Magnesium + Ashwagandha Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Magnesium + Ashwagandha against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Magnesium + Ashwagandha is a dietary supplement by Irwin Naturals with 11 active ingredients. Its ingredients are commonly taken for bone health and osteoporosis, correcting vitamin d deficiency, immune system support.Based on those ingredients, 1,586 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Sensoril, BioPerine, Ginger Rhizome Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Magnesium + Ashwagandha by Irwin Naturals
Ask about any prescription or over-the-counter medication and we check it for interactions with Magnesium + Ashwagandha by Irwin Naturals — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Magnesium + Ashwagandha by Irwin Naturals
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
Partial disclosure
This softgel contains 10 active ingredients. Magnesium and Vitamin D3 are minerals and fat-soluble vitamins that support bone and muscle function.
Vitamin K2 and Vitamin B6 are essential vitamins involved in blood clotting and energy metabolism. Ashwagandha (Sensoril brand) is an herbal adaptogen traditionally used for stress and sleep.
Ginger Rhizome Extract, flaxseed oil, black pepper extract (BioPerine), zinc (OptiZinc), and copper round out the blend with additional botanical and micronutrient support. The remaining ingredients are inactive fillers and capsule materials like gelatin, glycerin, and beeswax.
Does it work?
Moderate evidence
Magnesium is effective for constipation and dyspepsia (indigestion), and for treating magnesium deficiency and pre-eclampsia in pregnancy. Vitamin D3 is effective for rickets, osteomalacia, and certain bone disorders.
Vitamin K2 is effective for blood clotting disorders and possibly helpful for osteoporosis. Vitamin B6 is effective for certain types of anemia and deficiency, and possibly effective for pregnancy-related nausea.
Ashwagandha is rated possibly effective for anxiety, stress, insomnia, and generalized anxiety disorder. Ginger is rated possibly effective for pregnancy-related nausea and possibly ineffective for exercise soreness.
For zinc, the evidence shows it is effective for zinc deficiency and possibly effective for acne and age-related macular degeneration. Black pepper (BioPerine) lacks reliable evidence to rate its effectiveness for the conditions listed.
Flaxseed oil and copper lack solid evidence for the conditions tested in our data.
How safe is it?
Well-documented data
Magnesium is generally well tolerated at recommended doses; diarrhea is the most common side effect. It is needed in pregnancy but should be used only under doctor guidance.
Vitamin D3 is safe at recommended doses but very high doses over time can cause toxicity with high blood calcium (hypercalcemia); it is often used in pregnancy at recommended amounts under medical supervision. Vitamin K2 is generally safe in food and supplement amounts; normal dietary amounts are fine in pregnancy and lactation.
Vitamin B6 is safe below 100 mg daily but high doses over time can harm nerves (sensory neuropathy). Ginger is generally well tolerated; common side effects include mild stomach upset, heartburn, and diarrhea at higher doses (5 grams per day or more).
Black pepper is well tolerated in food and single doses as a spice. Zinc is well tolerated below 40 mg daily; side effects include nausea, metallic taste, and diarrhea at higher doses.
Ashwagandha is generally well tolerated short-term in healthy adults, though it should be avoided in pregnancy (traditionally thought to risk miscarriage) and during breastfeeding due to limited safety data. Ashwagandha has rare case reports of liver problems.
Flaxseed oil is generally well tolerated; high doses (30 grams daily or more) may cause loose stools.
Meds to double-check
Major interaction found
Blood thinners (particularly warfarin) — vitamin K2 can reverse warfarin's effect, and ginger and flaxseed oil may increase bleeding risk. Levodopa/carbidopa (Sinemet) for Parkinson's disease — magnesium can cut levodopa levels by about 35%.
Heart rhythm drugs (verapamil, diltiazem, digoxin) and thiazide diuretics — high-dose vitamin D can raise blood calcium and interfere with these. Seizure medications (phenytoin, phenobarbital) — high-dose vitamin B6 may reduce their levels.
CNS depressants, benzodiazepines, and antidiabetes drugs — ashwagandha may have additive sedative or blood-sugar-lowering effects. Antibiotic classes (quinolones, tetracyclines, cephalexin) — zinc can reduce absorption.
Antacids and acid reducers — they may reduce magnesium's laxative effect. Use the search tool on this page with your specific medications.
The bottom line
Scorecard at a glancePartially disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This product combines magnesium and ashwagandha for stress and relaxation support, with added vitamins and minerals. If you take any blood thinners (especially warfarin or aspirin), heart rhythm drugs, seizure medications, Parkinson's medications, or antibiotics, check your prescriptions against our interaction tool before starting — several ingredients can meaningfully affect how these drugs work.
Talk to your pharmacist or doctor, especially if you're pregnant, breastfeeding, or have a liver condition.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 10 of 10 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2025.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Magnesium + Ashwagandha, straight from the product label.
| Brand | Irwin Naturals |
|---|---|
| Barcode (UPC) | 840081404324 |
| Net contents | 60 Liquid Softgel(s) |
| Market status | On market |
| Date entered into DSLD | Feb 23, 2025 |
| DSLD ID | 323288 |
| Product type | Other Combinations |
| Supplement form | Softgel Capsule |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating) |
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 Magnesium + Ashwagandha by Irwin Naturals, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Calories | 30 Calorie(s) | -- |
| Vitamin D3 | 50 mcg | 250% |
| Total Fat | 1.5 Gram(s) | 2% |
| Protein | 3 Gram(s) | -- |
| BioPerine Complex | 3 mg | -- |
| Vitamin B6 | 10 mg | 588% |
| Vitamin K2 | 60 mcg | -- |
| Ginger Rhizome Extract | 0 NP | -- |
| BioPerine | 0 NP | -- |
| Copper | 1 mg | 111% |
| Flaxseed Oil | 1650 mg | -- |
| OptiZinc | 15 mg | 136% |
| Sensoril | 125 mg | -- |
| Magnesium | 150 mg | 36% |
Other ingredients: Gelatin, Water, Purified, Glycerin, Beeswax, Sunflower Lecithin, Annatto, Titanium Dioxide, Dicalcium Phosphate, Caramel, Red Cabbage extract, Maltodextrin
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.
