Sleep Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Sleep 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
Sleep is a dietary supplement by Motiv-8 Performance with 12 active ingredients. Its ingredients are commonly taken for insomnia and poor sleep, anxiety and stress, restlessness.Based on those ingredients, 1,670 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Melatonin, Ashwagandha powder, Chamomile flower extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Sleep by Motiv-8 Performance
Ask about any prescription or over-the-counter medication and we check it for interactions with Sleep by Motiv-8 Performance — 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 Sleep by Motiv-8 Performance
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
This product has 12 active ingredients formulated to support sleep and relaxation. They include valerian powder and passionflower powder (both traditional calming herbs), melatonin (a hormone that regulates sleep-wake cycles), 5-HTP (a compound your body uses to make serotonin), ashwagandha powder (an adaptogenic herb), lemon balm extract and hops powder (both with mild sedative properties), chamomile flower extract, GABA (gamma-aminobutyric acid, a brain chemical involved in relaxation), acetyl-L-carnitine (a nutrient related to energy metabolism), Mucuna pruriens (cowhage, a plant that contains levodopa), guggulipid extract, and a proprietary blend called Skinny Sleep Matrix.
The product also contains inactive ingredients used as fillers and binders: hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose (MCC), and silicon dioxide.
Does it work?
Moderate evidence
Evidence for this product's ingredients is mixed. Valerian and melatonin are both rated Possibly Effective for insomnia, while passionflower is Possibly Effective for both insomnia and pre-procedural anxiety.
Ashwagandha is rated Possibly Effective for insomnia, anxiety, and stress. Lemon balm is Possibly Effective for cold sores and stress.
5-HTP is Possibly Effective for depression. However, the evidence for many other uses in this product is insufficient — we don't have enough data to rate chamomile for anxiety, GABA for anxiety, hops for insomnia, or Mucuna pruriens for any of its claimed effects.
Acetyl-L-carnitine and guggulipid lack established effectiveness for the sleep or relaxation claims in this context.
How safe is it?
Well-documented data
Valerian and melatonin are generally well tolerated short-term, but long-term safety data are limited. Common side effects of valerian include dizziness, drowsiness, mental slowness, headache, and vivid dreams; rarely, it can cause withdrawal symptoms like anxiety and insomnia if stopped abruptly after long use.
Melatonin commonly causes dizziness, drowsiness, headache, and nausea. Ashwagandha may cause diarrhea, nausea, vomiting, and drowsiness but is generally well tolerated short-term.
Chamomile can cause allergic reactions in people sensitive to ragweed and related plants, ranging from mild irritation to severe reactions in rare cases. Passionflower commonly causes dizziness, confusion, and sedation.
Lemon balm, GABA, hops, and acetyl-L-carnitine are generally well tolerated, though each may cause drowsiness or mild gastrointestinal upset. 5-HTP commonly causes nausea, diarrhea, headache, drowsiness, and dizziness — effects that may be dose-dependent.
Cowhage (Mucuna pruriens) contains levodopa and requires careful use; serious adverse effects are rare but can include agitation and nausea. Guggulipid commonly causes bloating, nausea, diarrhea, and headache; allergic skin reactions are possible and dose-dependent.
Pregnancy safety: valerian, melatonin, chamomile, GABA, lemon balm, passionflower, hops, and 5-HTP all lack enough data — talk with your doctor before using. Ashwagandha and cowhage are rated unsafe or possibly unsafe in pregnancy and should be avoided.
Guggulipid is likely unsafe and best avoided. For breastfeeding: valerian, melatonin, ashwagandha, GABA, lemon balm, passionflower, hops, 5-HTP, acetyl-L-carnitine, and guggulipid lack enough safety data — check with your doctor or pharmacist.
Cowhage may reduce milk supply due to its levodopa content and should be avoided.
Meds to double-check
Major interaction found
Check with your doctor or pharmacist before combining this product with any of these medication types: blood pressure medications (especially methyldopa and antihypertensives in general — Major and Moderate severity), monoamine oxidase inhibitors (MAOIs) used for depression — Major severity, and levodopa drugs for Parkinson's disease — Major severity. Also double-check if you take sedating medications (CNS depressants), blood thinners (anticoagulants) or antiplatelet drugs, diabetes medications, thyroid hormones, seizure medications, antidepressants or other serotonergic drugs, immunosuppressants, or drugs your liver metabolizes, as these have Moderate-severity interactions with one or more ingredients.
If you take carbidopa (used with levodopa), check before starting, as the 5-HTP in this product may increase side effects.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
If you're looking to support sleep naturally and don't take prescription medications, this blend of herbs, amino acids, and hormones may be worth exploring — several ingredients like valerian and melatonin have some evidence for insomnia. However, if you take any medications, especially blood pressure drugs, antidepressants, MAOIs, blood thinners, seizure or diabetes medications, thyroid hormones, or sedatives, you need to check your specific medications against the interaction tool before starting.
Pregnant or breastfeeding individuals should talk with their doctor or pharmacist first, since most ingredients lack safety data in those situations. Long-term safety of several ingredients is not well studied, so this product works best as a short-term sleep support under professional guidance.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 12 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2022.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Sleep, straight from the product label.
| Brand | Motiv-8 Performance |
|---|---|
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 23, 2022 |
| DSLD ID | 261096 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Gluten 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 Sleep by Motiv-8 Performance, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Valerian powder | 0 NP | -- |
| Melatonin | 0 NP | -- |
| Acetyl L-Carnitine Hydrochloride | 0 NP | -- |
| Chamomile flower extract | 0 NP | -- |
| Gamma-Aminobutyric Acid | 0 NP | -- |
| Ashwagandha powder | 0 NP | -- |
| Guggulipid extract | 0 NP | -- |
| Lemon Balm Extract | 0 NP | -- |
| Mucuna pruriens | 0 NP | -- |
| Passionflower powder | 0 NP | -- |
| Skinny Sleep Matrix | 1203 mg | -- |
| Hops, Powder | 0 NP | -- |
| HTPurity | 0 NP | -- |
Other ingredients: Hydroxypropyl Methylcellulose, Magnesium Stearate, MCC, 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
All natural ingredients A natural sleep aid that boosts metabolism and speeds up the fat burning process while promoting essential relaxation and sleep. Boost metabolism Restful sleep Accelerate fat loss
Vegan product
Non GMO Gluten free
FDA Statement of Identity
Dietary Supplement
Formula
Motiv-8 Skinny Sleep Matrix featuring: - GABA - Improves sleep cycles leading to a more restful sleep while increasing growth hormone levels and fat burning. - Chamomile - Helps reduce anxiety and depression while encouraging a good night's sleep. - Acetyl L-Carnitine - Improves heart and brain function while breaking down fat cells. - 5-HTP - Supports healthy serotonin and cortisol levels which improves sleep and decreases fat storage in problem areas.
Suggested/Recommended/Usage/Directions
Directions: Take 2 capsules 15-30 minutes before bedtime.
Storage
Storage: Keep in a cool, dry place.
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.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Sleep by Motiv-8 Performance 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 Sleep by Motiv-8 Performance
These are the 12 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Vcap(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.
Skinny Sleep Matrix
Other (inactive) ingredients: Hydroxypropyl Methylcellulose, Magnesium Stearate, MCC, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Sleep by Motiv-8 Performance Drug Interactions
HelloPharmacist Interaction Report
Motiv-8 Performance Sleep contains 12 ingredients, and several of them interact with medications.
