Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Clinical Stress Relief Ingredients & Drug Interactions

by Protocol For Life Balance

Clinical Stress Relief label
See full label image
Capsule Category: Botanical With Nutrients
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Clinical Stress Relief 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

The interaction bottom line Most serious interaction: Moderate

Clinical Stress Relief is a dietary supplement by Protocol For Life Balance with 2 active ingredients. Its ingredients are commonly taken for high blood pressure, stress and relaxation, sleep support.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 Leaf, Root Extract, Lactium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Clinical Stress Relief by Protocol For Life Balance

Ask about any prescription or over-the-counter medication and we check it for interactions with Clinical Stress Relief by Protocol For Life Balance — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Clinical Stress Relief by Protocol For Life Balance

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.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 2 of its 2 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Clinical Stress Relief contains two active ingredients. Lactium is a casein peptide derived from milk protein.

Ashwagandha is an herbal extract from the leaf and root of the ashwagandha plant, traditionally used in Ayurvedic medicine. The product also includes three inactive ingredients — hypromellose (a capsule binder), stearic acid, and silicon dioxide — which help form and stabilize the capsule.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: support healthy cortisol levels and relieve stress.
  • We looked for evidence on: Stress, Anxiety, Generalized anxiety disorder (GAD), Insomnia, Fatigue, Psychological well-being — and 3 related terms.
  • The strongest evidence on file: Ashwagandha is rated "Possibly Effective" for Anxiety (Natural Medicines).
  • Also on file: Ashwagandha is rated "Possibly Effective" for Generalized anxiety disorder (GAD), Insomnia, Stress.
  • Also on file: Ashwagandha is rated "Insufficient Reliable Evidence To Rate" for Chemotherapy-related fatigue, Fatigue, Psychological well-being.

The evidence for what this product does depends on which ingredient you're asking about. Ashwagandha is possibly effective for insomnia, anxiety, stress, and generalized anxiety disorder based on the evidence we hold — meaning there's some clinical support, but it's not yet strong enough to call it proven.

The evidence for bipolar disorder is insufficient to rate. Lactium is likely effective for food allergies and atopic dermatitis (eczema), but it's important to note that the product is being marketed here for stress relief, and we hold no effectiveness data for lactium specifically for that purpose.

The evidence, ingredient by ingredient Casein Peptides Ashwagandha

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Both ingredients are generally well tolerated in the short term in healthy adults, though quality and long-term safety data for ashwagandha are limited. Lactium carries a caution that concentrated supplement doses haven't been well studied, so caution is advised — and it must be avoided by anyone with a milk allergy.

Ashwagandha has rare serious adverse effects: case reports describe acute hepatitis, liver failure, and very rarely reversible cerebral vasoconstriction syndrome (a blood vessel condition). More commonly, ashwagandha may cause diarrhea, stomach upset, nausea, vomiting, or drowsiness, though these don't typically occur at usual doses.

Ashwagandha is traditionally thought to risk miscarriage, so the safety data advises against it during pregnancy. There isn't enough safety data to know whether it's safe while breastfeeding, so you should talk with your doctor or pharmacist before using it.

Side effects, ingredient by ingredient Casein Peptides Ashwagandha

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 2 of the 2 matched ingredients can interact with medications — Ashwagandha, Casein Peptides.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,373 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, double-check if you're on blood pressure medications, liver-metabolized drugs, diabetes medications, benzodiazepines or other sedatives, thyroid hormones, immunosuppressants, or medications processed through the CYP1A2 liver pathway. The most serious documented interaction is with drugs that can harm the liver.

If any of these apply to you, confirm with your pharmacist first.

Check your own medication Run your meds through the checker above

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.

This product may help with stress and anxiety, but it carries real interaction risks — especially if you take blood pressure medications, diabetes drugs, benzodiazepines, or anything metabolized by the liver. The serious but rare hepatic (liver) risk with ashwagandha is something to know about.

Check your medications with the tool on this page before you start, and talk with your pharmacist if you have any questions about whether it's right for you.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 22, 2025.

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

At a glance

General information

Key facts about Clinical Stress Relief, straight from the product label.

Brand Protocol For Life Balance
Barcode (UPC) 707359123755
Net contents 60 Veg Capsule(s)
Market status On market
Date entered into DSLD Aug 22, 2025
DSLD ID 337779
Product type Botanical With Nutrients
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Women (not pregnant or lactating), Gluten Free
From the label
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 Clinical Stress Relief by Protocol For Life Balance, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Veg Capsule(s)
Maximum serving Sizes:
1 Veg Capsule(s)
Servings per container
60
UPC/BARCODE
707359123755
IngredientAmount% DV
Lactium150 mg--
Ashwagandha Leaf, Root Extract300 mg--

Other ingredients: Hypromellose, Stearic Acid, Silicon Dioxide

Tap any ingredient to jump to its full detail below.