Formula
Magnesium + Ashwagandha features three distinct forms of Magnesium that are highly-bioavailable and non-laxative for maximum health benefits. This formula is designed to promote whole-body and mind wellness by delivering a targeted combination of nutrients in combination with Sensoril Ashwagandha Extract to help you mentally and physically conquer your day, and recover well at night. When used daily, this product can support: Stress management & recovery - Sensoril Ashwagandha Extract helps reduce the negative impact that stress has on the body and mind. Bioavailable magnesium helps to relax the body and replenish nutrient stores for optimized recovery after a long and stressful day. Mood balance - Magnesium and activated Vitamin B6 (P5P) play important roles in managing important biochemistry related to mood and motivation. Immune defenses - Magnesium, Vitamin D3, and Zinc are daily essentials for the regular health maintenance of your primary immune defenses. Bone & muscle support - Magnesium along with Vitamin D3 + K2 (as MK-7) and zinc provide important nutritional support for the regular health maintenance of your physical structure. Integrate this product into your daily nutrition plan to optimize and maintain the health of your mind and body. Patented BioPerine - Our special BioPerine Complex enhances the bioavailability, absorption and potency of many nutrients.
Seals/Symbols
Pass Quality Tested Guaranteed
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.
Precautions
Usage warnings: Do not use if safety seal is broken. This product contains an ingredients that may affect blood sugar. Vitamin K should not be used by individuals with liver disease, kidney disease, and/or blood disorders. Do not exceed recommended daily intake.
Check with your doctor before using this product and engaging in activity, if you are using medication or have any medical conditions. Those individuals currently taking anticoagulant medications such as Coumadin (Warfarin) should consult with their doctor before taking supplemental Vitamin K. Do not use if you may become pregnant, are pregnant or nursing.
Not intended for use by persons under 18. Keep out of reach of children.
Storage
Store in a cool, dry place.
General Statements
Questions: Contact consumer affairs 1-800-297-3273 - Weekdays 8:00 AM to 5:00 PM (PST) 100+ highly specialized products: www.IrwinNaturals.com
Full Disclosure Ingredient Panel
Formulation
Triple-source Recovery Balance Stress Mind and body recovery formula Targeting key systems to improve overall health
What makes us different: Liquid Soft-Gels - The nutrients in these easy-to-swallow liquid soft-gels are released fast. Other forms of delivery can contain binders and fillers that may cause stomach upset and offer no nutritional value. Advanced Liquid Soft-Gels provide an optimum delivery system. Quality assurance - Irwin Naturals is committed to providing the highest quality products for your health. We employ compliance testing to ensure purity and potency. Global responsibility - Over the years we have donated to organizations that support the environment and the health of children.
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: (Adult) Take three (3) liquid soft-gels, up to two times per day, with food and a full glass (8oz) of water.
Brand IP Statement(s)
BioPerine is a registered trademark of Sabinsa Corporation. Aquamin is a registered trademark of Marigot Ltd. of Cork Ireland. OptiZinc is a Lonza trademark, registered in USA. Sensoril is protected under U.S. patent no. 7,318,938 and CA Patent No. 2,508,478, and is a registered trademark of Natreon, Inc.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Magnesium + Ashwagandha by Irwin Naturals 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 Magnesium + Ashwagandha by Irwin Naturals
These are the 11 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Liquid Soft-Gel(s) Dosage formSoftgel Capsule Servings per container20 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.
Vitamin D3
Interacts with715 drugs
Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people,...
Vitamin D3 monograph & interactionsProtein
BioPerine Complex
Vitamin B6
Interacts with210 drugs
Vitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is b...
Vitamin B6 monograph & interactionsVitamin K2
Interacts with2 drugs
Vitamin K is an essential nutrient your body needs for normal blood clotting and to support healthy bones. Most people get enough from food, but suppl...
Vitamin K2 monograph & interactionsCopper
Interacts with31 drugs
Copper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes wor...
Copper monograph & interactionsFlaxseed Oil
Interacts with293 drugs
Flaxseed oil is a plant-based source of the omega-3 fatty acid ALA, which the body can partly convert to the omega-3s found in fish oil. It may help s...
Flaxseed Oil monograph & interactionsOptiZinc
Interacts with67 drugs
Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...
OptiZinc monograph & interactionsSensoril
Interacts with1,372 drugs
Ashwagandha is an Ayurvedic herb most often taken to help with stress, anxiety, and sleep, and some small studies suggest it may help, though the evid...
Sensoril monograph & interactionsMagnesium
Interacts with295 drugs
Magnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preven...
Magnesium monograph & interactionsOther (inactive) ingredients: Gelatin, Water, Purified, Glycerin, Beeswax, Sunflower Lecithin, Annatto, Titanium Dioxide, Dicalcium Phosphate, Caramel, Red Cabbage extract, Maltodextrin. These complete the product’s ingredient list but are not active constituents.
Magnesium + Ashwagandha by Irwin Naturals Drug Interactions
HelloPharmacist Interaction Report
Magnesium + Ashwagandha by Irwin Naturals contains several ingredients with documented interactions to medications.
The most serious is magnesium's interaction with levodopa/carbidopa (Sinemet) — a Major severity interaction in which magnesium can reduce levodopa levels by around 35%, potentially weakening symptom control in Parkinson's disease.
