Ashwagandha Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Ashwagandha against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Ashwagandha is a dietary supplement by Metabolic Nutrition with 3 active ingredients. Its ingredients are commonly taken for stress and anxiety, sleep problems, fatigue and low energy.Based on those ingredients, 1,480 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Ashwagandha, Powder, Black Pepper Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Ashwagandha by Metabolic Nutrition
Ask about any prescription or over-the-counter medication and we check it for interactions with Ashwagandha by Metabolic Nutrition — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Ashwagandha by Metabolic Nutrition
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This product contains 3 active ingredients. Two are ashwagandha — one labeled Ashwagandha Powder and one as KSM-66, a concentrated extract form.
Both contain the same withanolide compounds that give ashwagandha its effects. The third active ingredient is Black Pepper Extract, which contains piperine, often added to supplements to improve absorption of other ingredients.
Silicon Dioxide is an inactive ingredient (a flow agent used in capsule manufacturing).
Does it work?
Moderate evidence
Ashwagandha is possibly effective for insomnia, anxiety, stress, and generalized anxiety disorder based on the evidence we hold. For bipolar disorder, the evidence is too limited to rate it either way.
Black Pepper Extract's effectiveness isn't established in our data for the conditions listed — the evidence for hay fever, asthma, athletic performance, headache, depression, and diarrhea is insufficient to rate.
How safe is it?
Well-documented data
Ashwagandha is generally well tolerated short-term in healthy adults, though quality and long-term safety data are limited. The most common side effects — diarrhea, stomach upset, nausea, and vomiting — don't typically occur at standard doses.
Rare but serious cases of liver damage, drowsiness, and headache have been reported. Because ashwagandha is traditionally thought to carry a miscarriage risk, the safety data advises against it during pregnancy.
There isn't enough safety information to use it while breastfeeding. Black Pepper Extract is generally safe as a food spice; concentrated supplements should be used more cautiously, with attention to interactions above.
Meds to double-check
Moderate interaction found
Check with your pharmacist if you take any liver-stressing medications, CNS depressants or sedatives (including benzodiazepines), blood pressure medications, diabetes drugs, immunosuppressants, or thyroid hormone. Also watch for propranolol, phenytoin, rifampin, nevirapine, theophylline, cyclosporine, atorvastatin, and pentobarbital — black pepper may raise their blood levels.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
If you take CNS depressants, blood pressure medications, diabetes drugs, immune-suppressing drugs, thyroid hormone, or any liver-stressing medications, talk to your pharmacist before starting this product. The same goes if you're on any of the specific drugs black pepper is known to interact with.
Ashwagandha may help with anxiety and sleep, but it's not without risks — your pharmacist can help you decide if it's right for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 22, 2024.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Ashwagandha, straight from the product label.
| Brand | Metabolic Nutrition |
|---|---|
| Barcode (UPC) | 764779310097 |
| Net contents | 90 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Mar 22, 2024 |
| DSLD ID | 307919 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Women (not pregnant or lactating), Gluten Free, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Ashwagandha by Metabolic Nutrition, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| AshwaMAX | 2205 mg | -- |
| Ashwagandha, Powder | 1100 mg | -- |
| KSM-66 | 1100 mg | -- |
| Black Pepper Extract | 5 mg | -- |
Other ingredients: Silicon Dioxide
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
Health & wellness solution
This product does not contain: Gluten, dairy, egg, peanut, fish, soy, shellfish, wheat, yeast, fillers, binders, preservatives, artificial ingredients.
Maximum potency formula Health & wellness solution Relieves stress Enhances energy & mood Boosts thyroid output Boosts sexual health Max dose
Vegan
Gluten free Non-GMO
Formula
Ashwagandha is a prized herb of India that has been used for over 3,000 years as a medicinal aid for its ability to heal the body and mind. Containing many active compounds, including the powerful withanolides, ashwagandha helps provide anti-stress benefits, ability to boost energy/mood/sexual health, improved memory & cognition, reduce cortisol level, aids lean muscle mass & supports a healthy metabolism. Metabolic Nutrition provides a purified, all natural, highly concentrated, ashwagandha formula combined with black pepper extract for maximum effectiveness & absorption... specifically developed for individuals who want to maximize their health and wellness.
