Meta Information
ID:bacopa-monnieri
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/dietary/high-fat-meal
Target name:
Meal Containing Fat
Severity:
moderate
Interaction type:
requirement
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The active compounds in Bacopa, bacosides, are fat-soluble, and their absorption is significantly improved when taken with dietary fats.
Actionable advice:
Bacopa Monnieri is best taken with a meal that includes some fat, like avocado, nuts, or olive oil.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
informational_none
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
There is insufficient safety data to recommend the use of Bacopa during pregnancy; its effects on fetal development are unknown.
Actionable advice:
Bacopa Monnieri should be strictly avoided during pregnancy.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
NatMed Pro Monograph: Bacopa
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is not known if the active compounds in Bacopa are excreted in breast milk or what effects they might have on a nursing infant.
Actionable advice:
Bacopa Monnieri should be strictly avoided while breastfeeding.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
It is not known if bacopa passes into breast milk.
Label source:
Anecdotal: WebMD
Action type:
avoid
Target id:
/class/cyp3a4-substrates
Target name:
Drugs Metabolized by CYP3A4
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa may induce (speed up) the activity of the CYP3A4 enzyme, which could lower the blood levels and effectiveness of many common medications.
Actionable advice:
It is important to talk to a doctor before use while taking medications metabolized by CYP3A4, such as certain statins or calcium channel blockers.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Blood pressure should be closely
monitored when Amlodipine is co-administered with CYP3A4 inducers.
Label source:
Action type:
informational_none
Target id:
/class/cyp2c9-substrates
Target name:
Drugs Metabolized by CYP2C9
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa may induce (speed up) the activity of the CYP2C9 enzyme, potentially reducing the effectiveness of drugs like warfarin or NSAIDs.
Actionable advice:
This is best used with caution, and it is important to talk to a healthcare professional when taking medications metabolized by CYP2C9.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
CYP2C9, a polymorphic enzyme, is likely to be the principal form of human liver CYP450 that modulates the in vivo anticoagulant activity of warfarin.
Label source:
Action type:
informational_none
Target id:
/class/cholinesterase-inhibitors
Target name:
Cholinesterase Inhibitors
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa may increase acetylcholine levels, and taking it with cholinesterase inhibitors (used for Alzheimer's) could lead to an excessive cholinergic effect and increased side effects.
Actionable advice:
Bacopa is best not combined with cholinesterase inhibitors like donepezil or galantamine without medical supervision.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Current evidence suggests BM acts via the following mechanisms-anti-oxidant neuroprotection (via redox and enzyme induction), acetylcholinesterase inhibition and/or choline acetyltransferase activation, β-amyloid reduction, increased cerebral blood flow, and neurotransmitter modulation (acetylcholine [ACh], 5-hydroxytryptamine [5-HT], dopamine [DA]).
Label source:
PubMed: Rejuvenation research (2013)
Source url:
Exact phrase from label:
The suppression of plasma AChE activity was also observed. These results suggest that B. monnieri can improve attention, cognitive processing, and working memory partly via the suppression of AChE activity.
Label source:
PubMed: Evidence-based complementary and alternative medicine : eCAM (2012)
Source url:
Exact phrase from label:
CONCLUSIONS: To our knowledge, there has only been one other documented cevimeline overdose, and it was not associated with an herbal supplementation interaction. Physicians should actively elicit herbal supplement information from patients to anticipate possible drug-herb interactions.
Label source:
PubMed: Journal of medical case reports (2022)
Action type:
avoid
Target id:
/class/anticholinergic-medications
Target name:
Anticholinergic Medications
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa may increase levels of the neurotransmitter acetylcholine, which could counteract and reduce the effectiveness of anticholinergic drugs used for conditions like incontinence or COPD.
Actionable advice:
Bacopa is best avoided with anticholinergic medications, as it may reduce their efficacy.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
On the basis of the present results it can be concluded that bacosides facilitate anterograde memory and attenuate anterograde experimental amnesia induced by scopolamine and sodium nitrite possibly by improving acetylcholine level and hypoxic conditions, respectively.
Label source:
PubMed: Effect of bacosides, alcoholic extract of Bacopa monniera Linn. (brahmi), on experimental amnesia in mice. (PMID 16053272)
Action type:
avoid
Target id:
/class/cns-depressants
Target name:
Sedatives and CNS Depressants
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa can cause drowsiness and may have an additive sedative effect when combined with other CNS depressants like benzodiazepines, barbiturates, or alcohol.
Actionable advice:
Other sedatives or alcohol are best avoided, especially when driving or operating machinery.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/intervention/levothyroxine
Target name:
Levothyroxine (Thyroid Hormone)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Animal studies suggest Bacopa may stimulate the thyroid gland and increase thyroxine (T4) levels, potentially leading to an overactive thyroid state when combined with thyroid medication.