The most serious interactions involve Mucuna pruriens (cowhage), which contains levodopa — a compound with Major-severity interactions with blood pressure medications like methyldopa and with monoamine oxidase inhibitors (MAOIs), a class of older antidepressants. Using cowhage with either of these can cause dangerous changes in blood pressure or a hypertensive crisis.
Read the full breakdown — every affected drug type, severity by severity
Valerian, melatonin, chamomile, GABA, ashwagandha, lemon balm, passionflower, and hops all interact with sedating medications (CNS depressants) at Moderate severity, potentially causing excessive drowsiness or sedation. Melatonin also has Moderate-severity interactions with blood thinners (anticoagulants) like warfarin, with blood pressure medications, with diabetes drugs, and with seizure medications.
Valerian interacts with some drugs your liver metabolizes (glucuronidated drugs). Chamomile may affect how your body processes several common drug types.
Acetyl-L-carnitine and 5-HTP both interact with serotonergic drugs (used for depression and anxiety) at Moderate severity, raising the risk of serotonin syndrome.
Guggulipid has Moderate interactions with blood thinners, thyroid hormones, and several other medication classes. Ashwagandha interacts with immunosuppressants, diabetes drugs, thyroid hormones, and drugs that stress the liver.
Lemon balm may interfere with thyroid hormone therapy. Passionflower has a Minor interaction with certain drug transporters.
Additionally, 5-HTP (HTPurity) has a Moderate interaction with carbidopa, a Parkinson's medication.
We could not check ingredients listed as a blend (Skinny Sleep Matrix). Altogether, these interactions span 1,671 individual medications.
Before you start this product, run your exact medications through the interaction checker on this page.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Sleep?
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 Sleep interact with 1,670 drugs. Click any drug to see the details.
12 of the 12 ingredients in Sleep interact with drugs. Each result below shows which ingredient is responsible. Melatonin Ashwagandha powder Chamomile flower extract Valerian powder Hops, Powder Passionflower powder Guggulipid extract Gamma-Aminobutyric Acid HTPurity Lemon Balm Extract Acetyl L-Carnitine Hydrochloride Mucuna pruriens
AmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Read the full Mucuna Pruriens + Amphetamine interactionChamomile Flower ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Flower Extract + Amphetamine interactionMelatoninSeizure Threshold Lowering Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Amphetamine interactionValerian PowderCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP2D6.
Read the full Valerian Powder + Amphetamine interactionBenserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Sleep — through 2 ingredients. Tap an ingredient for the detail:
Mucuna PruriensLevodopa Major
Interaction Summary
Concomitant use can increase the risk of levodopa-related adverse effects.
Read the full Mucuna Pruriens + Benserazide, Levodopa interactionMelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Benserazide, Levodopa interactionCarbidopa, LevodopaDhivy, Rytary, Sinemet, Sinemet CR
How Carbidopa, Levodopa interacts with Sleep — through 3 ingredients. Tap an ingredient for the detail:
Mucuna PruriensLevodopa Major
Interaction Summary
Concomitant use can increase the risk of levodopa-related adverse effects.
Read the full Mucuna Pruriens + Carbidopa, Levodopa interactionHtpurityCarbidopa (lodosyn) Moderate
Interaction Summary
Combining 5-HTP and carbidopa can increase the risk of serotonergic side effects.
Read the full Htpurity + Carbidopa, Levodopa interactionMelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Carbidopa, Levodopa interactionCarbidopa, Levodopa, EntacaponeStalevo
How Carbidopa, Levodopa, Entacapone interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Mucuna PruriensLevodopa Major
Interaction Summary
Concomitant use can increase the risk of levodopa-related adverse effects.
Read the full Mucuna Pruriens + Carbidopa, Levodopa, Entacapone interactionMelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Carbidopa, Levodopa, Entacapone interactionValerian PowderGlucuronidated Drugs Moderate
Interaction Summary
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
Read the full Valerian Powder + Carbidopa, Levodopa, Entacapone interactionHtpurityCarbidopa (lodosyn) Moderate
Interaction Summary
Combining 5-HTP and carbidopa can increase the risk of serotonergic side effects.
Read the full Htpurity + Carbidopa, Levodopa, Entacapone interactionChlorothiazide, MethyldopaAldochlor, Aldoclor 150, Aldoclor 250
How Chlorothiazide, Methyldopa interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMethyldopa (aldomet) Major
Interaction Summary
Theoretically, concomitant use of cowhage and methyldopa might increase the risk of hypotension.
Read the full Mucuna Pruriens + Chlorothiazide, Methyldopa interactionGamma-aminobutyric AcidAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking GABA with antihypertensive drugs might increase the risk of hypotension.
Read the full Gamma-aminobutyric Acid + Chlorothiazide, Methyldopa interactionMelatoninAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Read the full Melatonin + Chlorothiazide, Methyldopa interactionAshwagandha PowderAntihypertensive Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Read the full Ashwagandha Powder + Chlorothiazide, Methyldopa interactionHydrochlorothiazide, MethyldopaAldoril 15, Aldoril 25, Aldoril D30, Methazide
How Hydrochlorothiazide, Methyldopa interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMethyldopa (aldomet) Major
Interaction Summary
Theoretically, concomitant use of cowhage and methyldopa might increase the risk of hypotension.
Read the full Mucuna Pruriens + Hydrochlorothiazide, Methyldopa interactionMelatoninAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Read the full Melatonin + Hydrochlorothiazide, Methyldopa interactionGamma-aminobutyric AcidAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking GABA with antihypertensive drugs might increase the risk of hypotension.
Read the full Gamma-aminobutyric Acid + Hydrochlorothiazide, Methyldopa interactionAshwagandha PowderAntihypertensive Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Read the full Ashwagandha Powder + Hydrochlorothiazide, Methyldopa interactionIsocarboxazidMarplan
How Isocarboxazid interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Read the full Mucuna Pruriens + Isocarboxazid interactionAcetyl L-carnitine HydrochlorideSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl L-carnitine Hydrochloride + Isocarboxazid interactionHtpuritySerotonergic Drugs Moderate
Interaction Summary
Combining serotonergic drugs with 5-HTP might cause additive serotonergic effects.
Read the full Htpurity + Isocarboxazid interactionAshwagandha PowderSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Powder + Isocarboxazid interactionLevodopaInbrija, Larodopa
How Levodopa interacts with Sleep — through 2 ingredients. Tap an ingredient for the detail:
Mucuna PruriensLevodopa Major
Interaction Summary
Concomitant use can increase the risk of levodopa-related adverse effects.
Read the full Mucuna Pruriens + Levodopa interactionMelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Levodopa interactionLevodopa, CarbidopaDuodopa
How Levodopa, Carbidopa interacts with Sleep — through 3 ingredients. Tap an ingredient for the detail:
Mucuna PruriensLevodopa Major
Interaction Summary
Concomitant use can increase the risk of levodopa-related adverse effects.
Read the full Mucuna Pruriens + Levodopa, Carbidopa interactionHtpurityCarbidopa (lodosyn) Moderate
Interaction Summary
Combining 5-HTP and carbidopa can increase the risk of serotonergic side effects.
Read the full Htpurity + Levodopa, Carbidopa interactionMelatoninSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Read the full Melatonin + Levodopa, Carbidopa interactionMethyldopaAldomet, Methyldopa
How Methyldopa interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMethyldopa (aldomet) Major
Interaction Summary
Theoretically, concomitant use of cowhage and methyldopa might increase the risk of hypotension.
