Is Ashwagandha Safe With Bupropion, Sertraline And Azelastine?

In our latest question and answer, our pharmacist discusses the safety of combining ashwagandha with three different drugs.


Can ashwagandha be taken with bupropion, sertraline and azelastine??

Asked by Brig On Mar 16, 2023

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Mar 17, 2023
Last updated Sep 29, 2023

Key points

  • Ashwagandha may have anti-anxiety and anti-depressant effects but does not appear to significantly affect neurotransmitters in the brain, like serotonin.
  • There are no known interactions between it and bupropion, sertraline, or azelastine.

Quick Answer

There are no known interactions between ashwagandha and bupropion, sertraline, or azelastine.

Detailed Answer

Thanks for reaching out to us! I'm happy to answer this for you.

There are no known interactions between any of the medications you mentioned in your question (bupropion, sertraline, and azelastine) and ashwagandha.

I've linked specific interaction detail pages from our herbal interaction checker below:

Ashwagandha With Bupropion & Sertraline

The first two drugs on this list, bupropion, and sertraline, are antidepressants that affect different neurotransmitters in the brain, notably dopamine (bupropion) and serotonin (sertraline). Bupropion likely affects norepinephrine as well.

Antidepressants have the potential to interact with a number of different herbals, especially ones that also affect certain neurotransmitters. One good example here is St. John's Wort, as studies have consistently shown it has a similar mechanism of action to SSRI drugs, like Zoloft (sertraline).

In regard to ashwagandha, while it is most commonly used as an 'adaptogenic' herb, helping the body adapt to stress, some studies have evaluated whether or not it has antidepressant effects.

While the evidence for ashwagandha's antidepressant effects is promising, it's important to note that it does not appear to significantly affect neurotransmitters, like serotonin, dopamine, and norepinephrine. This is in contrast to conventional antidepressants, which often target these neurotransmitters.

Instead, ashwagandha appears to work through other mechanisms, such as reducing inflammation and oxidative stress in the brain.

Ashwagandha is not known to affect the metabolism of bupropion or sertraline either, so, based on the available evidence, there is nothing to suggest any type of clinically significant interaction between all these agents.

Ashwagandha With Azelastine

Azelastine is a second-generation antihistamine, but unlike others in this class, like Claritin and Allegra, azelastine is not available in an oral dosage form. It is only available as an eye drop and nose spray.

Ashwagandha isn't known to interact with antihistamines, and anyway, the overall systemic absorption of azelastine is relatively low due to how it is administered.

There is not thought to be any interaction between ashwagandha and azelastine.

Final Words

Thanks again for contacting us!

I hope this answer helped provide what you were looking for.

While it can oftentimes be a challenge to definitively know if certain drugs interact with herbals due to the lack of comprehensive studies, based on the evidence available to us, there appears to be no issue with combining ashwagandha, bupropion, azelastine and sertraline.

Nevertheless, always be sure to speak with your doctor before staring any new medications or supplements.


  • A double-blind, placebo-controlled evaluation of the anxiolytic efficacy of an ethanolic extract of withania somnifera, PubMed
  • 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, PubMed
  • Effects of Withania somnifera (Ashwagandha) on Stress and the Stress-Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia, PubMed
  • An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at! You can also connect with Dr. Brian Staiger on LinkedIn.

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