Adaptogens for People Taking Many Medicines
How adaptogens can interact with prescription medicines, what sources document for blood thinners, diabetes, blood pressure, sedatives and thyroid medicines, and how to check with a pharmacist.
Content last updated . This page has not been medically reviewed.
Safety first. Supplements can cause side effects and interact with medicines. Read mushroom safety and interactions before you use any mushroom product.
If you take several medicines, check with a pharmacist before adding an adaptogen, and never stop a prescribed medicine on your own. The National Institute on Aging (NIA) says to tell your doctor about all medicines, including over-the-counter drugs, vitamins, supplements and herbal remedies, "even ones you use infrequently", because mixing medicines and supplements can cause serious problems. [1] Ask the prescriber or pharmacist before changing anything.
Why many medicines raise the stakes
A 2025 review of 16 studies found that 23% to 82.5% of older adults combine supplements with prescription medicines, that clinicians often do not ask about supplements, and that actual harm seemed concentrated in high-risk combinations such as antithrombotics (for example warfarin) with some supplements. [2] The more medicines in the list, the harder it is to spot a cause when something changes. "Adaptogen" is a contested term and each plant is different, so this page lists what sources document plant by plant. For the overall picture see how interactions work and interactions by drug class.What sources document
| Medicine group | Plant | What the source says | Strength |
|---|---|---|---|
| Warfarin and other blood thinners | American ginseng (Panax quinquefolius) | In a trial of 20 healthy volunteers, American ginseng reduced warfarin's anticoagulant effect. [3] A review of nine trials found American ginseng altered warfarin effects while St John's wort, Korean red ginseng and several others did not significantly. [4] | Small trials; the participants were healthy volunteers, not patients |
| Blood thinners and clotting | Asian ginseng (Panax ginseng) | NCCIH says it may interfere with blood clotting. [5] LactMed says ginseng decreases blood levels of some drugs such as warfarin and enhances the effect of sedating drugs. [6] | Documented caution |
| Diabetes medicines | Ashwagandha, Asian ginseng | NCCIH says ashwagandha might interact with diabetes medicines, and some evidence suggests Asian ginseng might lower blood sugar. [7] [5] | Possible; ask a pharmacist |
| Blood pressure medicines | Ashwagandha, rhodiola | NCCIH says ashwagandha might interact with high blood pressure medicines and reports an interaction between rhodiola and losartan. [7] [8] The European herbal committee reported no clinically relevant interactions with rhodiola observed (2024). [9] | Mixed reports |
| Immunosuppressants | Ashwagandha | NCCIH lists medicines that decrease the immune system response. [7] | Documented caution |
| Sedatives, sleep medicines, anticonvulsants | Ashwagandha, ginseng | NCCIH lists sedatives and anti-seizure medicines for ashwagandha. [7] LactMed says ginseng enhances the effect of sedating drugs. [6] See supplements, sedatives and alcohol. | Documented caution |
| Thyroid hormone medicines | Ashwagandha | NCCIH lists thyroid hormone medications and says it is not recommended for thyroid disorders. [7] See ashwagandha, thyroid and medicines. | Documented caution |
| Medicines affecting the liver | Ashwagandha, ginseng | NIH LiverTox says ashwagandha has been implicated in clinically apparent liver injury, and that ginseng has not been implicated in liver injury but may cause herb-drug interactions that lead to it. [10] [11] A 2026 review lists ashwagandha among herbal and dietary supplements increasingly implicated in drug-induced liver injury in the US. [12] | Documented reports |
| Antidepressants and other mental-health medicines | Rhodiola, ashwagandha | Proper evidence not found for specific interaction rules in the sources we read for this page. NCCIH advises talking to a provider about herbs if you take any medicine. [8] If low mood is part of the picture, call or text 988 in the US. | Insufficient evidence |
An absence of a documented interaction is not proof of safety. Cases may be under-reported, and trials rarely include people on many drugs.
A practical checklist
- Write down each medicine and supplement and bring the bottles or labels to the pharmacist.
- Ask: could this plant change how my medicine works or add to its side effects?
- Note the exact plant and part (root, leaf) and the extract on the label; see reading adaptogen labels.
- Report new symptoms such as dizziness, bruising, yellowing of the skin or eyes or unusual bleeding to a clinician promptly; see liver safety.
- Use products with testing information (quality testing and certifications).
More detail by plant is in adaptogen medicine interactions and ginseng, blood sugar, blood thinners and other cautions.
Frequently asked questions
Can I take ashwagandha with my prescriptions?
NCCIH says it might interact with several medicine groups, including diabetes, blood pressure, immunosuppressant, sedative, anticonvulsant and thyroid hormone medicines. Ask a pharmacist. [7]
Does ginseng affect warfarin?
American ginseng reduced warfarin's effect in a small trial of healthy volunteers; results differ by ginseng type. [3] [4]
Is rhodiola safe with blood pressure medicine?
NCCIH reports an interaction with losartan, while the European monograph reports no clinically relevant interactions observed. Ask a pharmacist. [8] [9]
Should I stop my medicine if I want to try an adaptogen?
No. Ask the prescriber or pharmacist; do not stop or change a prescribed medicine on your own. [1]
Do I have to mention supplements to my doctor?
Yes, even ones used occasionally. The NIA says to mention everything. [1]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Pregnancy, surgery and other conditions
References
- National Institute on Aging (NIH). Taking Medicines Safely as You Age. Read 2026-10-23.
- Pharmacological Interactions Between Nutritional Supplements and Prescription Medications in Older Adults: A Comprehensive Review. Cureus, 2025. PubMed 41103884. Read 2026-10-23.
- Brief communication: American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled Trial. Annals of internal medicine, 2004. PubMed 15238367. Read 2026-10-23.
- A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin. PloS one, 2017. PubMed 28797065. Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH). Asian Ginseng: Usefulness and Safety. Read 2026-10-23.
- Ginseng. LiverTox/LactMed (NIH), 2006. PubMed 30000873. Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH). Ashwagandha: Usefulness and Safety. Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH). Rhodiola: Usefulness and Safety. Read 2026-10-23.
- European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). European Union herbal monograph on Rhodiola rosea L., rhizoma et radix, Final, Revision 1. EMA/HMPC/24177/2023, 20 March 2024. Read 2026-10-23.
- Ashwagandha. LiverTox/LactMed (NIH), 2012. PubMed 31643854. Read 2026-10-23.
- Ginseng. LiverTox/LactMed (NIH), 2012. PubMed 31643526. Read 2026-10-23.
- The contemporary epidemiology, causes, and management of drug-induced liver injury. Hepatology communications, 2026. PubMed 42475234. Read 2026-10-23.