Read the full breakdown — every affected drug type, severity by severity
Vitamin K2 interacts with warfarin (Coumadin), a blood thinner — vitamin K can reverse warfarin's anticoagulant effect, reducing protection against clots. This is also Major severity.
Vitamin D3 has Moderate interactions with thiazide diuretics, heart rhythm drugs (verapamil, diltiazem), digoxin, and cholesterol medication (atorvastatin), all tied to high-dose vitamin D raising calcium levels in the blood or affecting drug absorption. Vitamin B6 at high doses may reduce the effectiveness of seizure medications (phenytoin, phenobarbital) and can theoretically lower blood pressure with antihypertensive drugs.
Ginger, black pepper (BioPerine), flaxseed oil, and zinc each have Moderate interactions with blood thinners and anticoagulants — ginger and flaxseed oil may increase bleeding risk, and zinc can reduce absorption of several antibiotic classes (quinolones, tetracyclines, cephalexin). Black pepper increases levels of several medications including propranolol, phenytoin, and theophylline.
Ashwagandha theoretically increases the sedative effects of benzodiazepines and CNS depressants, and may lower blood glucose and blood pressure additively with those drug classes. Altogether, these interactions span 1,563 individual medications.
Copper and the BioPerine Complex had limited interaction data available — we could not fully check them. Use the medication checker below with your exact prescriptions before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Magnesium + Ashwagandha?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Magnesium + Ashwagandha interact with 1,586 drugs. Click any drug to see the details.
10 of the 11 ingredients in Magnesium + Ashwagandha interact with drugs. Each result below shows which ingredient is responsible. Sensoril BioPerine Ginger Rhizome Extract Vitamin D3 Magnesium Flaxseed Oil Vitamin B6 OptiZinc Copper Vitamin K2
Benserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Magnesium + Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Benserazide, Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Benserazide, Levodopa interactionCarbidopaLodosyn
How Carbidopa interacts with Magnesium + Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with Magnesium + Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with Magnesium + Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Carbidopa, Levodopa, Entacapone interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Carbidopa, Levodopa, Entacapone interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Magnesium + Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with Magnesium + Ashwagandha — through 2 ingredients. Tap an ingredient for the detail:
MagnesiumLevodopa/carbidopa (sinemet) Major
Interaction Summary
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Read the full Magnesium + Levodopa, Carbidopa interactionVitamin B6Levodopa Minor
Interaction Summary
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Read the full Vitamin B6 + Levodopa, Carbidopa interactionWarfarinWarfarin
How Warfarin interacts with Magnesium + Ashwagandha — through 7 ingredients. Tap an ingredient for the detail:
Vitamin K2Warfarin (coumadin) Major
Interaction Summary
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Read the full Vitamin K2 + Warfarin interactionGinger Rhizome ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +3 Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginger Rhizome Extract + Warfarin interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Warfarin interactionFlaxseed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full Flaxseed Oil + Warfarin interactionSensorilCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Sensoril + Warfarin interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Warfarin interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Warfarin interactionWarfarin SodiumCoumadin, Panwarfin, Sofarin
How Warfarin Sodium interacts with Magnesium + Ashwagandha — through 7 ingredients. Tap an ingredient for the detail:
Vitamin K2Warfarin (coumadin) Major
Interaction Summary
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Read the full Vitamin K2 + Warfarin Sodium interactionGinger Rhizome ExtractWarfarin (coumadin), Cytochrome P450 1a2 (cyp1a2) Substrates +3 Moderate
Interaction Summary
Ginger might increase the risk of bleeding with warfarin.
Read the full Ginger Rhizome Extract + Warfarin Sodium interactionFlaxseed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full Flaxseed Oil + Warfarin Sodium interactionBioperineAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Warfarin Sodium interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Warfarin Sodium interactionSensorilCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Sensoril + Warfarin Sodium interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Warfarin Sodium interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Magnesium + Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
SensorilHepatotoxic Drugs, Immunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Sensoril + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Magnesium + Ashwagandha — through 4 ingredients. Tap an ingredient for the detail:
Ginger Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger Rhizome Extract + Ado-trastuzumab Emtansine interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Ado-trastuzumab Emtansine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Ado-trastuzumab Emtansine interactionSensorilCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Sensoril + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Magnesium + Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
SensorilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Sensoril + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Magnesium + Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
SensorilHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Sensoril + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Magnesium + Ashwagandha — through 4 ingredients. Tap an ingredient for the detail:
Flaxseed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full Flaxseed Oil + Abciximab interactionBioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Abciximab interactionGinger Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginger Rhizome Extract + Abciximab interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Magnesium + Ashwagandha — through 4 ingredients. Tap an ingredient for the detail:
Ginger Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger Rhizome Extract + Abemaciclib interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Abemaciclib interactionSensorilCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Sensoril + Abemaciclib interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Magnesium + Ashwagandha — through 4 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Abiraterone interactionGinger Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger Rhizome Extract + Abiraterone interactionSensorilHepatotoxic 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 Sensoril + Abiraterone interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Magnesium + Ashwagandha — through 4 ingredients. Tap an ingredient for the detail:
Ginger Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger Rhizome Extract + Abiraterone Acetate interactionBioperineCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
Read the full Bioperine + Abiraterone Acetate interactionSensorilHepatotoxic 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 Sensoril + Abiraterone Acetate interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Magnesium + Ashwagandha — through 5 ingredients. Tap an ingredient for the detail:
Ginger Rhizome ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginger Rhizome Extract + Abrocitinib interactionFlaxseed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full Flaxseed Oil + Abrocitinib interactionSensorilImmunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Read the full Sensoril + Abrocitinib interactionBioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Abrocitinib interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Magnesium + Ashwagandha — through 4 ingredients. Tap an ingredient for the detail:
BioperineP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
Read the full Bioperine + Acalabrutinib interactionGinger Rhizome ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
Read the full Ginger Rhizome Extract + Acalabrutinib interactionSensorilCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Sensoril + Acalabrutinib interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Magnesium + Ashwagandha — through 3 ingredients. Tap an ingredient for the detail:
SensorilAntidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Sensoril + Acarbose interactionBioperineAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Bioperine + Acarbose interactionGinger Rhizome ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Ginger Rhizome Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Magnesium + Ashwagandha — through 3 ingredients. Tap an ingredient for the detail:
SensorilHepatotoxic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Sensoril + Acebutolol interactionVitamin B6Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Read the full Vitamin B6 + Acebutolol interactionFlaxseed OilAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, combining flaxseed oil with other antihypertensive drugs might have additive effects and increase the risk of hypotension.
