should Not Break It

At least one FDA label for a product containing Ganaxolone says to take it with food. If you take Ilex Guayusa on an empty stomach out of habit, keep them separate — and take Ganaxolone with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Ganaxolone products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

2 DOSAGE AND ADMINISTRATION Administer ZTALMY orally three times daily with food.

From the Dosage and Administration section of the FDA label we read for Ganaxolone — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Ganaxolone

This page covers Ilex Guayusa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ganaxolone page lists 195 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), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 9 major · 147 moderate · 39 minor.

From our pharmacist’s overview on the Ganaxolone page

“Families managing CDKL5 deficiency disorder, the rare childhood epilepsy that ganaxolone (Ztalmy) treats, should read this supplement list carefully rather than skim it. Most entries fall into two camps.”

Reviewed by 2 · Jul 18, 2026

Open the Ganaxolone interaction page

How much people look this up

Where Ilex Guayusa and Ganaxolone 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 Ilex Guayusa

Steady interest

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

29 days ago today

Medication Ganaxolone

Steady interest

#1,441 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 Ilex Guayusa reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Ilex Guayusa and Ganaxolone 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 Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Ilex Guayusa

What is Ilex Guayusa?

Energy and alertness
Mental focus
Antioxidant support
Appetite control
Athletic and physical performance

Ilex guayusa is a caffeine-containing holly leaf from the Amazon, traditionally brewed as a tea for energy and alertness, much like yerba mate or green tea. There is limited human research confirming specific health benefits, and its main reliable effect comes from its caffeine content. Because it is a stimulant, use it cautiously and check with your pharmacist or doctor if you have heart concerns or are pregnant.

Ilex guayusa · Aquifoliaceae · Leaves · Tea, brewed infusion, capsules, powdered extract, energy drinks

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

Ilex Guayusa: dosing

There is no official standardized dose for guayusa. It is most commonly taken as a brewed tea, and the amount of caffeine you get can vary widely depending on how much leaf you use and how long you steep it.If you use a packaged product, follow the directions on the label and do not exceed the recommended serving. Keep your total daily caffeine from all sources in mind.

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

Read the full Ilex Guayusa monograph & all interactions

Medication

About Ganaxolone

What Is Ganaxolone Used For?

Brand name: Ztalmy

Ztalmy (ganaxolone) oral suspension is approved to treat seizures associated with cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder — a rare genetic condition, often called CDD — in patients 2 years of age and older.

Most-Reported Side Effects for Ganaxolone

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Seizure 201 reports

Somnolence 52 reports

Change in seizure presentation 43 reports

Pneumonia 30 reports

Vomiting 24 reports

See full Ganaxolone drug information

Keep checking

Other Drugs & Ilex Guayusa

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

8Major

470Moderate

127Minor

2,224No known interaction

8 Major 470 Moderate 127 Minor 2,224 No interaction

Major

8 interactions

Moderate

470 interactions

Showing 60 of 470 moderate interactions — see all 470 on the Ilex Guayusa page.

Minor

127 interactions

Showing 60 of 127 minor interactions — see all 127 on the Ilex Guayusa page.

No interaction 2,224 drugs checked — show the list

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

Showing the 60 most looked-up of 2,224 medications checked with no known interaction — see the full Ilex Guayusa list.

See the full Ilex Guayusa interactions page

See every supplement checked against Ganaxolone, ranked by severity

Evidence & sources

Ilex Guayusa References

The 90 references that drive our Ilex Guayusa 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.

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Dews PB, Curtis GL, Hanford KJ, O'Brien CP. The frequency of caffeine withdrawal in a population-based survey and in a controlled, blinded pilot experiment. J Clin Pharmacol 1999;39:1221-32. PubMed
Boozer CN, Nasser JA, Heymsfield SB, et al. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Relat Metab Disord 2001;25:316-24. PubMed
Hagg S, Spigset O, Mjorndal T, Dahlqvist R. Effect of caffeine on clozapine pharmacokinetics in healthy volunteers. Br J Clin Pharmacol 2000;49:59-63. PubMed
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Helwig NJ, Schwager LE, Berry AC, et al. Acute, dose-response effects of guayusa leaf extract on mood, cognitive and motor-cognitive performance, and blood pressure, heart rate, and ventricular repolarization. J Int Soc Sports Nutr 2024;21(1):2379424. PubMed
Mello TC, Dias DDS, Bernardes N, et al. Ilex Guayusa Tea Improves Glycaemia and Autonomic Modulation in Female Streptozotocin-Induced Diabetic Rats. Pharmaceuticals (Basel) 2025;18(3):316. PubMed

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 Ilex Guayusa and Ganaxolone Together: Common Questions

Is it safe to take Ilex Guayusa with Ganaxolone?

We do not list a known interaction between Ilex Guayusa and Ganaxolone. 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.

Do Ilex Guayusa and Ganaxolone have any of the same side effects?

Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.

Should I take Ilex Guayusa and Ganaxolone at the same time of day?

At least one FDA label for a product containing Ganaxolone says to take it with food. If you take Ilex Guayusa on an empty stomach out of habit, keep them separate and take Ganaxolone with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Ganaxolone products can differ — so check the directions on your own box. This is about absorption, not an interaction.

How was the Ilex Guayusa and Ganaxolone combination checked?

Interactions in our licensed database are recorded against drug classes. Ganaxolone is filed under 3 classifications, and Ilex Guayusa has documented interactions with 37 drug classes — none of Ganaxolone'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 Ilex Guayusa interact with any other medications?

Yes. Ilex Guayusa has 605 documented drug interactions in our database — Ganaxolone 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 Ganaxolone interact with any supplements?

Yes. Ganaxolone has documented interactions with 195 supplements in our database — Ilex Guayusa is not one of them. The Ganaxolone interaction page linked on this page lists every one, ranked by severity.

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

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Ilex Guayusa monograph Uses, safety profile, and every drug interaction in one place Ganaxolone drug information The full plain-English guide to this medication Ganaxolone supplement interactions Every supplement checked against Ganaxolone, 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 90 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

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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.