Supplement·Interactions·Reviewed June 9, 2026
Ashwagandha interactions.
Ashwagandha has 51 documented interactions in the NutriStack database: 2 to avoid or watch closely, 30 that need timing or caution, and 19 that work synergistically. The full list, with what each pairing does, is below.
Ashwagandha at a glance.
A quick, data-grounded summary. The full table is below.
Ashwagandha has 51 documented interactions in the NutriStack database: 2 to avoid or watch closely, 30 that need timing or caution, and 19 that work synergistically. The full list, with what each pairing does, is below.
Everything that interacts with ashwagandha.
Every supplement and medication in the NutriStack database with a documented interaction with this substance, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Azathioprine | Conflict | Ashwagandha may have immune-stimulating effects and could conflict with immunosuppressive treatment goals in autoimmune disease or transplant. |
| Methimazole | Conflict | Ashwagandha may increase thyroid hormone levels or trigger thyrotoxicosis in susceptible people. That can oppose the purpose of methimazole, which... |
| Azelastine | Caution | Ashwagandha can be sedating in some people and may worsen azelastine-related drowsiness. |
| Cannabis (THC-Dominant) | Caution | Both can have sedative and CNS-depressant effects, so concurrent use may increase drowsiness and sedation. |
| Clonidine | Caution | Ashwagandha (Withania somnifera) has central calming and mild sedative-anxiolytic properties and may potentiate the sedation and drowsiness produced... |
| Clozapine | Caution | Ashwagandha can be sedating in some patients and may add to clozapine-related somnolence or orthostatic symptoms. |
| DHEA | Caution | DHEA raises androgens; ashwagandha modestly raises testosterone in men. Combined use can compound androgenic effects. |
| Epitalon | Caution | Ashwagandha may affect thyroid and sedation while epitalon is used for endocrine-adjacent claims. |
| GABA | Caution | Ashwagandha has GABA-mimetic activity, so stacking it with supplemental GABA can produce additive sedation and pronounced drowsiness. details → |
| Gotu Kola | Caution | Both are calming botanicals that may have additive sedative and central nervous system depressant effects, and both have isolated case reports... |
| Iodine | Caution | Ashwagandha may stimulate thyroid hormone production (T4 and T3) via its effects on the HPA axis and direct thyroid stimulation. Combined with... |
| Kava | Caution | Both can cause sedation, and both have rare liver-injury concerns in case reports. |
| Lavender | Caution | Both are used for anxiety or stress and may cause additive drowsiness or GI effects. |
| Lemon Balm | Caution | Both can reduce stress arousal and may cause sedation; ashwagandha also has thyroid-related cautions. |
| Levetiracetam Extended-Release | Caution | Ashwagandha can be sedating for some patients and may compound levetiracetam CNS effects. |
| Levocetirizine | Caution | Ashwagandha can be sedating in some users and may add to antihistamine-related drowsiness. |
| Levothyroxine | Caution | Ashwagandha has been associated with increased thyroid hormone levels and rare thyrotoxicosis reports. When combined with levothyroxine, it may... |
| Liothyronine | Caution | Ashwagandha may increase thyroid hormone activity or trigger thyrotoxicosis in susceptible people. Liothyronine is active T3 and can cause symptoms... |
| Lurasidone | Caution | Ashwagandha can cause sedation in some patients and may add to lurasidone's CNS effects. |
| Magnolia Bark | Caution | Both are used for stress and may add sedation or fatigue. |
| Oxcarbazepine | Caution | Ashwagandha may cause sedation and could add to oxcarbazepine CNS effects. |
| Phenobarbital | Caution | Ashwagandha may be sedating and can compound phenobarbital CNS depression. |
| Pregnenolone | Caution | Both pregnenolone and ashwagandha influence stress hormone and HPA axis activity, with ashwagandha lowering cortisol while pregnenolone is a... |
| Primidone | Caution | Ashwagandha may add to primidone-related sedation or dizziness. |
| Propranolol | Caution | Ashwagandha lowers cortisol and dampens sympathetic activity, which can modestly reduce heart rate and blood pressure. Combined with propranolol,... |
| Rivastigmine | Caution | Ashwagandha may cause sedation or dizziness and can complicate assessment of rivastigmine tolerability. |
| Tapentadol | Caution | Ashwagandha may be sedating and can compound opioid-related drowsiness and psychomotor impairment. |
| Testosterone | Caution | Ashwagandha (Withania somnifera) modestly raises testosterone and LH in men with infertility or stress and can also raise T4 and lower TSH. Adding... details → |
