RealClarity Ingredients & Drug Interactions
What is this page for?
First and foremost: checking RealClarity 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
RealClarity is a dietary supplement by Real Mushrooms with 4 active ingredients. Its ingredients are commonly taken for memory and cognitive support, nerve health, mood and anxiety.Based on those ingredients, 1,580 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are KSM-66, Rhodiola Root Extract, Bacopa Leaf Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against RealClarity by Real Mushrooms
Ask about any prescription or over-the-counter medication and we check it for interactions with RealClarity by Real Mushrooms — 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 RealClarity by Real Mushrooms
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
RealClarity contains four active ingredients: Lion's Mane Mushroom Extract, Rhodiola Root Extract, KSM-66 (a standardized extract of ashwagandha), and Bacopa Leaf Extract. The product also includes inactive ingredients — pullulan, agave inulin powder, L-leucine, and silicon dioxide — that serve as capsule material and flow agents.
Does it work?
Moderate evidence
The evidence for these ingredients is mixed. Ashwagandha (KSM-66) is possibly effective for insomnia, anxiety, and stress.
For the other three ingredients — Lion's Mane, Rhodiola, and Bacopa — the data we hold shows insufficient reliable evidence to rate their effectiveness for the conditions they're typically used for (memory, cognition, Alzheimer's disease, and others). That doesn't mean they don't work; it means the research published so far hasn't met the bar to call them established.
How safe is it?
Well-documented data
All four ingredients are generally well tolerated in the short term. Lion's Mane may cause gastrointestinal discomfort, nausea, or skin rash.
Rhodiola can cause dizziness and changes in saliva production. Ashwagandha may cause diarrhea, nausea, or drowsiness at typical doses, though rarely; serious cases of liver injury have been reported.
Bacopa commonly causes gastrointestinal upset — abdominal cramps, nausea, diarrhea, and dry mouth — with rates ranging from 12% to 30% in studies; it may also cause drowsiness or insomnia. Long-term safety data are limited for all four.
None of the ingredients have enough safety data in pregnancy or breastfeeding; the safety notes advise against use in both situations.
Meds to double-check
Moderate interaction found
Check with your pharmacist before using RealClarity if you take blood thinners or antiplatelet drugs (Moderate risk of bleeding), blood pressure medications (Moderate risk of low blood pressure), diabetes medications (Moderate risk of low blood sugar), benzodiazepines or other sedatives (Moderate risk of excess drowsiness), thyroid hormones (Moderate risk of overactive thyroid effects), hepatotoxic drugs (Moderate risk of liver damage with ashwagandha), or drugs metabolized by your liver — especially losartan, cevimeline, or CYP2C9, CYP2C19, CYP3A4, or CYP1A2 substrates.
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.
RealClarity is a multi-ingredient cognitive support formula. It's not for you if you take blood thinners, blood pressure medications, diabetes medications, sedatives, thyroid hormones, or hepatotoxic drugs — the interactions are too significant to ignore.
Even if you don't take these, run your exact medications through the checker below. Talk to your pharmacist or doctor before you start, especially if you're pregnant, breastfeeding, or have liver concerns.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 4 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 RealClarity, straight from the product label.
| Brand | Real Mushrooms |
|---|---|
| Barcode (UPC) | 628110068521 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 23, 2025 |
| DSLD ID | 327051 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for RealClarity by Real Mushrooms, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Lion's Mane Mushroom Extract | 500 mg | -- |
| Rhodiola Root Extract | 150 mg | -- |
| KSM-66 | 250 mg | -- |
| Bacopa Leaf Extract | 100 mg | -- |
Other ingredients: Pullulan, Agave Inulin, Powder, L-Leucine, Silicon Dioxide
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
3rd party lab verified for quality Guaranteed potency Our guarantee: This product is verified for active compounds.
Vegan
Gluten free Non GMO There are no added starch, grains or mycelium.