Read the full Flaxseed Oil + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Magnesium + Ashwagandha — through 4 ingredients. Tap an ingredient for the detail:
Flaxseed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full Flaxseed Oil + Acenocoumarol interactionGinger Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginger Rhizome Extract + Acenocoumarol interactionBioperineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Acenocoumarol interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Magnesium + Ashwagandha — through 1 ingredient. Tap an ingredient for the detail:
SensorilCns Depressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Sensoril + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Magnesium + Ashwagandha — through 3 ingredients. Tap an ingredient for the detail:
SensorilCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Sensoril + Acetaminophen interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen interactionGinger Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger Rhizome Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Magnesium + Ashwagandha — through 5 ingredients. Tap an ingredient for the detail:
SensorilCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Sensoril + Acetaminophen, Aspirin interactionGinger Rhizome ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Ginger Rhizome Extract + Acetaminophen, Aspirin interactionBioperineAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
Read the full Bioperine + Acetaminophen, Aspirin interactionFlaxseed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full Flaxseed Oil + Acetaminophen, Aspirin interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Magnesium + Ashwagandha — through 6 ingredients. Tap an ingredient for the detail:
Flaxseed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Read the full Flaxseed Oil + Acetaminophen, Aspirin, Caffeine interactionGinger Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger Rhizome Extract + Acetaminophen, Aspirin, Caffeine interactionSensorilHepatotoxic 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 Sensoril + Acetaminophen, Aspirin, Caffeine interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Aspirin, Caffeine interactionMagnesiumAnticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
Read the full Magnesium + Acetaminophen, Aspirin, Caffeine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Magnesium + Ashwagandha — through 3 ingredients. Tap an ingredient for the detail:
SensorilCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Sensoril + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionGinger Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger Rhizome Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Magnesium + Ashwagandha — through 3 ingredients. Tap an ingredient for the detail:
SensorilHepatotoxic 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 Sensoril + Acetaminophen, Butalbital interactionGinger Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger Rhizome Extract + Acetaminophen, Butalbital interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Magnesium + Ashwagandha — through 4 ingredients. Tap an ingredient for the detail:
SensorilCytochrome 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 Sensoril + Acetaminophen, Butalbital, Caffeine interactionGinger Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger Rhizome Extract + Acetaminophen, Butalbital, Caffeine interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Butalbital, Caffeine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Magnesium + Ashwagandha — through 4 ingredients. Tap an ingredient for the detail:
BioperineCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
Read the full Bioperine + Acetaminophen, Butalbital, Caffeine, Codeine interactionSensorilCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Sensoril + Acetaminophen, Butalbital, Caffeine, Codeine interactionGinger Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Ginger might increase or decrease the levels of CYP3A4 substrates.
Read the full Ginger Rhizome Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionVitamin D3Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
Read the full Vitamin D3 + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Magnesium + Ashwagandha — through 3 ingredients. Tap an ingredient for the detail:
SensorilHepatotoxic Drugs, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Sensoril + Acetaminophen, Butalbital, Codeine interactionBioperineCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
Read the full Bioperine + Acetaminophen, Butalbital, Codeine interactionGinger Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, ginger might increase the levels of CYP1A2 substrates.
Read the full Ginger Rhizome Extract + Acetaminophen, Butalbital, Codeine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Magnesium + Ashwagandha with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Sensoril
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/]
BioPerine
Anticoagulant/Antiplatelet Drugs
Theoretically, black pepper might increase the risk of bleeding when taken with antiplatelet or anticoagulant drugs.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit platelet aggregation. This has not been reported in humans.
Antidiabetes Drugs
Theoretically, black pepper might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research shows that piperine, a constituent of black pepper, can reduce blood glucose levels. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Atorvastatin (Lipitor)
Theoretically, black pepper might increase blood levels of atorvastatin.
Animal research shows that taking piperine, a constituent of black pepper, 35 mg/kg can increase the maximum serum concentration of atorvastatin three-fold. This has not been reported in humans.
Cyclosporine (Neoral, Sandimmune)
Theoretically, black pepper might increase the effects and side effects of cyclosporine.
In vitro research shows that piperine, a constituent of black pepper, increases the bioavailability of cyclosporine. This has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.
In vitro research suggests that some constituents of black pepper inhibit CYP2D6. This has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.
In vitro research and pharmacokinetic simulation data suggest that piperine, a constituent of black pepper, as well as the pepper fruit seem to inhibit CYP3A4. This has not been reported in humans.
Lithium
Theoretically, black pepper might increase blood levels of lithium due to its diuretic effects. The dose of lithium might need to be reduced.
Black pepper is thought to have diuretic properties.
Nevirapine (Viramune)
Black pepper might increase blood levels of nevirapine.
