David Winston's Calm Adapt Ingredients & Drug Interactions
What is this page for?
First and foremost: checking David Winston's Calm Adapt 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
David Winston's Calm Adapt is a dietary supplement by Herbalist & Alchemist with 5 active ingredients. Its ingredients are commonly taken for fatigue and low energy, stress and adaptogen support, liver health.Based on those ingredients, 1,486 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Ashwagandha root extract, Schisandra, Reishi mushroom extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against David Winston's Calm Adapt by Herbalist & Alchemist
Ask about any prescription or over-the-counter medication and we check it for interactions with David Winston's Calm Adapt by Herbalist & Alchemist — 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
Ask the Pharmacist
A licensed pharmacist will answer your question by email — free, usually within 24 hours.
Got it — thank you!
A licensed pharmacist will answer within 24 hours. Keep an eye on your email (worth checking spam, just in case).
HelloPharmacist Scorecard of David Winston's Calm Adapt by Herbalist & Alchemist
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
Low disclosure
David Winston's Calm Adapt contains five active herbal extracts in a proprietary blend: schisandra, oat milky seed extract, ashwagandha root extract, linden extract, and reishi mushroom extract. The product is delivered as a liquid in a base of distilled water, ethyl alcohol, and vegetable glycerin.
Does it work?
Moderate evidence
The evidence for this product's ingredients is mixed. Oat extract is likely effective for high cholesterol (dyslipidemia) and supporting heart health.
Ashwagandha is possibly effective for insomnia, anxiety, stress, and generalized anxiety disorder. Schisandra, linden, and reishi mushroom all lack sufficient evidence in our data to establish whether they work for the conditions they're traditionally used for—so we can't tell you whether this blend will help with what you're taking it for.
How safe is it?
Well-documented data
These ingredients are generally well tolerated short-term, though long-term and high-quality safety data are limited. The most common side effects are gastrointestinal—heartburn, stomach upset, bloating, nausea, and decreased appetite.
Ashwagandha and schisandra have rare reports of liver damage, so they're not ideal if you have liver disease or take other hepatotoxic drugs. Ashwagandha is traditionally thought to risk miscarriage and should be avoided in pregnancy; schisandra traditionally stimulates the uterus and should also be avoided.
Oat as food is generally considered safe in pregnancy and while breastfeeding, but concentrated oat supplements are less studied. Linden, reishi, and additional pregnancy/lactation data for schisandra and ashwagandha supplements lack enough safety information—talk with your doctor or pharmacist before use if you're pregnant or nursing.
Meds to double-check
Moderate interaction found
Check your doctor or pharmacist before adding this product if you take tacrolimus or other transplant or immune-suppressing drugs (schisandra can significantly raise levels), blood thinners like warfarin or antiplatelet drugs, diabetes medications or insulin, blood pressure medications, sedative or anxiety drugs including benzodiazepines, thyroid hormone, or lithium. Schisandra also affects how your liver breaks down many other drugs—the medication checker below is your best tool.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This is a multi-ingredient herbal blend with real interactions to watch—especially if you take transplant medications, blood thinners, diabetes drugs, blood pressure medications, sedatives, or thyroid hormone. Oat extract has solid evidence for cholesterol and heart health; ashwagandha has some evidence for sleep and anxiety.
Before starting, check your exact medications against the tool on this page and talk with your doctor or pharmacist 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: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 23, 2018.
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 David Winston's Calm Adapt, straight from the product label.
| Brand | Herbalist & Alchemist |
|---|---|
| Barcode (UPC) | 667056138189 |
| Net contents | 2 fl. Oz.; 60 mL |
| Market status | On market |
| Date entered into DSLD | Mar 23, 2018 |
| DSLD ID | 173807 |
| Product type | Other Combinations |
| Supplement form | Liquid |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Kosher, Organic |
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 David Winston's Calm Adapt by Herbalist & Alchemist, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Blend | 4 mL | -- |
| Schisandra | 0 NP | -- |
| Oat milky seed extract | 0 NP | -- |
| Ashwagandha root extract | 0 NP | -- |
| Linden extract | 0 NP | -- |
| Reishi mushroom extract | 0 NP | -- |
Other ingredients: distilled Water, Ethyl Alcohol, Vegetable Glycerin
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.