Quality grown
Formula
Contains hot water and dual extracts for improved bioavailability
Mushrooms + herbs Lion's Mane Mushroom Ashwaghanda Rhodiola & Bacopa
Seals/Symbols
Vegan
Suggested/Recommended/Usage/Directions
Suggested use: Adults take 2 capsules per day.
Storage
Storage: Store in a cool dry place with the lid securely closed.
Precautions
Warning: Keep out of reach of children.
Consult a physician if you are pregnant or nursing; have or had a medical condition; or are taking prescription drugs.
Manufactured in a facility which processes milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans, and sesame.
FDA Disclaimer Statement
This statement has 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
Brand IP Statement(s)
KSM-66 Ashwagandha is a registered trademark of Ixoreal Biomed, Inc.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
RealClarity by Real Mushrooms 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 RealClarity by Real Mushrooms
These are the 4 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.
Lion's Mane Mushroom Extract
Interacts with327 drugs
Lion's mane is an edible mushroom that is popular as a 'nootropic' for memory, focus, and nerve health, but solid human evidence is still limited and...
Lion's Mane Mushroom Extract monograph & interactionsRhodiola Root Extract
Interacts with1,271 drugs
Rhodiola is an herb traditionally used to fight fatigue and help the body cope with stress. Some small studies suggest it may modestly reduce fatigue...
Rhodiola Root Extract monograph & interactionsKSM-66
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...
KSM-66 monograph & interactionsBacopa Leaf Extract
Interacts with930 drugs
Bacopa is an Ayurvedic herb most often used for memory and thinking. Some small studies suggest it may modestly help memory when taken regularly for s...
Bacopa Leaf Extract monograph & interactionsOther (inactive) ingredients: Pullulan, Agave Inulin, Powder, L-Leucine, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
RealClarity by Real Mushrooms Drug Interactions
HelloPharmacist Interaction Report
RealClarity by Real Mushrooms contains four active ingredients, and together they interact with a substantial number of medications.
The most serious interaction we've documented is a Moderate-severity risk of bleeding when Lion's Mane Mushroom is used with blood thinners or antiplatelet drugs (such as warfarin or aspirin) — the mushroom extract may slow platelet clumping and raise your bleeding risk.
Read the full breakdown — every affected drug type, severity by severity
Rhodiola Root Extract carries several Moderate-severity interactions: it may lower blood pressure excessively with blood pressure medications, interfere with drugs metabolized by your liver (especially losartan and other CYP2C9 substrates), and increase the risk of low blood sugar (hypoglycemia) with diabetes medications. It also has Minor interactions with a few other liver-metabolized drugs.
KSM-66 (ashwagandha) presents Moderate risks with sedatives and anti-anxiety medications — it may boost their drowsy effects — and with blood pressure medications, diabetes medications, and thyroid hormones. It may also interfere with immune-suppressing drugs and carry a rare but serious risk of liver injury when combined with hepatotoxic drugs.
Bacopa Leaf Extract has Moderate interactions with multiple liver-metabolized drugs (CYP1A2, CYP2C19, CYP2C9, and CYP3A4 substrates) and may affect how anticholinergic and cholinergic drugs work; it also has a Minor interaction with thyroid hormones.
Altogether, these interactions span 1,557 individual medications. Use the search tool below to check your exact prescriptions before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against RealClarity?
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 RealClarity interact with 1,580 drugs. Click any drug to see the details.
4 of the 4 ingredients in RealClarity interact with drugs. Each result below shows which ingredient is responsible. KSM-66 Rhodiola Root Extract Bacopa Leaf Extract Lion's Mane Mushroom Extract
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Lion's Mane Mushroom ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, concurrent use of lion's mane mushroom might interfere with immunosuppressive therapy.
Read the full Lion's Mane Mushroom Extract + 6-mercaptopurine interactionKsm-66Hepatotoxic Drugs, Immunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + 6-mercaptopurine interactionRhodiola Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, rhodiola use might interfere with immunosuppressive therapy.
