Drug & supplement interaction

Puravive + Amitriptyline, Chlordiazepoxide

Amitriptyline, Chlordiazepoxide brand name: Limbitrol DS.

Moderate Interaction
Medically reviewed by · Updated February 2024
The bottom line Moderate

Amitriptyline, Chlordiazepoxide falls into 4 drug categories that Puravive can interact with; the most serious is rated moderate. Puravive contains quercetin, which has been shown in studies to mildly inhibit the CYP2C9 metabolizing enzyme.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Puravive and Amitriptyline, Chlordiazepoxide

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Puravive interacts with whole categories of medication. Amitriptyline, Chlordiazepoxide falls into 4 of those categories, so it can interact with Puravive in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

Cytochrome P450 2C9 (Cyp2C9) Substrates

1 of 4

Why this applies to Amitriptyline, Chlordiazepoxide

Amitriptyline, Chlordiazepoxide falls under Cytochrome P450 2C9 (Cyp2C9) Substrates — the group Puravive interacts with.

Puravive contains quercetin, which has been shown in studies to mildly inhibit the CYP2C9 metabolizing enzyme. This inhibition could potentially increase the risk of side effects from drugs. A small clinical trial with healthy volunteers found that taking 500 mg of quercetin twice daily for 10 days before using diclofenac, a drug metabolized by CYP2C9, increased diclofenac plasma levels by 75% and extended its half-life by 32.5% (source: https://pubmed.ncbi.nlm.nih.gov/29168292/). Combining quercetin with drugs metabolized by CYP2C9 could increase the risk of side effects, so caution is advised.
Severity Moderate Likelihood Possible Evidence C

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 (a combo of amitriptyline plus the benzodiazepine chlordiazepoxide). Puravive contains quercetin, which can mildly block a liver enzyme called CYP2C9. That enzyme helps clear certain medicines, so blocking it could let levels of an affected drug drift a little higher and linger longer. In plain terms, that may mean more of the typical effects from this combo: drowsiness, dizziness, dry mouth, constipation, blurred vision, or feeling extra sedated.

Neither part of this drug is a prodrug, so the worry here is buildup, not lost benefit. Honestly though, the evidence is modest, based mostly on a small study using a different medicine. I wouldn't panic, but since this combo already causes a lot of sedation, please run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
Moderate

Qt Interval-Prolonging Drugs

2 of 4

Amitriptyline, Chlordiazepoxide also falls under Qt Interval-Prolonging Drugs.

Puravive contains Panax ginseng. Panax ginseng is thought to have an additive effect with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias. However, research findings on this matter are conflicting. Clinical studies indicate that short-term use of Panax ginseng can increase the QT interval (source: https://pubmed.ncbi.nlm.nih.gov/27240158/). However, no changes in the QT interval have been observed with prolonged use (source: https://pubmed.ncbi.nlm.nih.gov/11978148/).
Severity Moderate Likelihood Possible Evidence C

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 Limbitrol DS (which combines amitriptyline and chlordiazepoxide): one of the ingredients in Puravive, Panax ginseng, may have a small effect on the heart's electrical timing, called the QT interval. Your amitriptyline can do the same thing. Stacking two QT-affecting things together could, in theory, raise the chance of an irregular heartbeat, which might show up as a racing, fluttering, or skipped feeling, dizziness, or fainting.

That said, the evidence here is mixed and fairly weak. Short studies showed a slight QT change with ginseng, while longer use showed none. So this is more of a caution than a strong warning. Still, since amitriptyline already nudges QT on its own, I'd run Puravive past your pharmacist or doctor before combining them, especially if you have any heart rhythm history.

Contact Dr. Brian directly if you have additional questions on this interaction
Minor

Cytochrome P450 2D6 (Cyp2D6) Substrates

3 of 4

Amitriptyline, Chlordiazepoxide also falls under Cytochrome P450 2D6 (Cyp2D6) Substrates.

Puravive contains Panax ginseng. Some research suggests that Panax ginseng might slow down the activity of an enzyme called CYP2D6 by about 6%. This enzyme plays a role in breaking down drugs in our system. One study (https://pubmed.ncbi.nlm.nih.gov/32557706/) found that Panax ginseng slows down the breakdown of dextromethorphan, a drug that is processed by CYP2D6, but only to a small extent. It is important to note that not all studies agree on these effects, and some suggest that Panax ginseng might not have a significant impact on CYP2D6 at all. Nevertheless, it's important to be cautious if you're taking medications that are processed by CYP2D6 and consider discussing it with your healthcare provider.
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

Limbitrol combines amitriptyline (an older antidepressant) with chlordiazepoxide (a benzodiazepine). The amitriptyline part is partly cleared by the CYP2D6 enzyme. The Panax ginseng in Puravive may slow that enzyme a tiny bit, so in theory amitriptyline could clear a little more slowly and build up slightly. That might mean a touch more of its usual side effects, like drowsiness, dry mouth, constipation, blurry vision, or dizziness when you stand.