Precautions
This product does not contain: Gluten, dairy, egg, peanut, fish, soy, shellfish, wheat, yeast, fillers, binders, preservatives, artificial ingredients. Produced in a facility that processes other ingredients containing these allergens.
Caution: Do not exceed the recommended dose.
Not intended for pregnant or nursing mothers.
Not intended for children under 18 years of age.
If you are taking any medications, have a known medical condition, or are planning a medical procedure, consult your doctor before use.
Discontinue use and consult your doctor if any adverse reactions occur.
Usage warning: Keep out of reach of children and pets.
Do not use if packaging has been tampered with.
California residents only Warning: Consuming this product can expose you to chemicals including (lead and cadmium), which is (are) known to the State of California to cause cancer and birth defects or other reproductive harm. For more information go to www.P65Warnings.ca.gov/food.
Storage
Store in a cool dry place away from direct sunlight. Avoid excess heat.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Brand IP Statement(s)
Copyright 2019 Metabolic Nutrition, Inc. All rights reserved.
Metabolic Nutrition Unleash Your Superhero
Seals/Symbols
GMP Quality Good Manufacturing Practice Certification Made in FDA Inspected Facility Made in USA
Vegan
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions for use: As a dietary supplement, take one serving (3 capsules) once a day with a meal.
General Statements
Questions? 800-626-1022 metabolicnutrition.com Follow us Facebook Instagram Twitter YouTube
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Ashwagandha by Metabolic Nutrition label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Ashwagandha by Metabolic Nutrition
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
AshwaMAX
Other (inactive) ingredients: Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Ashwagandha by Metabolic Nutrition Drug Interactions
HelloPharmacist Interaction Report
Metabolic Nutrition's Ashwagandha has documented interactions with multiple medication types.
The most serious concern is liver damage risk: ashwagandha has been linked to acute hepatitis, liver failure, and hepatic encephalopathy, especially when combined with drugs that already stress the liver (hepatotoxic drugs).
Read the full breakdown — every affected drug type, severity by severity
Ashwagandha may also increase sedation when taken with CNS depressants (including benzodiazepines like Valium and Klonopin, and barbiturates), raising the risk of excessive drowsiness or reduced alertness. It theoretically lowers blood pressure and may amplify the effects of blood pressure medications, risking dangerously low readings.
There's preliminary evidence it may lower blood sugar, so combined use with diabetes medications raises hypoglycemia risk. Ashwagandha may also dampen the effects of immunosuppressants and could interfere with thyroid hormone replacement therapy — potentially making it less effective or causing an overactive thyroid.
Black Pepper Extract in this product interacts with several specific medications: it may increase blood levels of propranolol (a beta-blocker), the antiseizure drug phenytoin, the antibiotic rifampin, the HIV drug nevirapine, the asthma/heart drug theophylline, the immunosuppressant cyclosporine, the statin atorvastatin, and the barbiturate pentobarbital. Altogether, these interactions span 1,458 individual medications.
Before starting this product, run your exact medications through the checker below.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Ashwagandha?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Ashwagandha interact with 1,480 drugs. Click any drug to see the details.
