Drug & supplement interaction

Indian Snakeroot + Naltrexone Hydrochloride, Oxycodone Hydrochloride

Naltrexone Hydrochloride, Oxycodone Hydrochloride brand name: Troxyca ER.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Naltrexone Hydrochloride, Oxycodone Hydrochloride falls into 2 drug categories that Indian Snakeroot can interact with; the most serious is rated moderate. Theoretically, taking Indian snakeroot might cause additive sedative effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Indian Snakeroot and Naltrexone Hydrochloride, Oxycodone Hydrochloride

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Indian Snakeroot interacts with whole categories of medication. Naltrexone Hydrochloride, Oxycodone Hydrochloride falls into 2 of those categories, so it can interact with Indian Snakeroot in 2 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 2

Why this applies to Naltrexone Hydrochloride, Oxycodone Hydrochloride

Naltrexone Hydrochloride, Oxycodone Hydrochloride falls under CNS DEPRESSANTS — the group Indian Snakeroot interacts with.

Theoretically, taking Indian snakeroot might cause additive sedative effects.
Sedation and drowsiness have been reported in clinical trials using Indian snakeroot.
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

Troxyca ER pairs oxycodone, a strong opioid painkiller, with naltrexone (which is only released if the capsule is tampered with). The opioid part already slows you down and can make you sleepy, foggy, or lightheaded. Indian snakeroot contains reserpine, which has its own calming, sedating effect and can lower blood pressure. Put them together and those effects can stack up.

This concern is theoretical, based on how each one works rather than firm studies in people, so it isn't a reason to panic. Still, watch for extra drowsiness, dizziness, slowed breathing, or low blood pressure if both are on board. Snakeroot is potent and isn't a casual home remedy, so please loop in your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sheldon MB, Kotte JH. Effect of Rauwolfia serpentina and reserpine on the blood pressure in essential hypertension; a long-term double-blind study. Circulation. 1957 Aug;16(2):200-6.
  2. Vakil RJ. A clinical trial of Rauwolfia serpentina in essential hypertension. Br Heart J. 1949 Oct;11(4):350-5. PubMed
  3. Achor RW, Hanson NO, Gifford RW Jr. Hypertension treated with Rauwolfia serpentina (whole root) and with reserpine; controlled study disclosing occasional severe depression. J Am Med Assoc. 1955 Oct 29;159(9):841-5. PubMed
  4. Wilkins RW, Judson WE. The use of Rauwolfia serpentina in hypertensive patients. N Engl J Med. 1953 Jan 8;248(2):48-53.
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 2

Naltrexone Hydrochloride, Oxycodone Hydrochloride also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, Indian snakeroot might inhibit CYP2D6 enzymes and reduce the metabolism of CYP2D6 substrates.
Indian snakeroot contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
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 with Troxyca ER (an oxycodone and naltrexone combo): the oxycodone part is partly handled by a liver enzyme called CYP2D6. Indian snakeroot may gently slow that enzyme down, based mostly on lab tests with a small amount of yohimbine in the plant. If CYP2D6 is slowed, a bit more oxycodone could hang around, which can mean more drowsiness, dizziness, constipation, nausea, or in a worst case slowed breathing.

Honestly, this is theoretical and the evidence is weak, so I wouldn't lose sleep over a single concern. But on its own, snakeroot also lowers blood pressure and adds sedation, which stacks with opioids. Please loop in your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. 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

Indian Snakeroot Also Interacts With Other Medications

Indian Snakeroot has 83 major, 759 moderate known drug interactions in our database — the Naltrexone Hydrochloride, Oxycodone Hydrochloride one above is among them. If you take anything else, check it against the full list below.

Major 83 Moderate 759 No known interaction 1,988 (incl. Naltrexone Hydrochloride, Oxycodone Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Indian Snakeroot

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

Everything else you take

See Every Supplement That Interacts With Naltrexone Hydrochloride, Oxycodone Hydrochloride

This page covers Indian Snakeroot only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Naltrexone Hydrochloride, Oxycodone Hydrochloride page lists 145 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 Kava (major).

By severity: 8 major · 114 moderate · 23 minor.

From our pharmacist’s overview on the Naltrexone Hydrochloride, Oxycodone Hydrochloride page

“Alcohol tops this list. Beer and wine both carry major, well-documented interactions with Troxyca ER (naltrexone and oxycodone hydrochloride), an extended-release opioid, because adding a second sedative to an opioid can slow breathing, not just deepen drowsiness.”

Reviewed by 2 · Jul 18, 2026

Open the Naltrexone Hydrochloride, Oxycodone Hydrochloride interaction page

One more smart check

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

We hold 70 real supplement products containing Indian Snakeroot, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Indian Snakeroot. Your product may carry other ingredients that interact with Naltrexone Hydrochloride, Oxycodone Hydrochloride too, on top of Indian Snakeroot — 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 Indian Snakeroot and Naltrexone Hydrochloride, Oxycodone Hydrochloride 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 Indian Snakeroot
Top half

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

29 days ago today
Medication Naltrexone Hydrochloride, Oxycodone Hydrochloride
Top 25%

#548 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 Indian Snakeroot

What is Indian Snakeroot?

Indian Snakeroot
  • High blood pressure
  • Anxiety and stress
  • Insomnia
  • Agitation
  • Fever (traditional use)

Indian snakeroot is a traditional Ayurvedic plant that contains reserpine, a compound with real blood-pressure-lowering and sedative effects. Because its potent alkaloids can cause serious side effects like depression and very low blood pressure, it should never be used without medical supervision. It is not a safe or simple home remedy, and many countries restrict its use.

Read the full Indian Snakeroot monograph & all interactions
Keep checking

Other Drugs & Indian Snakeroot

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

83Major
759Moderate
0Minor
1,987No known interaction
83 Major 759 Moderate 1,987 No interaction
Major

83 interactions

Showing 60 of 83 major interactions — see all 83 on the Indian Snakeroot page.

Moderate

759 interactions

Showing 60 of 759 moderate interactions — see all 759 on the Indian Snakeroot page.

No interaction 1,987 drugs checked — show the list

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

Showing the 60 most looked-up of 1,987 medications checked with no known interaction — see the full Indian Snakeroot list.

See the full Indian Snakeroot interactions page
See every supplement checked against Naltrexone Hydrochloride, Oxycodone Hydrochloride, ranked by severity
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

Keep exploring
Indian Snakeroot monograph › Uses, safety, and every drug interaction in one place Naltrexone Hydrochloride, Oxycodone Hydrochloride supplement interactions › Every supplement checked against Naltrexone Hydrochloride, Oxycodone Hydrochloride, 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Indian Snakeroot and Naltrexone Hydrochloride, Oxycodone Hydrochloride Together: Common Questions

Can you take Indian Snakeroot with Naltrexone Hydrochloride, Oxycodone Hydrochloride?
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 2 interactions listed for Indian Snakeroot and Naltrexone Hydrochloride, Oxycodone Hydrochloride?
Naltrexone Hydrochloride, Oxycodone Hydrochloride belongs to more than one drug category, and Indian Snakeroot 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 Indian Snakeroot and Naltrexone Hydrochloride, Oxycodone Hydrochloride 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 Naltrexone Hydrochloride, Oxycodone Hydrochloride and Indian Snakeroot?

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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.