The short answer
Not known in people. We found no study of ashwagandha taken with atorvastatin or any other statin. In lab tests on human liver cells, an ethanol extract of ashwagandha root changed the activity of CYP3A4, an enzyme the atorvastatin label names in its interaction warnings. That could in theory change atorvastatin levels, in a direction nobody has measured.
A trial in Lahore compared ashwagandha with atorvastatin for cholesterol, but in separate groups, so it says nothing about taking both. If you take a statin, tell your prescribing doctor before you start ashwagandha, and report any muscle pain, or yellow eyes or dark urine.
Statins sold in India include Atorva (atorvastatin), Rosuvas (rosuvastatin) and Simvotin (simvastatin).
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Ethanol root extract changed CYP3A4 in human liver cells[1][6] | CYP3A4 modulation in human liver cells grown in the lab | Could change atorvastatin or simvastatin levels; direction in people not known | In vitro |
| No reversible blocking of liver enzymes by root or leaf extracts[2] | No CYP inhibition at the strengths tested | Does not rule out induction | In vitro |
| Ashwagandha compared with atorvastatin in separate groups[3] | Not applicable | No information on taking both | Controlled trial |
| Liver injury from ashwagandha products[4][5] | Not established | Herb safety context, not an interaction with statins | Case report |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Laboratory study, United States, 2025 In vitro
At Auburn University, water and 70% ethanol extracts of ashwagandha root and leaf were tested on cultured human liver cells. The ethanol root extract changed the expression and activity of CYP3A4, and a high concentration of the ethanol leaf extract harmed the cells. No statin was tested. Lab findings like this show a possible route for an interaction. They do not show that one happens in people.[1]
Laboratory study, United States, 2025 In vitro
A second Auburn study tested four root and leaf extracts against seven liver enzymes, including CYP3A4/5. None blocked them in a reversible way at the strengths tested. This does not cover enzyme induction.[2]
Trial in high cholesterol, Lahore, 2026 Controlled trial
Sixty people with high cholesterol were split into four groups for three months. They took atorvastatin (10 mg at night), ashwagandha (500 mg twice a day), jamun (Syzygium cumini), or both herbs. Ashwagandha alone improved LDL and VLDL cholesterol, and no side effects were reported. The summary does not say the groups were randomised, each group was compared only with its own starting values, and nobody took ashwagandha with atorvastatin.[3]
Case series, India, 2023 Case report
Liver specialists at several Indian centres 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. This is about ashwagandha's own risk to the liver, not about statins.[4]
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.[5]
What your doctor may watch for
- New muscle pain, tenderness or weakness. The atorvastatin label warns about myopathy, a muscle injury.[6]
- Yellow eyes or skin, dark urine, itching or nausea, which can be signs of liver injury.[5]
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 statin. A lab study found ashwagandha can change CYP3A4, an enzyme involved in some statin interactions, and ashwagandha has been linked to liver injury. Should anything be checked?”
Withheld until review
Questions people ask
Can ashwagandha replace my statin?
No study supports that. The one trial was small, short and compared each group only with its own starting values. Any change to a statin is for your prescribing doctor to decide.[3]
Does taking them at different times help?
We found no study that tested a time gap between ashwagandha and any statin, so there is no evidence that spacing them helps. That is a question for your doctor.[1]
Related
Arjuna and statins for cholesterol
In the lab, arjuna bark extract blocked CYP3A4, an enzyme that clears atorvastatin. Nobody has measured statin levels with arjuna.
InteractionGuggulu and cholesterol medicines (statins)
Guggul raised rosuvastatin levels in rats, and lab work suggests it speeds up an enzyme that clears some statins. We found no study in people.
InteractionAshwagandha and blood pressure medicines
We found no study of ashwagandha with a named BP medicine. A US health agency lists BP drugs among those it might interact with.
InteractionAshwagandha with metformin and insulin
Not studied in people. A US health agency lists diabetes medicines among those ashwagandha might interact with, without details.
Sources
- McDonald KL, Raichura Z, Pondugula SR, Marney L, Yang L, Choi J, Salamat JM, Brandes MS, Neff C, Adams K, Farmer G, Dennis C, Maier CS, Soumyanath A, Arnold RD, Calderón AI. Ashwagandha (Withania somnifera) plant extracts affect the cytochrome P450 system and cytotoxicity of primary human hepatocytes. J Diet Suppl. 2025;22(4):613-639. PMID 40551718.
- Raichura Z, Heck K, Choi J, Yang L, Brandes M, Marney L, Mangaña AA, Neff C, Maier CS, Soumyanath A, van Breemen RB, Arnold RD, Calderón AI. Evaluation of reversible cytochrome P450 inhibition by Withania somnifera leaf and root extracts. Drug Metab Dispos. 2025;53(2):100024. PMID 40023576.
- Zubair K, Zafar F, Saif S, Khaliq U, Syed H, Sarfraz A, Rukh Sultan S, Imran Hussain M, Nisar T. Combined effect of Withania somnifera and Syzygium cumini on hyperlipidemic patients. Pak J Pharm Sci. 2026;39(7):2120-2126. PMID 42170977.
- 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.
- Atorvastatin calcium tablets, US prescribing information (DailyMed).
Updated 4 November 2026
Taking ashwagandha with other medicines? A vaidya can check your full list.
Medicine Check · ₹299