Drug & supplement interaction

Tinospora Cordifolia + Nortriptyline

Nortriptyline brand names: Pamelor, Nortriptyline, Aventyl, Allegron.

Moderate Interaction
The bottom line Moderate

Nortriptyline falls into 2 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
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Tinospora Cordifolia and Nortriptyline

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

Why Are There 2 Interactions?

Tinospora Cordifolia interacts with whole categories of medication. Nortriptyline falls into 2 of those categories, so it can interact with Tinospora Cordifolia in 2 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 2

Why this applies to Nortriptyline

Nortriptyline 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

Here's the simple version: your body relies on a liver enzyme called CYP2D6 to break down nortriptyline and clear it out. In lab dish studies, Tinospora cordifolia (Giloy) seemed to slow that same enzyme down when used at high concentrations. If that were to happen in real life, your nortriptyline could clear more slowly and build up, which can mean stronger side effects like drowsiness, dry mouth, constipation, blurry vision, dizziness when standing, or a faster heartbeat.

Now, the honest caveat: this is only seen in test tubes, never confirmed in actual people, so it stays theoretical for now. Still, since nortriptyline is sensitive to blood-level changes, I'd loop in your pharmacist or doctor before combining them rather than guessing.

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

2 of 2

Nortriptyline 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

Here's the gist for Nortriptyline (Pamelor). Your body partly relies on a liver enzyme called CYP1A2 to break this antidepressant down. In lab testing, Tinospora cordifolia (Giloy) seemed to slow that same enzyme, at least at high concentrations in a test tube. If that happened in a real person, nortriptyline could clear more slowly and build up a bit, which might mean stronger effects and more side effects like drowsiness, dry mouth, constipation, blurred vision, or a racing heartbeat.

I want to be honest, though: this is theoretical and has not actually been seen in people. Still, since tricyclics have a fairly narrow safe range, it's worth a quick chat with your pharmacist or doctor before combining them.

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 Nortriptyline 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 Tinospora Cordifolia

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

From our Q&A

Questions About Tinospora Cordifolia or Nortriptyline

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

This page covers Tinospora Cordifolia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nortriptyline page lists 198 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Henbane (major), Lithium (major), Scopolia (major) and 1,3-dmaa (moderate).

By severity: 4 major · 150 moderate · 44 minor.

Open the Nortriptyline 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 Nortriptyline 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 Nortriptyline 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

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

29 days ago today
Medication Nortriptyline
Top 25%

#383 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
Medication

About Nortriptyline

What Is Nortriptyline Used For?

Brand names: Pamelor, Nortriptyline, Aventyl, Allegron

Nortriptyline is approved to relieve symptoms of depression. This applies to nortriptyline hydrochloride capsules, nortriptyline hydrochloride oral solution, and Pamelor capsules — all used for the same core indication.

The label notes that depression arising from within the body (endogenous depression) may respond better than other types of depression, though all of these products are indicated for the broader relief of depressive symptoms.

See full Nortriptyline drug information
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
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
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 Tinospora Cordifolia and Nortriptyline Together: Common Questions

Can you take Tinospora Cordifolia with Nortriptyline?
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 Tinospora Cordifolia and Nortriptyline?
Nortriptyline 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 Nortriptyline 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.