Read the full Rhodiola Root Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Leaf Extract + Ado-trastuzumab Emtansine interactionRhodiola Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Root Extract + Ado-trastuzumab Emtansine interactionKsm-66Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with RealClarity — through 1 ingredient. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with RealClarity — through 1 ingredient. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with RealClarity — through 1 ingredient. Tap an ingredient for the detail:
Lion's Mane Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, lion's mane mushroom may increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Lion's Mane Mushroom Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Leaf Extract + Abemaciclib interactionKsm-66Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Abemaciclib interactionRhodiola Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Root Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Abiraterone interactionBacopa Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Leaf Extract + Abiraterone interactionRhodiola Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Root Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Leaf Extract + Abiraterone Acetate interactionKsm-66Cytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Abiraterone Acetate interactionRhodiola Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Root Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with RealClarity — through 4 ingredients. Tap an ingredient for the detail:
Ksm-66Immunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Read the full Ksm-66 + Abrocitinib interactionLion's Mane Mushroom ExtractImmunosuppressants, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, concurrent use of lion's mane mushroom might interfere with immunosuppressive therapy.
Read the full Lion's Mane Mushroom Extract + Abrocitinib interactionBacopa Leaf ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP2C19 substrates.
Read the full Bacopa Leaf Extract + Abrocitinib interactionRhodiola Root ExtractImmunosuppressants, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, rhodiola use might interfere with immunosuppressive therapy.
Read the full Rhodiola Root Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Rhodiola Root ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, rhodiola might increase levels of P-glycoprotein substrates.
Read the full Rhodiola Root Extract + Acalabrutinib interactionBacopa Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Leaf Extract + Acalabrutinib interactionKsm-66Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Rhodiola Root ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking rhodiola with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Rhodiola Root Extract + Acarbose interactionKsm-66Hepatotoxic Drugs, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acarbose interactionLion's Mane Mushroom ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, lion's mane mushroom may have additive effects when used with antidiabetes drugs.
Read the full Lion's Mane Mushroom Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with RealClarity — through 2 ingredients. Tap an ingredient for the detail:
Rhodiola Root ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking rhodiola with antihypertensive drugs might increase the risk of hypotension.
Read the full Rhodiola Root Extract + Acebutolol interactionKsm-66Antihypertensive Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Read the full Ksm-66 + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with RealClarity — through 1 ingredient. Tap an ingredient for the detail:
Lion's Mane Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, lion's mane mushroom may increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Lion's Mane Mushroom Extract + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Cns Depressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acepromazine interactionBacopa Leaf ExtractAnticholinergic Drugs Moderate
Interaction Summary
Theoretically, concurrent use might decrease the effectiveness of both agents.
Read the full Bacopa Leaf Extract + Acepromazine interactionRhodiola Root ExtractCns Depressants Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.
Read the full Rhodiola Root Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen interactionKsm-66Hepatotoxic 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 Ksm-66 + Acetaminophen interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with RealClarity — through 4 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ksm-66 + Acetaminophen, Aspirin interactionBacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Aspirin interactionLion's Mane Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, lion's mane mushroom may increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Lion's Mane Mushroom Extract + Acetaminophen, Aspirin interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with RealClarity — through 4 ingredients. Tap an ingredient for the detail:
Lion's Mane Mushroom ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, lion's mane mushroom may increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Read the full Lion's Mane Mushroom Extract + Acetaminophen, Aspirin, Caffeine interactionBacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Aspirin, Caffeine interactionKsm-66Hepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acetaminophen, Aspirin, Caffeine interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionKsm-66Hepatotoxic 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 Ksm-66 + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ksm-66 + Acetaminophen, Butalbital interactionBacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Butalbital interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Butalbital, Caffeine interactionKsm-66Hepatotoxic 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 Ksm-66 + Acetaminophen, Butalbital, Caffeine interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ksm-66 + Acetaminophen, Butalbital, Caffeine, Codeine interactionBacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Cns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acetaminophen, Butalbital, Codeine interactionBacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Butalbital, Codeine interactionRhodiola Root ExtractCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.
