Drug & supplement interaction

Tinospora Cordifolia + Amitriptyline, Perphenazine

Amitriptyline, Perphenazine brand names: Triavil, Etrafon, Etrafon-A, Etrafon-Forte.

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

Amitriptyline, Perphenazine falls into 4 drug categories that Tinospora Cordifolia can interact with; the most serious is rated moderate. Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2D6.

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

Tinospora Cordifolia and Amitriptyline, Perphenazine

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

Why Are There 4 Interactions?

Tinospora Cordifolia interacts with whole categories of medication. Amitriptyline, Perphenazine falls into 4 of those categories, so it can interact with Tinospora Cordifolia 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 2D6 (CYP2D6) SUBSTRATES

1 of 4

Why this applies to Amitriptyline, Perphenazine

Amitriptyline, Perphenazine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Tinospora Cordifolia interacts with.

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2D6.
In vitro research shows that Tinospora cordifolia extract inhibits CYP2D6 at high concentrations. However, this interaction has not been reported in humans.
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

This combination pill pairs amitriptyline (an older antidepressant) with perphenazine (an antipsychotic). Both rely partly on a liver enzyme called CYP2D6 to be cleared from your body. In lab dish studies, Tinospora cordifolia (Giloy) slowed down this same enzyme, but only at high concentrations, and this has never actually been seen in real people.

If it did happen, the worry would be that these drugs build up a bit, which could mean more drowsiness, dry mouth, constipation, blurry vision, dizziness on standing, or a faster heartbeat. Because the evidence here is only test-tube level, I would not lose sleep over it. Still, since both drugs already cause real side effects, it is worth a quick chat with your pharmacist or doctor before adding Giloy.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. PubMed
Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

2 of 4

Amitriptyline, Perphenazine also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2C19.
In vitro research shows that Tinospora cordifolia extract inhibits CYP2C19 at high concentrations. However, this interaction has not been reported in humans.
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

This combo pill pairs amitriptyline (an older antidepressant) with perphenazine (an antipsychotic). Your liver uses several enzymes to clear these medicines, and one of them, called CYP2C19, helps break down amitriptyline. In lab dish studies, Tinospora cordifolia (Giloy) slowed that enzyme down. If that happened in the body, amitriptyline could build up a bit and you might notice more of its usual side effects, like drowsiness, dry mouth, constipation, blurry vision, or feeling lightheaded when you stand.

Here's the honest part: this is only a theoretical concern from test-tube work at high concentrations, and it has not been seen in real people. I wouldn't panic, but since both ingredients affect your brain and Giloy has been linked to liver issues, please run it by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. PubMed
Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

3 of 4

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

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that Tinospora cordifolia extract inhibits CYP1A2 at high concentrations. However, this interaction has not been reported in humans.
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

This combination pill pairs amitriptyline (an older antidepressant) with perphenazine (an antipsychotic). The liver enzyme CYP1A2 helps clear amitriptyline. In test-tube studies, Tinospora cordifolia (Giloy) blocked this enzyme at high concentrations, which could in theory let the drug build up a bit more than usual.

If that happened, you might notice stronger side effects like drowsiness, dry mouth, constipation, blurry vision, or dizziness when standing. But here's the honest part: this is only lab data and has not been seen in real people, so it may not matter much in practice. Since this medicine and Giloy can both stress the liver, please run it by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

4 of 4

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

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2C9.
In vitro research shows that Tinospora cordifolia extract inhibits CYP2C9. Animal research shows that Tinospora cordifolia extract 400 mg/kg twice daily for 14 days reduces the clearance and increases plasma levels of glyburide, a CYP2C9 substrate. However, this interaction has not been reported in humans.
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 the combo pill Triavil (which packs both amitriptyline, an antidepressant, and perphenazine, an antipsychotic): lab studies suggest Giloy may block a liver enzyme called CYP2C9. If that enzyme helps clear part of this medicine, levels could creep up a bit, and that could mean more of the usual side effects, things like drowsiness, dry mouth, constipation, blurry vision, dizziness when you stand, or a faster heartbeat.

I want to be honest about the evidence though. This is only test-tube and animal data, and it hasn't been shown in real people. So I wouldn't panic. Just loop in your pharmacist or doctor before adding Giloy, especially since this supplement has also been tied to liver problems.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. 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

Tinospora Cordifolia Also Interacts With Other Medications

Tinospora Cordifolia has 611 moderate known drug interactions in our database — the Amitriptyline, Perphenazine one above is among them. If you take anything else, check it against the full list below.

Moderate 611 No known interaction 2,219 (incl. Amitriptyline, Perphenazine)
Taking anything else?

Check Another of Your Medications Against Tinospora Cordifolia

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

Everything else you take

See Every Supplement That Interacts With Amitriptyline, Perphenazine

This page covers Tinospora Cordifolia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline, Perphenazine page lists 311 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: 19 major · 235 moderate · 57 minor.

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

“Alcohol is the risk I'd flag first for anyone taking amitriptyline with perphenazine (Triavil, Etrafon). Beer and wine both carry major ratings here, and 78 of the 311 ingredients on file deepen the drowsiness this antidepressant and antipsychotic combination already causes, sometimes to the point of slowed breathing.”

Reviewed by 2 · Jul 18, 2026

Open the Amitriptyline, Perphenazine interaction page

One more smart check

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

We hold 393 real supplement products containing Tinospora Cordifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tinospora Cordifolia. Your product may carry other ingredients that interact with Amitriptyline, Perphenazine too, on top of Tinospora Cordifolia — 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 Tinospora Cordifolia and Amitriptyline, Perphenazine 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 Tinospora Cordifolia
Top half

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

29 days ago today
Medication Amitriptyline, Perphenazine
Steady interest

#1,715 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 Tinospora Cordifolia

What is Tinospora Cordifolia?

  • Immune support
  • Fever
  • Blood sugar support
  • General wellness and 'rejuvenation'
  • Allergic rhinitis
  • Inflammation

Tinospora cordifolia, known as Guduchi or Giloy in Ayurvedic medicine, is a climbing plant traditionally used to support immunity and treat fevers. Early laboratory and small human studies suggest possible immune and blood sugar effects, but high-quality evidence is limited, and there have been reports of liver injury. Talk with your pharmacist or doctor before using it.

Read the full Tinospora Cordifolia monograph & all interactions
Keep checking

Other Drugs & Tinospora Cordifolia

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

0Major
611Moderate
0Minor
2,218No known interaction
611 Moderate 2,218 No interaction
Moderate

611 interactions

Showing 60 of 611 moderate interactions — see all 611 on the Tinospora Cordifolia page.

No interaction 2,218 drugs checked — show the list

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

Showing the 60 most looked-up of 2,218 medications checked with no known interaction — see the full Tinospora Cordifolia list.

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

Can you take Tinospora Cordifolia with Amitriptyline, Perphenazine?
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 Tinospora Cordifolia and Amitriptyline, Perphenazine?
Amitriptyline, Perphenazine belongs to more than one drug category, and Tinospora Cordifolia 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 Tinospora Cordifolia and Amitriptyline, Perphenazine 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.