Herb & supplement monograph

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

But these pages have grown well beyond that into a full monograph — what Indian Snakeroot 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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Indian Snakeroot Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Because Indian Snakeroot contains reserpine, a compound with real drug-like effects on the heart and nervous system, the risk of a clinically significant Indian Snakeroot drug interaction is meaningful for many people, especially those taking heart, blood pressure, or mental health medicines. Dozens of its interactions are rated major and the rest moderate, with none considered minor.

Interactions deserving the most attention

The best-supported concerns involve heart and nerve-related medicines. Combining it with beta-blockers or digoxin may slow the heart or drop blood pressure too far, and slow heart rate has actually been reported in human studies of this herb. It may also work against levodopa, since Parkinson-like movement symptoms have appeared in trials, and it may add to the effects of antipsychotic drugs. Its documented blood pressure lowering also matters for anyone on blood pressure medication.

What the rest of the list means

Even so, most entries on the long list are theoretical. Many rest on tiny amounts of yohimbine that might affect an enzyme the body uses to clear certain medications, based on lab or animal research. Some predicted effects, like low blood sugar, have not been seen in people.

Check your medications against Indian Snakeroot

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

Interaction report

Drugs that interact with Indian Snakeroot

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

83 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 Indian Snakeroot.

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

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

AI summaries are generated from our Indian Snakeroot 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 Indian Snakeroot 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 Indian Snakeroot affects

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

All 13 drug categories Indian Snakeroot interacts with

Antipsychotic DrugsBeta-blockersDigoxin (lanoxin)LevodopaAnticoagulant/antiplatelet DrugsAntidiabetes DrugsAntihypertensive DrugsCns DepressantsCytochrome P450 2d6 (cyp2d6) SubstratesEphedrineMonoamine Oxidase Inhibitors (maois)Stimulant DrugsTricyclic Antidepressants (tcas)

Antipsychotic Drugs

Theoretically, concomitant use might increase the risk of adverse effects.
Concomitant use of neuroleptics with Indian snakeroot may potentiate the effects of these drugs, as well as the alkaloid constituents of Indian snakeroot.

Likelihood Probable Evidence D

Beta-Blockers

Theoretically, taking Indian snakeroot with beta-blockers might increase the risk of bradycardia and/or hypotension.
Indian snakeroot contains small amounts of reserpine. Reserpine causes catecholamine-depletion. Concomitant use of Indian snakeroot and beta-blockers might increase the risk or bradycardia and/or hypotension.

Likelihood Probable Evidence D

Digoxin (Lanoxin)

Theoretically, taking Indian snakeroot with digoxin might increase the risk of bradycardia.
Bradycardia has been reported in clinical trials using Indian snakeroot. Concomitant use of digoxin with Indian snakeroot might potentiate this effect.

Likelihood Probable Evidence D

Levodopa

Theoretically, taking Indian snakeroot with levodopa may reduce the effectiveness of levodopa.
Extrapyramidal motor symptoms and Parkinson-like symptoms have been reported in clinical trials using Indian snakeroot. Concomitant use of Indian snakeroot with levodopa may reduce the effectiveness of levodopa and increase extrapyramidal motor symptoms.

Likelihood Probable Evidence D

Anticoagulant/Antiplatelet Drugs

Theoretically, taking Indian snakeroot might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Indian snakeroot contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits platelet aggregation.

Likelihood Possible Evidence D

Antidiabetes Drugs

Theoretically, concomitant use of Indian snakeroot with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research shows that Indian snakeroot lowers blood glucose levels. This effect has not been reported in humans.

Likelihood Possible Evidence D

Antihypertensive Drugs

Theoretically, concomitant use of Indian snakeroot and antihypertensive drugs might increase the risk of hypotension.
Indian snakeroot, which contains reserpine, can reduce both systolic and diastolic blood pressure.

Likelihood Possible Evidence B

Cns Depressants

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

Likelihood Possible Evidence D

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.

Likelihood Possible Evidence D

Ephedrine

Theoretically, taking Indian snakeroot with ephedrine might alter the effects and side effects of ephedrine.
Indian snakeroot contains small amounts of reserpine. Reserpine reduces indirect sympathomimetic drug activity. However, another constituent of Indian snakeroot, yohimbine, has stimulant activity and may increase the risk of adverse effects with ephedrine.

Likelihood Probable Evidence D

Monoamine Oxidase Inhibitors (Maois)

Theoretically, taking Indian snakeroot with MAOIs might cause additive effects.
Yohimbine, a constituent of Indian snakeroot, has MAO inhibitory effects. At high doses, yohimbine is a non-selective inhibitor of MAO.

Likelihood Possible Evidence D

Stimulant Drugs

Theoretically, concomitant use might cause additive effects.
Yohimbine, a constituent of Indian snakeroot, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. Theoretically, taking Indian snakeroot with stimulant drugs can have additive stimulant and hypertensive effects.

Likelihood Possible Evidence D

Tricyclic Antidepressants (Tcas)

Theoretically, concomitant use might alter the effects of Indian snakeroot and increase the risk of adverse effects.
A small clinical study in patients taking TCAs for at least 4 weeks shows that receiving doses of intravenous yohimbine, a constituent of Indian snakeroot, 2.5-20 mg daily for up to 7 days precipitates severe anxiety, agitation, and tremor. Also, concomitant use of TCAs with Indian snakeroot may decrease the effects of other rauwolfia alkaloids.

Likelihood Possible Evidence D

Monograph

Indian Snakeroot: Uses, Safety & Side Effects

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

The bottom line

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.

Scientific name: Rauvolfia serpentina
Family: Apocynaceae
Part used: Root
Common forms: Powder, capsules, tablets, dried root, traditional preparations

People commonly use it for

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

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

Safety at a glance

OverallUse caution

Contains potent alkaloids that can cause serious side effects and should only be used under medical supervision.

PregnancyInsufficient reliable information

Insufficient reliable information available; avoid using. The reserpine alkaloid constituents appear to cross the placenta and are excreted in breast...

Read the full pregnancy detail

BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using. The reserpine alkaloid constituents appear to cross the placenta and are excreted in breast...

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.

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Overview

Indian snakeroot comes from the plant Rauvolfia serpentina, a small evergreen shrub native to India and other parts of South Asia. It is also called sarpagandha or chandra. The root is the part most often used.

This plant has a long history in Ayurvedic and Unani medicine. Traditional healers used it for high blood pressure, anxiety, trouble sleeping, fever, and even mental agitation. One of its compounds, reserpine, was later studied by modern medicine and used as a prescription blood pressure drug.

Today, Indian snakeroot is still found in some herbal products, but its use is restricted or controlled in many countries because of its strong effects and safety concerns.

How it works

Indian snakeroot root contains many alkaloids, the best known being reserpine. Other compounds include ajmaline, ajmalicine, and serpentine.

Reserpine works by lowering the levels of certain brain and nerve chemicals called catecholamines, including norepinephrine. By reducing these, it relaxes blood vessels and lowers blood pressure, and it can also have a calming or sedating effect.

Because reserpine lowers these brain chemicals, it can also lead to depression in some people. Much of what we understand comes from studies of purified reserpine rather than the whole herb, and the amount of active compounds in plant products can vary a lot.

Effectiveness

Does Indian Snakeroot work?

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

Evidence overview · 11 uses evaluated

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

Also studied for 11 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Abdominal pain