General Statements
Relaxing adaptogenic tonic to balance stress
FDA Statement of Identity
Herbal Supplement
Suggested/Recommended/Usage/Directions
Suggested Use: 60-80 drops (3-4 mL) in juice or water. Take 2-3 times per day. Shake well before using.
Precautions
Contraindications: Do not use if you have mushroom allergies.
Keep out of children's reach
FDA Disclaimer Statement
This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
General
NO. CAC-2 1735TU
Seals/Symbols
OK
Formula
OK
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
David Winston's Calm Adapt by Herbalist & Alchemist 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 David Winston's Calm Adapt by Herbalist & Alchemist
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 mL Dosage formLiquid Servings per container15 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.
Proprietary Blend
Other (inactive) ingredients: Distilled Water, Ethyl Alcohol, Vegetable Glycerin. These complete the product’s ingredient list but are not active constituents.
David Winston's Calm Adapt by Herbalist & Alchemist Drug Interactions
HelloPharmacist Interaction Report
David Winston's Calm Adapt by Herbalist & Alchemist contains five ingredients, and through its schisandra, oat milky seed extract, ashwagandha, linden, and reishi mushroom extract content, it interacts with a significant number of medications.
The most serious documented interaction is schisandra's effect on tacrolimus (Prograf), an immune-suppressing drug used in transplant patients: schisandra can raise tacrolimus levels by 183% to 268%, potentially causing toxicity and organ damage.
Read the full breakdown — every affected drug type, severity by severity
Schisandra affects multiple drug-metabolizing pathways. It can increase levels of drugs broken down by CYP3A4 enzymes (including certain chemotherapy agents, sedatives, and immune drugs), increase levels of CYP2C19 substrates (such as voriconazole, an antifungal), and theoretically decrease effects of CYP2C9 substrates.
It may also boost levels of drugs transported by P-glycoprotein and could reduce the effectiveness of warfarin (Coumadin), a blood thinner.
Ashwagandha and oat extract both interact with blood sugar control. They may increase the risk of low blood sugar (hypoglycemia) when combined with diabetes medications or insulin.
Ashwagandha also interacts with sedating drugs and benzodiazepines (anxiety or sleep medications), potentially deepening drowsiness; with blood pressure medications, raising the risk of excessively low blood pressure; with immune-suppressing medications, potentially weakening their effects; and with thyroid hormone, possibly causing overactive thyroid symptoms. Reishi mushroom may lower blood pressure further with blood pressure drugs, increase bleeding risk at higher doses when combined with blood thinners (anticoagulants or antiplatelet drugs), and theoretically add to the blood sugar-lowering effects of diabetes medications.
Linden may increase lithium levels and side effects through its diuretic properties.
Altogether, these interactions span 1,487 individual medications. Use the medication checker on this page to look up your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against David Winston's Calm Adapt?
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 David Winston's Calm Adapt interact with 1,486 drugs. Click any drug to see the details.
5 of the 5 ingredients in David Winston's Calm Adapt interact with drugs. Each result below shows which ingredient is responsible. Ashwagandha root extract Schisandra Reishi mushroom extract Oat milky seed extract Linden extract
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha Root ExtractHepatotoxic Drugs, Immunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Root Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
SchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Ado-trastuzumab Emtansine interactionAshwagandha Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Root Extract + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Root Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Root Extract + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Reishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
SchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Abemaciclib interactionAshwagandha Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Root Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
Ashwagandha Root 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 Root Extract + Abiraterone interactionSchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
SchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Abiraterone Acetate interactionAshwagandha Root 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 Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with David Winston's Calm Adapt — through 3 ingredients. Tap an ingredient for the detail:
Ashwagandha Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Read the full Ashwagandha Root Extract + Abrocitinib interactionReishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Abrocitinib interactionSchisandraCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
Read the full Schisandra + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
SchisandraCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acalabrutinib interactionAshwagandha Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Root Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with David Winston's Calm Adapt — through 3 ingredients. Tap an ingredient for the detail:
Ashwagandha Root ExtractHepatotoxic Drugs, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Root Extract + Acarbose interactionOat Milky Seed ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Read the full Oat Milky Seed Extract + Acarbose interactionReishi Mushroom ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, reishi mushroom might have additive effects with antidiabetes drugs.
