Interactions on record — worth a quick check against your medications. Based on 4 of 5 ingredients. Check your meds →
Dietary supplement

Instaflex PM Ingredients & Drug Interactions

by Instaflex

Capsule Category: Other Combinations
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Instaflex PM is a dietary supplement by Instaflex with 5 active ingredients. Its ingredients are commonly taken for anxiety and stress, sleep problems, relaxation.Based on those ingredients, 1,378 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Ashwagandha Root Extract, Passionflower extract, Gamma-Aminobutyric Acid. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Instaflex PM by Instaflex

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

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 5 of its 5 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Instaflex PM contains five active ingredients. GABA is a brain chemical that may help with relaxation.

Ashwagandha root extract is an herb traditionally used to manage stress and sleep. Levagen+ is a form of palmitoylethanolamide (PEA), a naturally occurring compound studied for joint and nerve comfort.

Passionflower extract is an herb used to support sleep and calm. The product also contains three inactive ingredients — gelatin, magnesium stearate, and rice husks concentrate — which are fillers and capsule materials.

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: joint relief and sleep support.
  • We looked for evidence on: Osteoarthritis, Back pain, Insomnia, Neuropathic pain, Fibromyalgia, Exercise-induced muscle soreness — and 4 related terms.
  • The strongest evidence on file: Passion Flower is rated "Possibly Effective" for Pre-procedural anxiety (Natural Medicines).
  • Also on file: Passion Flower is rated "Possibly Effective" for Insomnia.
  • Also on file: Ashwagandha is rated "Possibly Effective" for Anxiety, Generalized anxiety disorder (GAD), Insomnia.

Ashwagandha is possibly effective for insomnia, anxiety, stress, and generalized anxiety disorder. Passionflower extract is possibly effective for insomnia and pre-procedural anxiety.

Levagen+ (PEA) is possibly effective for osteoarthritis. GABA has insufficient reliable evidence for the conditions it's studied in — anxiety, ADHD, athletic performance, and cerebral palsy — meaning the evidence we hold doesn't support claims about how well it works.

For the other conditions listed on various product labels, we have no effectiveness data on file.

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 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Ashwagandha is traditionally thought to carry a risk of miscarriage, so the data advises against it during pregnancy; there isn't enough safety information to know if it's safe while breastfeeding, so talk with your doctor or pharmacist for personalized advice. Passionflower lacks safety data in pregnancy and is considered possibly unsafe; breastfeeding safety isn't established either.

For Levagen+ (PEA) and GABA, there isn't enough information to know whether they're safe in pregnancy or while breastfeeding — speak with your doctor or pharmacist. Common side effects from GABA include drowsiness, nausea, stomach upset, muscle weakness, and minor throat burning.

Ashwagandha may cause diarrhea, nausea, vomiting, and stomach upset, though these don't happen often at typical doses. Passionflower commonly causes drowsiness, dizziness, and confusion.

Long-term safety for all ingredients is not well studied.

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?
  • 3 of the 4 matched ingredients can interact with medications — Gamma-aminobutyric Acid (gaba), Passion Flower, Ashwagandha.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,379 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 Instaflex PM, check with your doctor or pharmacist if you take blood pressure medications (ashwagandha and GABA may lower blood pressure further), sedating drugs or benzodiazepines (three ingredients may intensify drowsiness), diabetes medications (ashwagandha may lower blood sugar), liver-toxic drugs (ashwagandha raises liver damage risk), thyroid hormones (ashwagandha may boost their effects), immune-suppressing drugs (ashwagandha may weaken them), or medications processed by your liver through CYP3A4 or CYP1A2 pathways (ashwagandha and passionflower may affect levels). These are Moderate-severity concerns — don't skip this step.

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.

Instaflex PM is designed to support sleep and relaxation through ashwagandha, passionflower, and GABA, with Levagen+ for joint support. If you take blood pressure medications, sedating drugs, diabetes medications, thyroid hormones, or anything that affects the liver or immune system, you need to check this product with your doctor or pharmacist before starting — the interactions are real and could affect how your medications work.

Pregnant or breastfeeding? Talk with your doctor or pharmacist first.

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

Assessment coverage: 4 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 16, 2022.

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 Instaflex PM, straight from the product label.

Brand Instaflex
Barcode (UPC) 855710002932
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Jun 16, 2022
DSLD ID 263814
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
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 Instaflex PM by Instaflex, 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:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
30
UPC/BARCODE
855710002932
IngredientAmount% DV
Gamma-Aminobutyric Acid100 mg--
Ashwagandha Root Extract75 mg--
Levagen+300 mg--
TamaFlex250 mg--
Passionflower extract50 mg--

Other ingredients: Gelatin, Magnesium Stearate, Rice Husks Concentrate

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.
Formulation

Powerful joint relief works while you sleep! Instaflex PM is uniquely formulated with Levagen+, a clinically validated ingredient that relieves joint discomfort and supports a healthy inflammatory response. It works like CBD by targeting pathways in the body’s endocannabinoid system. But you can rest easy knowing Instaflex PM is entirely safe, legal, and non-habit forming!

