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Ashwagandha (Withania somnifera)



Interactions

Ashwagandha/Drug Interactions:
  • Analgesics, narcoticAnalgesics, narcotic: Repeated administration of ashwagandha may attenuate the development of tolerance to narcotics, based on limited animal data (50).
  • AndrogensAndrogens: Ashwagandha may possess androgenic (testosterone-like) properties, based on animal evidence of increased testicular weight and spermatogenesis (27).
  • AnticholinergicsAnticholinergics: Based on laboratory study, ashwagandha has been associated with cholinesterase inhibition (45; 3). Theoretically, anticholinergics may antagonize the effects of ashwagandha.
  • Anticoagulants and antiplatelets Anticoagulants and antiplatelets : In animal study, ashwagandha was shown to significantly increase coagulation time (1) and increase platelet count (2).
  • Antidiabetic agentsAntidiabetic agents: Based on limited human and animal study, ashwagandha may have hypoglycemic effects (31; 32).
  • AntihypertensivesAntihypertensives: Based on animal study, ashwagandha may lower systolic and diastolic blood pressure (43).
  • Antilipemic agentsAntilipemic agents: In human case study, treatment with ashwagandha caused significant decreases in serum total cholesterol levels, triglycerides, low-density lipoprotein (LDL), and very low-density lipoproteins (VLDL) (31).
  • Antineoplastic agentsAntineoplastic agents: Alcoholic extracts of ashwagandha dried roots, as well as the ashwagandha constituent withaferin A, have been suggested to possess antitumor or radiosensitizing properties, based on in vitro (51; 52; 53; 54; 55; 56) and animal study (57; 41; 55; 58; 54; 59). Antiangiogenic properties have been reported in laboratory study (60). Ashwagandha has been shown to increase paclitaxel's effectiveness in mice with lung cancer (12).
  • Antiparkinsonian agentsAntiparkinsonian agents: In animals with drug-induced parkinsonism, significant improvement in behavior and antioxidant status and a significant reduction in the level of lipid peroxidation were seen with ashwagandha treatment (61; 62). In case study, in patients who received a multiherb preparation, including powdered milk and ashwagandha (as well as powdered Mucuna pruriens and Hyoscyamus reticulatus seeds), following a cleansing procedure, improvements in symptoms were observed, however these were likely due to the presence of L-dopa found in the preparation, which is an established drug used in the treatment of Parkinson's disease (63).
  • Cholinesterase inhibitorsCholinesterase inhibitors: Based on laboratory study, ashwagandha has been associated with cholinesterase inhibition (45) (3).
  • Chronotropic agentsChronotropic agents: In animal study, ashwagandha has shown mild positive inotropic and chronotropic effects (33).
  • CNS depressantsCNS depressants: In preliminary study, the effects of alkaloids from ashwagandha on the central nervous system (34; 44) and smooth muscle (35) have been evaluated and may cause sedation and possible life-threatening respiratory depression. Based on in vitro and animal study, ashwagandha may have GABA-mimetic activity (36) and may interact with sedatives, hypnotics, or other central nervous system depressants (18), or increase the effects of barbiturates and ethanol.
  • DiureticsDiuretics: In case study of patients treated with powdered ashwagandha root for 12 days, significant increases in urine volume and sodium were reported (31). In animal study, the development of kidney lesions was reported (49).
  • ImmunosuppressantsImmunosuppressants: Based on limited animal data, ashwagandha extract may reduce cyclophosphamide-induced immunosuppression or leukopenia (13; 21; 2) and may have immunomodulatory effects, such as enhancement of total WBC count, bone marrow cellularity, antibody titre, plaque-forming cells, and macrophage phagocytic activity (16).
  • InotropesInotropes: In animal study, ashwagandha has shown mild positive inotropic and chronotropic effects (33).
  • Iron saltsIron salts: Ashwagandha is reportedly rich in iron (46).
  • Paclitaxel (Taxol®)Paclitaxel (Taxol®): Ashwagandha has been shown to increase paclitaxel's effectiveness in mice with lung cancer (12).
  • Radioprotective drugsRadioprotective drugs: Alcoholic extracts of ashwagandha dried roots, as well as the ashwagandha constituent withaferin A, have been suggested to possess antitumor or radiosensitizing properties, based on in vitro (51; 52; 53; 54; 55; 56) and animal study (57; 41; 55; 58; 54; 59).
  • SedativesSedatives: In preliminary study, the effects of alkaloids from ashwagandha on the central nervous system (34; 44) and smooth muscle (35) have been evaluated and may cause sedation and possible life-threatening respiratory depression. Based on in vitro and animal study, ashwagandha may have GABA-mimetic activity (36) and may interact with sedatives, hypnotics, or other central nervous system depressants (18), or increase the effects of barbiturates and ethanol.
  • SteroidsSteroids: Ashwagandha may possess androgenic (testosterone-like) properties, based on animal evidence of increased testicular weight and spermatogenesis (27).
  • StimulantsStimulants: In preliminary study, the effects of ashwagandholine alkaloids from ashwagandha on the central nervous system have been evaluated (34). In theory, ashwagandha may increase the effects of amphetamines.
  • Thyroid agentsThyroid agents: In animal study, ashwagandha has been reported to stimulate thyroid function, including increased serum T4 concentrations (38; 39). A case report in a 32 year-old woman reported the development of thyrotoxicosis while taking capsules that contained ashwagandha herbal extract (40).