Read the full Mucuna Pruriens + Methyldopa interactionMelatoninAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Read the full Melatonin + Methyldopa interactionGamma-aminobutyric AcidAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking GABA with antihypertensive drugs might increase the risk of hypotension.
Read the full Gamma-aminobutyric Acid + Methyldopa interactionAshwagandha PowderAntihypertensive Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with antihypertensive drugs might increase the risk of hypotension.
Read the full Ashwagandha Powder + Methyldopa interactionMoclobemideManerix, Moclobemide
How Moclobemide interacts with Sleep — through 2 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Read the full Mucuna Pruriens + Moclobemide interactionMelatoninCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP2C19.
Read the full Melatonin + Moclobemide interactionOzanimod HydrochlorideZeposia
How Ozanimod Hydrochloride interacts with Sleep — through 3 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Read the full Mucuna Pruriens + Ozanimod Hydrochloride interactionAshwagandha PowderImmunosuppressants, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Read the full Ashwagandha Powder + Ozanimod Hydrochloride interactionMelatoninImmunosuppressants Moderate
Interaction Summary
Theoretically, melatonin might interfere with immunosuppressive therapy.
Read the full Melatonin + Ozanimod Hydrochloride interactionPhenelzine SulfateNardil
How Phenelzine Sulfate interacts with Sleep — through 11 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Read the full Mucuna Pruriens + Phenelzine Sulfate interactionAcetyl L-carnitine HydrochlorideSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl L-carnitine Hydrochloride + Phenelzine Sulfate interactionHtpurityCns Depressants, Serotonergic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of 5-HTP with medications that cause sedation might have additive effects.
Read the full Htpurity + Phenelzine Sulfate interactionHops, PowderCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops, Powder + Phenelzine Sulfate interactionPassionflower PowderCns Depressants Moderate
Interaction Summary
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Read the full Passionflower Powder + Phenelzine Sulfate interactionValerian PowderCns Depressants Moderate
Interaction Summary
Valerian can have additive sedative effects when used concomitantly with CNS depressant drugs.
Read the full Valerian Powder + Phenelzine Sulfate interactionAshwagandha PowderCns Depressants, Serotonergic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha might increase the sedative effects of CNS depressants.
Read the full Ashwagandha Powder + Phenelzine Sulfate interactionChamomile Flower ExtractCns Depressants Moderate
Interaction Summary
Theoretically, German chamomile might have additive effects when used with CNS depressants.
Read the full Chamomile Flower Extract + Phenelzine Sulfate interactionLemon Balm ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Extract + Phenelzine Sulfate interactionMelatoninCns Depressants Moderate
Interaction Summary
Theoretically, taking melatonin might increase the sedative effects of CNS depressants.
Read the full Melatonin + Phenelzine Sulfate interactionGamma-aminobutyric AcidCns Depressants Minor
Interaction Summary
Theoretically, GABA might have additive sedative effects when used in conjunction with CNS depressants.
Read the full Gamma-aminobutyric Acid + Phenelzine Sulfate interactionRasagilineAzilect
How Rasagiline interacts with Sleep — through 7 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Read the full Mucuna Pruriens + Rasagiline interactionMelatoninCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP1A2.
Read the full Melatonin + Rasagiline interactionHtpuritySerotonergic Drugs Moderate
Interaction Summary
Combining serotonergic drugs with 5-HTP might cause additive serotonergic effects.
Read the full Htpurity + Rasagiline interactionAcetyl L-carnitine HydrochlorideSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl L-carnitine Hydrochloride + Rasagiline interactionAshwagandha PowderSerotonergic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Powder + Rasagiline interactionHops, PowderCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops, Powder + Rasagiline interactionChamomile Flower ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Flower Extract + Rasagiline interactionSafinamide MesylateXadago
How Safinamide Mesylate interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Read the full Mucuna Pruriens + Safinamide Mesylate interactionAcetyl L-carnitine HydrochlorideSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl L-carnitine Hydrochloride + Safinamide Mesylate interactionHtpuritySerotonergic Drugs Moderate
Interaction Summary
Combining serotonergic drugs with 5-HTP might cause additive serotonergic effects.
Read the full Htpurity + Safinamide Mesylate interactionAshwagandha PowderSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Powder + Safinamide Mesylate interactionSelegilineCarbex, Eldepryl, Emsam, Zelapar
How Selegiline interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Read the full Mucuna Pruriens + Selegiline interactionHtpuritySerotonergic Drugs Moderate
Interaction Summary
Combining serotonergic drugs with 5-HTP might cause additive serotonergic effects.
Read the full Htpurity + Selegiline interactionAcetyl L-carnitine HydrochlorideSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl L-carnitine Hydrochloride + Selegiline interactionAshwagandha PowderSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Powder + Selegiline interactionTranylcypromineParnate
How Tranylcypromine interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Mucuna PruriensMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Read the full Mucuna Pruriens + Tranylcypromine interactionHtpuritySerotonergic Drugs Moderate
Interaction Summary
Combining serotonergic drugs with 5-HTP might cause additive serotonergic effects.
Read the full Htpurity + Tranylcypromine interactionAcetyl L-carnitine HydrochlorideSerotonergic Drugs Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Read the full Acetyl L-carnitine Hydrochloride + Tranylcypromine interactionAshwagandha PowderSerotonergic Drugs Minor
Interaction Summary
Some animal studies have reported that ashwagandha can enhance serotonergic transmission by altering certain serotonin (5-HT) receptors.
Read the full Ashwagandha Powder + Tranylcypromine interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Sleep — through 2 ingredients. Tap an ingredient for the detail:
Ashwagandha PowderHepatotoxic Drugs, Immunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Powder + 6-mercaptopurine interactionMelatoninImmunosuppressants Moderate
Interaction Summary
Theoretically, melatonin might interfere with immunosuppressive therapy.
Read the full Melatonin + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Sleep — through 7 ingredients. Tap an ingredient for the detail:
Guggulipid ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggulipid Extract + Ado-trastuzumab Emtansine interactionChamomile Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Flower Extract + Ado-trastuzumab Emtansine interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Ado-trastuzumab Emtansine interactionPassionflower PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Powder + Ado-trastuzumab Emtansine interactionHops, PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops, Powder + Ado-trastuzumab Emtansine interactionAshwagandha PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Powder + Ado-trastuzumab Emtansine interactionValerian PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian Powder + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Sleep — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha PowderHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Powder + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Sleep — through 1 ingredient. Tap an ingredient for the detail:
Ashwagandha PowderHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Powder + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Sleep — through 2 ingredients. Tap an ingredient for the detail:
MelatoninAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, melatonin may have anticoagulant effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Melatonin + Abciximab interactionGuggulipid ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Guggulipid Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Sleep — through 7 ingredients. Tap an ingredient for the detail:
Guggulipid ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggulipid Extract + Abemaciclib interactionChamomile Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Flower Extract + Abemaciclib interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Abemaciclib interactionHops, PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops, Powder + Abemaciclib interactionPassionflower PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Powder + Abemaciclib interactionAshwagandha PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Powder + Abemaciclib interactionValerian PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian Powder + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Sleep — through 7 ingredients. Tap an ingredient for the detail:
Chamomile Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Flower Extract + Abiraterone interactionGuggulipid ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggulipid Extract + Abiraterone interactionAshwagandha PowderHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Powder + Abiraterone interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Abiraterone interactionHops, PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops, Powder + Abiraterone interactionValerian PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian Powder + Abiraterone interactionPassionflower PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Powder + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Sleep — through 7 ingredients. Tap an ingredient for the detail:
Ashwagandha PowderCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Powder + Abiraterone Acetate interactionGuggulipid ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggulipid Extract + Abiraterone Acetate interactionChamomile Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Flower Extract + Abiraterone Acetate interactionHops, PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops, Powder + Abiraterone Acetate interactionPassionflower PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Powder + Abiraterone Acetate interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Abiraterone Acetate interactionValerian PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian Powder + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Sleep — through 4 ingredients. Tap an ingredient for the detail:
Ashwagandha PowderImmunosuppressants Moderate
Interaction Summary
Theoretically, taking ashwagandha might decrease the effects of immunosuppressants.
