Ashwagandha (Withania somnifera) is a powerful adaptogenic herb traditionally used to manage stress, anxiety, and fatigue. Despite its natural origins, it can significantly interact with various medications, potentially causing harmful side effects.
Understanding these interactions is crucial before incorporating ashwagandha into your routine—especially if you're on prescription drugs.
1. Diabetes Medications
Ashwagandha has been shown to help lower blood sugar levels, which can be beneficial for some. However, when taken alongside diabetes medications like metformin, insulin, or semaglutide (Ozempic/Wegovy), the combination can dangerously lower blood sugar levels.
This may lead to hypoglycemia, causing symptoms like shakiness, confusion, sweating, fainting, or even seizures. Always monitor your blood sugar if you're combining both and consult a healthcare professional first.
2. Blood Pressure Medications
Ashwagandha may help reduce blood pressure naturally, but pairing it with antihypertensive medications such as amlodipine, losartan, or furosemide could lead to hypotension (low blood pressure).
Low blood pressure can cause dizziness, blurred vision, weakness, or fainting spells. Anyone on blood pressure meds should use caution and check their readings frequently when adding ashwagandha to their regimen.
3. Sedatives and Sleep Aids
Because ashwagandha promotes relaxation, it can increase the effects of sedatives and central nervous system depressants. This includes benzodiazepines (like diazepam or clonazepam), opioids (like oxycodone), and sleep aids (like zolpidem).
Combining them can result in excessive drowsiness, slowed breathing, and increased sedation. For safety, avoid mixing these or do so only under close medical supervision.
4. Immunosuppressants
Ashwagandha is believed to boost immune function, which could counteract medications designed to suppress immune activity. Drugs used after organ transplants or for autoimmune diseases, such as prednisone or tacrolimus, might not work as intended if ashwagandha is also being taken.
This could increase the risk of rejection in transplant patients or flare-ups in autoimmune disorders. Always check with your provider before using ashwagandha if you’re on immunosuppressants.
5. Liver-Toxic Medications
While rare, ashwagandha has been linked to liver inflammation and even liver failure in isolated cases. Combining it with other hepatotoxic drugs—such as phenytoin, rifampin, or certain NSAIDs—can elevate your risk of liver damage.
Watch for early signs like jaundice, fatigue, nausea, or dark urine. Liver function tests may be necessary to monitor safety during use.
6. Thyroid Medications
Ashwagandha may stimulate the thyroid gland and elevate levels of thyroid hormones T3 and T4. For individuals taking levothyroxine, liothyronine, or desiccated thyroid, this could lead to hyperthyroidism symptoms.
Signs include anxiety, insomnia, rapid heartbeat, and weight loss. Regular monitoring of thyroid hormone levels is crucial if you’re combining ashwagandha with thyroid medications.
When To Talk To a Healthcare Provider
If you’re currently taking any prescription or over-the-counter medications, it’s essential to speak with your healthcare provider before starting ashwagandha. They can evaluate possible drug-herb interactions and determine if it's appropriate for you.
Seek medical advice immediately if you notice any unusual symptoms while using ashwagandha, especially symptoms related to blood sugar, blood pressure, liver health, or mood.
A Quick Recap
Ashwagandha is a widely used herbal supplement with multiple potential health benefits. However, it’s not risk-free—especially when taken alongside certain medications. Drugs that manage blood sugar, blood pressure, immune function, sedation, thyroid health, or liver conditions can be affected.
Always inform your doctor of all supplements you're taking. Natural doesn’t always mean harmless—especially in combination.