Read the full Reishi Mushroom Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
Reishi Mushroom ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Read the full Reishi Mushroom Extract + Acebutolol interactionAshwagandha Root ExtractAntihypertensive Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Read the full Ashwagandha Root Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Reishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha Root ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ashwagandha Root Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha Root 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 Root Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
Ashwagandha Root 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 Root Extract + Acetaminophen, Aspirin interactionReishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with David Winston's Calm Adapt — through 3 ingredients. Tap an ingredient for the detail:
Reishi Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
Read the full Reishi Mushroom Extract + Acetaminophen, Aspirin, Caffeine interactionSchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acetaminophen, Aspirin, Caffeine interactionAshwagandha Root 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 Root Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha Root 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 Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha Root 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 Root Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
Ashwagandha Root ExtractHepatotoxic 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 Ashwagandha Root Extract + Acetaminophen, Butalbital, Caffeine interactionSchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
SchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acetaminophen, Butalbital, Caffeine, Codeine interactionAshwagandha Root 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 Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha Root 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 Root Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with David Winston's Calm Adapt — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha Root ExtractHepatotoxic Drugs, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
Ashwagandha Root 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 Root Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionSchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + 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 David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
SchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acetaminophen, Caffeine, Codeine interactionAshwagandha Root ExtractCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ashwagandha Root Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
Ashwagandha Root 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 Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionSchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
SchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acetaminophen, Caffeine, Dihydrocodeine interactionAshwagandha Root ExtractCns Depressants, Hepatotoxic Drugs +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ashwagandha Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
Ashwagandha Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ashwagandha Root Extract + Acetaminophen, Caffeine, Isometheptene interactionSchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
SchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acetaminophen, Caffeine, Pyrilamine interactionAshwagandha Root ExtractHepatotoxic 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 Ashwagandha Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with David Winston's Calm Adapt — through 2 ingredients. Tap an ingredient for the detail:
Ashwagandha Root ExtractHepatotoxic Drugs, Serotonergic Drugs +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionSchisandraCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Read the full Schisandra + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEach ingredient & the kinds of drugs it affects
For each ingredient in David Winston's Calm Adapt 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 root 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/]
Schisandra
Cyclophosphamide
Theoretically, schisandra might increase the levels and clinical effects of cyclophosphamide.
In vitro research shows that schisandra increases the concentration of cyclophosphamide, likely through inhibition of cytochrome P450 3A4. After multiple doses of the schisandra constituents schisandrin A and schisantherin A, the maximum concentration of cyclophosphamide was increased by 7% and 75%, respectively, while the overall exposure to cyclophosphamide was increased by 29% and 301%, respectively.
Cyclosporine (Neoral, Sandimmune)
Schisandra can increase the levels and clinical effects of cyclosporine.
A small observational study in children with aplastic anemia found that taking schisandra with cyclosporine increased cyclosporine trough levels by 93% without increasing the risk of adverse events. However, the dose of cyclosporine was reduced in 9% of children to maintain appropriate cyclosporine blood concentrations.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, schisandra might increase the levels and clinical effects of CYP2C19 substrates.
In vitro research shows that schisandra inhibits CYP2C19, and animal research shows that schisandra increases the concentration of voriconazole, a CYP2C19 substrate. Theoretically, schisandra may also inhibit the metabolism of other CYP2C19 substrates. This effect has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, schisandra might decrease the levels and clinical effects of CYP2C9 substrates.
In vitro and animal research suggests that schisandra induces CYP2C9 enzymes. This effect has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Schisandra can increase the levels and clinical effects of drugs metabolized by CYP3A4.