Ashwagandha/Herb/Supplement Interactions:
  • 5-hydroxytryptophan (5-HTP)5-hydroxytryptophan (5-HTP): Reduced 5-HTP levels were associated with 12 weeks of ashwagandha therapy in patients with anxiety (9).
  • AnalgesicsAnalgesics: Repeated administration of ashwagandha may attenuate the development of tolerance to narcotics, based on limited animal data (50).
  • AndrogensAndrogens: Ashwagandha may possess androgenic (testosterone-like) properties, based on animal evidence of increased testicular weight and spermatogenesis (27).
  • Anticholinergic herbsAnticholinergic herbs: Based on laboratory study, ashwagandha has been associated with cholinesterase inhibition (45; 3). Theoretically, anticholinergics may antagonize the effects of ashwagandha.
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: In animal study, ashwagandha was shown to significantly increase coagulation time (1) and increase platelet count (2).
  • AntilipemicsAntilipemics: In human case study, treatment with ashwagandha caused significant decreases in serum total cholesterol levels, triglycerides, low-density lipoprotein (LDL), and very low-density lipoproteins (VLDL) (31).
  • AntineoplasticsAntineoplastics: Alcoholic extracts of ashwagandha dried roots, as well as the ashwagandha constituent withaferin A, have been suggested to possess antitumor or radiosensitizing properties, based on in vitro (51; 52; 53; 54; 55; 56) and animal study (57; 41; 55; 58; 54; 59). Antiangiogenic properties have been reported in laboratory study (60). Ashwagandha has been shown to increase paclitaxel's effectiveness in mice with lung cancer (12).
  • AntioxidantsAntioxidants: Ashwagandha has been reported to possess antioxidant properties (6; 7), including prevention of lipid peroxidation in animal studies (64; 65; 66).
  • Antiparkinsonian agentsAntiparkinsonian agents: In animals with drug-induced parkinsonism, significant improvement in behavior and antioxidant status and a significant reduction in the level of lipid peroxidation were seen with ashwagandha treatment (61; 62). In case study, in patients who received a multiherb preparation, including powdered milk and ashwagandha (as well as powdered Mucuna pruriens and Hyoscyamus reticulatus seeds), following a cleansing procedure, improvements in symptoms were observed, however these were likely due to the presence of L-dopa found in the preparation, which is an established drug used in the treatment of Parkinson's disease (63).
  • Arginine (L-Arginine)Arginine (L-Arginine): Ashwagandha reportedly contains arginine.
  • Chronotropic herbsChronotropic herbs: In animal study, ashwagandha has shown mild positive inotropic and chronotropic effects (33).
  • DiureticsDiuretics: In case study of patients treated with powdered ashwagandha root for 12 days, significant increases in urine volume and sodium were reported (31). In animal study, the development of kidney lesions was reported (49).
  • Hormonal herbs and supplementsHormonal herbs and supplements: Ashwagandha may possess androgenic (testosterone-like) properties, based on animal evidence of increased testicular weight and spermatogenesis (27).
  • Hypoglycemics Hypoglycemics : Based on limited human and animal study, ashwagandha may have hypoglycemic effects (31; 32)
  • HypotensivesHypotensives: Based on animal study, ashwagandha may lower systolic and diastolic blood pressure (43).
  • ImmunosuppressantsImmunosuppressants: Based on limited animal data, ashwagandha extract may reduce cyclophosphamide-induced immunosuppression or leukopenia (13; 21; 2) and may have immunomodulatory effects, such as enhancement of total WBC count, bone marrow cellularity, antibody titre, plaque forming cells, and macrophage phagocytic activity (16).
  • Inotropic herbsInotropic herbs: In animal study, ashwagandha has shown mild positive inotropic and chronotropic effects (33).
  • IronIron: Ashwagandha is reportedly rich in iron (46).
  • Neurologic herbs and supplementsNeurologic herbs and supplements: Central nervous system depressant properties have been reported in animal studies (7).
  • OrnithineOrnithine: Based on secondary sources, ashwagandha reportedly contains ornithine.
  • Radioprotective agentsRadioprotective agents: Alcoholic extracts of ashwagandha dried roots, as well as the ashwagandha constituent withaferin A, have been suggested to possess antitumor or radiosensitizing properties, based on in vitro (51; 52; 53; 54; 55; 56) and animal study (57; 41; 55; 58; 54; 59).
  • Saw palmetto (Serenoa repens)Saw palmetto (Serenoa repens): Ashwagandha may possess androgenic (testosterone-like) properties, based on animal evidence of increased testicular weight and spermatogenesis (27). Saw palmetto possesses 5-alpha reductase properties similar to finasteride (Proscar®) and may antagonize potential androgenic effects of ashwagandha.
  • SedativesSedatives: In preliminary study, the effects of alkaloids from ashwagandha on the central nervous system (34; 44) and smooth muscle (35) have been evaluated, and may cause sedation and possible life-threatening respiratory depression. Based on in vitro and animal study, ashwagandha may have GABA-mimetic activity (36), and may interact with sedatives, hypnotics, or other central nervous system depressants (18), or increase the effects of barbiturates and ethanol.
  • SteroidsSteroids: Ashwagandha may possess androgenic (testosterone-like) properties, based on animal evidence of increased testicular weight and spermatogenesis (27).
  • StimulantsStimulants: In preliminary study, the effects of ashwagandholine alkaloids from ashwagandha on the central nervous system have been evaluated (34). In theory, ashwagandha may increase the effects of amphetamines.
  • Thyroid agentsThyroid agents: In animal study, ashwagandha has been reported to stimulate thyroid function, including increased serum T4 concentrations (38; 39). A case report in a 32 year-old woman reported the development of thyrotoxicosis while taking capsules that contained ashwagandha herbal extract (40).