Read the full Rhodiola Root Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionKsm-66Cns Depressants, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acetaminophen, Butalbital, Codeine Phosphate interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ksm-66 + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionBacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Cns Depressants, Hepatotoxic Drugs +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acetaminophen, Caffeine, Codeine interactionBacopa Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Caffeine, Codeine interactionRhodiola Root ExtractCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Minor
Interaction Summary
Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.
Read the full Rhodiola Root Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionKsm-66Cns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ksm-66 + Acetaminophen, Caffeine, Codeine, Salicylamide interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Cytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Ksm-66 + Acetaminophen, Caffeine, Dihydrocodeine interactionBacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acetaminophen, Caffeine, Isometheptene interactionBacopa Leaf ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Caffeine, Isometheptene interactionRhodiola Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
Read the full Rhodiola Root Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Leaf Extract + Acetaminophen, Caffeine, Pyrilamine interactionKsm-66Cytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ksm-66 + Acetaminophen, Caffeine, Pyrilamine interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with RealClarity — through 3 ingredients. Tap an ingredient for the detail:
Ksm-66Hepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +2 Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ksm-66 + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionBacopa Leaf ExtractAnticholinergic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, concurrent use might decrease the effectiveness of both agents.
Read the full Bacopa Leaf Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionRhodiola Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
Read the full Rhodiola Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEach ingredient & the kinds of drugs it affects
For each ingredient in RealClarity 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.
KSM-66
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/]
Rhodiola Root Extract
Antidiabetes Drugs
Theoretically, taking rhodiola with antidiabetes drugs might increase the risk of hypoglycemia.
In vitro and animal research shows that rhodiola extract can decrease blood glucose due to alpha-glucosidase activity.
Antihypertensive Drugs
Theoretically, taking rhodiola with antihypertensive drugs might increase the risk of hypotension.
In vitro and animal research shows that rhodiola extract inhibits angiotensin-converting enzyme (ACE) and might lower blood pressure.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP2C9.
In vitro research shows that rhodiola inhibits CYP2C9. This effect is highly variable and appears to be dependent on the rhodiola product studied. Also, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days reduces the metabolism of losartan, a CYP2C9 substrate, by 21% after 4 hours.
Immunosuppressants
Theoretically, rhodiola use might interfere with immunosuppressive therapy.
In vitro and animal research show that rhodiola has immunostimulatory effects.
Losartan (Cozaar)
Rhodiola might increase the levels and adverse effects of losartan.
A clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days reduces the metabolism of losartan, a CYP2C9 substrate, by 21% after 4 hours.
P-Glycoprotein Substrates
Theoretically, rhodiola might increase levels of P-glycoprotein substrates.
In vitro research shows that rhodiola inhibits P-glycoprotein. Theoretically, using rhodiola with P-glycoprotein substrates might increase drug levels and potentially increase the risk of adverse effects.
Antidepressant Drugs
Theoretically, rhodiola might increase the risk of adverse effects when taken with antidepressants.
A review of adverse event reports in Poland identified cases of tachyarrhythmias, myalgia, arthralgia, gum pain, restless leg syndrome, swallowing disorders, and changes in consciousness when rhodiola was taken in combination with paroxetine, escitalopram, fluoxetine, sertraline, trazodone, and/or duloxetine.
Cns Depressants
Theoretically, rhodiola might increase the risk of adverse effects when taken with CNS depressants.
A review of adverse event reports in Poland identified cases of excessive sedation, myoclonus, hypotension, and hallucinations when rhodiola was taken with haloperidol, diazepam, or alprazolam.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that rhodiola inhibits CYP1A2. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of caffeine, a CYP1A2 substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that rhodiola inhibits CYP3A4. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of midazolam, a CYP3A4 substrate.
