Medication Interactions

Please read this before you take Bacovita, and bring it to your doctor or pharmacist. The herbs in Bacovita are food-grade and have been used for a long time, but several of them are known to interact with common medications. This list is for your safety. It is not medical advice, and it is not complete. If you take any prescription medication, are pregnant or nursing, or have surgery scheduled, talk to your doctor before starting.

Bacopa

• Thyroid medication (levothyroxine and others). Bacopa may raise thyroid hormone levels.
• Sedatives and sleep medication. Bacopa may add to their calming effect.
• Medications that act on acetylcholine, including some prescribed for memory conditions, and anticholinergic drugs for bladder, allergy or Parkinson's symptoms. Bacopa may increase or work against their effects.
• Calcium channel blockers for blood pressure. A possible additive effect.
• Not recommended if you have a slow heart rate, stomach ulcers, a urinary tract obstruction, or lung conditions with heavy mucus, because Bacopa can increase secretions.

Ashwagandha

• Thyroid medication. Ashwagandha may raise thyroid hormone levels.
• Sedatives, sleep aids and anti-anxiety medication (benzodiazepines and others). Additive drowsiness is possible.
• Immunosuppressants, including those taken after a transplant or for autoimmune conditions. Ashwagandha may stimulate the immune system.
• Diabetes medication. Ashwagandha may lower blood sugar further.
• Blood pressure medication. Ashwagandha may lower blood pressure further.
• Not recommended if you are pregnant. Rare cases of liver injury have been reported with ashwagandha products; stop and see your doctor if you notice yellowing of the skin or eyes, dark urine or unusual fatigue.

Turmeric (curcumin)

• Blood thinners (warfarin, clopidogrel, apixaban, rivaroxaban, daily aspirin). Turmeric may increase bleeding risk. Stop at least two weeks before scheduled surgery.
• Diabetes medication. May lower blood sugar further.
• Stomach acid reducers (omeprazole, famotidine and others). Turmeric can increase stomach acid.
• Iron supplements. Turmeric may reduce iron absorption; take them at a different time of day.
• Chemotherapy. Ask your oncologist; curcumin may interfere with some agents.
• Use caution with gallstones or a bile duct obstruction.

Trikatu (black pepper, long pepper, ginger)

• Black pepper (piperine) raises the absorption of many medications, not only herbs. Documented examples include phenytoin, propranolol, theophylline, carbamazepine, and some HIV and blood pressure medications. If you take a drug with a narrow dosing window, ask your pharmacist.
• Ginger with blood thinners. Additive effect on bleeding risk.
• Ginger with diabetes or blood pressure medication. Possible additive lowering.

Supporting herbs in the traditional formula

• Licorice root. In regular use it can raise blood pressure and lower potassium. Caution with blood pressure medication, diuretics, digoxin and corticosteroids. Not recommended in pregnancy.
• Shilajit. May raise iron and uric acid levels; caution with hemochromatosis or gout.
• Cinnamon. May lower blood sugar further with diabetes medication.
• Holy basil, clove, garlic. Mild blood-thinning effects; caution with anticoagulants and before surgery.

General

• Take two capsules with breakfast. Taking them on an empty stomach is the most common cause of mild stomach upset.
• Do not take Bacovita if you are pregnant or nursing.
• If you have a diagnosed memory condition or take medication for one, talk to your doctor first. Bacovita is not a treatment for any disease.
• Stop and contact your doctor if you notice any unusual symptom after starting.

Sources for this list include the NIH National Center for Complementary and Integrative Health, Memorial Sloan Kettering's About Herbs database, and published pharmacokinetic studies on piperine. Check the current label for the full ingredient list and amounts.

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