Alprazolam and supplements: 2 sourced interactions
Benzodiazepine, also sold as Xanax and Xanax XR. Of these, 2 named by an FDA label or NIH page. Plus 3 predicted from how each works (not established). Plus 1 food and drink line. Each links its source and the date it was checked.
From the Interaction Map Sources checked Oct 25, 2026
A combination missing here is not on our list; that does not mean it is safe together.
Alprazolam with supplements
Most serious first. Open a row for the mechanism, the source's words and the date checked.
Educational only. Check with your pharmacist or prescriber before changing anything you take.
Moderate
3AshwagandhaLabel or NIHAn NIH page names this pair (cause not established).
moderate · Named by an FDA label or NIH page · Cause not established
In the source’s own words; rated moderate from that wording, not from a study of the pair.
“There is evidence that ashwagandha might interact with some medications, including those for diabetes and high blood pressure, medicines that decrease the immune system response (immunosuppressants), sedatives, anti-seizure medications (anticonvulsants), and thyroid hormone medications.”
- NIH National Center for Complementary and Integrative Health · Ashwagandha: Usefulness and Safety, What Do We Know About Safety?
- Checked Oct 23, 2026
KavaLabel or NIHAn NIH page names this pair (drowsiness).
moderate · Named by an FDA label or NIH page · Drowsiness
In the source’s own words; rated moderate from that wording, not from a study of the pair.
“Kava should not be used together with other substances that have sedative effects, such as benzodiazepines or alcohol.”
- NIH National Center for Complementary and Integrative Health · Kava: Usefulness and Safety, What Do We Know About Safety?
- Checked Oct 25, 2026
St John's wortPredictedSt John's wort may lower Alprazolam levels and effect: it speeds up CYP3A, an enzyme that breaks Alprazolam down.
moderate · Predicted from how each works, not established · Breakdown by liver enzymes
Predicted from what each is known to do, not studied as a pair and not established.
St John's wort may lower Alprazolam levels and effect: it speeds up CYP3A, an enzyme that breaks Alprazolam down.
- FDA table of drugs that interact with CYP enzymes · St John's wort: CYP3A strong inducer (Table 1, row "St. John’s wort", column "CYP Strg IND" (footnote 18: The effect of St. John’s wort varies widely and is preparation dependent.))
- FDA table of drugs that interact with CYP enzymes · Alprazolam: CYP3A substrate (Table 1, row "alprazolam", column "CYP Mod SENS SUB")
- Checked Oct 23, 2026
Minor
2Cannabidiol (CBD)PredictedBoth can cause drowsiness, which may add up.
minor · Predicted from how each works, not established · Drowsiness
Predicted from what each is known to do, not studied as a pair and not established.
Both can cause drowsiness, which may add up.
- FDA drug label (DailyMed) · Alprazolam: can cause drowsiness (XANAX (ALPRAZOLAM) TABLET [VIATRIS SPECIALTY LLC], section 5.4)
- NIH National Center for Complementary and Integrative Health · Cannabidiol (CBD): can cause drowsiness (Cannabis (Marijuana) and Cannabinoids: What You Need To Know, Can CBD be harmful?)
- Checked Oct 25, 2026
MelatoninPredictedBoth can cause drowsiness, which may add up.
minor · Predicted from how each works, not established · Drowsiness
Predicted from what each is known to do, not studied as a pair and not established.
Both can cause drowsiness, which may add up.
- NIH National Center for Complementary and Integrative Health · Melatonin: can cause drowsiness (Melatonin: What You Need To Know, Is it safe to take melatonin? > Safety concerns for older people)
- FDA drug label (DailyMed) · Alprazolam: can cause drowsiness (XANAX (ALPRAZOLAM) TABLET [VIATRIS SPECIALTY LLC], section 5.4)
- Checked Oct 25, 2026
Alprazolam with food and drink
Food and drink
1GrapefruitPredictedGrapefruit may raise Alprazolam levels: it slows CYP3A, an enzyme that breaks Alprazolam down.
moderate · Predicted from how each works, not established · Breakdown by liver enzymes
Predicted from what each is known to do, not studied as a pair and not established.
Grapefruit may raise Alprazolam levels: it slows CYP3A, an enzyme that breaks Alprazolam down.
- FDA table of drugs that interact with CYP enzymes · Grapefruit: CYP3A moderate inhibitor (Table 1, row "grapefruit juice", column "CYP Mod INH" (footnote 9: The effect of grapefruit juice varies widely among brands and is concentration-, dose-, and preparation-dependent. Studies have shown that it can be classified as a “strong CYP3A inhibitor” when a certain preparation was used (e.g., high dose, double strength) or more commonly as a “moderate CYP3A inhibitor” when another preparation was used (e.g., low dose, single strength).))
- FDA table of drugs that interact with CYP enzymes · Alprazolam: CYP3A substrate (Table 1, row "alprazolam", column "CYP Mod SENS SUB")
- Checked Oct 23, 2026
How these lines are sourced
Three kinds of line
- Studied in people (PubMed): PubMed records that were opened and read, graded A (several controlled studies, or a finding in the dosing guidance), B (at least one controlled human study) or C (case reports, observational data or mechanism only).
- Named by an FDA label or NIH page: quoted word for word from that page. Its severity comes from the source’s wording, not from a study of the pair.
- Predicted from how each works, not established: built from sourced facts about each substance, such as the FDA’s table of enzyme roles. Never rated major.
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- Interaction MapCheck several medicines and supplements at once, each interaction sourced to PubMed, FDA labels or NIH; a pair we have no source for reads as not on our list, never as safe.