Read the full Ashwagandha Powder + Abrocitinib interactionGuggulipid ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Guggulipid Extract + Abrocitinib interactionMelatoninCytochrome P450 2c19 (cyp2c19) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP2C19.
Read the full Melatonin + Abrocitinib interactionChamomile Flower ExtractCytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Flower Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Sleep — through 7 ingredients. Tap an ingredient for the detail:
Chamomile Flower ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
Read the full Chamomile Flower Extract + Acalabrutinib interactionGuggulipid ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
Read the full Guggulipid Extract + Acalabrutinib interactionAshwagandha PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, ashwagandha might decrease the levels and clinical effects of CYP3A4 substrates.
Read the full Ashwagandha Powder + Acalabrutinib interactionHops, PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops, Powder + Acalabrutinib interactionValerian PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Read the full Valerian Powder + Acalabrutinib interactionMelatoninCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Read the full Melatonin + Acalabrutinib interactionPassionflower PowderCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
Read the full Passionflower Powder + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Sleep — through 3 ingredients. Tap an ingredient for the detail:
Ashwagandha PowderAntidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Ashwagandha Powder + Acarbose interactionMucuna PruriensAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, concomitant use of cowhage and antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Mucuna Pruriens + Acarbose interactionMelatoninAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Melatonin + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Sleep — through 3 ingredients. Tap an ingredient for the detail:
MelatoninAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Read the full Melatonin + Acebutolol interactionAshwagandha PowderHepatotoxic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.
Read the full Ashwagandha Powder + Acebutolol interactionGamma-aminobutyric AcidAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking GABA with antihypertensive drugs might increase the risk of hypotension.
Read the full Gamma-aminobutyric Acid + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Sleep — through 3 ingredients. Tap an ingredient for the detail:
Guggulipid ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
Read the full Guggulipid Extract + Acenocoumarol interactionMelatoninAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, melatonin may have anticoagulant effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Melatonin + Acenocoumarol interactionAcetyl L-carnitine HydrochlorideAcenocoumarol (sintrom) Moderate
Interaction Summary
Theoretically, acetyl-L-carnitine might increase the anticoagulant effects of acenocoumarol.
Read the full Acetyl L-carnitine Hydrochloride + Acenocoumarol interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Sleep 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.
Melatonin
Anticoagulant/Antiplatelet Drugs
Theoretically, melatonin may have anticoagulant effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
There are isolated case reports of minor bleeding and decreased prothrombin activity in people taking melatonin with warfarin (Coumadin). The mechanism, if any, of this interaction is unknown. Taking melatonin orally seems to decrease coagulation activity within one hour of dosing in healthy men.
Anticonvulsants
Theoretically, melatonin may reduce the effects of anticonvulsants. Some clinical research suggests that melatonin may increase the frequency of seizures in certain patients, particularly children with neurological impairment.
Antidiabetes Drugs
Theoretically, taking melatonin with antidiabetes drugs might increase the risk of hypoglycemia.
Some clinical research shows that melatonin reduces levels of fasting blood glucose and improves glycemic control. However, other research suggests that melatonin might impair glucose utilization and increase insulin resistance, while other research has found no effect on glucose levels. Until more is known, use melatonin cautiously in combination with antidiabetes drugs.
Antihypertensive Drugs
Theoretically, taking melatonin with antihypertensive drugs might increase the risk of hypotension or hypertension.
Some clinical research suggests that taking melatonin decreases blood pressure in healthy adults. Also, melatonin seems to lower systolic and diastolic blood pressure in individuals with high blood pressure at nighttime or untreated essential hypertension. However, melatonin seems to worsen blood pressure in patients who are taking antihypertensive medications. Immediate-release melatonin 5 mg at night in combination with nifedipine GITS (Procardia XL) increases systolic blood pressure an average of 6.5 mmHg, diastolic blood pressure by an average of 4.9 mmHg, and heart rate by 3.9 bpm. Also, results from animal research suggest that melatonin reduces the effectiveness of certain antihypertensive drugs, including methoxamine and clonidine.
Caffeine
Theoretically, taking caffeine with melatonin might increase levels of melatonin.
Some evidence suggests that caffeine consumption can decrease endogenous melatonin levels, while other evidence suggests that caffeine increases endogenous melatonin levels. When administered in combination with melatonin supplements, caffeine seems to increase melatonin effects and levels. The reason for this discrepancy is not completely clear. Part of the discrepancy may result from the fact that caffeine can inhibit melatonin synthesis as well as inhibit melatonin metabolism. By functioning as an adenosine receptor antagonist, caffeine may indirectly inhibit the synthesis of melatonin. Conversely, because melatonin and caffeine are both metabolized by cytochrome P450 1A2 (CYP1A2) enzyme, concomitant use of melatonin and caffeine may reduce the metabolism of melatonin, resulting in higher serum levels.
Cns Depressants
Theoretically, taking melatonin might increase the sedative effects of CNS depressants.
Melatonin has sedative effects. Theoretically, concomitant use of melatonin with alcohol, benzodiazepines, or other sedative drugs might cause additive sedation.
Contraceptive Drugs
Theoretically, taking contraceptive drugs with melatonin might increase the effects and adverse effects of melatonin.
Contraceptive drugs can increase the levels of endogenous melatonin. Theoretically, these drugs may increase the effects and adverse effects of oral melatonin.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP1A2. Also, other CYP1A2 substrates might decrease the metabolism of melatonin, increasing melatonin levels.
Melatonin is metabolized in the liver primarily by the CYP2C19 and CYP1A2 enzymes. Theoretically, combined administration of melatonin with drugs metabolized by the CYP1A2 enzyme might reduce the metabolism of these drugs, resulting in increased serum levels. Conversely, some drugs metabolized by CYP1A2 may inhibit the metabolism of melatonin, resulting in increased serum levels of melatonin. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP2C19. Also, other CYP2C19 substrates might decrease the metabolism of melatonin, increasing melatonin levels.
Melatonin is metabolized in the liver primarily by the CYP2C19 and CYP1A2 enzymes. Theoretically, combined administration of melatonin with certain drugs metabolized by the CYP2C19 enzyme may reduce the metabolism of these drugs, resulting in increased serum levels. Conversely, some drugs metabolized by CYP2C19 may inhibit the metabolism of melatonin, resulting in increased serum levels of melatonin. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Fluvoxamine (Luvox)
Theoretically, taking fluvoxamine with melatonin might increase levels of melatonin.