Most clinical and laboratory research shows that schisandra, administered either as a single dose or up to twice daily for 14 days, inhibits CYP3A4 and increases the concentration of CYP3A4 substrates such as cyclophosphamide, midazolam, tacrolimus, and talinolol. Although one in vitro and animal study shows that schisandra may induce CYP3A4 metabolism, this effect appears to be overpowered by schisandra's CYP3A4 inhibitory activity and has not been reported in humans.
Midazolam (Versed)
Schisandra can increase the levels and clinical effects of midazolam.
A small pharmacokinetic study in healthy adults shows that taking schisandra extract (Hezheng Pharmaceutical Co.) containing deoxyschizandrin 33.75 mg twice daily for 8 days and a single dose of midazolam 15 mg on day 8 increases the overall exposure to midazolam by about 119%, increases the peak plasma level of midazolam by 86%, and decreases midazolam clearance by about 52%. This effect has been attributed to inhibition of CYP3A4 by schisandra.
P-Glycoprotein Substrates
Schisandra might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that schisandra extracts and constituents such as schisandrin B inhibit P-glycoprotein mediated efflux in intestinal cells and in P-glycoprotein over-expressing cell lines. Additionally, a small clinical study shows that schisandra increases the peak concentration and overall exposure to talinolol, a P-glycoprotein probe substrate. Theoretically, schisandra might inhibit the efflux of other P-glycoprotein substrates.
Sirolimus (Rapamune)
Schisandra can increase the levels and clinical effects of sirolimus.
A small pharmacokinetic study in healthy volunteers shows that taking 3 capsules of schisandra (Hezheng Pharmaceutical Company) containing a total of 33.75 mg deoxyschizandrin twice daily for 13 days and then taking a single dose of sirolimus 2 mg increases the overall exposure and peak level of sirolimus by two-fold. This effect is thought to be due to inhibition of cytochrome P450 3A4 by schisandra, as well as possible inhibition of the P-glycoprotein drug transporter.
Tacrolimus (Prograf)
Schisandra can increase the levels and clinical effects of tacrolimus.
Clinical research in healthy children and adults, transplant patients, and patients with nephrotic syndrome and various rheumatic immunologic disorders shows that taking schisandra with tacrolimus increases tacrolimus peak levels by 183% to 268%, prolongs or delays time to peak tacrolimus concentrations, increases overall exposure to tacrolimus by 126% to 343%, and decreases tacrolimus clearance by 19% to 73%. This effect is thought to be due to inhibition of P-glycoprotein drug transporter and CYP3A4 and CYP3A5 by schisandra. Some clinical and observational studies suggest that schisandra increases tacrolimus levels similarly in both expressors and non-expressors of CYP3A5, while other studies suggest it does so to a greater degree in CYP3A5 expressors than non-expressors. Animal research suggests that the greatest increase in tacrolimus levels occurs when schisandra is taken either concomitantly or up to 2 hours before tacrolimus, and clinical and observational research in humans suggests that schisandra may increase whole blood levels of tacrolimus and decrease clearance of tacrolimus in a dose-dependent manner.
Talinolol
Schisandra can increase the levels and clinical effects of talinolol.
A small pharmacokinetic study in healthy volunteers shows that taking schisandra extract 300 mg twice daily for 14 days with a single dose of talinolol 100 mg on day 14 increases the peak talinolol level by 51% and the overall exposure to talinolol by 47%. This effect is thought to be due to the possible inhibition of cytochrome P450 3A4 and P-glycoprotein by schisandra.
tly.
Voriconazole (Vfend)
Theoretically, schisandra might increase the levels and clinical effects of voriconazole.
Animal research shows that oral schisandra given daily for 1 or 14 days increases levels of intravenously administered voriconazole, a cytochrome P450 (CYP) 2C19 substrate. This effect is thought to be due to inhibition of CYP2C19 by schisandra. However, this interaction has not been reported in humans.
Warfarin (Coumadin)
Theoretically, schisandra might decrease the levels and clinical effects of warfarin.
Animal research suggests that oral schisandra extract, given daily for 6 days, reduces levels of intravenously administered warfarin. This effect might be due to the induction of cytochrome P450 (CYP) 2C9 metabolism by schisandra. However, this interaction has not been reported in humans.