Bacopa Leaf Extract
Anticholinergic Drugs
Theoretically, concurrent use might decrease the effectiveness of both agents.
Bacopa seems to inhibit acetylcholinesterase and might increase acetylcholine levels, which could counteract the effects of anticholinergic drugs. Similarly, anticholinergic drugs might counteract the cholinergic effects of bacopa.
Cevimeline (Evoxac)
Theoretically, bacopa might increase the effects and adverse effects of cevimeline.
In one case, a 58-year-old female taking cevimeline long-term for Sjogren syndrome experienced hyperhidrosis, malaise, nausea, and tachycardia shortly after taking a single dose of bacopa. Symptoms resolved after two days. Cevimeline is metabolized by cytochrome P450 (CYP) 2D6 and CYP3A4, and researchers theorize that bacopa may have inhibited these isoenzymes. However, it is unclear if bacopa causes clinically significant inhibition of either CYP2D6 or CYP3A4.
Cholinergic Drugs
Theoretically, concurrent use of bacopa with other cholinergic drugs might have additive effects.
Bacopa seems to inhibit acetylcholinesterase and might increase acetylcholine levels. Theoretically, this could result in additive cholinergic effects when used with cholinergic drugs.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Research on the effects of bacopa extracts on CYP1A2 enzymes is conflicting. Some in vitro evidence shows that bacopa extract can moderately and non-competitively inhibit CYP1A2, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, bacopa might increase the levels and adverse effects of CYP2C19 substrates.
In vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C19 enzymes. It is not known whether this is clinically significant.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, bacopa might increase the levels and adverse effects of CYP2C9 substrates.
Research on the effect of bacopa extracts on CYP2C9 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C9, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Research on the effects of bacopa extracts on CYP3A4 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and competitively inhibit CYP3A4, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Thyroid Hormone
Theoretically, bacopa might have additive effects when used with thyroid hormone.
Animal research suggests that bacopa increases thyroxine (T4) levels in mice by about 40%.
Lion's Mane Mushroom Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, lion's mane mushroom may increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
In vitro research suggests that lion's mane mushroom extracts can inhibit platelet aggregation.
Antidiabetes Drugs
Theoretically, lion's mane mushroom may have additive effects when used with antidiabetes drugs.
Animal research suggests that an aqueous extract of lion's mane mushroom can reduce serum glucose and increase serum insulin.
Immunosuppressants
Theoretically, concurrent use of lion's mane mushroom might interfere with immunosuppressive therapy.
In animal and in vitro research, lion's mane mushroom polysaccharides stimulate the immune system.
Brand information
Manufacturer and brand details for RealClarity, from the product label.
Real Mushrooms
See all Real Mushrooms products- Name
- Real Mushrooms Inc.
- Street Address
- 908 17 Ave SW, Suite 303
- City
- Calgary
- ZipCode
- AB T2T 0A3
- Phone Number
- 1-800-263-4387
RealClarity by Real Mushrooms: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Our pharmacists answer your medication & supplement questions — free.
Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind RealClarity’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Lion's Mane Mushroom
Interacts with 327 drugsLion's mane is an edible mushroom that is popular as a 'nootropic' for memory, focus, and nerve health, but solid human evidence is still limited and early. It is generally well tolerated as...
Read the full Lion's Mane Mushroom monograph → Herb & supplement monographRhodiola
Interacts with 1,271 drugsRhodiola is an herb traditionally used to fight fatigue and help the body cope with stress. Some small studies suggest it may modestly reduce fatigue and improve mood, but the evidence is li...
Read the full Rhodiola 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 monographBacopa
Interacts with 930 drugsBacopa is an Ayurvedic herb most often used for memory and thinking. Some small studies suggest it may modestly help memory when taken regularly for several weeks, but the evidence is limite...
Read the full Bacopa monograph →Sources & How We Checked
RealClarity'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 63 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.
