Medication interaction hub

What Supplements Interact with Zonisamide?

Zonisamide brand names: Zonegran, Zonisade. Every interaction below applies to the brands too.

206 Interactions 9 Major 157 Moderate 40 Minor
Curated & coded by · Clinical Pharmacist · Updated September 24, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Zonisamide? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Zonisamide against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

Zonisamide (Zonegran, Zonisade) keeps seizures under control, which means anything that shifts its blood level or stacks extra sedation on top deserves real respect, and nine of the 206 supplement ingredients on file rate major. Two big themes run through nearly everything here. More than half the list can change how the CYP3A4 enzyme clears the drug, with grapefruit raising levels and St. John's wort lowering them, a direction that could cost seizure protection. Another 78 pile drowsiness onto a medicine that already sedates, and alcohol lands in that major column.

The remaining entries, 157 moderate and 40 minor, mostly echo those same mechanisms at lower intensity. A smaller cluster interferes with how much of an oral dose gets absorbed, so those belong well spaced from when you take zonisamide. Get familiar with the nine majors first; they carry most of the danger on this page.

— , Clinical Pharmacist · July 18, 2026

Major 9 Moderate 157 Minor 40 No known interaction 1,246

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Most Viewed Ingredient Interactions

Zonisamide: Top Interactions at a Glance

The Zonisamide supplement & herbal interactions people checked most in the last 24 hours, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 206 interacting ingredients — plus 1,246 more checked with no known interaction. See the complete ranked list.

Start here

The Most-Checked Zonisamide Combinations Today

The Zonisamide + supplement pages people viewed most in the last 24 hours (resets at midnight). Open any card for the full report.

Moderate Likelihood Possible Lemon Balm + Zonisamidei

Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.

Read the full interaction Major Likelihood Probable L-tryptophan + Zonisamidei

Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.

Read the full interaction Moderate Likelihood Possible Slippery Elm + Zonisamidei

Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.

Read the full interaction Moderate Likelihood Possible Vitex Agnus-castus + Zonisamidei

Theoretically, vitex agnus-castus could interfere with dopamine agonists.

Read the full interaction Moderate Likelihood Possible Black Horehound + Zonisamidei

Theoretically, black horehound might have additive effects when used with dopamine agonists.

Read the full interaction Moderate Likelihood Possible Guar Gum + Zonisamidei

Guar gum might reduce the absorption of some oral drugs, potentially decreasing their effectiveness.

Read the full interaction
The complete list

Every Supplement Checked Against Zonisamide

All 1,452 ingredients in our database, ranked by severity — 206 with a Zonisamide interaction on file and 1,246 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Zonisamide?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Lemon Balm with Zonisamide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.

Full Lemon Balm + Zonisamide answer

Can you take L-tryptophan with Zonisamide?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.

Full L-tryptophan + Zonisamide answer

Can you take Slippery Elm with Zonisamide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.

Full Slippery Elm + Zonisamide answer

Can you take Vitex Agnus-castus with Zonisamide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, vitex agnus-castus could interfere with dopamine agonists.

Full Vitex Agnus-castus + Zonisamide answer

Can you take Black Horehound with Zonisamide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, black horehound might have additive effects when used with dopamine agonists.

Full Black Horehound + Zonisamide answer

Can you take Carob with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, carob might also impair the absorption of oral drugs.

Full Carob + Zonisamide answer

Can you take Cascara Sagrada with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.

Full Cascara Sagrada + Zonisamide answer

Can you take Fucus Vesiculosus with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.

Full Fucus Vesiculosus + Zonisamide answer

Can you take Hemp with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, hemp might decrease the levels and clinical effects of CYP3A4 substrates.

Full Hemp + Zonisamide answer

Can you take Hibiscus Sabdariffa with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP3A4 substrates.

Full Hibiscus Sabdariffa + Zonisamide answer

Can you take Honey with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, honey might decrease levels of drugs metabolized by CYP3A4, but research is conflicting.

Full Honey + Zonisamide answer

Can you take Karaya Gum with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Co-administration of oral drugs with bulk forming laxatives such as karaya gum may decrease, increase, or have no effect on the absorption o...

Full Karaya Gum + Zonisamide answer

Can you take Marshmallow with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, mucilage in marshmallow might impair absorption of oral drugs.

Full Marshmallow + Zonisamide answer

Can you take Puravive with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Puravive contains Panax ginseng.

Full Puravive + Zonisamide answer

Can you take Rhodiola with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.

Full Rhodiola + Zonisamide answer

Can you take Vitamin D with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.

Full Vitamin D + Zonisamide answer

Can you take Xanthan Gum with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, xanthan gum can alter the absorption of oral drugs due to its fiber qualities.