Fluvoxamine can significantly increase melatonin levels. In some cases, fluvoxamine might increase bioavailability of exogenously administered melatonin by up to 20 times. Some researchers think this might be a beneficial interaction and be potentially useful for cases of refractory insomnia. However, this interaction might also cause unwanted excessive drowsiness and possibly other adverse effects. Fluvoxamine is known to increase endogenous melatonin secretion. It seems to increase serum levels of exogenously administered melatonin possibly by decreasing melatonin metabolism by inhibiting cytochrome P450 (CYP450) 1A2 and 2C19 or by inhibiting melatonin elimination. This effect has been found in healthy people taking fluvoxamine 50-75 mg and melatonin 5 mg.
Immunosuppressants
Theoretically, melatonin might interfere with immunosuppressive therapy.
Melatonin can stimulate immune function. Theoretically, melatonin might interfere with immunosuppressive therapy.
Methamphetamine (Desoxyn)
Theoretically, taking melatonin with methamphetamine may increase the adverse effects of methamphetamine.
Animal research suggests that melatonin exacerbates the adverse effects of methamphetamine, resulting in greater depression of tryptophan hydroxylase (TPH) and tyrosine hydroxylase (TH) activity, as well as a significant reduction in dopamine levels. This has not been shown in humans.
Nifedipine Gits (Procardia Xl)
Theoretically, taking melatonin with extended release nifedipine reduces the effects of nifedipine.
Melatonin can decrease the effectiveness of extended release nifedipine (GITS). Immediate-release melatonin 5 mg at night in combination with nifedipine GITS 30-60 mg daily increases systolic and blood pressure by an average of 6.5 mmHg and 4.9 mmHg, respectively. Concomitant use with melatonin also increases heart rate by 3.9 bpm. The mechanism of this interaction is not known.
Seizure Threshold Lowering Drugs
Theoretically, taking melatonin with drugs that lower the seizure threshold might increase the risk of seizure activity.
Some clinical evidence suggests that melatonin may increase the frequency of seizures in certain patients, particularly children with neurological disabilities.
Warfarin (Coumadin)
Theoretically, melatonin may have antiplatelet effects and may increase the risk of bleeding with warfarin.
Three cases of increased prothrombin time have been reported for patients aged 48-72 years who took melatonin orally in combination with warfarin. However, three cases of decreased prothrombin time have also been reported for patients aged 51-84 years who took melatonin orally in combination with warfarin. Until more is known, use melatonin cautiously in patients taking warfarin.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP2D6.
Laboratory research suggests that certain lots of melatonin inhibit CYP2D6. Theoretically, combined administration of melatonin with certain drugs metabolized by the CYP2D6 enzyme may reduce the metabolism of these drugs, resulting in increased serum levels. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, melatonin might increase levels of drugs metabolized by CYP3A4.
Laboratory research shows that certain lots of melatonin inhibit CYP3A4. Theoretically, combined administration of melatonin with certain drugs metabolized by CYP3A4 may reduce the metabolism of these drugs, resulting in increased serum levels. Until more is known, use melatonin cautiously in patients taking drugs metabolized by these enzymes.
Flumazenil (Romazicon)
Theoretically, taking flumazenil with melatonin might reduce the effects of melatonin.
Animal research shows that flumazenil may inhibit the effect of melatonin.
Ashwagandha powder
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/]
Chamomile flower extract
Cns Depressants
Theoretically, German chamomile might have additive effects when used with CNS depressants.
German chamomile has mild sedative effects. Theoretically, concomitant use with drugs with sedative properties can cause additive effects and side effects.
Contraceptive Drugs
Theoretically, large amounts of German chamomile might reduce the effectiveness of oral contraceptives.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, concomitant use of large amounts of German chamomile might interfere with contraceptive drugs through competition for estrogen receptors.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, German chamomile might inhibit CYP2C9 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2C9. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2C9 in patients taking German chamomile.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2D6. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2D6 in patients taking German chamomile.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.
Estrogens
Theoretically, large amounts of German chamomile might reduce the effectiveness of estrogens.
In vitro, German chamomile has demonstrated antiestrogenic activity. Theoretically, large amounts of German chamomile might interfere with hormone replacement therapy through competition for estrogen receptors.
Tamoxifen (Nolvadex)
Theoretically, large amounts of German chamomile might interfere with the activity of tamoxifen.
In vitro, German chamomile has demonstrated antiestrogenic activity.
Warfarin (Coumadin)
German chamomile might increase the effects of warfarin and increase the risk of bleeding.
In one case, a 70-year-old female taking warfarin developed retroperitoneal hematoma and bilateral recti muscle bleeding along with an INR of 7.9 following ingestion of German chamomile tea 4-5 cups daily and use of a topical chamomile-based lotion applied 4-5 times daily.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
In vitro and animal research shows that German chamomile might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP1A2 in patients taking German chamomile.
Valerian powder
Alcohol (Ethanol)
Valerian can have additive sedative effects when used concomitantly with alcohol.
Valerian has sedative effects. Theoretically, valerian might have an additive sedative effect when combined with alcohol. Excessive sedation has been reported in an alcohol-abusing individual who took valerian and Gingko biloba. However, the potential interaction between valerian and alcohol has been disputed in other research. Limited evidence suggests that a combination of valerian 160 mg and lemon balm 80 mg (Euvegal) does not cause further deterioration in reaction ability and reaction rate when taken with alcohol as compared to the effects of alcohol alone.
Alprazolam (Xanax)
Valerian can have additive sedative effects when used with alprazolam. Also, valerian in high doses might modestly increase alprazolam levels, though this is not likely to be clinically significant.
Valerian has sedative effects. Theoretically, valerian might cause additive sedation when combined with alprazolam. Also, a small pharmacokinetic study shows that taking valerian extract 1000 mg daily (providing 11 mg valerenic acid) might increase alprazolam levels by about 19%. This might be due to valerian's mild inhibition of cytochrome P450 3A4 (CYP3A4). Despite being statistically significant, this increase is not likely to be clinically significant.
Cns Depressants
Valerian can have additive sedative effects when used concomitantly with CNS depressant drugs.
Theoretically, concomitant use of valerian and drugs with sedative and anesthetic properties may cause additive therapeutic and adverse effects.
Glucuronidated Drugs
Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
In vitro research shows that methanolic valerian extract and valerenic acid might competitively inhibit UDP-glucuronosyltransferase (UGT) 1A1 (UGT1A1) and UGT2B7.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP2D6.
Although some in vitro evidence suggests that valerian affects CYP2D6, clinical pharmacokinetic (PK) studies show that valerian is unlikely to affect the CYP2D6 enzyme. In one PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days did not affect the metabolism of dextromethorphan, a CYP2D6 substrate. In another PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of debrisoquine, an accepted CYP2D6 probe-substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
Although some in vitro evidence suggests that valerian extract might inhibit or induce CYP3A4, clinical pharmacokinetic (PK) studies show that valerian does not have a clinically significant effect on the CYP3A4 enzyme. In one PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of midazolam, an accepted CYP3A4 probe-substrate. In another PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days modestly increases levels of alprazolam, a CYP3A4 substrate, suggesting mild inhibition of CYP3A4. However, this mild inhibition is unlikely to be clinically relevant.
Hops, Powder
Cns Depressants
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Some animal research shows that hops has sedative effects.
