Herb & supplement monograph

Cowhage Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Cowhage interacts with medications. The heart of this page is the interaction list — every drug Cowhage is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Cowhage is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Cowhage Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Because cowhage naturally contains levodopa, an active drug, the risk of clinically significant Cowhage drug interactions is higher than for a typical supplement, especially for people taking medications that affect dopamine, blood pressure, or blood sugar. Every listed interaction is rated major or moderate, none minor, and the interaction with levodopa itself is well documented in humans.

Interactions deserving the most attention

The clearest concern is combining cowhage with levodopa, since the supplement adds to the levodopa dose and can increase side effects. Non-selective MAOIs are also serious, because the combination could trigger dangerously high blood pressure, while methyldopa raises the opposite worry of blood pressure dropping too far. Cowhage may also blunt the effect of antipsychotic medications and could add to the blood-sugar-lowering effect of diabetes drugs.

What the rest of the list means

Most of the long list of moderate interactions is predicted from what is known about levodopa rather than from studies of cowhage itself, and many have not been confirmed in people, such as possible effects with certain older anesthetics or antidepressants. Still, because this supplement delivers a real drug, its interactions deserve more caution than those of a typical herbal product.

Check your medications against Cowhage

Based on HelloPharmacist’s Cowhage interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Cowhage

193 medications have a known interaction with Cowhage, graded by severity. Select any drug for the full evidence-based detail.

17 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Cowhage.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Cowhage using our pharmacist-reviewed interaction data.

AI summaries are generated from our Cowhage interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. Interaction 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.
Possible. 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
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Cowhage combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Cowhage affects

Every type of medication (drug category) Cowhage is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 8 drug categories Cowhage interacts with

LevodopaMethyldopa (aldomet)Monoamine Oxidase Inhibitors (maois)AnesthesiaAntidiabetes DrugsAntipsychotic DrugsGuanethidine (ismelin)Tricyclic Antidepressants (tcas)

Levodopa

Concomitant use can increase the risk of levodopa-related adverse effects.
Cowhage contains levodopa. Some cowhage products have been standardized to contain 75-400 mg of levodopa per dose.

Likelihood Likely Evidence D

Methyldopa (Aldomet)

Theoretically, concomitant use of cowhage and methyldopa might increase the risk of hypotension.
Cowhage contains levodopa. Use of levodopa with methyldopa might cause additive hypotension. In addition, methyldopa may inhibit peripheral decarboxylation of levodopa and increase levodopa levels in the central nervous system; avoid using.

Likelihood Probable Evidence D

Monoamine Oxidase Inhibitors (Maois)

Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Cowhage contains levodopa. Use of levodopa with non-selective MAOIs might cause hypertensive crisis. However, this interaction has not been reported with MAO-B selective inhibitors such as selegiline.

Likelihood Probable Evidence D

Anesthesia

Theoretically, concomitant use of cowhage and anesthesia might increase the risk of arrhythmias.
Cowhage contains levodopa. Use of levodopa with cyclopropane or halogenated hydrocarbon anesthesia has led to arrhythmias. Other anesthetics have not been implicated. Use other anesthetics in patients taking cowhage or tell patients to stop taking cowhage at least 2 weeks before surgery.

Likelihood Possible Evidence D

Antidiabetes Drugs

Theoretically, concomitant use of cowhage and antidiabetes drugs might increase the risk of hypoglycemia.
Animal research shows that cowhage might have hypoglycemic effects.

Likelihood Possible Evidence D

Antipsychotic Drugs

Theoretically, use of cowhage might decrease the clinical effects of antipsychotic drugs.
Cowhage contains levodopa. Use of levodopa might counteract the antidopaminergic effects of antipsychotic medications.

Likelihood Possible Evidence D

Guanethidine (Ismelin)

Theoretically, concomitant use of cowhage and guanethidine might increase the risk of hypotension.
Cowhage contains levodopa. Use of levodopa with guanethidine might cause additive hypotension; avoid using.

Likelihood Probable Evidence D

Tricyclic Antidepressants (Tcas)

Theoretically, use of TCAs might reduce the levels and clinical effects of cowhage.
Cowhage contains levodopa. Use of TCAs might reduce the absorption of levodopa. Some case reports describe patients that developed hypertension and dyskinesia when taking both levodopa and TCAs.

Likelihood Possible Evidence D

Monograph

Cowhage: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Cowhage (Mucuna pruriens) is a tropical legume best known as a natural source of L-dopa, the compound the body turns into dopamine. It is most studied for Parkinson's disease symptoms and male fertility, but evidence is still limited and the L-dopa content makes it potentially powerful and risky—talk to your doctor or pharmacist before using it.

Scientific name: Mucuna pruriens
Family: Fabaceae
Part used: Seeds (and seed hairs from the pods)
Common forms: Capsules, powder, standardized extracts

People commonly use it for

Parkinson's disease symptoms
Male fertility and libido
Mood and stress support
Traditional aphrodisiac
General energy and vitality

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallUse caution

It contains L-dopa, an active drug-like compound, so it should be used carefully and with professional guidance.

PregnancyBest avoided

Not enough safety data and its dopamine effects make it best avoided during pregnancy.

BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Cowhage, also called velvet bean, is a climbing tropical legume known by the scientific name Mucuna pruriens. It grows in warm regions of Asia, Africa, and the Americas. The plant is famous for the fine hairs on its seed pods, which can cause intense itching when they touch the skin.

Despite that irritating feature, the seeds have a long history of use in traditional systems of medicine, especially Ayurveda in India. The seeds are a natural source of levodopa (L-dopa), a compound that the body converts into the brain chemical dopamine. Today cowhage is sold as a supplement in capsule, powder, and extract forms.

How it works

The main active ingredient in cowhage seeds is L-dopa, the same compound used in some Parkinson's disease drugs. L-dopa crosses into the brain and is converted into dopamine, a chemical messenger involved in movement, mood, and motivation. Low dopamine levels are central to Parkinson's disease.

The seeds also contain other compounds, including antioxidants and plant chemicals that have been studied in the lab. Some proposed effects on hormones and fertility come mainly from animal and test-tube research, so we cannot be sure they apply the same way in people.

Effectiveness

Does Cowhage work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 7 uses evaluated

7 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

For Cowhage, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 7 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Anxiety