Reishi mushroom extract
Anticoagulant/Antiplatelet Drugs
Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
A dose of 1.5 grams daily of reishi mushroom does not seem to decrease platelet aggregation, but a higher dose of 3 grams daily does.
Antidiabetes Drugs
Theoretically, reishi mushroom might have additive effects with antidiabetes drugs.
Animal research suggests that reishi mushroom decreases blood sugar. However, in patients with type 2 diabetes, taking reishi mushroom does not reduce fasting glucose levels, and its effects on glycated hemoglobin are inconsistent.
Antihypertensive Drugs
Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Reishi mushroom has shown hypotensive activity in animal research. Clinical evidence suggests that reishi mushroom reduces blood pressure in some, but not all, patients with hypertension.
Oat milky seed extract
Antidiabetes Drugs
Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Consuming oats can decrease blood glucose in patients with diabetes. In those who require insulin, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.
Insulin
Concomitant use of oats and insulin might increase the risk of hypoglycemia.
In patients with insulin-dependent type 2 diabetes, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.
Linden extract
Lithium
Theoretically, due to its potential diuretic effects, linden might increase the effects and adverse effects of lithium.
Linden is thought to have diuretic properties. The dose of lithium might need to be decreased.
Brand information
Manufacturer and brand details for David Winston's Calm Adapt, from the product label.
Herbalist & Alchemist
See all Herbalist & Alchemist products- Name
- Herbalist & Alchemist, Inc.
- City
- Washington
- State
- NJ
- ZipCode
- 07882
- Phone Number
- 800-611-8235
- Web Address
- www.herbalist-alchemist.com
David Winston's Calm Adapt by Herbalist & Alchemist: Common Questions
Does David Winston's Calm Adapt by Herbalist & Alchemist interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Is this safe during pregnancy?
Is this safe while breastfeeding?
What's schisandra used for in this blend?
Will this help my cholesterol or heart health?
What are the most common side effects?
Does ashwagandha in this product have enough evidence that it works?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if David Winston's Calm Adapt is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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 David Winston's Calm Adapt’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Schisandra
Interacts with 803 drugsSchisandra is a traditional Chinese medicine berry used as an adaptogen for stress, fatigue, and liver support. Human evidence is limited and most claims are not well proven, but it appears...
Read the full Schisandra monograph → Herb & supplement monographOats
Interacts with 86 drugsOats are a well-studied whole grain whose soluble fiber (beta-glucan) can help lower cholesterol and support heart health when eaten regularly. As a food, oats are safe for most people, and...
Read the full Oats monograph → Herb & supplement monographAshwagandha
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 monographLinden
Interacts with 1 drugLinden (also called lime flower) is a traditional herbal tea long used to calm nerves, ease cold symptoms, and support restful sleep. Strong human evidence for these uses is lacking, but the...
Read the full Linden monograph → Herb & supplement monographReishi Mushroom
Interacts with 375 drugsReishi is a traditional Asian mushroom widely used to support the immune system and overall wellness. Human evidence for most of its claimed benefits is limited or low-quality, so it should...
Read the full Reishi Mushroom monograph →Sources & How We Checked
David Winston's Calm Adapt'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 90 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.
Schisandra 26 references
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- Iwata H, Tezuka Y, Kadota S, et al. Identification and characterization of potent CYP3A4 inhibitors in Schisandra fruit extract. Drug Metab Dispos 2004;32:1351-8. PubMed
- Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
- Xin HW, Wu XC, Li Q, et al. Effects of Schisandra sphenanthera extract on the pharmacokinetics of tacrolimus in healthy volunteers. Br J Clin Pharmacol 2007;64:469-75.
- Qin XL, Bi HC, Wang XD, et al. Mechanistic understanding of the different effects of Wuhzi Tablet (Schisandra sphenanthera extract) on the absorption and first-pass intestinal and hepatic metabolism of tacrolimus (FK506). Int J Pharm 2010;389:114-21.