Lion's Mane Mushroom 6 references
- Product information for <em>Niaspan</em>. Abbott Laboratories. North Chicago, IL 60064. April 2015.
- Liang B, Guo Z, Xie F, Zhao A. Antihyperglycemic and antihyperlipidemic activities of aqueous extract of Hericium erinaceus in experimental diabetic rats. BMC Complement Altern Med. 2013;13:253. PubMed
- Mori K, Inatomi S, Ouchi K, Azumi Y, Tuchida T. Improving effects of the mushroom Yamabushitake (Hericium erinaceus) on mild cognitive impairment: a double-blind placebo-controlled clinical trial. Phytother Res. 2009;23(3):367-72.
- Mori K, Kikuchi H, Obara Y, et al. Inhibitory effect of hericenone B from Hericium erinaceus on collagen-induced platelet aggregation. Phytomedicine. 2010;17(14):1082-5. PubMed
- Li IC, Chang HH, Lin CH, et al. Prevention of early Alzheimer's disease by erinacine A-enriched Hericium erinaceus mycelia pilot double-blind placebo-controlled study. Front Aging Neurosci 2020 Jun 3;12:155. doi: 10.3389/fnagi.2020.00155. PubMed
- Tian B, Liu R, Xu T, et al. Modulating effects of Hericium erinaceus polysaccharides on the immune response by regulating gut microbiota in cyclophosphamide-treated mice. J Sci Food Agric 2023;103(6):3050-3064.
See these in context on the Lion's Mane Mushroom monograph →
Rhodiola 13 references
- Kim SH, Hyun SH, Choung SY. Antioxidative effects of Cinnamomi cassiae and Rhodiola rosea extracts in liver of diabetic mice. Biofactors 2006;26:209-19.
- Kwon YI, Jang HD, Shetty K. Evaluation of Rhodiola crenulata and Rhodiola rosea for management of type II diabetes and hypertension. Asia Pac J Clin Nutr 2006;15:425-32.
- Bystritsky A, Kerwin L, Feusner JD. A pilot study of Rhodiola rosea (Rhodax) for generalized anxiety disorder (GAD). J Altern Complement Med 2008;14:175-80.
- Shevtsov VA, Zholus BI, Shervarly VI, et al. A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work. Phytomedicine 2003;10:95-105. PubMed
- Apostolidis E, Kwon YI, Shetty K. Potential of cranberry-based herbal synergies for diabetes and hypertension management. Asia Pac J Clin Nutr 2006;15:433-41.
- Hellum BH, Tosse A, Hoybakk K, et al. Potent in vitro inhibition of CYP3A4 and P-glycoprotein by Rhodiola rosea. Planta Med 2010;76:331-8.
- Skopriska-Rozewska E, Wojcik R, Siwicki AK, et al. The effect of Rhodiola quadrifida extracts on cellular immunity in mice and rats. Pol J Vet Sci 2008;11:105-11.
- Mishra KP, Chanda S, Shukla K, Ganju L. Adjuvant effect of aqueous extract of Rhodiola imbricate rhizome on the immune responses to tetanus toxoid and ovalbumin in rats. Immunopharmacol Immunotoxicol 2010;32:141-6.
- Li HX, Sze SC, Tong Y, Ng TB. Production of Th1- and Th2-dependent cytokines induced by the Chinese medicine herb, Rhodiola algida, on human peripheral blood monocytes. J Ethnopharmacol 2009;123:257-66. PubMed
- Mishra KP, Ganju L, Chanda S, et al. Aqueous extract of Rhodiola imbricate rhizome stimulates Toll-like receptor 4, granzyme-B and Th1 cytokines in vitro. Immunobiology 2009;214:27-31.
- Thu OK, Nilsen OG, Hellum B. In vitro inhibition of cytochrome P-450 activities and quantification of constituents in a selection of commercial Rhodiola rosea products. Pharm Bio. 2016 Dec;54(12):3249-3256.