Full Xanthan Gum + Zonisamide answer

Can you take Yerba Mate with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, yerba mate might increase the levels and clinical effects of CYP3A4 substrates.

Full Yerba Mate + Zonisamide answer

Can you take Yohimbe with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, yohimbe might decrease the levels and clinical effects of CYP3A4 substrates.

Full Yohimbe + Zonisamide answer

Can you take Andiroba with Zonisamide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Andiroba contains fatty acid amides that have shown potential anticonvulsant effects in animal studies.

Full Andiroba + Zonisamide answer
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 entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Zonisamide is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Zonisamide, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Zonisamide sits in 6 interaction categories. Open any one to see what the group means:

Cytochrome P450 3A4 (Cyp3A4) Substrates 121 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

121 of the supplement ingredients on this page reach Zonisamide through this category.

Cns Depressants 78 ingredients

Central-nervous-system depressants. Sedating supplements can intensify drowsiness and slowed reactions when combined.

78 of the supplement ingredients on this page reach Zonisamide through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Zonisamide through this category.

Anticonvulsants 15 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

15 of the supplement ingredients on this page reach Zonisamide through this category.

Dopamine Agonists 4 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

4 of the supplement ingredients on this page reach Zonisamide through this category.

Zonisamide (Zonegran) 1 ingredient

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

1 of the supplement ingredient on this page reaches Zonisamide through this category.

About Zonisamide

Zonisamide is an antiseizure medicine used alongside other seizure medications to help control partial-onset seizures in adults and adolescents 16 and older.

Generic name: Zonisamide  ·  Brand names: Zonegran, Zonisade.

See the full Zonisamide drug information

Related: does Zonisamide deplete any nutrients?

Zonisamide has 2 reported nutrient associations in the research literature — see the Zonisamide nutrient depletion report.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Zonisamide

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Zonisamide.

Search a supplement product

Type a product name, brand, or UPC — smart search across our full catalog.

Grounded search over our product catalog — every verdict comes from our interaction database, never AI guesswork. How we use AI

Or scan the bottle

Photograph any Supplement Facts panel — we read the ingredients and check each one against your medications. Free, in seconds.

Open the label scanner

Prefer typing? The interaction checker looks up products by name too.

Products that contain Zonisamide-interacting ingredients

Real supplements from the NIH label database that contain the top interacting ingredients on this page — each one is worth a full label check before combining with Zonisamide.

Yeast-Cleanse by Solaray contains Grapefruit Ultimate GCB by M3 Supplement Company contains Grapefruit Neuro Health by Nature’s Craft contains Grapefruit NDF Happy Peach by Bioray Kids contains Grapefruit
Pharmacist Counseling Corner

Zonisamide & Supplements: Common Questions

What supplements interact with Zonisamide?
In our interaction database, 206 supplement and herbal ingredients have an interaction with Zonisamide on file — 9 rated major, 157 moderate, and 40 minor. That number sounds scarier than it is: severity matters far more than the count, which is why the list on this page is ranked instead of alphabetical. Start at the top. The highest-ranked right now: Beer, Grapefruit, Wine.
Which Zonisamide supplement interactions are the most serious?
The 9 major-rated combinations — led by Beer, Grapefruit, Wine, 1,4-butanediol and Activated Charcoal — deserve real caution: these are the ones generally best avoided, or used only with your prescriber watching. If you take any of them today, don't panic and don't stop anything abruptly — call your pharmacist first. Jump to the ranked list.
Can I take vitamins or supplements while on Zonisamide?
That depends entirely on which supplement. The honest answer for Zonisamide is in the ranked list above — and if what you take is a combination product with a dozen ingredients, don't check them one by one: photograph the label with our scanner and we'll check the whole thing at once. Try the label scanner or the interaction checker.
Do brands like Zonegran have the same supplement interactions as Zonisamide?
Yes — Zonegran, Zonisade all contain Zonisamide, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
Does Zonisamide deplete any vitamins or nutrients?
It might — Zonisamide has 2 reported nutrient-depletion associations in the research literature, which is a different question from interactions: instead of a supplement changing the drug, the drug may lower a nutrient over time. See the Zonisamide nutrient depletion report for the specifics and what to discuss with your pharmacist.
What about Zonisamide and my other medications?
This page covers Zonisamide against supplements and herbal ingredients. Checking Zonisamide against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker, or read the full Zonisamide drug information.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

More Free Pharmacist Tools

Supplement interaction checker Check any supplement or product against your medications Supplement label scanner Photograph a Supplement Facts panel; we check every ingredient Browse medications A–Z Every drug we’ve checked against herbs & supplements Ingredient directory Every vitamin, herb & mineral we track, with interaction data Product directory Look up any bottle by name, brand, or barcode Ask a pharmacist Free, personal answer from our licensed team
Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 24, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.