Clinical research shows that piperine, a constituent of black pepper, increases the plasma concentration of nevirapine. However, no adverse effects were observed in this study.
P-Glycoprotein Substrates
Theoretically, black pepper might increase levels of P-glycoprotein substrates.
In vitro research shows that piperine, a constituent of black pepper, seems to inhibit P-glycoprotein.
Pentobarbital (Nembutal)
Theoretically, black pepper might increase the sedative effects of pentobarbital.
Animal research shows that piperine, a constituent of black pepper, increases pentobarbital-induced sleeping time.
Phenytoin (Dilantin)
Black pepper might increase blood levels of phenytoin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption, slow elimination, and increase levels of phenytoin. Taking a single dose of black pepper 1 gram along with phenytoin seems to double the serum concentration of phenytoin. Consuming a soup with black pepper providing piperine 44 mg/200 mL of soup along with phenytoin also seems to increase phenytoin levels when compared with consuming the same soup without black pepper.
Propranolol (Inderal)
Black pepper might increase blood levels of propranolol.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of propranolol.
Rifampin (Rifadin)
Black pepper might increase blood levels of rifampin.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and serum levels of rifampin.
Theophylline
Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.
Amoxicillin (Amoxil, Trimox)
Theoretically, black pepper might increase the effects and side effects of amoxicillin.
Animal research shows that taking piperine, a constituent of black pepper, with amoxicillin increases plasma levels of amoxicillin. This has not been reported in humans.
Carbamazepine (Tegretol)
Theoretically, black pepper might increase blood levels of carbamazepine, potentially increasing the effects and side effects of carbamazepine.
One clinical study in patients taking carbamazepine 300 mg or 500 mg twice daily shows that taking a single 20 mg dose of purified piperine, a constituent of black pepper, increases carbamazepine levels. Piperine may increase carbamazepine absorption by increasing blood flow to the GI tract, increasing the surface area of the small intestine, or inhibiting cytochrome P450 3A4 (CYP3A4) in the gut wall. Absorption was significantly increased by 7-10 mcg/mL/hour. The time to eliminate carbamazepine was also increased by 4-8 hours. Although carbamazepine levels were increased, this did not appear to increase side effects. In vitro research also shows that piperine can increase carbamazepine levels by 11% in a time-dependent manner.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.
Ginger Rhizome Extract
Anticoagulant/Antiplatelet Drugs
Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking ginger with antidiabetes drugs might increase the risk of hypoglycemia.
Animal and human research suggests that ginger might increase insulin levels and/or decrease blood glucose levels.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.
Losartan (Cozaar)
Theoretically, ginger might increase levels of losartan and the risk of hypotension.
In animal research, ginger increased the levels and hypotensive effects of a single dose of losartan. It is not clear if ginger alters the concentration or effects of losartan when taken continuously. Additionally, this interaction has not been shown in humans.
Nifedipine (Procardia)
Ginger may have antiplatelet effects and increase the risk of bleeding if used with nifedipine.
Clinical research shows that combined treatment with ginger 1 gram plus nifedipine 10 mg significantly inhibits platelet aggregation when compared to nifedipine or ginger alone.
P-Glycoprotein Substrates
Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Phenprocoumon (Marcoumar, Others)
Ginger might increase the risk of bleeding with phenprocoumon.
Phenprocoumon, a warfarin-related anticoagulant, might increase the international normalized ratio (INR) when taken with ginger. There is one case report of a 76-year-old woman with a stable INR on phenprocoumon that increased to greater than 10 when she began consuming dried ginger and ginger tea.
Warfarin (Coumadin)
Ginger might increase the risk of bleeding with warfarin.
Laboratory research suggests that ginger might inhibit thromboxane synthetase and decrease platelet aggregation. In one case report, ginger increased the INR when taken with phenprocoumon, which has similar pharmacological effects as warfarin. In another case report, ginger increased the INR when taken with a combination of warfarin, hydrochlorothiazide, and acetaminophen. A longitudinal analysis suggests that taking ginger increases the risk of bleeding in patients taking warfarin for at least 4 months. However, research in healthy people suggests that ginger has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. Until more is known, monitor INRs closely in patients taking large amounts of ginger.
Calcium Channel Blockers
Theoretically, taking ginger with calcium channel blockers might increase the risk of hypotension.
Some animal and in vitro research suggests that ginger has hypotensive and calcium channel-blocking effects. Another animal study shows that concomitant administration of ginger and the calcium channel blocker amlodipine leads to greater reductions in blood pressure when compared with amlodipine alone.
Cyclosporine (Neoral, Sandimmune)
Theoretically, when taken prior to cyclosporine, ginger might decrease cyclosporine levels.
In an animal model, ginger juice taken 2 hours prior to cyclosporine administration reduced the maximum concentration and area under the curve of cyclosporine by 51% and 40%, respectively. This effect was not observed when ginger juice and cyclosporine were administered at the same time.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, ginger might increase the levels of CYP2B6 substrates.
In vitro research shows that ginger inhibits CYP2B6 activity. However, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, ginger might increase the levels of CYP2C9 substrates.
In vitro research shows that ginger inhibits CYP2C9 activity. However, this interaction has not been reported in humans.
Metronidazole (Flagyl)
Theoretically, ginger might increase levels of metronidazole.
In an animal model, ginger increased the absorption and plasma half-life of metronidazole. In addition, the elimination rate and clearance of metronidazole was significantly reduced.
Vitamin D3
Aluminum
Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
The protein that transports calcium across the intestinal wall can also bind and transport aluminum. This protein is stimulated by vitamin D, which may therefore increase aluminum absorption. This mechanism may contribute to increased aluminum levels and toxicity in people with renal failure, when they take vitamin D and aluminum-containing phosphate binders chronically.
