Benzodiazepines
Considering a supplement or medicine with a benzodiazepine? Check interaction information for alprazolam, lorazepam, diazepam, clonazepam, temazepam, and midazolam.
Interactions
Supplement interactions on fileNo supplement in this library is recorded as interacting with this medication. Coverage is partial — 171 of 216 medications have interaction data, drawn from the 107 supplements written up so far. Absence here is incomplete coverage, not a safety claim.
- Trade names
- Alprazolam (Xanax), Lorazepam (Ativan), Diazepam (Valium), Clonazepam (Klonopin), Temazepam (Restoril), Midazolam (Versed)
- family
- sedatives
Full write-up
What is it
Benzodiazepines are psychiatric medicines in the sedative family. This group includes Alprazolam (Xanax), Lorazepam (Ativan), Diazepam (Valium), Clonazepam (Klonopin), Temazepam (Restoril), and Midazolam (Versed).
This page is an educational reference for checking how these medicines may interact with supplements or other medicines, including Ashwagandha, CBD (Cannabidiol), Chamomile, St. John's Wort, Curcumin, Caffeine, GABA, Rhodiola Rosea, Lavender Extract, Melatonin, and Resveratrol. Consult a clinician regarding any medical condition.
What interacts with it
The main shared concern with several supplements is additive central nervous system depression. Ashwagandha, CBD (Cannabidiol), Chamomile, GABA, Lavender Extract, and Melatonin may increase sedation, dizziness, drowsiness, coordination problems, or psychomotor impairment when combined with benzodiazepines. Chamomile and Lavender Extract are described in terms of GABA-related activity, while the clinical significance of the potential effect with Ashwagandha is uncertain. CBD may increase excessive drowsiness and coordination problems, and Melatonin may add to sedation and psychomotor impairment.
Curcumin and Resveratrol raise a different, mainly pharmacokinetic concern. Curcumin has limited evidence for affecting CYP3A4 substrates such as midazolam, so an effect on some benzodiazepines is possible, although clinical relevance and respiratory effects are uncertain. Resveratrol may theoretically inhibit CYP3A4-mediated metabolism of certain benzodiazepines, including midazolam and triazolam, potentially increasing exposure, particularly with high-dose products or narrow-therapeutic-index drugs.
Some combinations may work in the opposite direction rather than increase sedation. Caffeine stimulates the CNS through adenosine antagonism, opposing benzodiazepine-related GABAergic sedation. Rhodiola Rosea may theoretically have stimulating effects that oppose sedation, but this has not been demonstrated in clinical studies, and any effect on anxiolytic efficacy is unconfirmed. St. John’s Wort induces CYP3A4 and can lower concentrations and reduce the efficacy of susceptible benzodiazepines, including midazolam, alprazolam, and triazolam; withdrawal symptoms may occur in dependent patients. A prescriber or pharmacist can help assess these combinations in context.