Ashwagandha Extract Ingredients & Drug Interactions
by 21st Century
What is this page for?
First and foremost: checking Ashwagandha Extract 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 Extract is a dietary supplement by 21st Century with 1 active ingredient. Its ingredients are commonly taken for stress and anxiety, sleep problems, fatigue and low energy.Based on those ingredients, 1,372 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Ashwagandha Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Ashwagandha Extract by 21st Century
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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 Extract by 21st Century
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 one active ingredient: Ashwagandha Extract. Ashwagandha is an herb traditionally used to help with relaxation and stress, and it's been studied for its possible effects on sleep and anxiety.
The capsule also includes inactive ingredients — cellulose, magnesium stearate, rice bran, and silicon dioxide — which are fillers and binders that hold the supplement together.
Does it work?
Moderate evidence
The evidence on ashwagandha shows it's possibly effective for insomnia, anxiety, stress, and generalized anxiety disorder (GAD). That means there's some promising research, but the data isn't solid enough to call it proven.
For bipolar disorder, we don't have enough reliable evidence to rate whether it works at all. If you're considering this for sleep or anxiety, talk with your pharmacist or doctor about whether the preliminary evidence fits your situation.
How safe is it?
Well-documented data
Ashwagandha is generally well tolerated in the short term by healthy adults, but long-term safety data are limited and product quality can vary. The most common side effects — when they occur — are diarrhea, stomach upset, nausea, and vomiting, though these don't typically happen at standard doses.
Rarely, cases of liver damage, including acute hepatitis and liver failure, have been reported. Drowsiness has also been reported.
If you're pregnant, the safety data advises against this supplement — it's traditionally thought to raise the risk of miscarriage. If you're breastfeeding, there isn't enough safety information, so it's best to avoid it.
If you're taking thyroid hormone, be aware that ashwagandha may boost those levels and cause side effects like a rapid heartbeat, tremor, and irritability. Talk with your pharmacist or doctor before starting.
Meds to double-check
Moderate interaction found
Before taking ashwagandha, check your medications with the tool below if you take immune suppressants (like tacrolimus or mycophenolate), benzodiazepines (like alprazolam or diazepam), sedatives or sleeping pills, blood pressure medications, diabetes drugs, thyroid hormone (like levothyroxine), or any medication processed by your liver's CYP1A2 enzyme. All are Moderate severity concerns.
You should also mention it to your pharmacist if you take any drug that stresses your liver.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.
Ashwagandha Extract may help with sleep, anxiety, and stress, but it interacts with several common medication types — especially immune suppressants, sedatives, blood pressure drugs, and diabetes medications. If you're on any prescriptions, check them against our database before you start.
Pregnant and breastfeeding women should avoid it. It's generally well tolerated short-term, but long-term safety data are sparse, so run it by your pharmacist first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Jan 23, 2023.
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 Extract, straight from the product label.
| Brand | 21st Century |
|---|---|
| Barcode (UPC) | 740985280713 |
| Net contents | 60 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jan 23, 2023 |
| DSLD ID | 286870 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Gluten 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 Extract by 21st Century, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Ashwagandha Extract | 500 mg | -- |
Other ingredients: Cellulose, Magnesium Stearate, Rice Bran, 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.
Suggested/Recommended/Usage/Directions
Directions: As an herbal supplement, adults take one (1) capsule daily with any meal or as directed by a healthcare provider. Do not exceed recommended dosage. Individual results may vary.
Precautions
Warning: Consult a healthcare provider prior to use if pregnant, nursing, on medications, have a medical condition or are planning a medical procedure.
Stop use and contact a physician if adverse reactions occur.
Keep out of reach of children.
Do not use if product appears to be tampered with or seal is broken.
Storage
Store at room temperature.
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.
General Statements
New
Trusted quality for over 30 years
Formulation
Standardized Stress & mood support
Gluten free Non-GMO
No added sugar, salt, yeast, preservatives or artificial flavors.
Suitable for vegans.
Guaranteed quality Laboratory tested
FDA Statement of Identity
Herbal Supplement
Formula
Ashwagandha Extract is an adaptogenic herb that supports a healthy stress response and mood.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Ashwagandha Extract by 21st Century 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 Extract by 21st Century
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1 Vegetarian Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.
Ashwagandha Extract
Interacts with1,372 drugs
Ashwagandha is an Ayurvedic herb most often taken to help with stress, anxiety, and sleep, and some small studies suggest it may help, though the evid...
Ashwagandha Extract monograph & interactionsOther (inactive) ingredients: Cellulose, Magnesium Stearate, Rice Bran, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Ashwagandha Extract by 21st Century Drug Interactions
HelloPharmacist Interaction Report
Ashwagandha Extract by 21st Century has documented interactions with a number of medication types, so you'll want to check this one before you start if you're on any prescriptions.
The most serious concern is with drugs that suppress your immune system (immunosuppressants). Ashwagandha appears to boost immune function, which could work against medications like those used after organ transplants or for certain autoimmune conditions, potentially reducing their effectiveness.