Atorvastatin (Lipitor)
Vitamin D might reduce absorption of atorvastatin.
A small, low-quality clinical study shows that taking vitamin D reduces levels of atorvastatin and its active metabolites by up to 55%. However, while atorvastatin levels decreased, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels did not substantially change. Atorvastatin is metabolized in the gut by CYP3A4 enzymes, and researchers theorized that vitamin D might induce CYP3A4, causing reduced levels of atorvastatin. However, this proposed mechanism was not specifically studied.
Calcipotriene (Dovonex)
Taking calcipotriene with vitamin D increases the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with vitamin D supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Theoretically, hypercalcemia induced by high-dose vitamin D can increase the risk of arrhythmia from digoxin.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and digoxin concurrently.
Diltiazem (Cardizem, Others)
Theoretically, hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of diltiazem for arrhythmia.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically this could also occur with diltiazem. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and diltiazem concurrently.
Thiazide Diuretics
Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Thiazide diuretics decrease urinary calcium excretion, which could lead to hypercalcemia if vitamin D supplements are taken concurrently. This has been reported in people being treated with vitamin D for hypoparathyroidism, and also in elderly people with normal parathyroid function who were taking a thiazide, vitamin D, and calcium-containing antacids daily.
Verapamil (Calan, Others)
Hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of verapamil for arrhythmia.
Hypercalcemia due to high doses of vitamin D can reduce the effectiveness of verapamil in atrial fibrillation. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and verapamil concurrently.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
There is some concern that vitamin D might induce CYP3A4. In vitro research suggests that vitamin D induces CYP3A4 transcription. Additionally, observational research has found that increased UV light exposure and serum vitamin D levels are associated with decreased serum levels of CYP3A4 substrates such as tacrolimus and sirolimus, while no association between UV light exposure or vitamin D levels and levels of mycophenolic acid, a non-CYP3A4 substrate, was found. A small, low-quality clinical study shows that taking vitamin D reduces levels of the CYP3A4 substrate atorvastatin and its active metabolites by up to 55%; however, the clinical effects of atorvastatin were not reduced. While researchers theorized that vitamin D might induce CYP3A4, this proposed mechanism was not specifically studied.
Magnesium
Levodopa/Carbidopa (Sinemet)
Magnesium can reduce the bioavailability of levodopa/carbidopa.
Clinical research in healthy volunteers shows that taking magnesium oxide 1000 mg with levodopa 100 mg/carbidopa 10 mg reduces the area under the curve (AUC) of levodopa by 35% and of carbidopa by 81%. In vitro and animal research shows that magnesium produces an alkaline environment in the digestive tract, which might lead to degradation and reduced bioavailability of levodopa/carbidopa.
Aminoglycoside Antibiotics
Concomitant use of aminoglycoside antibiotics and magnesium can increase the risk for neuromuscular weakness.
Both aminoglycosides and magnesium reduce presynaptic acetylcholine release, which can lead to neuromuscular blockade and possible paralysis. This is most likely to occur with high doses of magnesium given intravenously.
Antacids
Use of acid reducers may reduce the laxative effect of magnesium oxide.
A retrospective analysis shows that, in the presence of H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs), a higher dose of magnesium oxide is needed for a laxative effect. This may also occur with antacids. Under acidic conditions, magnesium oxide is converted to magnesium chloride and then to magnesium bicarbonate, which has an osmotic laxative effect. By reducing acidity, antacids may reduce the conversion of magnesium oxide to the active bicarbonate salt.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Magnesium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after magnesium containing products.
Bisphosphonates
Magnesium can decrease absorption of bisphosphonates.
Cations, including magnesium, can decrease bisphosphonate absorption. Advise patients to separate doses of magnesium and these drugs by at least 2 hours.
Calcium Channel Blockers
Magnesium can have additive effects with calcium channel blockers, although evidence is conflicting.
Magnesium inhibits calcium entry into smooth muscle cells and may therefore have additive effects with calcium channel blockers. Severe hypotension and neuromuscular blockades may occur when nifedipine is used with intravenous magnesium, although some contradictory evidence suggests that concurrent use of magnesium with nifedipine does not increase the risk of neuromuscular weakness. High doses of magnesium could theoretically have additive effects with other calcium channel blockers.
Digoxin
Magnesium salts may reduce absorption of digoxin.
Clinical evidence suggests that treatment with oral magnesium hydroxide or magnesium trisilicate reduces absorption of digoxin from the intestines. This may reduce the blood levels of digoxin and decrease its therapeutic effects.
Potassium-Sparing Diuretics
Potassium-sparing diuretics decrease excretion of magnesium, possibly increasing magnesium levels.
Potassium-sparing diuretics also have magnesium-sparing properties, which can counteract the magnesium losses associated with loop and thiazide diuretics. Theoretically, increased magnesium levels could result from concomitant use of potassium-sparing diuretics and magnesium supplements.
Quinolone Antibiotics
Magnesium decreases absorption of quinolones.
Magnesium can form insoluble complexes with quinolones and decrease their absorption. Advise patients to take these drugs at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Skeletal Muscle Relaxants
Parenteral magnesium alters the pharmacokinetics of skeletal muscle relaxants, increasing their effects and accelerating the onset of effect.