2 of the 3 ingredients in Ashwagandha interact with drugs. Each result below shows which ingredient is responsible. Ashwagandha, Powder Black Pepper Extract
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs, Immunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Extract + Ado-trastuzumab Emtansine interactionKsm-66Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
Black Pepper ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Black Pepper Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Extract + Abemaciclib interactionKsm-66Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Abiraterone interactionBlack Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Black Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Extract + Abiraterone Acetate interactionKsm-66Hepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Immunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Read the full Ksm-66 + Abrocitinib interactionBlack Pepper ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Black Pepper Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Black Pepper ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Black Pepper Extract + Acalabrutinib interactionKsm-66Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acarbose interactionBlack Pepper ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Black Pepper Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
Ksm-66Antihypertensive Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Read the full Ksm-66 + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
Black Pepper ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Black Pepper Extract + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
Ksm-66Cns Depressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acetaminophen interactionBlack Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ksm-66 + Acetaminophen, Aspirin interactionBlack Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Black Pepper ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Black Pepper Extract + Acetaminophen, Aspirin, Caffeine interactionKsm-66Hepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionBlack Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ksm-66 + Acetaminophen, Butalbital interactionBlack Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acetaminophen, Butalbital, Caffeine interactionBlack Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Black Pepper ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Black Pepper Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionKsm-66Cns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ksm-66 + Acetaminophen, Butalbital, Codeine interactionBlack Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Black Pepper ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Black Pepper Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionKsm-66Cns Depressants, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ksm-66 + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionBlack Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen, Caffeine, Codeine interactionKsm-66Cns Depressants, Hepatotoxic Drugs +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Acetaminophen, Caffeine, Codeine, Salicylamide interactionBlack Pepper ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Black Pepper Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Cns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acetaminophen, Caffeine, Dihydrocodeine interactionBlack Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acetaminophen, Caffeine, Isometheptene interactionBlack Pepper ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Black Pepper Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Black Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen, Caffeine, Pyrilamine interactionKsm-66Cytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs, Serotonergic Drugs +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionBlack Pepper ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Black Pepper Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Ashwagandha with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Ashwagandha, Powder
Antidiabetes Drugs
Theoretically, taking ashwagandha with antidiabetes drugs might increase the risk of hypoglycemia.
There is preliminary clinical evidence suggesting that ashwagandha might lower blood glucose levels. Theoretically, ashwagandha might have additive effects when used with antidiabetes drugs and increase the risk of hypoglycemia.
Antihypertensive Drugs
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Animal research suggests that ashwagandha might lower systolic and diastolic blood pressure. Theoretically, ashwagandha might have additive effects when used with antihypertensive drugs and increase the risk of hypotension.
Benzodiazepines
Theoretically, taking ashwagandha might increase the sedative effects of benzodiazepines.
There is preliminary evidence that ashwagandha might have an additive effect with diazepam (Valium) and clonazepam (Klonopin). This may also occur with other benzodiazepines.
Cns Depressants
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Ashwagandha seems to have sedative effects. Theoretically, this may potentiate the effects of barbiturates, other sedatives, and anxiolytics.
Hepatotoxic Drugs
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Ashwagandha has been linked to cases of acute hepatitis, liver failure, hepatic encephalopathy, autoimmune hepatitis, the need for liver transplantation, and death due to liver failure.
Immunosuppressants
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Ashwagandha has demonstrated immunostimulant effects in humans. Animal research has shown that ashwagandha can attenuate the immunosuppression caused by cyclophosphamide.
Thyroid Hormone
Ashwagandha might increase the effects and adverse effects of thyroid hormone.
Concomitant use of ashwagandha with thyroid hormones may cause additive therapeutic and adverse effects. Preliminary clinical research and animal studies suggest that ashwagandha boosts thyroid hormone synthesis and secretion. In one clinical study, ashwagandha increased triiodothyronine (T3) and thyroxine (T4) levels by 41.5% and 19.6%, respectively, and reduced serum TSH levels by 17.4% from baseline in adults with subclinical hypothyroidism.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that ashwagandha extract induces CYP1A2 enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that ashwagandha extract induces CYP3A4 enzymes.
Serotonergic Drugs
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors. However, there is no evidence to suggest that ashwagandha increases the risk of serotonin-related effects, and there have been no published case reports of serotonin syndrome when combined with other serotonergic drugs. Nevertheless, due to the lack of extensive studies on the matter and the fact that ashwagandha appears to affect serotonergic pathways, it would be prudent to exercise caution when combining it with drugs that affect serotonin. [References: - Effects of Withania somnifera (Ashwaga ndha) on Stress and the Stress-Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia. Curr Neuropharmacol. 2021 Sep 14; 19: 1468–1495. - A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/]
Black Pepper Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.
Antidiabetes Drugs
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Atorvastatin (Lipitor)
Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.
Cyclosporine (Neoral, Sandimmune)
Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.
Lithium
Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.
Nevirapine (Viramune)
Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.
P-Glycoprotein Substrates
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.