Nighttime joint support

Works like CBD Doctor formulated Targets endocannabinoid system Joint relief in 5 days Supports restful sleep

Formula

We’ve also added TamaFlex, a powerful blend of turmeric and tamarind extracts. It’s been shown to decrease stiffness and increase mobility in just 5 days—with results that grow over time. And we added GABA for deeper sleep, so you wake up feeling rejuvenated and like the best is yet to come!

Featuring Levagen+

Precautions

Precautions: Only for adults over 18 years.

Use only as directed.

Consult your healthcare practitioner if you have or suspect a medical condition, are pregnant or nursing, or if you use any medications, as certain ingredients may alter their potency and/or side effects.

Discontinue use two weeks prior to surgery or if any serious adverse reaction occurs. Do not use if safety seal is missing.

Keep out of the reach of children.

Storage

Keep product at room temperature and humidity [59-86 degrees F (15-30 degrees C), 40% RH].

Brand IP Statement(s)

Levagen+ is a trademark of Gencor. TamaFlex is a trademark of NXT USA, Inc. Patents Pending.

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.

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Two small capsules nightly Adult Usage: Take two (2) capsules with or without food, 30-60 minutes before bedtime.

See for yourself

Instaflex PM by Instaflex label

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

What’s inside

The Ingredients in Instaflex PM by Instaflex

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Gamma-Aminobutyric Acid

Interacts with
419 drugs
100 mg per serving

GABA is a calming chemical messenger (neurotransmitter) that your body makes on its own, and it is sold as a supplement for stress, anxiety, and sleep...

Gamma-Aminobutyric Acid monograph & interactions

Ashwagandha Root Extract

Interacts with
1,372 drugs
75 mg per serving Form: Withanolides

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 Root Extract monograph & interactions

Levagen+

No known
interactions
300 mg per serving Form: Palmitoylethanolamide

Palmitoylethanolamide (PEA) is a fat-like molecule made naturally in the body and studied mainly for pain and inflammation. Some research suggests it...

Levagen+ monograph & interactions

TamaFlex

250 mg per serving Form: Turmeric Rhizome Extract, Tamarind Seed Extract

Passionflower extract

Interacts with
836 drugs
50 mg per serving Form: Vitexin

Passion flower is a traditional calming herb that many people use for anxiety and sleep. Early studies hint it may help with mild anxiety and restless...

Passionflower extract monograph & interactions

Other (inactive) ingredients: Gelatin, Magnesium Stearate, Rice Husks Concentrate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Instaflex PM by Instaflex Drug Interactions

Want to check YOUR meds against Instaflex PM?

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
1,378Drugs
916 Moderate 462 Minor

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Instaflex PM 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 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

Passionflower extract3 drug types · 836 drugs

Cns Depressants

Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Research in animals and humans shows that passion flower has sedative effects which can be additive when used with sedative medications like lorazepam.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
In vitro research suggests that passion flower can induce CYP3A4 enzymes, albeit to a much lower degree than rifampin, a known CYP3A4 inducer.

Likelihood Possible Evidence D
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Theoretically, passion flower might reduce the bioavailability of OATP2B1 and OATP1A2 substrates.
In vitro research shows that the passion flower constituents apigenin and vitexin inhibit OATP2B1 and OATP1A2. This inhibition may be dose-dependent. One specific high-flavonoid passion flower extract (Valverde) seems to inhibit OATP2B1 and OATP1A2, while another extract with a lower flavonoid concentration (Arkocaps) shows less potent inhibition. OATPs are responsible for the uptake of drugs and other compounds into the body; however, the specific activities of OATP2B1 and OATP1A2 are not well characterized.

Likelihood Possible Evidence D

Gamma-Aminobutyric Acid2 drug types · 419 drugs

Antihypertensive Drugs

Theoretically, taking GABA with antihypertensive drugs might increase the risk of hypotension.
Some clinical research shows that GABA can decrease blood pressure in patients with hypertension.

Likelihood Possible Evidence B
Cns Depressants

Theoretically, GABA might have additive sedative effects when used in conjunction with CNS depressants. However, it is unclear if this concern is clinically relevant.
Endogenous GABA has well-established relaxant effects and GABA(A) receptors have an established physiological role in sleep. However, the effects of GABA supplements are unclear, as it is unknown whether exogenous GABA crosses the blood-brain barrier. Although there have been limited reports of drowsiness or tiredness with GABA supplements, these effects have not been widely reported in clinical studies. Additionally, intravenous GABA 0.1-1 mg/kg has been shown to induce anxiety in a dose-dependent manner.

Likelihood Unlikely Evidence D
The maker

Brand information

Manufacturer and brand details for Instaflex PM, from the product label.

