Medications that decrease the immune system

• Cyclosporine

• Tacrolimus

• Mycophenolate

• Prednisone

• Methotrexate

• Azathioprine

Selenium can increase the activity of the immune system. Some medications, such as those used after a transplant, decrease the activity of the immune system. Taking selenium along with these medications might decrease the effects of these medications.

Medications that slow blood clotting

• Heparin

• Rivaroxaban

• Apixaban

• Dabigatran

• Clopidogrel

Selenium might slow blood clotting. Taking selenium along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Niacin

Taking niacin along with the drug simvastatin can increase good cholesterol levels. Taking niacin plus simvastatin along with selenium and other antioxidants can decrease the effects of niacin and simvastatin on good cholesterol levels. It is unknown if selenium alone decreases the effects of niacin plus simvastatin on good cholesterol levels.

Sedative medications

• Diazepam

• Alprazolam

• Temazepam

• Zolpidem

• Zopiclone

• Promethazine

Selenium might reduce how quickly the body breaks down sedative medications. Taking selenium with these medications might increase the effects and side effects of these medications.

• Jantoven

• Used for: blood thinning, clot prevention

Selenium might slow blood clotting. Selenium might also increase the effects of warfarin in the body. Taking selenium along with warfarin might increase the chances of bruising and bleeding.

Medications for diabetes

• Glyburide

• Glipizide

• Insulin

• Sitagliptin

• Empagliflozin

• Semaglutide

• Dapagliflozin

Ashwagandha might lower blood sugar levels. Taking ashwagandha along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

Medications for high blood pressure

• Amlodipine

• Ramipril

• Perindopril

• Metoprolol

• Losartan

• Hydrochlorothiazide

Ashwagandha might lower blood pressure. Taking ashwagandha along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

Medications that can harm the liver

• Acetaminophen / Paracetamol

• Methotrexate

• Atorvastatin

• Simvastatin

• Isoniazid

Ashwagandha might harm the liver. Some medications can also harm the liver. Taking ashwagandha along with a medication that can harm the liver might increase the risk of liver damage.

Ashwagandha can increase the activity of the immune system. Some medications, such as those used after a transplant, decrease the activity of the immune system. Taking ashwagandha along with these medications might decrease the effects of these medications.

Ashwagandha might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking ashwagandha with sedative medications might cause breathing problems and/or too much sleepiness.

Thyroid hormone

The body naturally produces thyroid hormones. Ashwagandha might increase how much thyroid hormone the body produces. Taking ashwagandha with thyroid hormone pills might cause too much thyroid hormone in the body, and increase the effects and side effects of thyroid hormone.

Large amounts of iodine can decrease thyroid function. Lithium can also decrease thyroid function. Taking iodine along with lithium might decrease thyroid function too much. Do not take large amounts of iodine if you are taking lithium.

Medications for an overactive thyroid

• Antithyroid drugs

Iodine can increase or decrease thyroid function. Taking iodine along with medications for an overactive thyroid might change the effects of these medications. Do not take iodine supplements if you are taking medications for an overactive thyroid, unless recommended by a healthcare provider.

Medications changed by the liver

• Glipizide

• Phenytoin

• Losartan

Some medications are changed and broken down by the liver. Rhodiola might change how quickly the liver breaks down these medications. If you are taking medications metabolised by the liver, monitor for any changes in how your medication affects you.

Rhodiola might lower blood sugar levels. Taking rhodiola along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

Rhodiola might lower blood pressure. Taking rhodiola along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

Medications moved by pumps in cells

• P-glycoprotein substrates

Some medications are moved in and out of cells by pumps. Rhodiola might change how these pumps work and change how much medication stays in the body. In some cases, this might change the effects and side effects of a medication.

Rhodiola can increase the activity of the immune system. Some medications, such as those used after a transplant, decrease the activity of the immune system. Taking rhodiola along with these medications might decrease the effects of these medications.

Cyclosporine

• Restasis

• Used for: organ transplant, autoimmune conditions

Taking large amounts of vitamin E along with cyclosporine might increase how much cyclosporine the body absorbs. This might increase the effects and side effects of cyclosporine.

• Atorvastatin

• Simvastatin

• Amlodipine

• Diltiazem

• Cyclosporine

• Tacrolimus

• Midazolam

• Alprazolam

• Rivaroxaban

• Some HIV antiretrovirals

Some medications are changed and broken down by the liver. Vitamin E might change how quickly the liver breaks down these medications. If you are taking medications metabolised by the liver, monitor for any changes in how your medication affects you.

