The short answer
Not known. We found no study that tested ashwagandha with a named blood pressure medicine. In a 60-day trial in Bhubaneswar, 60 people with stress, anxiety and high blood pressure took an ashwagandha extract or a placebo. The authors report favourable trends in blood pressure, but the summary gives no figures and does not say which medicines people took.
The US National Center for Complementary and Integrative Health (NCCIH) lists blood pressure medicines among those ashwagandha might interact with. If you take one, tell your prescribing doctor before you start ashwagandha, and ask whether you should check your blood pressure at home for a while.
Common Indian packs include Telma (telmisartan), Amlong (amlodipine), Cardace (ramipril) and Met XL (metoprolol).
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Favourable blood pressure trends with ashwagandha extract in people with high blood pressure[1] | Not established | Could add to blood pressure lowering; size and drug-specific effect unknown | RCT |
| Named by a US health agency as a possible interaction[2] | Not stated | Not quantified | Theoretical by mechanism |
| Liver injury from ashwagandha products[3][4] | Not established | Herb safety context, not an interaction with blood pressure medicines | Case report |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Trial in stress with high blood pressure, Bhubaneswar, 2026 RCT
Sixty people with stress, anxiety and high blood pressure took a standardised ashwagandha extract (Ashwagen, 300 mg twice a day) or a placebo for 60 days. Anxiety and stress scores and cortisol fell with the extract, and the authors describe favourable trends in LDL cholesterol and blood pressure. No serious side effects were reported. The summary gives no blood pressure figures and does not name the medicines people were taking.[1]
Case series, India, 2023 Case report
Liver specialists at several Indian centres, led from Kerala, described 8 people with liver injury after single-herb ashwagandha products, out of 23 ashwagandha cases seen between 2019 and 2022. Five already had chronic liver disease, and three of them developed acute-on-chronic liver failure and died. Testing found no contamination in the products. This is about ashwagandha's own risk to the liver, not about blood pressure medicines.[3]
Case series, Iceland and the United States, 2020 Case report
Five people developed jaundice 2 to 12 weeks after starting supplements containing ashwagandha. Their liver tests returned to normal within 1 to 5 months in four of them; the fifth was lost to follow-up. Four were also taking other supplements.[4]
What your doctor may watch for
- Blood pressure readings at home or in the clinic, and dizziness on standing up.[1]
- Yellow eyes or skin, dark urine, itching or nausea, which can be signs of liver injury.[4]
What to tell your prescribing doctor
You can read this out, or show them this page:
“I am taking, or planning to take, ashwagandha (name of product, form and how much) along with my blood pressure medicine. A US health agency lists blood pressure drugs among those ashwagandha might interact with. Should I check my blood pressure at home, and how often?”
Withheld until review
Questions people ask
Does ashwagandha lower blood pressure?
One 60-day trial in people with high blood pressure reported favourable trends with an ashwagandha extract, but its summary gives no numbers. So we cannot say whether it lowers blood pressure, or by how much.[1]
Does taking them at different times help?
We found no study that tested a time gap between ashwagandha and any blood pressure medicine, so there is no evidence that spacing them helps. That is a question for your doctor.[2]
Can ashwagandha harm the liver?
Liver injury has been reported, including in an Indian series of 8 people in which three with existing liver disease died. If you have liver disease, talk to your doctor before you start.[3]
Related
Ashwagandha with metformin and insulin
Not studied in people. A US health agency lists diabetes medicines among those ashwagandha might interact with, without details.
InteractionAshwagandha with sleeping pills and benzodiazepines
Not studied in people. Ashwagandha may have sedative effects that add to benzodiazepines and sleeping pills, based on preclinical work.
InteractionArjuna and blood pressure medicines
Arjuna capsules lowered blood pressure further in people taking telmisartan, in one small 28-day trial. Other BP drugs are untested.
EvidenceDoes ashwagandha reduce stress?
One small placebo-controlled trial found ashwagandha root extract lowered stress scores and cortisol over 60 days. Promising, not settled.
Sources
- Pattojoshi A, Kumar Patra S, Idrees SA, Behera S, Dalua SS, Tiwari P, Valavan R. Safety and efficacy of Ashwagen (a standardized Withania somnifera extract) in stress and anxiety with hypertension and associated cardiometabolic risk factors: a randomized, placebo-controlled trial. Stress. 2026;29(1):2669544. PMID 42105298.
- National Center for Complementary and Integrative Health (US). Ashwagandha.
- Philips CA, Valsan A, Theruvath AH, Ravindran R, Oommen TT, Rajesh S, Bishnu S, Augustine P; Liver Research Club India. Ashwagandha-induced liver injury: a case series from India and literature review. Hepatol Commun. 2023;7(10):e0270. PMID 37756041.
- Björnsson HK, Björnsson ES, Avula B, Khan IA, Jonasson JG, Ghabril M, Hayashi PH, Navarro V. Ashwagandha-induced liver injury: a case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4):825-829. PMID 31991029.
Updated 4 November 2026
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