NutriStack
Alprazolam and Bacopa Monnieri, a caution.
Bacopa Monnieri extract inhibited CYP3A4 in vitro, and alprazolam exposure is clinically increased by CYP3A inhibition. Human data proving a Bacopa-alprazolam interaction are lacking, but the combination is plausible enough to matter because alprazolam has dose-related sedation and impairment. Risk is higher with high-dose Bacopa products, older age, liver disease, alcohol, opioids, or other sedatives.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Alprazolam and Bacopa Monnieri
- Pair type
- Caution
- Evidence (highest tier)
- Emerging
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Emerging evidence
Caution
What is happening. Bacopa Monnieri extract inhibited CYP3A4 in vitro, and alprazolam exposure is clinically increased by CYP3A inhibition. Human data proving a Bacopa-alprazolam interaction are lacking, but the combination is plausible enough to matter because alprazolam has dose-related sedation and impairment. Risk is higher with high-dose Bacopa products, older age, liver disease, alcohol, opioids, or other sedatives.
Mechanism. Bacopa Monnieri standardized extract competitively inhibited CYP3A4 in vitro. Alprazolam is metabolized by CYP3A enzymes, and CYP3A inhibitors can increase alprazolam pharmacokinetic exposure and pharmacodynamic effects.
Recommendation. Use extra caution when starting Bacopa Monnieri if you take alprazolam. Avoid alcohol and other sedatives, and watch for stronger or longer alprazolam effects such as unusual drowsiness, confusion, poor coordination, or memory problems. Ask your prescriber whether alprazolam dose timing or dose should be adjusted if symptoms increase.
Sources (2)
- Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules. 2014;19(2):2588-2601. PMID 24566323
- Yasui N, Kondo T, Otani K, Furukori H, Kaneko S, Ohkubo T, et al. Effect of itraconazole on the single oral dose pharmacokinetics and pharmacodynamics of alprazolam. Psychopharmacology (Berl). 1998;139(3):269-273. PMID 9784084
Stack Score
How this pair moves the number.
Effect on the composite score
If both Alprazolam and Bacopa Monnieri are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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