Drug Interactions between ashwaganda and pramlintide

MONITOR: Coadministration of ashwagandha with antidiabetic drugs may potentiate the risk of hypoglycemia. Clinical data are conflicting. Some studies have reported that ashwagandha reduced the blood levels of glucose and/or glycosylated hemoglobin (HbA1c) in diabetic patients, whereas others have not. In vitro studies suggest that the antidiabetic actions of ashwagandha are mediated through an increase in cellular glucose uptake in both skeletal and fat cells, and an increase in insulin secretion.

MANAGEMENT: Until more information is available, blood glucose should be monitored if antidiabetic agents are used concomitantly with ashwagandha. Patients should be advised on the potential signs and symptoms of hypoglycemia (e.g., headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, palpitation, and tachycardia), how to treat it, and to contact their doctor if it occurs. Patients should also be advised to take precautions to avoid hypoglycemia while driving or operating hazardous machinery.