- Makino, T., Mizuno, F., and Mizukami, H. Does a kampo medicine containing schisandra fruit affect pharmacokinetics of nifedipine like grapefruit juice? Biol.Pharm.Bull. 2006;29(10):2065-2069. PubMed
- Fan L, Mao XQ, Tao GY, Wang G, Jiang F, Chen Y, Li Q, Zhang W, Lei HP, Hu DL, Huang YF, Wang D, Zhou HH. Effect of Schisandra chinensis extract and Ginkgo biloba extract on the pharmacokinetics of talinolol in healthy volunteers. Xenobiotica. 2009 Mar;39(
- Jiang W, Wang X, Xu X, Kong L. Effect of Schisandra sphenanthera extract on the concentration of tacrolimus in the blood of liver transplant patients. Int J Clin Pharmacol Ther. 2010 Mar;48(3):224-9. PubMed
- Xin HW, Wu XC, Li Q, Yu AR, Xiong L. Effects of Schisandra sphenanthera extract on the pharmacokinetics of midazolam in healthy volunteers. Br J Clin Pharmacol. 2009 May;67(5):541-6.
- Li J, Chen S, Qin X, et at. Wuzhi Tablet (<i>Schisandra sphenanthera</i> Extract) is a Promising Tacrolimus-Sparing Agent for Renal Transplant Recipients Who are CYP3A5 Expressers: a Two-Phase Prospective Study. Drug Metab Dispos. 2017;45(11):1114-1119.
- Qin XL, Li JL, Wang SH, Chen X, Huang M, Bi HC. Co-administration of Wuzhi tablet (Schisandra sphenanthera extract) alters tacrolimus pharmacokinetics in a dose- and time-dependent manner in rats. J Ethnopharmacol. 2020;263:113233. PubMed
- Yuan F, Liang X, Chen X, Qin X, Tan C, Wang L. CYP2C19 is involved in the effect of Wuzhi tablet (Schisandra sphenanthera extract) and its constituents on the pharmacokinetics of intravenous voriconazole. Pharmazie. 2020;75(11):559-564. DOI
- Zhang Z, Lu X, Dong L, Ma J, Fan X. Clinical observation on the effect of Wuzhi soft capsule on FK506 concentration in membranous nephropathy patients. Medicine (Baltimore). 2019;98(48):e18150. PubMed
- Yoo HH, Lee M, Lee MW, Lim SY, Shin J, Kim DH. Effects of Schisandra lignans on P-glycoprotein-mediated drug efflux in human intestinal Caco-2. Planta Med. 2007;73(5):444-50.
- Qiangrong P, Wang T, Lu Q, Hu X. Schisandrin B--a novel inhibitor of P-glycoprotein. Biochem Biophys Res Commun. 2005;335(2):406-11. PubMed
- Chen L, Ji N, Zhang M, Chen W. The influence of Wuzhi capsule on the pharmacokinetics of cyclophosphamide. Recent Pat Anticancer Drug Discov 2021. PubMed
- Cheng X, Ma J, Xu X, Zhang L, Wang X, Wu R. Effect of Wuzhi capsules on cyclosporine A concentration in children with aplastic anemia immunotherapy: a single-center observational study. Expert Rev Clin Pharmacol 2022:1-5. PubMed
- Cheng F, Li Q, Wang J, Zeng F, Zhang Y. Effects and safety evaluation of Wuzhi capsules combined with tacrolimus for the treatment of kidney transplantation recipients. J Clin Pharm Ther 2021;46(6):1636-49. PubMed
- Teng F, Wang W, Zhang W, et al. Effect of hepar-protecting Wuzhi capsule on pharmacokinetics and dose-effect character of tacrolimus in healthy volunteers. Biopharm Drug Dispos 2022.