Medications for cancer

• Cyclophosphamide

• Chlorambucil

• Melphalan

• Busulfan

• Temozolomide

Vitamin E is an antioxidant. There is some concern that antioxidants might decrease the effects of some medications used for cancer. If you are taking medications for cancer, check with your healthcare provider before taking vitamin E.

Vitamin E might slow blood clotting. Taking vitamin E along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Taking niacin along with the drug simvastatin can increase good cholesterol levels. Taking niacin plus simvastatin along with vitamin E and other antioxidants can decrease the effects of niacin and simvastatin on good cholesterol levels. It is unknown if vitamin E alone decreases the effects of niacin plus simvastatin on good cholesterol levels.

Selumetinib

• Koselugo

Selumetinib, a drug used for cancer, contains vitamin E. Taking selumetinib with vitamin E-containing supplements can result in an unsafe dose of vitamin E. This could increase the risk of bleeding.

Warfarin is used to slow blood clotting. Vitamin E can also slow blood clotting. Taking vitamin E along with warfarin can increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin might need to be changed.

Estrogens

• Oral contraceptive pill

• Estradiol

• Conjugated estrogens

• HRT combination products

Vitex agnus-castus seems to change hormone levels in the body. Taking vitex agnus-castus along with estrogen pills might decrease the effects of estrogen pills.

Medications for mental conditions

• Olanzapine

• Quetiapine

• Risperidone

• Clozapine

• Haloperidol

• Aripiprazole

Vitex agnus-castus seems to affect a chemical in the brain called dopamine. Some medications for mental disorders help to decrease dopamine. Taking vitex agnus-castus along with these medications might decrease the effects of these medications.

Medications used for Parkinson disease

• Dopamine agonists

Vitex agnus-castus contains chemicals that affect the brain. These chemicals affect the brain similarly to some medications used for Parkinson disease. Taking vitex agnus-castus with these medications might increase the effects and side effects of the medications used for Parkinson disease.

Metoclopramide

Vitex agnus-castus seems to affect a certain brain chemical called dopamine. Metoclopramide also affects dopamine. Taking vitex agnus-castus along with metoclopramide might decrease the effects of metoclopramide.

Antibiotics

• Doxycycline

• Ciprofloxacin

• Amoxicillin

• Azithromycin

• Norfloxacin

• Trimethoprim

Zinc might decrease how much antibiotic the body absorbs from the gut. Taking zinc along with quinolone antibiotics might decrease the effects of these antibiotics. To avoid this interaction, take antibiotics at least 2 hours before or 4-6 hours after zinc supplements.

Zinc can decrease the amount of tetracyclines the body absorbs. Taking zinc with tetracyclines might decrease the effects of tetracyclines. To avoid this interaction, take tetracyclines 2 hours before or 4-6 hours after taking zinc supplements.

Bictegravir/emtricitabine/tenofovir alafenamide

• Biktarvy

In theory, zinc might decrease how much bictegravir/emtricitabine/tenofovir alafenamide the body absorbs from the stomach. To avoid this interaction, take bictegravir/emtricitabine/tenofovir alafenamide at least 2 hours before or 6 hours after zinc containing products.

Cephalexin

• Keflex

Zinc can reduce how much cephalexin the body absorbs. This might decrease how well cephalexin works for treating infections. To avoid this interaction, take zinc 3 hours after taking cephalexin.

Cisplatin

• Platinol-AQ

Cisplatin is used to treat cancer. Taking zinc along with cisplatin might inactivate cisplatin therapy. But it's not clear if this is a big concern.

Medications for HIV/AIDS

• Integrase inhibitors

Taking zinc along with integrase inhibitors might decrease blood levels of integrase inhibitors. This might decrease the effects of these medications. Talk to your healthcare provider if you are using integrase inhibitors and want to start taking zinc.

Penicillamine

• Cuprimine, Depen

Zinc might decrease how much penicillamine the body absorbs. Taking zinc with penicillamine might decrease the effects of penicillamine. Take zinc and penicillamine at least 2 hours apart.

Ritonavir

• Norvir

Ritonavir is a drug used for HIV infection. Zinc can reduce how much ritonavir the body absorbs. But it isn't clear if this is a big concern.

Bupleurum can increase the activity of the immune system. Some medications, such as those used after a transplant, decrease the activity of the immune system. Taking bupleurum along with these medications might decrease the effects of these medications.

Bupleurum might slow blood clotting. Taking bupleurum along with medications that also slow blood clotting might increase the risk of bruising and bleeding.