- Thu OK, Spigset O, Nilsen OG, Hellum B. Effect of commercial Rhodiola rosea on CYP enzyme activity in humans. Eur J Clin Pharmacol. 2016 Mar;72(3):295-300. PubMed
- Woron J, Siwek M. Unwanted effects of psychotropic drug interactions with medicinal products and diet supplements containing plant extracts. Psychiatr Pol 2018;52(6):983-96. PubMed
Ashwagandha 32 references
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.
- Davis L, Kuttan G. Effect of Withania somnifera on cyclophosphamide-induced urotoxicity. Cancer Lett 2000;148:9-17. PubMed
- Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol 1998;62:209-14. PubMed
- Mishra LC, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): a review. Altern Med Rev 2000;5:334-46. DOI
- Andallu B, Radhika B. Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian J Exp Biol 2000;38:607-9.
- Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5. PubMed
- Ahumada F, Aspee F, Wikman G, Hancke J. Withania somnifera exract. Its effects on arterial blood pressure in anaesthetized dogs. Phytother Res 1991;5:111-14.
- Panda S, Kar A. Withania somnifera and Bauhinia purpurea in the regulation of circulating thyroid hormone concentrations in female mice. J Ethnopharmacol 1999;67:233-39. PubMed
- Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol 1998;50:1065-68. PubMed
- Sehgal, V. N., Verma, P., and Bhattacharya, S. N. Fixed-drug eruption caused by ashwagandha (Withania somnifera): a widely used Ayurvedic drug. Skinmed. 2012;10(1):48-49.
- Agnihotri AP, Sontakke SD, Thawani VR, Saoji A, Goswami VS. Effects of Withania somnifera in patients of schizophrenia: a randomized, double blind, placebo controlled pilot trial study. Indian J Pharmacol. 2013;45(4):417-8. PubMed
- Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Integr Cancer Ther. 2013;12(4):312-22.
- Sharma AK, Basu I, Singh S. Efficacy and safety of Ashwagandha root extract in subclinical hypothyroid patients: a double-blind, randomized placebo-controlled trial. J Altern Complement Med. 2018 Mar;24(3):243-248. PubMed
- Durg S, Bavage S, Shivaram SB. Withania somnifera (Indian ginseng) in diabetes mellitus: A systematic review and meta-analysis of scientific evidence from experimental research to clinical application. Phytother Res. 2020;34(5):1041-1059.
- Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4):825-829. PubMed
- Tharakan A, Shukla H, Benny IR, Tharakan M, George L, Koshy S. Immunomodulatory Effect of Withania somnifera (Ashwagandha) Extract-A Randomized, Double-Blind, Placebo Controlled Trial with an Open Label Extension on Healthy Participants. J Clin Med 2021;1 PubMed
- Ireland PJ, Hardy T, Burt AD, Donnelly MC. Drug-induced hepatocellular injury due to herbal supplement ashwagandha. J R Coll Physicians Edinb. 2021;51(4):363-365. PubMed
- Kamal HI, Patel K, Brdak A, Heffernan J, Ahmad N. Ashwagandha as a unique cause of thyrotoxicosis presenting with supraventricular tachycardia. Cureus. 2022 Mar 25;14(3):e23494. PubMed
- Suryawanshi G, Abdallah M, Thomson M, Desai N, Chauhan A, Lim N. Ashwagandha-Associated Acute Liver Failure Requiring Liver Transplantation. Am J Ther 2023;30(1):e80-e83. PubMed
- Pusec CM, Wolsky R, Llerena C, Sura P. A Case of Supplement-Induced Hepatitis. Cureus 2022;14(10):e30433. PubMed
- Ajgaonkar A, Jain M, Debnath K. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract for Improvement of Sexual Health in Healthy Women: A Prospective, Randomized, Placebo-Controlled Study. Cureus 2022;14(10):e30787. PubMed
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
- Lubarska M, Halasinski P, Hryhorowicz S, et al. Liver Dangers of Herbal Products: A Case Report of Ashwagandha-Induced Liver Injury. Int J Environ Res Public Health 2023;20(5):3921. PubMed
- Tóth M, Benedek AE, Longerich T, Seitz HK. Ashwagandha-induced acute liver injury: A case report. Clin Case Rep 2023;11(3):e7078.