Estrogens
Theoretically, concomitant use of large amounts of hops might interfere with hormone replacement therapy due to competition for estrogen receptors.
In vitro research suggests that certain hops constituents can competitively bind to estrogen receptors. However, most hops extracts contain very small amounts of these constituents.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
In vitro research suggests that flavonoid constituents of hops inhibit CYP1A2 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, does not affect levels of caffeine, a CYP1A2 probe substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Animal research suggests that specific constituents of hops, called lupulones, can induce hepatic CYP3A4 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients with normal metabolism shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, decreases the concentration of alprazolam, a CYP3A4 probe substrate, by 7.6%. This reduction is unlikely to be clinically relevant.
Passionflower powder
Cns Depressants
Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Research in animals and humans shows that passion flower has sedative effects which can be additive when used with sedative medications like lorazepam.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
In vitro research suggests that passion flower can induce CYP3A4 enzymes, albeit to a much lower degree than rifampin, a known CYP3A4 inducer.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, passion flower might reduce the bioavailability of OATP2B1 and OATP1A2 substrates.
In vitro research shows that the passion flower constituents apigenin and vitexin inhibit OATP2B1 and OATP1A2. This inhibition may be dose-dependent. One specific high-flavonoid passion flower extract (Valverde) seems to inhibit OATP2B1 and OATP1A2, while another extract with a lower flavonoid concentration (Arkocaps) shows less potent inhibition. OATPs are responsible for the uptake of drugs and other compounds into the body; however, the specific activities of OATP2B1 and OATP1A2 are not well characterized.
Guggulipid extract
Anticoagulant/Antiplatelet Drugs
Theoretically, guggul might increase the risk of bleeding when taken with anticoagulant/antiplatelet drugs.
In vitro research and preliminary clinical studies suggest that guggul might have antiplatelet and anticoagulant effects.
Contraceptive Drugs
Theoretically, guggul might increase the risk of adverse effects when taken with contraceptive drugs.
In vitro research shows that guggul has estrogen-alpha receptor agonist activity.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, guggul might reduce the effects of CYP3A4 substrates.
In vitro research shows that guggul constituents known as guggulsterones can induce CYP3A4.
Diltiazem (Cardizem, Others)
Guggul might reduce the effects of diltiazem.
A small pharmacokinetic study shows that concomitant use of guggul with diltiazem reduces the bioavailability of diltiazem.
Estrogens
Theoretically, guggul might increase the risk of adverse effects when taken with estrogens.
In vitro research shows that guggul constituents known as guggulsterones have estrogen-alpha receptor agonist activity.
Propranolol (Inderal)
Guggul might reduce the effects of propranolol.
A small pharmacokinetic study shows that concomitant use of guggul with propranolol reduces the bioavailability of propranolol.
Rosuvastatin (Crestor)
Theoretically, guggul might increase the effects and adverse effects of rosuvastatin.
Animal research shows that guggul increases the bioavailability and hypolipidemic effects of rosuvastatin. The mechanism of this interaction is unclear.
Tamoxifen (Nolvadex)
Theoretically, guggul might interfere with tamoxifen therapy.
In vitro research shows that guggul has estrogen-alpha receptor agonist activity.
Thyroid Hormone
Theoretically, guggul might increase the risk for adverse effects when taken with thyroid hormone therapy.
Animal research suggests that guggul has thyroid-stimulating effects.
Gamma-Aminobutyric Acid
Antihypertensive Drugs
Theoretically, taking GABA with antihypertensive drugs might increase the risk of hypotension.
Some clinical research shows that GABA can decrease blood pressure in patients with hypertension.
Cns Depressants
Theoretically, GABA might have additive sedative effects when used in conjunction with CNS depressants. However, it is unclear if this concern is clinically relevant.
Endogenous GABA has well-established relaxant effects and GABA(A) receptors have an established physiological role in sleep. However, the effects of GABA supplements are unclear, as it is unknown whether exogenous GABA crosses the blood-brain barrier. Although there have been limited reports of drowsiness or tiredness with GABA supplements, these effects have not been widely reported in clinical studies. Additionally, intravenous GABA 0.1-1 mg/kg has been shown to induce anxiety in a dose-dependent manner.
HTPurity
Carbidopa (Lodosyn)
Combining 5-HTP and carbidopa can increase the risk of serotonergic side effects.
Carbidopa is sometimes used with 5-HTP to minimize peripheral 5-HTP metabolism and boost the amount that reaches the brain. However, this combination might also increase the risk of some side effects including hypomania, restlessness, rapid speech, anxiety, insomnia, and aggressiveness. Combining carbidopa and 5-HTP might also increase the risk of scleroderma-like skin changes due to elevated serotonin levels.
Cns Depressants
Theoretically, concomitant use of 5-HTP with medications that cause sedation might have additive effects.
In clinical trials, 5-HTP has been associated with drowsiness and somnolence.
Serotonergic Drugs
Combining serotonergic drugs with 5-HTP might cause additive serotonergic effects.
5-HTP can increase serotonin levels and cause serotonergic effects. Theoretically, combining serotonergic drugs with 5-HTP might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders. However, serotonin syndrome with 5-HTP has not yet been reported in humans. Monitor patients for signs of serotonin syndrome and other serotonergic side effects if using 5-HTP with serotonergic drugs.
Lemon Balm Extract
Cns Depressants
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Lemon balm seems to have CNS depressant activity in animals and in humans.
Thyroid Hormone
Theoretically, lemon balm might interfere with thyroid hormone replacement therapy.
In vitro, constituents of lemon balm extract bind to thyroid stimulating hormone (TSH), preventing TSH receptor-binding and leading to the inhibition of TSH-stimulated adenylate cyclase activity. In animals, lemon balm extract has been shown to decrease levels of circulating TSH and inhibit thyroid secretion.
Acetyl L-Carnitine Hydrochloride
Acenocoumarol (Sintrom)
Theoretically, acetyl-L-carnitine might increase the anticoagulant effects of acenocoumarol.
L-carnitine, the parent compound of acetyl-L-carnitine, might enhance the anticoagulant effects of acenocoumarol, an oral anticoagulant that is similar to warfarin, but shorter-acting. There are at least two case reports of INR elevation when L-carnitine was taken with acenocoumarol. In one case, a 33-year-old male with a previously stable INR had an elevated INR of 4.65 after L-carnitine was started and continued for 10 weeks. INR normalized after discontinuation of the L-carnitine-containing product. It is unclear if such an interaction would also occur with acetyl-L-carnitine.
Serotonergic Drugs
Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, when taken with serotonergic drugs.
Animal research shows that acetyl-L-carnitine can increase levels of serotonin in the brain.
Thyroid Hormone
Theoretically, acetyl-L-carnitine might decrease the effectiveness of thyroid hormone replacement.
L-carnitine appears to act as a peripheral thyroid hormone antagonist by inhibiting entry of thyroid hormone into the nucleus of cells. Taking L-carnitine also seems to diminish some of the symptoms of hyperthyroidism. It is unclear if such an interaction would occur with acetyl-L-carnitine.
Warfarin (Coumadin)
Theoretically, acetyl-L-carnitine might increase the anticoagulant effects of warfarin.
L-carnitine, the parent compound of acetyl-L-carnitine, might increase the anticoagulant effects of acenocoumarol, a shorter-acting oral anticoagulant similar to warfarin. There is not enough information to know whether this interaction occurs with acetyl-L-carnitine and warfarin.