Ashwagandha/Food Interactions:
  • Iron containing foodsIron containing foods: Ashwagandha is reportedly rich in iron (46).

Ashwagandha/Lab Interactions:
  • Blood pressureBlood pressure: Based on animal study, ashwagandha may lower systolic and diastolic blood pressure (43).
  • Coagulation panelCoagulation panel: In animal study, ashwagandha was shown to significantly increase coagulation time (1) and increase platelet count (2).
  • Blood glucose levelsBlood glucose levels: Based on limited human and animal study, ashwagandha may have hypoglycemic effects (31; 32)
  • ElectrolytesElectrolytes: Ashwagandha has been reported to possess diuretic properties, based on a case series in individuals treated with powdered ashwagandha root for 12 days, after which significant increases in urine volume and sodium were reported (31). In rat study, the development of kidney lesions was reported (49).
  • FSHFSH: Based on animal study, ashwagandha decreased serum follicle-stimulating hormone (FSH) (27)
  • Iron levelsIron levels: Ashwagandha is reportedly rich in iron (46).
  • Lipid profileLipid profile: In human case study, treatment with ashwagandha caused significant decreases in serum total cholesterol levels, triglycerides, low-density lipoprotein (LDL), and very low-density lipoproteins (VLDL) (31).
  • Red blood cell countRed blood cell count: Based on animal study, ashwagandha may stimulate red blood cell production (2).
  • TestosteroneTestosterone: Based on animal study, ashwagandha decreased testosterone levels (27).
  • Thyroid panelThyroid panel: Ashwagandha may increase serum T4 concentrations, based on animal study (38; 39).
  • White blood cell countWhite blood cell count: Based on animal study, ashwagandha may stimulate white blood cell production (2).

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