Parenteral magnesium shortens the time to onset of skeletal muscle relaxants by about 1 minute and prolongs the duration of action by about 2 minutes. Magnesium potentiates the effects of skeletal muscle relaxants by decreasing calcium-mediated release of acetylcholine from presynaptic nerve terminals, reducing postsynaptic sensitivity to acetylcholine, and having a direct effect on the membrane potential of myocytes. Magnesium also has vasodilatory actions and increases cardiac output, allowing a greater amount of muscle relaxant to reach the motor end plate. A clinical study found that low-dose rocuronium (0.45 mg/kg), when given after administration of magnesium 30 mg/kg over 10 minutes, has an accelerated onset of effect, which matches the onset of effect seen with a full-dose rocuronium regimen (0.6 mg/kg). In another clinical study, onset times for rocuronium doses of 0.3, 0.6, and 1.2 mg/kg were 86, 76, and 50 seconds, respectively, when given alone, but were reduced to 66, 44, and 38 seconds, respectively, when the doses were given after a 15-minute infusion of magnesium sulfate 60 mg/kg. Giving intraoperative intravenous magnesium sulfate, 50 mg/kg loading dose followed by 15 mg/kg/hour, reduces the onset time of rocuronium, enhances its clinical effects, reduces the dose of intraoperative opiates, and prolongs the spontaneous recovery time. It does not affect the activity of subsequently administered neostigmine.
Sulfonylureas
Magnesium increases the systemic absorption of sulfonylureas, increasing their effects and side effects.
Clinical research shows that administration of magnesium hydroxide with glyburide increases glyburide absorption, increases maximal insulin response by 35-fold, and increases the risk of hypoglycemia, when compared with glyburide alone. A similar interaction occurs between magnesium hydroxide and glipizide. The mechanism of this effect appears to be related to the elevation of gastrointestinal pH by magnesium-based antacids, increasing solubility and enhancing absorption of sulfonylureas.
Tetracycline Antibiotics
Magnesium decreases absorption of tetracyclines.
Magnesium can form insoluble complexes with tetracyclines in the gut and decrease their absorption and antibacterial activity. Advise patients to take these drugs 1 hour before or 2 hours after magnesium supplements.
Anticoagulant/Antiplatelet Drugs
Theoretically, magnesium may have antiplatelet effects, but the evidence is conflicting.
In vitro evidence shows that magnesium sulfate inhibits platelet aggregation, even at low concentrations. Some preliminary clinical evidence shows that infusion of magnesium sulfate increases bleeding time by 48% and reduces platelet activity. However, other clinical research shows that magnesium does not affect platelet aggregation, although inhibition of platelet-dependent thrombosis can occur.
Gabapentin (Neurontin)
Gabapentin absorption can be decreased by magnesium.
Clinical research shows that giving magnesium oxide orally along with gabapentin decreases the maximum plasma concentration of gabapentin by 33%, time to maximum concentration by 36%, and area under the curve by 43%. Advise patients to take gabapentin at least 2 hours before, or 4 to 6 hours after, magnesium supplements.
Sevelamer (Renagel, Renvela)
Sevelamer may increase serum magnesium levels.
In patients on hemodialysis, sevelamer use was associated with a 0.28 mg/dL increase in serum magnesium. The mechanism of this interaction remains unclear.
Flaxseed Oil
Anticoagulant/Antiplatelet Drugs
Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Small clinical studies show that consuming flaxseed oil might decrease platelet aggregation and increase bleeding time.
Antihypertensive Drugs
Theoretically, combining flaxseed oil with other antihypertensive drugs might have additive effects and increase the risk of hypotension.
Some clinical evidence suggests that long-term consumption of flaxseed oil can modestly lower systolic and diastolic blood pressure, while other clinical research shows no effect.
Ezetimibe (Zetia)
Concomitant use of flaxseed oil and ezetimibe reduces the absorption of alpha-linolenic acid from flaxseed oil.
In one clinical study, concomitant consumption of ezetimibe 10 mg daily with flaxseed oil 2 grams providing 1 gram of alpha-linolenic acid daily blocked the absorption of alpha-linolenic acid, resulting in an overall reduction in alpha-linolenic plasma levels from baseline.
Vitamin B6
Amiodarone (Cordarone)
Theoretically, vitamin B6 might increase the photosensitivity caused by amiodarone.
Despite initial case reports suggesting that pyridoxine may have a protective effect against amiodarone-induced photosensitivity, preliminary clinical research suggests that pyridoxine may actually exacerbate this adverse effect.
Antihypertensive Drugs
Theoretically, vitamin B6 may have additive effects when used with antihypertensive drugs.
Research in hypertensive rats shows that vitamin B6 can decrease systolic blood pressure. Similarly, clinical research in patients with hypertension shows that taking high doses of vitamin B6 may reduce systolic and diastolic blood pressure, possibly by reducing plasma levels of epinephrine and norepinephrine.
Phenobarbital (Luminal)
High doses of vitamin B6 may reduce the levels and clinical effects of phenobarbital.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenobarbital, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenobarbital to avoid high doses of vitamin B6.
Phenytoin (Dilantin)
High doses of vitamin B6 may reduce the levels and clinical effects of phenytoin.
Preliminary clinical evidence suggests that vitamin B6 200 mg daily can reduce plasma levels of phenytoin, possibly by increasing metabolism. It is not known whether lower doses have any effect. Advise people taking phenytoin to avoid high doses of vitamin B6.
Levodopa
Vitamin B6 may increase the metabolism of levodopa when taken alone, but not when taken in conjunction with carbidopa.
Vitamin B6 (pyridoxine) enhances the metabolism of levodopa, reducing its clinical effects. However, this interaction does not occur when carbidopa is used concurrently with levodopa (Sinemet). Therefore, it is not likely to be a problem in most people.
OptiZinc
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.
Cephalexin (Keflex)
Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.
Cisplatin (Platinol-Aq)
Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.
Integrase Inhibitors
Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.
Penicillamine (Cuprimine, Depen)
Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.
Quinolone Antibiotics
Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.
Ritonavir (Norvir)
Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.
Tetracycline Antibiotics
Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.
Amiloride (Midamor)
Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.
Atazanavir (Reyataz)
Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.