- Kou K, Sun X, Li M, et al. Beneficial effects of Wuzhi capsule on tacrolimus blood concentrations in liver transplant patients with different donor-recipient CYP3A5 genotypes. J Clin Pharm Ther 2022;47(2):200-10. PubMed
- Peng Y, Jiang F, Zhou R, et al. Clinical evaluation of the efficacy and safety of co-administration of Wuzhi capsule and tacrolimus in adult Chinese patients with myasthenia gravis. Neuropsychiatr Dis Treat 2021;17:2281-9. PubMed
- Chen P, Dai R, She Y, et al. Prediction of tacrolimus and Wuzhi tablet pharmacokinetic interaction magnitude in renal transplant recipients. Clin Transplant 2022;36(12):e14807. PubMed
- Qu J, Bian R, Liu B, et al. The pharmacokinetic study of tacrolimus and Wuzhi capsule in Chinese liver transplant patients. Front Pharmacol 2022;13:956166. PubMed
- Zhou Y, Huang X, Liu L, et al. Effect of Wuzhi preparations on tacrolimus in CYP3A5 expressers during the early period after transplantation: A real-life experience from heart transplant recipients. Transpl Immunol 2023;76:101748. PubMed
- Huang Q, Lin X, Wang Y, et al. Tacrolimus pharmacokinetics in pediatric nephrotic syndrome: A combination of population pharmacokinetic modelling and machine learning approaches to improve individual prediction. Front Pharmacol 2022;13:942129. PubMed
- Wang CB, Zhang YJ, Zhao MM, Zhao LM. Population pharmacokinetic analyses of tacrolimus in non-transplant patients: a systematic review. Eur J Clin Pharmacol 2023;79(7):897-913. PubMed
Oats 13 references
- Cooper SG, Tracey EJ. Small-bowel obstruction caused by oat-bran bezoar. N Engl J Med 1989;320:1148-9. DOI
- Pick ME, Hawrysh ZJ, Gee MI, et al. Oat bran concentrate bread products improve long-term control of diabetes: a pilot study. J Am Diet Assoc 1996;96:1254-61. PubMed
- Braaten JT, Scott FW, Wood PJ, et al. High beta-glucan oat bran and oat gum reduce postprandial blood glucose and insulin in subjects with and without type 2 diabetes. Diabet Med 1994;11:312-8.
- Rosario PG, Gerst PH, Prakash K, Albu E. Dentureless distention: oat bran bezoars cause obstruction. J Am Geriatr Soc 1990;38:608. PubMed
- Food and Drug Administration. Food labeling: health claims: oats and coronary heart disease. Fed Regist 1996;61:296-313.
- Foulke J. FDA Allows Whole Oat Foods To Make Health Claim on Reducing the Risk of Heart Disease. FDA Talk Paper. 1997. Available at: http://www.fda.gov/bbs/topics/ANSWERS/ANS00782.html.
- Chandalia M, Garg A, Lutjohann D, et al. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med 2000;342:1392-8. PubMed
- Lembo A, Camilleri M. Chronic constipation. N Engl J Med 2003;349:1360-8. . PubMed
- De Paz Arranz S, Perez Montero A, Remon LZ, Molero MI. Allergic contact urticaria to oatmeal. Allergy 2002;57:1215. . PubMed
- Delgado G, Kleber ME, Krämer BK, et al. Dietary intervention with oatmeal in patients with uncontrolled type 2 diabetes mellitus - A crossover study. Exp Clin Endocrinol Diabetes. 2019;127(9):623-629. PubMed
- Sobhan M, Hojati M, Vafaie SY, Ahmadimoghaddam D, Mohammadi Y, Mehrpooya M. The efficacy of colloidal oatmeal cream 1% as add-on therapy in the management of chronic irritant hand eczema: A double-blind study. Clin Cosmet Investig Dermatol. 2020;13:241-25
- Hou Q, Li Y, Li L, Cheng G, Sun X, Li S, Tian H. The metabolic effects of oats intake in patients with type 2 diabetes: A systematic review and meta-analysis. Nutrients. 2015;7(12):10369-87. PubMed
- González-Afonso M, Cañas JA, Sastre B, et al. A Case of Anaphylaxis After Ingestion of Oats: Research Into New Allergens. J Investig Allergol Clin Immunol 2022;32(6):506-508. PubMed
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
Linden 2 references
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
Reishi Mushroom 17 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.