Label statements
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

Suggested usage: Take 1 capsule 1 to 2 times dally, with or without food, or as directed by your healthcare practitioner. May be taken during daytime for stress or before bed to help with sleep.

Formula

How it works: Clinical Stress Relief features Lactium a clinically tested milk protein derivative.

Lactium

Clinical Stress Relief With Lactium & Ashwagandha

Formulation

How it works: Clinical Stress Relief features Lactium a clinically tested milk protein derivative. Lactium has been shown to support healthy cortisol levels and thus, can help to relieve the symptoms of stress from everyday life In addition, it can help to bring on sleep more quickly, maintain uninterrupted sleep, and promote better over all sleep quality. Ashwagandha has been included as an "adaptogen", which helps the body adapt to typical daily stress.

Mood & Sleep Support Support for Everyday Stress

Not manufactured with yeast, wheat, gluten, soy, egg, fish, shellfish, tree nut or sesame ingredients.

Natural color variation may occur in this product.

Precautions

Cautions/Interactions: Not recommended for pregnant/nursing women. Consult your healthcare practitioner if taking medication (especially thyroid hormones) or have a medical condition (especially thyroid and gastrointestinal conditions including ulcers).

Do not take if allergic to milk protein.

Discontinue use if rash/itching occurs.

Contains milk.

Not manufactured with yeast, wheat, gluten, soy, egg, fish, shellfish, tree nut or sesame ingredients. Produced in a GMP facility that processes other ingredients containing these allergens.

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

EUA # 1482865

FDA Statement of Identity

A Dietary Supplement

Brand IP Statement(s)

Lactium is a registered trademark of Ingredia.

Storage

Store in a cool, dry place after opening.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Clinical Stress Relief by Protocol For Life Balance label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Clinical Stress Relief label

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)
What’s inside

The Ingredients in Clinical Stress Relief by Protocol For Life Balance

These are the 2 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Veg Capsule(s) Dosage formCapsule Servings per container60 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.

Lactium

Interacts with
172 drugs
150 mg per serving Form: Casein Hydrolysate

Casein peptides are small protein fragments made from milk casein, often studied for mild blood pressure support and relaxation. The evidence is limit...

Lactium monograph & interactions

Ashwagandha Leaf, Root Extract

Interacts with
1,372 drugs
300 mg per serving Form: Ashwagandha Leaf Extract , Ashwagandha Root Extract

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 Leaf, Root Extract monograph & interactions

Other (inactive) ingredients: Hypromellose, Stearic Acid, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Clinical Stress Relief by Protocol For Life Balance Drug Interactions

Want to check YOUR meds against Clinical Stress Relief?

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 checker
1,372Drugs
916 Moderate 456 Minor

Ingredients driving the most interactions

Ashwagandha Leaf, Root Extract 1,372
Lactium 172

Individual Drug Interactions

The ingredients in Clinical Stress Relief interact with 1,372 drugs. Click any drug to see the details.

2 of the 2 ingredients in Clinical Stress Relief interact with drugs. Each result below shows which ingredient is responsible. Ashwagandha Leaf, Root Extract Lactium

Each ingredient & the kinds of drugs it affects

For each ingredient in Clinical Stress Relief 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 Leaf, Root Extract10 drug types · 1,372 drugs

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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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/]

Likelihood Possible Evidence C
Ashwagandha Leaf, Root Extract full monograph & interactions

Lactium1 drug type · 172 drugs

Antihypertensive Drugs

Theoretically, combining these casein peptides with antihypertensive drugs might increase the risk of hypotension.
Clinical research shows that some casein peptides, including the lactotripeptides isoleucine-proline-proline (IPP) and valine-proline-proline (VPP), can modestly reduce blood pressure in patients with hypertension.

Likelihood Probable Evidence B
Lactium full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Clinical Stress Relief, from the product label.