Mucuna pruriens
Levodopa
Concomitant use can increase the risk of levodopa-related adverse effects.
Cowhage contains levodopa. Some cowhage products have been standardized to contain 75-400 mg of levodopa per dose.
Methyldopa (Aldomet)
Theoretically, concomitant use of cowhage and methyldopa might increase the risk of hypotension.
Cowhage contains levodopa. Use of levodopa with methyldopa might cause additive hypotension. In addition, methyldopa may inhibit peripheral decarboxylation of levodopa and increase levodopa levels in the central nervous system; avoid using.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Cowhage contains levodopa. Use of levodopa with non-selective MAOIs might cause hypertensive crisis. However, this interaction has not been reported with MAO-B selective inhibitors such as selegiline.
Anesthesia
Theoretically, concomitant use of cowhage and anesthesia might increase the risk of arrhythmias.
Cowhage contains levodopa. Use of levodopa with cyclopropane or halogenated hydrocarbon anesthesia has led to arrhythmias. Other anesthetics have not been implicated. Use other anesthetics in patients taking cowhage or tell patients to stop taking cowhage at least 2 weeks before surgery.
Antidiabetes Drugs
Theoretically, concomitant use of cowhage and antidiabetes drugs might increase the risk of hypoglycemia.
Animal research shows that cowhage might have hypoglycemic effects.
Antipsychotic Drugs
Theoretically, use of cowhage might decrease the clinical effects of antipsychotic drugs.
Cowhage contains levodopa. Use of levodopa might counteract the antidopaminergic effects of antipsychotic medications.
Guanethidine (Ismelin)
Theoretically, concomitant use of cowhage and guanethidine might increase the risk of hypotension.
Cowhage contains levodopa. Use of levodopa with guanethidine might cause additive hypotension; avoid using.
Tricyclic Antidepressants (Tcas)
Theoretically, use of TCAs might reduce the levels and clinical effects of cowhage.
Cowhage contains levodopa. Use of TCAs might reduce the absorption of levodopa. Some case reports describe patients that developed hypertension and dyskinesia when taking both levodopa and TCAs.
Brand information
Manufacturer and brand details for Sleep, from the product label.
Sleep by Motiv-8 Performance: Common Questions
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The Full Monographs Behind Sleep’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Valerian
Interacts with 902 drugsValerian is an herb whose root is widely used as a natural sleep aid and for calming nerves. The evidence is mixed and often weak, so it may help some people sleep but does not work reliably...
Read the full Valerian monograph → Herb & supplement monographMelatonin
Interacts with 1,461 drugsMelatonin is a hormone your body makes naturally to help control your sleep-wake cycle, and the supplement form is widely used to help with sleep timing problems and jet lag. The evidence is...
Read the full Melatonin monograph → Herb & supplement monographAcetyl-l-carnitine
Interacts with 203 drugsAcetyl-L-carnitine is a form of the amino acid carnitine that the body uses to help produce energy in cells. It is most studied for nerve pain and memory-related conditions, though the evide...
Read the full Acetyl-l-carnitine monograph → Herb & supplement monographGerman Chamomile
Interacts with 960 drugsGerman chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin o...
Read the full German Chamomile monograph → Herb & supplement monographGamma-aminobutyric Acid (gaba)
Interacts with 419 drugsGABA is a calming chemical messenger (neurotransmitter) that your body makes on its own, and it is sold as a supplement for stress, anxiety, and sleep. The science behind oral GABA supplemen...
Read the full Gamma-aminobutyric Acid (gaba) 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 monographGuggul
Interacts with 757 drugsGuggul is a gum resin from the Commiphora wightii tree, long used in Ayurvedic medicine for cholesterol, joint, and skin problems. Modern studies are mixed and often low-quality, and it can...
Read the full Guggul monograph → Herb & supplement monographLemon Balm
Interacts with 264 drugsLemon balm is a gentle, lemon-scented mint-family herb traditionally used to ease stress, support sleep, and calm digestion, and topically for cold sores. Early studies are promising but gen...
Read the full Lemon Balm monograph → Herb & supplement monographCowhage
Interacts with 193 drugsCowhage (Mucuna pruriens) is a tropical legume best known as a natural source of L-dopa, the compound the body turns into dopamine. It is most studied for Parkinson's disease symptoms and ma...
Read the full Cowhage monograph → Herb & supplement monographPassion Flower
Interacts with 836 drugsPassion flower is a traditional calming herb that many people use for anxiety and sleep. Early studies hint it may help with mild anxiety and restlessness, but the evidence is limited and mo...
Read the full Passion Flower monograph → Herb & supplement monographHops
Interacts with 863 drugsHops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They are generally well tolerated when used sho...
Read the full Hops monograph → Herb & supplement monograph5-htp
Interacts with 398 drugs5-HTP is a compound your body uses to make serotonin, and people take it as a supplement hoping to improve mood, sleep, and headaches. Some early research is promising, but the overall evide...
Read the full 5-htp monograph →Sources & How We Checked
Sleep'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 347 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.
Valerian 37 references
- Willey LB, Mady SP, Cobaugh DJ, Wax PM. Valerian overdose: a case report. Vet Hum Toxicol 1995;37:364-5.
- Kuhlmann J, Berger W, Podzuweit H, Schmidt U. The influence of valerian treatment on "reaction time, alertness and concentration" in volunteers. Pharmacopsychiatry 1999;32:235-41. PubMed
- Klepser TB, Klepser ME. Unsafe and potentially safe herbal therapies. Am J Health Syst Pharm 1999;56:125-38. PubMed
- Houghton PJ. The scientific basis for the reputed activity of Valerian. J Pharm Pharmacol 1999;51:505-12. PubMed
- Garges HP, Varia I, Doraiswamy PM. Cardiac complications and delirium associated with Valerian root withdrawal. [Letter to the Editor]. JAMA 1998;280:1566-7. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- MacGregor FB, Abernethy VE, Dahabra S, et al. Hepatotoxicity of herbal remedies. BMJ 1989;299:1156-7. PubMed
- Leathwood PD, Chauffard F. Aqueous extract of valerian reduces latency to fall asleep in man. Planta Med 1985;2:144-8. PubMed
- Hadley S, Petry JJ. Valerian. Am Fam Physician 2003;67:1755-8..
- Glass JR, Sproule BA, Herrmann N, et al. Acute pharmacological effects of temazepam, diphenhydramine, and valerian in healthy elderly subjects. J Clin Psychopharmacol 2003;23:260-8. PubMed
- Lefebvre T, Foster BC, Drouin CE, et al. In vitro activity of commercial valerian root extracts against human cytochrome P450 3A4. J Pharm Pharmaceut Sci 2004;7:265-73.