- Tao J, Feng KY. Experimental and clinical studies on inhibitory effect of ganoderma lucidum on platelet aggregation. J Tongji Med Univ 1990;10:240-3. PubMed
- Singh AB, Gupta SK, Pereira BM, Prakash D. Sensitization to Ganoderma lucidum in patients with respiratory allergy in India. Clin Exp Allergy 1995;25:440-7.
- Lee SY, Rhee HM. Cardiovascular effects of mycelium extract of Ganoderma lucidum: inhibition of sympathetic outflow as a mechanism of its hypotensive action. Chem Pharm Bull (Tokyo) 1990;38:1359-64. PubMed
- Kwok Y, Ng KFJ, Li, CCF, et al. A prospective, randomized, double-blind, placebo-controlled study of the platelet and global hemostatic effects of Ganoderma lucidum (Ling-Zhi) in healthy volunteers. Anesth Analg 2005;101:423-6. PubMed
- Wanmuang, H., Leopairut, J., Kositchaiwat, C., Wananukul, W., and Bunyaratvej, S. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. J Med Assoc Thai. 2007;90(1):179-181.
- Seto, S. W., Lam, T. Y., Tam, H. L., Au, A. L., Chan, S. W., Wu, J. H., Yu, P. H., Leung, G. P., Ngai, S. M., Yeung, J. H., Leung, P. S., Lee, S. M., and Kwan, Y. W. Novel hypoglycemic effects of Ganoderma lucidum water-extract in obese/diabetic (+db/+db
- Chu, T. T., Benzie, I. F., Lam, C. W., Fok, B. S., Lee, K. K., and Tomlinson, B. Study of potential cardioprotective effects of Ganoderma lucidum (Lingzhi): results of a controlled human intervention trial. Br.J.Nutr. 2012;107(7):1017-1027.
- Jin, X., Ruiz, Beguerie J., Sze, D. M., and Chan, G. C. Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane.Database.Syst.Rev. 2012;6:CD007731.
- Kabir, Y., Kimura, S., and Tamura, T. Dietary effect of Ganoderma lucidum mushroom on blood pressure and lipid levels in spontaneously hypertensive rats (SHR). J Nutr Sci Vitaminol.(Tokyo) 1988;34(4):433-438. PubMed
- Kanmatsuse, K., Kajiwara, N., Hayashi, K., Shimogaichi, S., Fukinbara, I., Ishikawa, H., and Tamura, T. [Studies on Ganoderma lucidum. I. Efficacy against hypertension and side effects]. Yakugaku Zasshi 1985;105(10):942-947. PubMed
- Gao, Y., Lan, J., Dai, X., Ye, J., and Zhou, S. A Phase I/II Study of Ling Zhi Mushroom Ganoderma lucidum(W.Curt: Fr.) Lloyd (Aphyllophoromycetideae) Extract in Patients with Type II Diabetes Mellitus. International Journal of Medicinal Mushrooms 2004;6. DOI
- Jin H, Zhang G, Cao X, and et al. Treatment of hypertension by linzhi combined with hypotensor and its effects on arterial, arteriolar and capillary pressure and microcirculation. In: Niimi H, Xiu RJ, Sawada T, and et al. Microcirculatory Approach to Asi
- Klupp NL, Chang D, Hawke F, Kiat H, Cao H, Grant SJ, Bensoussan A. Ganoderma lucidum mushroom for the treatment of cardiovascular risk factors. Cochrane Database Syst Rev. 2015 Feb 17;2:CD007259. PubMed
- Zhao H, Zhang Q, Zhao L, Huang X, Wang J, Kang X. Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial. Evid Based Complement Alternat Med. 2012;2012:809614.
- Pazzi F, Adsuar JC, Domínguez-Muñoz FJ, García-Gordillo MA, Gusi N, Collado-Mateo D. Ganoderma lucidum effects on mood and health-related quality of life in women with fibromyalgia. Healthcare (Basel) 2020;8(4):520. PubMed
- Kogure T, Koiwai A, Fukushi D, et al. Hypereosinophilia with hepatic nodule formation caused by Ganoderma lucidum. Intern Med 2021;60(24):3897-3903.
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