Copper
Penicillamine (Cuprimine, Depen)
Theoretically, taking copper with penicillamine might decrease the absorption of penicillamine; separate dosing by at least 2 hours.
Copper chelates penicillamine, which decreases its absorption and may reduce its clinical effects.
Contraceptive Drugs
Theoretically, taking copper with contraceptive drugs might increase the levels and toxic effects of copper.
A meta-analysis of clinical studies suggests that chronic use of oral contraceptives increases serum copper levels by a mean of 57 mcg/dL. In most people, this resulted in levels above the normal reference range for copper.
Vitamin K2
Warfarin (Coumadin)
Vitamin K can antagonize and reverse the therapeutic effects of warfarin.
Vitamin K antagonizes the effects of warfarin. Excessive vitamin K intake, either from supplements or from changes in the diet, can reduce the anticoagulant effect of warfarin.
Brand information
Manufacturer and brand details for Magnesium + Ashwagandha, from the product label.
Irwin Naturals
See all Irwin Naturals products- Name
- Irwin Naturals
- Street Address
- 5310 Beethoven Street
- City
- Los Angeles
- State
- CA
- ZipCode
- 90066
- Phone Number
- 1-800-297-3273
- Web Address
- www.IrwinNaturals.com
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The Full Monographs Behind Magnesium + Ashwagandha’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin D
Interacts with 715 drugsVitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people, especially those with low sun exposure,...
Read the full Vitamin D monograph → Herb & supplement monographGinger
Interacts with 1,007 drugsGinger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pr...
Read the full Ginger monograph → Herb & supplement monographBlack Pepper
Interacts with 1,019 drugsBlack pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (li...
Read the full Black Pepper monograph → Herb & supplement monographVitamin B6
Interacts with 210 drugsVitamin B6 (pyridoxine) is an essential water-soluble vitamin that your body needs for metabolism, brain function, and making red blood cells. It is best known for helping with pregnancy-rel...
Read the full Vitamin B6 monograph → Herb & supplement monographVitamin K
Interacts with 2 drugsVitamin K is an essential nutrient your body needs for normal blood clotting and to support healthy bones. Most people get enough from food, but supplements are sometimes used for deficiency...
Read the full Vitamin K monograph → Herb & supplement monographCopper
Interacts with 31 drugsCopper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes work. Most people get enough copper from fo...
Read the full Copper monograph → Herb & supplement monographFlaxseed Oil
Interacts with 293 drugsFlaxseed oil is a plant-based source of the omega-3 fatty acid ALA, which the body can partly convert to the omega-3s found in fish oil. It may help support heart health and provide healthy...
Read the full Flaxseed Oil monograph → Herb & supplement monographZinc
Interacts with 67 drugsZinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...
Read the full Zinc 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 monographMagnesium
Interacts with 295 drugsMagnesium is an essential mineral your body needs for muscles, nerves, blood pressure, and many other functions, and supplements are useful for preventing or correcting deficiency. Some othe...
Read the full Magnesium monograph →Sources & How We Checked
Magnesium + Ashwagandha's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 396 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.
Vitamin D 26 references
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- Demontis R, Leflon A, Fournier A, et al. 1 alpha(OH) vitamin D3 increases plasma aluminum in hemodialyzed patients taking AI(OH)3. Clin Nephrol 1986;26:146-9.
- Crowe M, Wollner L, Griffiths RA. Hypercalcemia following vitamin D and thiazide therapy in the elderly. Practitioner 1984;228:312-3.
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- Thiazide diuretics and the risk of osteoporosis. Pharmacist's Letter/Prescriber's Letter 2003;19(11):191105.
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- Demontis R, Reissi D, Noel C, et al. Indirect clinical evidence that 1alphaOH vitamin D<SUB>3</SUB> increases the intestinal absorption of aluminum. Clin Nephrol 1989;31:123-7.
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- Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
- Cox KA, Dunn MA. Aluminum toxicity alters the regulation of calbindin-D28k protein and mRNA expression in chick intestine. J Nutr 2001;131:2007-13. PubMed
- Escribano, J., Balaguer, A., Pagone, F., Feliu, A., and Roque, I. Figuls. Pharmacological interventions for preventing complications in idiopathic hypercalciuria. Cochrane.Database.Syst.Rev. 2009;(1):CD004754. PubMed
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- Weiner M, Epstein FH. Signs and symptoms of electrolyte disorders. Yale J Biol Med. 1970;43(2):76-109.
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- Murai IH, Fernandes AL, Sales LP, et al. Effect of a single high dose of vitamin D3 on hospital length of stay in patients with moderate to severe COVID-19: A randomized clinical trial. JAMA. 2021.
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- Doyle D, Browne U, Brickley A, Murphy D. Vitamin D-induced hypercalcaemia and acute kidney injury in sarcoidosis. BMJ Case Rep 2023;16(1):e250580. PubMed
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Vitamin B6 32 references
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- Kaufman G. Pyridoxine against amiodarone-induced photosensitivity (letter). Lancet 1984;1:51-2. PubMed
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- Kawada A, Kashima A, Shiraishi H, et al. Pyridoxine-induced photosensitivity and hypophosphatasia. Dermatology 2000;201:356-60.. PubMed
- Vasile A, Goldberg R, Kornberg B. Pyridoxine toxicity: report of a case. J Am Osteopath Assoc 1984;83:790-1. DOI
- Hansson O, Sillanpaa M. Pyridoxine and serum concentration of phenytoin and phenobarbitone. Lancet 1976;1:256. DOI
- Jansen T, Romiti R, Kreuter A, Altmeyer P. Rosacea fulminans triggered by high-dose vitamins B6 and B12. J Eur Acad Dermatol Venereol 2001;15:484-5..
- Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007;90:15-20.
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