Pentobarbital (Nembutal)
Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.
Phenytoin (Dilantin)
Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.
Propranolol (Inderal)
Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.
Rifampin (Rifadin)
Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.
Theophylline
Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.
Amoxicillin (Amoxil, Trimox)
Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.
Carbamazepine (Tegretol)
Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.
Brand information
Manufacturer and brand details for Ashwagandha, from the product label.
Metabolic Nutrition
See all Metabolic Nutrition products- Name
- Metabolic Nutrition
- City
- Fort Lauderdale
- State
- FL
- Phone Number
- 800-626-1022
- Web Address
- metabolicnutrition.com
Ashwagandha by Metabolic Nutrition: Common Questions
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Why is Black Pepper Extract in this product?
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Ashwagandha’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Ashwagandha
Interacts with 1,372 drugsAshwagandha is an Ayurvedic herb most often taken to help with stress, anxiety, and sleep, and some small studies suggest it may help, though the evidence is still limited. It is generally w...
Read the full Ashwagandha monograph → Herb & supplement monographBlack Pepper
Interacts with 1,019 drugsBlack pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...
Read the full Black Pepper monograph →Sources & How We Checked
Ashwagandha's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 61 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Ashwagandha 32 references
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- Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.
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- Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol 1998;62:209-14. PubMed
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- Andallu B, Radhika B. Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian J Exp Biol 2000;38:607-9.
- Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5. PubMed
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- Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol 1998;50:1065-68. PubMed
- Sehgal, V. N., Verma, P., and Bhattacharya, S. N. Fixed-drug eruption caused by ashwagandha (Withania somnifera): a widely used Ayurvedic drug. Skinmed. 2012;10(1):48-49.
- Agnihotri AP, Sontakke SD, Thawani VR, Saoji A, Goswami VS. Effects of Withania somnifera in patients of schizophrenia: a randomized, double blind, placebo controlled pilot trial study. Indian J Pharmacol. 2013;45(4):417-8. PubMed
- Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Integr Cancer Ther. 2013;12(4):312-22.
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- Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4):825-829. PubMed
- Tharakan A, Shukla H, Benny IR, Tharakan M, George L, Koshy S. Immunomodulatory Effect of Withania somnifera (Ashwagandha) Extract-A Randomized, Double-Blind, Placebo Controlled Trial with an Open Label Extension on Healthy Participants. J Clin Med 2021;1 PubMed
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- Kamal HI, Patel K, Brdak A, Heffernan J, Ahmad N. Ashwagandha as a unique cause of thyrotoxicosis presenting with supraventricular tachycardia. Cureus. 2022 Mar 25;14(3):e23494. PubMed
- Suryawanshi G, Abdallah M, Thomson M, Desai N, Chauhan A, Lim N. Ashwagandha-Associated Acute Liver Failure Requiring Liver Transplantation. Am J Ther 2023;30(1):e80-e83. PubMed
- Pusec CM, Wolsky R, Llerena C, Sura P. A Case of Supplement-Induced Hepatitis. Cureus 2022;14(10):e30433. PubMed
- Ajgaonkar A, Jain M, Debnath K. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract for Improvement of Sexual Health in Healthy Women: A Prospective, Randomized, Placebo-Controlled Study. Cureus 2022;14(10):e30787. PubMed
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
- Lubarska M, Halasinski P, Hryhorowicz S, et al. Liver Dangers of Herbal Products: A Case Report of Ashwagandha-Induced Liver Injury. Int J Environ Res Public Health 2023;20(5):3921. PubMed
- Tóth M, Benedek AE, Longerich T, Seitz HK. Ashwagandha-induced acute liver injury: A case report. Clin Case Rep 2023;11(3):e7078.
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- Patel PA, Sanborn E, Then R, Williams DM. Recurrent Reversible Cerebral Vasoconstriction Syndrome: A Report of Two Cases. Cureus 2023;15(8):e42992. PubMed
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- Patel M, Newell R, Hillier M, Ramalingam R. Herbal remedies as a potential cause of hypoadrenalism. Br J Hosp Med (Lond) 2024;85(6):1-4. PubMed
Black Pepper 29 references
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- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
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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