Also indexed as: Ativan, Bromazepam, Centrax, Chlordiazepoxide,
Clonazepam, Clorazepate, Dalmane, Diastat, Diazepam, Dizac, Doral, Estazolam, Flunitrazepam,
Flurazepam, Halazepam, Klonopin, Libritabs, Librium, Loprazolam, Lorazepam, Lormetazepam,
Midazolam, Nitrazepam, Paxipam, Prazepam, ProSom, Quazepam, Restoril, Temazepam, Valium,
Benzodiazepines are a family of drugs used to treat insomnia,
anxiety, panic attacks, muscle spasms, and seizure disorders. One benzodiazepine,
midazolam, is used as a general anesthetic.
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
| May Be Beneficial: Supportive
interaction—Taking these supplements may support or otherwise help your medication
Avoid: Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results.
St. John's wort (alprazolam)
|Depletion or interference
|Side effect reduction/prevention
|Interactions common to many, if not all,
Benzodiazepines are described in this article. Interactions reported for only one or several
drugs in this class may not be listed in this article. Some drugs listed in this article are
linked to articles specific to that respective drug; please refer to those individual drug
articles. The information in this article may not necessarily apply to drugs in this class for
which no separate article exists. If you are taking a Benzodiazepine for which no separate
article exists, talk with your doctor or pharmacist.
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
Interactions involving benzodiazepines in general are described on this page. For
interactions involving a specific benzodiazepine, refer to the highlighted drugs listed
- Alprazolam (Xanax®)
- Chlordiazepoxide (Librium®, Libritabs®)
- Clonazepam (Klonopin®)
- Clorazepate Dipotassium
- Diazepam (Valium®)
- Estazolam (ProSom®)
- Flunitrazepam (Rohypnol®)
- Flurazepam (Dalmane®)
- Lorazepam (Ativan®)
- Midazolam (Versed®)
- Oxazepam (Serax®)
- Quazepam (Doral®)
- Temazepam (Restoril®)
- Triazolam (Halcion®)
Interactions with Dietary Supplements —
In a preliminary trial, an extract of periwinkle called vinpocetine was shown to produce minor
improvements in short-term memory among people taking flunitrazepam, a
benzodiazepine.1 Further study is needed to determine if vinpocetine would be a
helpful adjunct to use of benzodiazepines.
Interactions with Herbs —
Kava is an herb used to treat anxiety disorder. One individual who took a benzodiazepine (alprazolam) and kava together, along with two
other medications (cimetidine and terazosin) was hospitalized in a lethargic and
disoriented condition.2 Further research is needed to determine whether the
combination of kava and benzodiazepines produces an adverse interaction. However, individuals
should not take benzodiazepines and kava together unless supervised by a doctor.
St. John's wort
In a study of healthy volunteers, administration of St. John's wort along with alprazolam
decreased blood levels of alprazolam, compared with the levels when alprazolam was taken by
itself.3 Individuals taking alprazolam should not take St. John's wort without
supervision by a doctor.
Interactions with Foods and Other Compounds
Drinking alcoholic beverages while taking benzodiazepines may increase side effects, such as
drowsiness, confusion, and dizziness;4 if taken in excess, this combination may
result in death. Consequently, people taking benzodiazepines should avoid drinking
1. Bhatti JZ, Hindmarch I. Vinpocetine effects on cognitive impairments
produced by flunitrazepam. Int Clin Psychopharmacol 1987;2:325–31.
2. Almeida JC. Coma from the health food store: Interaction between kava
and alprazolam. Ann Intern Med 1996;125:940–1.
3. Markowitz JS, Donovan JL, DeVane CL, et al. Effect of St John's wort
on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA
4. Olin BR, ed. Central Nervous System Drugs, Psychotherapeutic Drugs,
Antianxiety Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and
Comparisons, 1993, 1255–69.