A Note on Medical Advice
This article is for informational purposes only and does not constitute medical advice. The interaction between supplements and prescription drugs can be complex and dangerous. Always consult with a qualified healthcare provider before starting, stopping, or combining any medications or supplements.
What is Lisinopril and How Does It Work?
Lisinopril is a widely prescribed medication belonging to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors [1.4.1]. It is primarily used to treat high blood pressure (hypertension) and heart failure, and it can improve survival chances after a heart attack [1.4.1, 1.4.6].
The drug's mechanism of action involves blocking the conversion of angiotensin I to angiotensin II [1.4.8]. Angiotensin II is a powerful chemical in the body that constricts blood vessels, raising blood pressure [1.4.2, 1.4.4]. By inhibiting its production, lisinopril helps relax and widen blood vessels, which lowers blood pressure and allows blood to flow more easily, reducing the heart's workload [1.4.1]. ACE inhibitors like lisinopril can also cause the body to retain potassium, which is an important consideration for potential interactions [1.5.1, 1.5.5]. Common side effects include a persistent dry cough, dizziness, headache, and fatigue [1.4.5].
What is Ashwagandha?
Ashwagandha (Withania somnifera) is an evergreen shrub native to Asia and Africa, and it is a cornerstone of traditional Ayurvedic medicine [1.3.5, 1.6.2]. Known as an "adaptogen," it is believed to help the body resist and adapt to physical and mental stress [1.3.5]. People commonly use it for stress relief, anxiety, and to improve sleep [1.3.7, 1.6.2].
Research has explored its various physiological effects. Ashwagandha contains chemicals that might help calm the brain, reduce inflammation, and alter the immune system [1.3.5]. Importantly, some studies suggest that ashwagandha may lower blood pressure [1.3.2, 1.3.5, 1.3.6]. While generally considered safe for short-term use, it can cause side effects like drowsiness, stomach upset, and diarrhea [1.6.2, 1.6.7]. It also has contraindications; for instance, it should not be used during pregnancy as it may cause miscarriages [1.6.1, 1.6.5].
The Core Interaction: Can You Take Ashwagandha with Lisinopril?
Combining ashwagandha and lisinopril is not recommended without direct medical supervision due to two primary risks: an additive blood pressure-lowering effect (hypotension) and a theoretical increased risk of liver injury (hepatotoxicity) [1.2.1, 1.3.6].
The Risk of Hypotension (Low Blood Pressure)
The most significant concern is the potential for an additive hypotensive effect. Lisinopril is designed to lower blood pressure, and ashwagandha may also have a blood-pressure-lowering effect [1.3.1, 1.3.5]. Taking both concurrently could cause your blood pressure to drop to an unsafe level, a condition known as hypotension [1.3.1].
Hypotension occurs when blood pressure falls below 90/60 mmHg [1.3.1]. This can reduce blood flow to vital organs like the brain and heart, leading to symptoms such as:
- Dizziness and lightheadedness, especially when standing up [1.4.7]
- Fainting (syncope) [1.3.1]
- Confusion [1.3.1]
- Weakness [1.3.1]
- Blurred vision
- Nausea
While clinical reports of severe hypotension from this specific combination are not widely documented, the theoretical risk is significant enough that experts advise close monitoring of blood pressure if they are used together [1.3.1, 1.3.4].
The Risk of Hepatotoxicity (Liver Injury)
A secondary but serious concern involves potential liver damage. In rare cases, both lisinopril and ashwagandha have been individually linked to liver injury [1.2.1, 1.3.1]. Case reports have documented instances of individuals developing liver dysfunction, jaundice, and other signs of liver damage after taking ashwagandha supplements [1.2.2, 1.2.5]. Logically, taking two substances that can both potentially affect the liver may increase that risk [1.2.1, 1.6.5].
Symptoms of liver damage can include:
- Jaundice (yellowing of the skin or eyes) [1.2.1]
- Abdominal pain and nausea [1.2.1]
- Unusual fatigue [1.2.2]
- Dark urine or pale stools [1.2.1]
Due to this potential risk, medical professionals recommend monitoring liver function if these substances are taken together [1.2.2].
Comparison: Lisinopril vs. Ashwagandha
| Feature | Lisinopril | Ashwagandha |
|---|---|---|
| Primary Use | High blood pressure, heart failure [1.4.1] | Stress, anxiety, sleep (adaptogen) [1.3.7] |
| Regulation | FDA-approved prescription medication | Dietary supplement (less regulated by FDA) [1.3.6] |
| Mechanism | Blocks angiotensin II production (ACE inhibitor) [1.4.8] | Affects stress pathways, may calm the brain [1.3.5] |
| Effect on BP | Lowers blood pressure by design [1.4.1] | May lower blood pressure [1.3.2, 1.3.5] |
| Key Interaction Risk | Additive hypotension, hyperkalemia (high potassium) [1.3.1, 1.5.5] | Additive hypotension, potential liver issues [1.3.1, 1.2.1] |
| Common Side Effects | Dry cough, dizziness, headache [1.4.5] | Drowsiness, stomach upset, diarrhea [1.6.7] |
Other Potential Interactions with ACE Inhibitors
When taking an ACE inhibitor like lisinopril, it's crucial to be aware of other supplements that can cause interactions:
- Potassium Supplements: ACE inhibitors can cause the body to retain potassium. Taking potassium supplements or using salt substitutes containing potassium can lead to dangerously high levels (hyperkalemia), which can affect heart rhythm [1.5.1, 1.5.5].
- Licorice Root: Certain forms of licorice can increase sodium retention and blood pressure, counteracting the effect of lisinopril [1.5.1, 1.5.3].
- Green Tea Extract: High doses of green tea extract have been shown to reduce the absorption of lisinopril, potentially making it less effective [1.5.1].
Conclusion: Prioritize Safety and Medical Guidance
While ashwagandha offers potential benefits for stress and wellness, its interaction profile requires careful consideration, especially for those on prescription medications. The primary danger of combining it with lisinopril is the risk of causing an excessive drop in blood pressure. The secondary, though rarer, risk to liver health adds another layer of caution.
The consensus among medical experts is clear: do not combine ashwagandha and lisinopril without first consulting your healthcare provider [1.2.1, 1.2.6]. They can assess your individual health status, evaluate the potential risks versus benefits, and recommend the safest course of action for managing your health.
Authoritative Link: For more information on herb-drug interactions, consult the National Center for Complementary and Integrative Health (NCCIH). [1.5.7]