Honestly, this is a minor, weakly supported concern. The research showed only about a 6% change, and not all studies even agree it happens. Still, since Limbitrol can already make you sleepy, it's worth a quick chat with your pharmacist or doctor before adding Puravive, especially if you notice extra grogginess.

Contact Dr. Brian directly if you have additional questions on this interaction
Minor

Cytochrome P450 3A4 (Cyp3A4) Substrates

4 of 4

Amitriptyline, Chlordiazepoxide also falls under Cytochrome P450 3A4 (Cyp3A4) Substrates.

Puravive contains Panax ginseng. Panax ginseng has the potential to affect the breakdown of drugs that are metabolized by an enzyme called CYP3A4. One example of such a drug is imatinib. There was a case where imatinib was thought to have caused liver damage, and it was believed that this might have been due to Panax ginseng inhibiting CYP3A4, which is involved in imatinib's metabolism (https://pubmed.ncbi.nlm.nih.gov/20332334/). On the other hand, Panax ginseng has been found to increase the breakdown of another drug called midazolam, which is also metabolized by CYP3A4 (https://pubmed.ncbi.nlm.nih.gov/21646440/), suggesting Panax ginseng induces CYP3A4 in some cases (i.e., makes more potent). Given these contradictory findings, it is important to use Panax ginseng cautiously if you are taking medications that are metabolized by CYP3A4, as the interaction between Panax ginseng and these drugs is not fully understood.
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

Limbitrol DS combines two active drugs: amitriptyline (an older antidepressant) and chlordiazepoxide (a benzodiazepine for anxiety). Both lean on the liver's CYP3A4 enzyme as part of how they're cleared. Puravive contains Panax ginseng, which has shown mixed effects on this enzyme. In some studies it slowed CYP3A4 down, which could let these drugs build up a bit and add to drowsiness, dizziness, dry mouth, constipation, or grogginess. In other studies it sped the enzyme up, which could weaken the effect.

Honestly, this is a theoretical, minor concern based on shaky and conflicting evidence, not strong real-world reports with this combo. Still, since both ingredients can already make you sleepy, I'd run Puravive past your pharmacist or doctor before adding it. Please don't change anything on your own.

Contact Dr. Brian directly if you have additional questions on this interaction

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

Puravive Also Interacts With Other Medications

Puravive has 356 moderate, 881 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.

Moderate 356 Minor 881 No known interaction 1,593 (incl. Amitriptyline, Chlordiazepoxide)
Taking anything else?

Check Another of Your Medications Against Puravive

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

From our Q&A

Questions About Puravive or Amitriptyline, Chlordiazepoxide

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Puravive or Amitriptyline, Chlordiazepoxide, 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, Chlordiazepoxide

This page covers Puravive 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

How much people look this up

Where Puravive 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 Puravive
Top half

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

29 days ago today
Medication Amitriptyline, Chlordiazepoxide
Steady interest

#2,236 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 Puravive

What is Puravive?

Puravive
  • Weight management
  • Metabolism support
  • Energy levels
  • General wellness
  • Stress and brain health

Puravive is a branded, multi-ingredient capsule marketed mainly for weight loss by claiming to boost brown fat activity, but there is no published, independent clinical research showing the product itself works for this purpose. Some individual ingredients have been studied in laboratory or small human studies, but those results do not prove the finished blend is safe or effective. Talk to a pharmacist or doctor before trying it, especially if you have health conditions or take medications.

Read the full Puravive monograph & all interactions
Keep checking

Other Drugs & Puravive

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

0Major
356Moderate
881Minor
1,592No known interaction
356 Moderate 881 Minor 1,592 No interaction
Moderate

356 interactions

Showing 60 of 356 moderate interactions — see all 356 on the Puravive page.

Minor

881 interactions

Showing 60 of 881 minor interactions — see all 881 on the Puravive page.

No interaction 1,592 drugs checked — show the list

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

Showing the 60 most looked-up of 1,592 medications checked with no known interaction — see the full Puravive list.

See the full Puravive interactions page
See every supplement checked against Amitriptyline, Chlordiazepoxide, 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
Puravive monograph › Uses, safety, and every drug interaction in one place Amitriptyline, Chlordiazepoxide supplement interactions › Every supplement checked against Amitriptyline, Chlordiazepoxide, 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 Puravive and Amitriptyline, Chlordiazepoxide Together: Common Questions

Can you take Puravive 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 4 interactions listed for Puravive and Amitriptyline, Chlordiazepoxide?
Amitriptyline, Chlordiazepoxide belongs to more than one drug category, and Puravive 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 Puravive 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.