Contraindications and Precautions for Ashwagandha Use

Introduction to Contraindications

• Ashwagandha is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs), those with hyperthyroidism, personal or family history of thyroid disorders, pregnancy, autoimmune diseases, and in patients scheduled for surgery, as it may lead to severe hypertension, cerebrovascular accidents, and other adverse effects 1

Drug Interactions

• Complete avoidance of MAOIs is necessary when taking ashwagandha, as concomitant use can lead to severe hypertension and risk of cerebrovascular accidents 2
• Ashwagandha has sedative properties that can potentiate effects of benzodiazepines and other sedatives 1
• Ashwagandha may interact with CYP450 enzymes, and spacing with other medications may be necessary 3

Special Populations

• Caution is advised when using ashwagandha in patients with liver disease due to potential hepatic metabolism 1
• Ashwagandha should be discontinued at least 2 weeks before scheduled surgery due to potential effects on blood pressure, blood glucose, and immune function 1