- Bokan G, Glamocanin T, Mavija Z, et al. Herb-Induced Liver Injury by Ayurvedic Ashwagandha as Assessed for Causality by the Updated RUCAM: An Emerging Cause. Pharmaceuticals (Basel) 2023;16(8):1129. PubMed
- Patel PA, Sanborn E, Then R, Williams DM. Recurrent Reversible Cerebral Vasoconstriction Syndrome: A Report of Two Cases. Cureus 2023;15(8):e42992. PubMed
- Majeed M, Nagabhushanam K, Murali A, Vishwanathan DT, Mamidala RV, Mundkur L. A Standardized Withania somniferra (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomize
- Philips CA, Valsan A, Theruvath AH, et al. Ashwagandha-induced liver injury-A case series from India and literature review. Hepatol Commun 2023;7(10):e0270. PubMed
- Hayashi M, Hamada H, Azuma SI, Hayashi K. Painless Thyroiditis by Withania somnifera (Ashwagandha). Cureus 2024;16(3):e55352. PubMed
- Vazirani S, Kothari A, Fujimoto J, Gomez M. Supplements Are Not a Synonym for Safe: Suspected Liver Injury From Ashwagandha. Fed Pract 2023;40(9):315-319. PubMed
- Patel M, Newell R, Hillier M, Ramalingam R. Herbal remedies as a potential cause of hypoadrenalism. Br J Hosp Med (Lond) 2024;85(6):1-4. PubMed
Bacopa 12 references
- Stough C, Lloyd J, Clarke J, et al. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology 2001;156:481-4..
- Yadav SK, Jain AK, Tripathi SN, Gupta JP. Irritable bowel syndrome: therapeutic evaluation of indigenous drugs. Indian J Med Res 1989;90:496-503..
- Morgan A, Stevens J. Does Bacopa monnieri improve memory performance in older persons? Results of a randomized, placebo-controlled, double-blind trial. J Altern Complement Med 2010;16:753-9.
- Kar, A., Panda, S., and Bharti, S. Relative efficacy of three medicinal plant extracts in the alteration of thyroid hormone concentrations in male mice. J Ethnopharmacol. 2002;81(2):281-285. PubMed
- Mukherjee, G. D. and Dey, C. D. Clinical trial on Brahmi. I. J.Exp.Med.Sci. 1966;10(1):5-11.
- Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
- Kongkeaw C, Dilokthornsakul P, Thanarangsarit P, et al. Meta-analysis of randomized controlled trials on cognitive effects of Bacopa monnieri extract. J Ethnopharmacol 2014;151(1):528-35. PubMed
- Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
- Prabhakar S, Vishnu VY, Modi M, et al. Efficacy of Bacopa monnieri (Brahmi) and donepezil in Alzheimer's disease and mild cognitive impairment: a randomized double-blind parallel phase 2b study. Ann Indian Acad Neurol 2020;23(6):767-73. PubMed
- Acquarulo B, Tandon P, Macica CM. Suspected cholinergic toxicity due to cevimeline hydrochloride and Bacopa monnieri interaction: a case report. J Med Case Rep 2022;16(1):253. PubMed
- Keegan AP, Stough C, Paris D, et al. Bacopa monnieri supplementation has no effect on serum brain-derived neurotrophic factor levels but beneficially modulates nuclear factor kappa B and cyclic AMP response element-binding protein levels in healthy elderl
- Yaworski AM, Blyumin M, Chang T, Mammen AL, Greene M. Necrotizing myopathy with elevated anti-HMGCR antibodies following exposure to the supplement Bacopa. Muscle Nerve 2023;67(2):E1-E3.
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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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