It’s important not to mix ashwagandha with certain medications. Always talk with a doctor before starting new supplements to prevent side effects.
Ashwagandha can cause drowsiness, sleepiness, and slow breathing. It’s best to avoid taking it with other medications that have similar effects.
Sedatives can relieve anxiety and help you sleep. Common sedatives include:
- Benzodiazepines like Valium (diazepam) and Klonopin (clonazepam)
- Kava
- L-tryptophan
- Melatonin
- Opioid medications like Roxicodone or Xtampza ER (oxycodone)
- Sleeping medications like Ambien (zolpidem)
Taking ashwagandha with sedatives or other sleep medications may lead to excessive drowsiness, sleepiness, or trouble breathing.
Ashwagandha may increase the amount of thyroid hormone your body naturally makes. These hormones include triiodothyronine (T3) and thyroxine (T4).
Symptoms of high thyroid hormone levels include:
- Diarrhea
- Fast and irregular heartbeat
- Mood swings
- Nervousness
- Trouble sleeping
Thyroid medications increase certain thyroid hormone levels. Examples include:
- Armour Thyroid (desiccated thyroid)
- Cytomel (liothyronine)
- Synthroid, Tirosint, and Unithroid (levothyroxine)
Ashwagandha increases the risk of side effects from these medications. You may have hair loss, joint pain, nervousness, sweating, and weight gain or loss.
Ashwagandha may lower blood sugar levels. Taking it with medications that treat diabetes may lead to hypoglycemia (dangerously low blood sugar levels).
Examples of diabetes medications include:
- Insulin
- Glucotrol (glipizide)
- Glumetza (metformin)
- Ozempic and Wegovy (semaglutide)
Signs of hypoglycemia include:
- Confusion
- Feeling weak
- Hunger
- Increased heart rate
- Passing out
- Seizures
- Sweating
Hypoglycemia is considered an emergency. You can often treat it by drinking or eating foods to raise blood sugar.
Ashwagandha can affect the immune system’s activity. It may cause side effects in people with immune system disorders.
Immunosuppressants block the immune system from working as normal. They help treat autoimmune diseases, certain cancers, and organ transplants.
Examples of immunosuppressants include:
- Corticosteroids like Rayos (prednisone)
- Organ transplant medication like Prograf (tacrolimus)
- Some chemotherapies
Taking ashwagandha with immunosuppressants may affect how well the medication works.
Ashwagandha may lower your blood pressure. Taking it with blood pressure medications may cause hypotension (dangerously low blood pressure).
Low blood pressure can decrease blood flow to vital organs, such as the heart and brain. It can lead to confusion, fainting, lightheadedness, and weakness.
Medications and supplements that lower blood pressure include:
- Arginine
- Cozaar (losartan)
- Lasix (furosemide)
- Niacin
- Norvasc (amlodipine)
- Omega-3 fatty acids
- Tenormin (atenolol)
Monitor your blood pressure closely if you are taking ashwagandha with a blood pressure-lowering medication.
Ashwagandha may be hepatotoxic (harmful to the liver). It may cause side effects like:
- Hepatitis (inflammation of the liver)
- Jaundice (yellowing of the skin and eyes)
- Liver failure
- Need for liver transplantation
Taking ashwagandha with other hepatotoxic medications or supplements may increase your risk of liver damage. Examples include:
- Black cohosh
- Dilantin (phenytoin)
- Garcinia
- Green tea extract
- Indocin (indomethacin)
- Kava
- Rifadin (rifampin)
A doctor will need to monitor your liver health closely if you are taking ashwagandha with any of these medications or supplements.
Ashwagandha is likely safe for most adults. However, it may be unsafe for pregnant or breastfeeding people. Some evidence suggests that ashwagandha may cause miscarriage.
Ashwagandha also raises testosterone levels. This can be dangerous for people with hormone-sensitive prostate cancer.
Experts recommend against ashwagandha if you have an upcoming surgery.
If you are taking ashwagandha, let a doctor know. They will help you determine if it’s safe with other medications and supplements.
See a doctor if you have signs or symptoms of:
- Drowsiness
- High thyroid hormone levels
- Liver injury
- Low blood pressure
- Low blood sugar
If left untreated, any of these conditions can lead to serious complications.