- Yuan CS, Mehendale S, Xiao Y, et al. The gamma-aminobutyric acidergic effects of valerian and valerenic acid on rat brainstem neuronal activity. Anesth Analg 2004;98:353-8. PubMed
- Donovan JL, DeVane CL, Chavin KD, et al. Multiple night-time doses of valerian (Valeriana officinalis) had minimal effects on CYP3A4 activity and no effect on CYP2D6 activity in healthy volunteers. Drug Metab Dispos 2004;32:1333-6. PubMed
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
- Gutierrez S, Ang-Lee MK, Walker DJ, Zacny JP. Assessing subjective and psychomotor effects of the herbal medication valerian in healthy volunteers. Pharmacol Biochem Behav 2004;78:57-64. PubMed
- Jacobs BP, Bent S, Tice JA, et al. An internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia. Medicine (Baltimore) 2005;84:197-207. PubMed
- National Toxicology Program, US Department of Health and Human Services. Chemical Information Review Document for Valerian (Valeriana officinalis L.) [CAS No. 8057-49-6] and Oils [CAS No. 8008-88-6]. Supporting Nomination for Toxicological Evaluation by t
- Fernández-San-Martín MI, Masa-Font R, Palacios-Soler L, et al. Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials. Sleep Med. 2010 Jun;11:505-11. PubMed
- Coxeter PD, Schluter PJ, Eastwood HL, et al. Valerian does not appear to reduce symptoms for patients with chronic insomnia in general practice using a series of randomised n-of-1 trials. Complement Ther Med. 2003 Dec;11:215-22. PubMed
- Diaper A, Hindmarch I. A double-blind, placebo-controlled investigation of the effects of two doses of a valerian preparation on the sleep, cognitive and psychomotor function of sleep-disturbed older adults. Phytother Res. 2004 Oct;18:831-6. PubMed
- Cuellar NG, Ratcliffe SJ. Does valerian improve sleepiness and symptom severity in people with restless legs syndrome? Altern Ther Health Med 2009;15:22-8.
- Chen D, Klesmer J, Giovanniello A, et al. Mental status changes in an alcohol abuser taking valerian and gingko biloba. Am J Addict. 2002 Winter;11:75-7. PubMed
- Albrecht M, Berger W, Laux P, Schmidt U, et al. Psychopharmaka und Verkehrssicherheit. Der Einfluß von Euvegal® - Dragees forte auf die Fahrtüchtigkeit und Kombinationswirkungen mit Alkohol Z Allg Med 1995;71:1215-25.
- Carrasco MC, Vallejo JR, Pardo-de-Santayana M, et al. Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam. Phytother Res. 2009 Dec;23:1795-6.
- Hellum BH, Nilsen OG. The in vitro inhibitory potential of trade herbal products on human CYP2D6-mediated metabolism and the influence of ethanol. Basic Clin Pharmacol Toxicol. 2007 Nov;101:350-8.
- Hellum BH, Hu Z, Nilsen OG. The induction of CYP1A2, CYP2D6 and CYP3A4 by six trade herbal products in cultured primary human hepatocytes. Basic Clin Pharmacol Toxicol. 2007 Jan;100:23-30. PubMed
- Alkharfy, K. M. and Frye, R. F. Effect of valerian, valerian/hops extracts, and valerenic acid on glucuronidation in vitro. Xenobiotica 2007;37(2):113-123.
- Vassiliadis, T., Anagnostis, P., Patsiaoura, K., Giouleme, O., Katsinelos, P., Mpoumponaris, A., and Eugenidis, N. Valeriana hepatotoxicity. Sleep Med 2009;10(8):935. PubMed
- Muller, Z., Sarkany, A., Altorjay, A., Szilagyi, A., Tura, T., and Ozsvar, Z. [Liver failure a la Eastern Europe]. Orv.Hetil. 3-22-2009;150(12):555-557. PubMed
- National Toxicology Program, US Department of Health and Human Services. Chemical Information Review Document for Valerian (Valeriana officinalis L.) [CAS No. 8057-49-6] and Oils [CAS No. 8008-88-6]. 2009;
- Wells SR. International intravenous administration of a crude valerian root extract. NACCT 1995;33:542.
- Aydinoglu U, Özcan H, Yücel A, Yücel N, Mutlu M. Valerian induced hypomania: a case report. Bull Clin Psychopharma 2012;22(Suppl. 1):S63.
- Mirabi P, Mojab F. The effects of valerian root on hot flashes in menopausal women. Iran J Pharm Res 2013;12(1):217-22.
- Thomas K, Canedo J, Perry PJ, et al. Effects of valerian on subjective sedation, field sobriety testing and driving simulator performance. Accid Anal Prev. 2016 Jul;92:240-4. PubMed
- Kia YH, Alexander S, Dowling D, Standish R. A case of steroid-responsive valerian-associated hepatitis. Intern Med J. 2016 Jan;46(1):118-9. PubMed
- Burke H, Jiang S, Chatham P, Stern TA. Delirium After Withdrawal From Valerian Root: A Case Report. Psychosomatics. 2020;61(6):787-790. PubMed
- Hajizadeh I, Jamshidi M, Kazemi M, Kargar H, Sadeghi T. Comparison the effect of valerian and gabapentin on RLS and sleep quality in hemodialysis patients: A randomized clinical trial. Ther Apher Dial 2023.
Melatonin 118 references
- Voordouw BC, Euser R, Verdonk RE, et al. Melatonin and melatonin-progestin combinations alter pituitary-ovarian function in women and can inhibit ovulation. J Clin Endocrinol Metab 1992;74:108-17. DOI
- Ellis CM, Lemmens G, Parkes JD. Melatonin and insomnia. J Sleep Res 1996;5:61-5. PubMed
- Petrie K, Dawson AG, Thompson L, Brook R. A double-blind trial of melatonin as a treatment for jet lag in international cabin crew. Biol Psychiatr 1993;33:526-30. PubMed
- Claustrat B, Brun J, David M, et al. Melatonin and jet lag: confirmatory result using a simplified protocol. Biol Psychiatr 1992;32:705-11.
- Fauteck J, Schmidt H, Lerchl A, et al. Melatonin in epilepsy: first results of replacement therapy and first clinical results. Biol Signals Recept 1999;8:105-10. PubMed
- Arangino S, Cagnacci A, Angiolucci M, et al. Effects of melatonin on vascular reactivity, catecholamine levels, and blood pressure in healthy men. Am J Cardiol 1999;83:1417-9. PubMed
- Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
- Lancioni GE, O'Reilly MF, Basili G. Review of strategies for treating sleep problems in persons with severe or profound mental retardation or multiple handicaps. Am J Ment Retard 1999;104:170-86. PubMed
- Carman JS, Post RM, Buswell R, et al. Negative effects of melatonin on depression. Am J Psychiatry 1976;133:1181-1186. PubMed
- Hartter S, Grozinger M, Weigmann H, et al. Increased bioavailability of oral melatonin after fluvoxamine coadministration. Clin Pharmacol Ther 2000;67:1-6.
- Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
- Lusardi P, et al. Cardiovascular effects of melatonin in hypertensive patients well controlled by nifedipine: a 24-hour study. Br J Clin Pharmacol 2000;49:423-7. PubMed
- von Bahr C, Ursing C, Yasui N, et al. Fluvoxamine but not citalopram increases serum melatonin in healthy subjects – an indication that cytochrome P450 CYP1A2 and CYP2C19 hydroxylate melatonin. Eur J Clin Pharmacol 2000;56:123-7.
- Grozinger M, Hartter S, Wang X, et al. Fluvoxamine strongly inhibits melatonin metabolism in a patient with low-amplitude melatonin profile. Arch Gen Psychiatry 2000 Aug;57:812-3. PubMed
- Lissoni P, Barni S, Mandala M, et al. Decreased toxicity and increased efficacy of cancer chemotherapy using the pineal hormone melatonin in metastatic solic tumor patients with poor clinical status. Eur J Cancer 1999;35:1688-92.
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See these in context on the Gamma-aminobutyric Acid (gaba) monograph →
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