Protocol For Life Balance

See all Protocol For Life Balance products
Name
Protocol For Life Balance
Street Address
395 S. Glen Ellyn Rd.
City
Bloomingdale
State
IL
ZipCode
60108
Web Address
protocolforlife.com
Pharmacist Counseling Corner

Clinical Stress Relief by Protocol For Life Balance: Common Questions

Does Clinical Stress Relief by Protocol For Life Balance interact with any medications?
Yes. Based on its ingredients, Clinical Stress Relief has a known interaction with 1,372 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Clinical Stress Relief contains 2 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm on blood pressure medication?
Both ingredients in this product may lower blood pressure, so combining them with blood pressure medications could cause your pressure to drop too far. You'll need to check with your pharmacist or doctor first — don't start this on your own if you're on any antihypertensive drug.
Will ashwagandha make me sleepy?
Drowsiness has been reported with ashwagandha, and it may increase the sedating effects of sleep aids, anti-anxiety medications like diazepam, or other central nervous system depressants. If you're sensitive to sedation or take those kinds of drugs, this is worth discussing with your pharmacist first.
Is ashwagandha safe long-term?
Ashwagandha is generally well tolerated in the short term, but quality and long-term safety data are limited. Rare serious cases of liver problems have been reported. If you're thinking of taking it long-term, talk with your doctor or pharmacist about whether that's right for you.
Can I take this while pregnant or breastfeeding?
Ashwagandha is traditionally thought to risk miscarriage, so the safety data advises against it during pregnancy. There isn't enough safety information for breastfeeding either. Talk with your doctor or pharmacist about whether this is appropriate for you right now.
What is Lactium, and why is it in here?
Lactium is a casein peptide derived from milk protein. It's likely effective for food allergies and eczema based on our data, but the product is being sold for stress relief — we don't have effectiveness data for Lactium for that purpose. Anyone with a milk allergy must avoid it.
Are there any fillers in this?
The product contains three inactive ingredients that help form the capsule: hypromellose, stearic acid, and silicon dioxide. These are standard capsule materials, not fillers in the sense of inert padding.

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.

Clinical Stress Relief label
Go deeper

The Full Monographs Behind Clinical Stress Relief’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Casein Peptides

Interacts with 172 drugs

Casein peptides are small protein fragments made from milk casein, often studied for mild blood pressure support and relaxation. The evidence is limited and mostly modest, so they should not...

Read the full Casein Peptides monograph → Herb & supplement monograph

Ashwagandha

Interacts with 1,372 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 evidence is still limited. It is generally w...

Read the full Ashwagandha monograph →
Sources

Sources & How We Checked

Clinical Stress Relief'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.

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 36 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.

Casein Peptides 4 references
  1. Cicero AFG, Aubin F, Azais-Braesco V, Borghi C. Do the lactotripeptides isoleucine-proline-proline and valine-proline-proline reduce systolic blood pressure in European subjects? A meta-analysis of randomized controlled trials. Am J Hypertens. 2013;26(3): PubMed
  2. Fekete AA, Givens DA, Lovegrove JA. Casein-derived lactotripeptides reduce systolic and diastolic blood pressure in a meta-analysis of randomised clinical trials. Nutrients. 2015;7(1):659-81. PubMed
  3. Qin LQ, Xu JY, Dong JY, Zhao Y, van Bladeren P, Zhang W. Lactotripeptides intake and blood pressure management: a meta-analysis of randomised controlled clinical trials. Nutr Metab Cardiovasc Dis. 2013;23(5):395-402. PubMed
  4. Turpeinen AM, Järvenpää S, Kautiainen H, Korpela R, Vapaatalo H. Antihypertensive effects of bioactive tripeptides-a random effects meta-analysis. Ann Med. 2013;45(1):51-6. PubMed

See these in context on the Casein Peptides monograph →

Ashwagandha 32 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.
  3. Davis L, Kuttan G. Effect of Withania somnifera on cyclophosphamide-induced urotoxicity. Cancer Lett 2000;148:9-17. PubMed
  4. Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol 1998;62:209-14. PubMed
  5. 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
  6. Andallu B, Radhika B. Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian J Exp Biol 2000;38:607-9.
  7. 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
  8. 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.
  9. 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
  10. 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
  11. 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.
  12. 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
  13. 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.
  14. 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
  15. 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.
  16. 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
  17. 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
  18. 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
  19. 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
  20. 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
  21. Pusec CM, Wolsky R, Llerena C, Sura P. A Case of Supplement-Induced Hepatitis. Cureus 2022;14(10):e30433. PubMed
  22. 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
  23. 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
  24. 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
  25. Tóth M, Benedek AE, Longerich T, Seitz HK. Ashwagandha-induced acute liver injury: A case report. Clin Case Rep 2023;11(3):e7078.
  26. 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
  27. Patel PA, Sanborn E, Then R, Williams DM. Recurrent Reversible Cerebral Vasoconstriction Syndrome: A Report of Two Cases. Cureus 2023;15(8):e42992. PubMed
  28. 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
  29. 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
  30. Hayashi M, Hamada H, Azuma SI, Hayashi K. Painless Thyroiditis by Withania somnifera (Ashwagandha). Cureus 2024;16(3):e55352. PubMed
  31. 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
  32. 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

See these in context on the Ashwagandha monograph →

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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.

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