| Thymalin | Caution | Both may affect immune signaling and could worsen autoimmune instability. |
| Thymosin Alpha-1 | Caution | Ashwagandha has immune and thyroid effects and could complicate autoimmune or immune-modulating protocols. |
| Trazodone | Caution | Ashwagandha contains compounds with GABA-A agonist activity that produce mild sedation. Trazodone is a strongly sedating antidepressant. Combined... |
| Wild Yam | Caution | Both are sometimes marketed for hormone balance despite limited direct evidence for this pairing. |
| Bacopa Monnieri | Synergy | Bacopa monnieri and Ashwagandha are traditionally combined in Ayurvedic practice for cognition and stress, with Bacopa supporting memory and... |
| Crocin (Saffron Extract) | Synergy | Both adaptogenic/mood-supportive botanicals target stress and mood through partly distinct mechanisms, so they may be combined for broader stress... |
| D-Aspartic Acid | Synergy | Both are marketed for supporting testosterone and male reproductive parameters and may act through complementary pathways on the gonadal axis and... |
| Holy Basil/Tulsi | Synergy | Both are adaptogenic herbs with stress-modulating effects; combined use is common in HPA-axis support stacks. |
| Iron | Synergy | Ashwagandha root contains natural iron and has been shown to support healthy iron levels and hemoglobin formation in traditional use. |
| Iron Bisglycinate | Synergy | Ashwagandha has limited human research involving vitality and hematologic markers, but it is not an iron source and is not a substitute for iron... |
| L-Theanine | Synergy | Both are studied for relaxation, perceived-stress, and calm-focus markers; direct combination evidence is limited. |
| Magnesium Citrate | Synergy | Both promote relaxation and support sleep quality through complementary mechanisms. |
| Magnesium Glycinate | Synergy | Both promote relaxation and support sleep quality through complementary mechanisms. |
| Magnesium L-Threonate | Synergy | Both promote relaxation and support sleep quality through complementary mechanisms. |
| Magnesium Malate | Synergy | Both promote relaxation and support sleep quality through complementary mechanisms. |
| Magnesium Taurate | Synergy | Both promote relaxation and support sleep quality through complementary mechanisms. |
| Panax Ginseng | Synergy | Panax ginseng (stimulating adaptogen) and Ashwagandha (calming adaptogen) are sometimes paired so that daytime stress resilience is supported... |
| Reishi | Synergy | Both support immune modulation and stress adaptation through complementary mechanisms. |
| Rhodiola Rosea | Synergy | Both are adaptogens studied for perceived-stress or fatigue markers, but direct combination evidence is limited. |
| Schisandra | Synergy | Schisandra and ashwagandha are both adaptogens that help regulate the stress axis and lower perceived stress, with complementary calming and... |
| Shilajit | Synergy | Shilajit and ashwagandha are frequently paired as complementary adaptogens, with shilajit supporting cellular energy and free testosterone while... |
| Tongkat Ali | Synergy | Tongkat ali raises testosterone in low-T men; ashwagandha lowers cortisol that suppresses testosterone. Combined effect on male hormonal status is... |
| Tribulus Terrestris | Synergy | Ashwagandha adds adaptogenic, stress-lowering and modest androgen-supportive effects that complement Tribulus, with additive potential for male... |
The full ashwagandha profile.
Benefits, dosing by goal, forms, and the cited evidence for this supplement.
Common ashwagandha questions.
Quick answers drawn from the table above.
What interacts with Ashwagandha?
In the NutriStack database, Ashwagandha has 51 documented interactions with other supplements and medications. The most notable include Azathioprine, Methimazole, Azelastine, Cannabis (THC-Dominant), and Clonidine.
What should you not take with Ashwagandha?
Ashwagandha is flagged against 2 substances in the database, including Azathioprine and Methimazole. Review these with a clinician before combining, especially alongside prescription medications.
What works well with Ashwagandha?
Ashwagandha pairs synergistically with Bacopa Monnieri, Crocin (Saffron Extract), D-Aspartic Acid, Holy Basil/Tulsi, and Iron in the NutriStack database. Synergy still depends on dose and timing; open any pair for the detail.
Can you take Ashwagandha with Azathioprine?
NutriStack classifies the Ashwagandha and Azathioprine pairing as conflict: Ashwagandha may have immune-stimulating effects and could conflict with immunosuppressive treatment goals in autoimmune disease or transplant. Avoid without clinician approval when azathioprine is used to prevent rejection or control autoimmune activity.
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