Read the full breakdown — every affected drug type, severity by severity
You should also be cautious if you take sedatives, anti-anxiety medications (benzodiazepines), blood pressure drugs (antihypertensives), blood sugar medications (antidiabetes drugs), thyroid hormone, or drugs processed through a liver enzyme called CYP1A2. Ashwagandha may increase the sedative effects of calming medications, lower your blood pressure further, raise the risk of low blood sugar, and boost thyroid hormone levels — all of which could amplify side effects or change how well your medications work.
There's also a theoretical concern with medications that are toxic to the liver (hepatotoxic drugs), since ashwagandha itself has been rarely linked to liver damage.
Although ashwagandha appears to have minor interaction potential with CYP1A2 substrates, the other concerns are all rated Moderate. Altogether, these interactions span 1,351 individual medications.
Use the medication checker below to look up your exact drugs before taking this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Ashwagandha Extract?
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 Extract interact with 1,372 drugs. Click any drug to see the details.
1 of the 1 ingredient in Ashwagandha Extract interact with drugs. Each result below shows which ingredient is responsible. Ashwagandha Extract
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic Drugs, Immunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Extract + 6-mercaptopurine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Extract + Abacavir, Lamivudine interactionAbiraterone
How Abiraterone interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic 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 Ashwagandha Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Read the full Ashwagandha Extract + Abrocitinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic Drugs, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractAntihypertensive Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Read the full Ashwagandha Extract + Acebutolol interactionAcepromazineAtravet
How Acepromazine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ashwagandha Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic 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 Ashwagandha Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ashwagandha Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic 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 Ashwagandha Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ashwagandha Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic 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 Ashwagandha Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ashwagandha Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic 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 Ashwagandha Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ashwagandha Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic Drugs, Cns Depressants +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha 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 Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ashwagandha Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ashwagandha Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome 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 Ashwagandha Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome 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 Ashwagandha Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Serotonergic Drugs +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ashwagandha Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +3 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractSerotonergic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Ashwagandha Extract — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ashwagandha Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Ashwagandha Extract with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
Ashwagandha Extract
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/]
Brand information
Manufacturer and brand details for Ashwagandha Extract, from the product label.
21st Century
See all 21st Century products- Name
- 21st Century HealthCare, Inc.
- Street Address
- 2119 S. Wilson St.
- City
- Tempe
- State
- AZ
- ZipCode
- 85282
- Web Address
- 21stcenturyvitamins.com
Ashwagandha Extract by 21st Century: Common Questions
Does Ashwagandha Extract by 21st Century interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
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What are the most common side effects?
Will this help my insomnia?
Can this help with my anxiety?
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The Full Monographs Behind Ashwagandha Extract’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Ashwagandha Extract'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 32 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
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.
- Davis L, Kuttan G. Effect of Withania somnifera on cyclophosphamide-induced urotoxicity. Cancer Lett 2000;148:9-17. PubMed
- Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol 1998;62:209-14. PubMed
- Mishra LC, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): a review. Altern Med Rev 2000;5:334-46. DOI
- 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
- Ahumada F, Aspee F, Wikman G, Hancke J. Withania somnifera exract. Its effects on arterial blood pressure in anaesthetized dogs. Phytother Res 1991;5:111-14.
- Panda S, Kar A. Withania somnifera and Bauhinia purpurea in the regulation of circulating thyroid hormone concentrations in female mice. J Ethnopharmacol 1999;67:233-39. PubMed
- 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.
- Sharma AK, Basu I, Singh S. Efficacy and safety of Ashwagandha root extract in subclinical hypothyroid patients: a double-blind, randomized placebo-controlled trial. J Altern Complement Med. 2018 Mar;24(3):243-248. PubMed
- Durg S, Bavage S, Shivaram SB. Withania somnifera (Indian ginseng) in diabetes mellitus: A systematic review and meta-analysis of scientific evidence from experimental research to clinical application. Phytother Res. 2020;34(5):1041-1059.
- 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
- Ireland PJ, Hardy T, Burt AD, Donnelly MC. Drug-induced hepatocellular injury due to herbal supplement ashwagandha. J R Coll Physicians Edinb. 2021;51(4):363-365. PubMed
- 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.
- Bokan G, Glamocanin T, Mavija Z, et al. Herb-Induced Liver Injury by Ayurvedic Ashwagandha as Assessed for Causality by the Updated RUCAM: An Emerging Cause. Pharmaceuticals (Basel) 2023;16(8):1129. PubMed
- Patel PA, Sanborn E, Then R, Williams DM. Recurrent Reversible Cerebral Vasoconstriction Syndrome: A Report of Two Cases. Cureus 2023;15(8):e42992. PubMed
- Majeed M, Nagabhushanam K, Murali A, Vishwanathan DT, Mamidala RV, Mundkur L. A Standardized Withania somniferra (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomize
- Philips CA, Valsan A, Theruvath AH, et al. Ashwagandha-induced liver injury-A case series from India and literature review. Hepatol Commun 2023;7(10):e0270. PubMed
- Hayashi M, Hamada H, Azuma SI, Hayashi K. Painless Thyroiditis by Withania somnifera (Ashwagandha). Cureus 2024;16(3):e55352. PubMed
- Vazirani S, Kothari A, Fujimoto J, Gomez M. Supplements Are Not a Synonym for Safe: Suspected Liver Injury From Ashwagandha. Fed Pract 2023;40(9):315-319. PubMed
- 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
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