Interactions between Ashwaganda and Papaverine

Ashwagandha has been found in some studies to lower blood pressure and may theoretically potentiate the effects of hypotensive agents or agents with hypotensive properties. There have been no reports of clinical hypotension associated with concomitant use of ashwagandha and antihypertensive agents.

Adjust dosing interval

Smoking before administration of an intracavernosal papaverine/phentolamine combination may reduce its erection-inducing effect.

Management

Smoking should be avoided for at least 1 hour before the intracavernosal papaverine/phentolamine combination is administered. The applicable manufacturer's labeling should be consulted for additional guidance.

Monitor

Certain psychotherapeutic and other CNS-active agents may have blood pressure-lowering effects and may cause dizziness, orthostatic hypotension, or syncope. These effects may be more likely during treatment initiation, dose escalation, or treatment restart. Coadministration with antihypertensives or other agents with blood pressure-lowering properties, particularly vasodilators and alpha-adrenergic blockers, may result in additive hypotensive or orthostatic effects.

Management

Monitor blood pressure and clinical response during concomitant use, especially when starting or increasing the dose of either agent. Patients should be advised to rise slowly from a sitting or lying position and to report dizziness, lightheadedness, fainting, orthostasis, palpitations, or troublesome changes in pulse or heart rate. Patients should be cautioned that alcohol may enhance blood pressure-lowering effects during concomitant use with antihypertensives or other agents with hypotensive properties. Patients should avoid driving or operating hazardous machinery until they know how the medications affect them.