Instaflex

See all Instaflex products
Name
Adaptive Health
City
Charlotte
State
NC
ZipCode
28202
Phone Number
1-800-436-0920
Web Address
www.INSTAFLEX.com
Pharmacist Counseling Corner

Instaflex PM by Instaflex: Common Questions

Does Instaflex PM by Instaflex interact with any medications?
Yes. Based on its ingredients, Instaflex PM has a known interaction with 1,378 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Instaflex PM contains 5 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.
Does Instaflex PM really help with sleep?
Ashwagandha and passionflower extract are both possibly effective for insomnia according to our data. GABA and Levagen+ haven't been shown reliably to work for sleep in the studies we have. That said, many people find these ingredients helpful, and sleep is individual — talk with your doctor or pharmacist about whether this product makes sense for you.
Is it safe to take Instaflex PM every night?
Long-term safety for all five ingredients is not well studied. Ashwagandha and GABA are often well tolerated short-term, but we don't have solid data on nightly use over months or years. If you're thinking about regular use, check in with your doctor or pharmacist to make sure it's right for you.
Can I take Instaflex PM if I'm on thyroid medication?
Ashwagandha may increase the effects of thyroid hormones, which could cause problems like racing heart, tremor, or anxiety. You absolutely need to check with your doctor or pharmacist before combining this product with thyroid medication — don't start it without their go-ahead.
Will Instaflex PM make me drowsy during the day?
Yes, drowsiness is possible. GABA, ashwagandha, and passionflower can all cause drowsiness, and that's partly how they help with sleep. Take it at night before bed to avoid daytime sleepiness, and don't drive or operate machinery until you know how it affects you.
Is Instaflex PM safe during pregnancy?
No. Ashwagandha is traditionally thought to risk miscarriage and should be avoided in pregnancy. Passionflower is considered possibly unsafe in pregnancy too. If you're pregnant or planning to become pregnant, talk with your doctor or pharmacist before taking this product.
What's Levagen+ and why is it in a sleep product?
Levagen+ is a form of palmitoylethanolamide (PEA), a naturally occurring compound. It's possibly effective for osteoarthritis and nerve-related discomfort, not specifically for sleep — it's likely in this product to address joint or muscle comfort that might interfere with rest.

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

Not sure if Instaflex PM is safe with your meds?

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Ask a pharmacist

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.

Instaflex PM label
Sources

Sources & How We Checked

Instaflex PM'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 67 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.

Gamma-aminobutyric Acid (gaba) 12 references
  1. Cavagnini F, Invitti C, Pinto M, et al. Effect of acute and repeated administration of gamma aminobutyric acid (GABA) on growth hormone and prolactin secretion in man. Acta Endocrinol (Copenh) 1980;93:149-54.
  2. Nurnberger JI Jr, Berrettini WH, Simmons-Alling S, et al. Intravenous GABA administration is anxiogenic in man. Psychiatry Res 1986;19:113-7. PubMed
  3. Gershman RN, Vasilenko MA, Iliushina GG, et al. [Gammalon in the rehabilitation in infantile cerebral palsy]. Pediatr.Akus.Ginekol. 1977;(6):26-7.
  4. Loeb C, Benassi E, Bo, GP, et al. Preliminary evaluation of the effect of GABA and phosphatidylserine in epileptic patients. Epilepsy Res. 1987;1:209-12 . PubMed
  5. Inoue K, Shirai T, Ochiai H, et al. Blood-pressure-lowering effect of a novel fermented milk containing gamma-aminobutyric acid (GABA) in mild hypertensives. Eur J Clin Nutr 2003;57:490-95.
  6. ELLIOTT, K. A. and JASPER, H. H. Gammaaminobutyric acid. Physiol Rev. 1959;39(2):383-406.
  7. Winsky-Sommerer, R. Role of GABAA receptors in the physiology and pharmacology of sleep. Eur.J.Neurosci. 2009;29(9):1779-1794.
  8. Meldrum, B. S. GABAergic mechanisms in the pathogenesis and treatment of epilepsy. Br.J.Clin.Pharmacol. 1989;27 Suppl 1:3S-11S. PubMed
  9. Loeb, C., Marinari, U. M., Benassi, E., Besio, G., Cottalasso, D., Cupello, A., Maffini, M., Mainardi, P., Pronzato, M. A., and Scotto, P. A. Phosphatidylserine increases in vivo the synaptosomal uptake of exogenous GABA in rats. Exp.Neurol. 1988;99(2):4 PubMed
  10. Melis, G. B., Paoletti, A. M., Mais, V., and Fioretti, P. Interference of dopamine infusion on gamma-amino butyric acid (GABA)-stimulated prolactin increase. J.Endocrinol.Invest 1980;3(4):445-448.
  11. Boonstra E, de Kleijn R, Colzato LS, Alkemade A, Forstmann BU, Nieuwenhuis S. Neurotransmitters as food supplements: the effects of GABA on brain and behavior. Front Psychol. 2015 Oct 6;6:1520. doi: 10.3389/fpsyg.2015.01520. eCollection 2015. PubMed
  12. de Bie TH, Witkamp RF, Balvers MG, Jongsma MA. Effects of ?-aminobutyric acid supplementation on glucose control in adults with prediabetes: A double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 2023;118(3):708-719. PubMed

See these in context on the Gamma-aminobutyric Acid (gaba) 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
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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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