Actionable advice:
It is a good idea to consult a doctor and monitor thyroid function closely for those who take thyroid hormones and wish to use Bacopa.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Inform patients that agents such as iron and calcium supplements and antacids can decrease the absorption of levothyroxine.
Label source:
FDA label: Levothyroxine (Synthroid)
Action type:
monitor
Target id:
/condition/thyroid-disorders
Target name:
Thyroid Disorders
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Because Bacopa may increase thyroid hormone production, it could potentially worsen hyperthyroidism or alter the medication needs for hypothyroidism.
Actionable advice:
This is best used with caution and under medical supervision in those with any thyroid condition.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
T(4) concentration was increased by B. monnieri extract suggesting its thyroid-stimulating role.
Label source:
PubMed: Journal of ethnopharmacology (2002)
Source url:
Exact phrase from label:
B. monnieri could increase T(4) concentration by 41% without enhancing hepatic lipid peroxidation (LPO) suggesting that it can be used as a thyroid-stimulating drug.
Label source:
PubMed: Journal of ethnopharmacology (2002)
Source url:
Exact phrase from label:
However, interactions with certain medications and contraindications in conditions like hyperthyroidism should be considered.
Label source:
PubMed: Nutrients (2025)
Action type:
informational_none
Target id:
/condition/asthma-copd
Target name:
Asthma and COPD
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The cholinergic effects of Bacopa could theoretically cause bronchoconstriction (narrowing of the airways), which may worsen symptoms of asthma or COPD.
Actionable advice:
This is best used with caution, and it is important to talk to a doctor before taking Bacopa for those with asthma or COPD.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
informational_none
Target id:
/condition/bradycardia
Target name:
Bradycardia (Slow Heart Rate)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Due to its potential cholinergic effects, Bacopa might further slow the heart rate, which could be problematic for individuals with pre-existing bradycardia.
Actionable advice:
Bacopa is best avoided with a known slow heart rate, or used only under medical supervision.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/procedure/surgery
Target name:
Scheduled Surgery
Severity:
moderate
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
336
Hours after target:
null
Description:
Bacopa may interact with medications used during and after surgery, such as anesthetics (additive sedation) and anticholinergics, and could theoretically affect bleeding risk.
Actionable advice:
Bacopa should be discontinued at least 2 weeks before any scheduled surgery.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/class/cyp1a2-substrates
Target name:
Drugs Metabolized by CYP1A2
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa may inhibit (slow down) the CYP1A2 enzyme, which could increase the levels and side effects of substances like caffeine or theophylline.
Actionable advice:
Increased effects from caffeine or other CYP1A2 substrates are worth keeping in mind when taking Bacopa.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
B. monnieri extract exhibited non-competitive inhibition of CYP2C19 (IC50/Ki = 23.67/9.5 µg/mL), CYP2C9 (36.49/12.5 µg/mL), CYP1A2 (52.20/25.1 µg/mL); competitive inhibition of CYP3A4 (83.95/14.5 µg/mL) and weak inhibition of CYP2D6 (IC50 = 2061.50 µg/mL).
Label source:
PubMed: Molecules (Basel, Switzerland) (2014)
Source url:
Exact phrase from label:
These findings suggest that B. monnieri extract could contribute to herb-drug interactions when orally co-administered with drugs metabolized by CYP1A2, CYP3A4, CYP2C9 and CYP2C19.
Label source:
PubMed: Molecules (Basel, Switzerland) (2014)
Source url:
Exact phrase from label:
It has been previously demonstrated that B. monnieri alters cytochrome P450 enzymes.
Label source:
PubMed: Journal of medical case reports (2022)
Action type:
informational_none
Target id:
/class/cyp2d6-substrates
Target name:
Drugs Metabolized by CYP2D6
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa may weakly inhibit the CYP2D6 enzyme, potentially increasing levels and side effects of many antidepressants, antipsychotics, and beta-blockers.
Actionable advice:
It is worth watching out for increased side effects if medications metabolized by CYP2D6 are taken, and it is important to talk to a doctor.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: in vitro/preclinical data suggest bacopa constituents can inhibit CYP2D6, which could theoretically raise levels of CYP2D6-substrate drugs. Not confirmed in humans; low-certainty, monitoring-level caution.
Label source:
Class inference
Action type:
monitor
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa may have a mild blood pressure-lowering effect, which could be additive with antihypertensive drugs, potentially causing hypotension (low blood pressure).
Actionable advice:
It is a good idea to check blood pressure if Bacopa is combined with blood pressure-lowering medications.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
monitor
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
There is a theoretical concern that Bacopa could have mild antiplatelet effects, potentially increasing the risk of bleeding when combined with anticoagulant or antiplatelet drugs.
Actionable advice:
This is best used with caution, and it is worth talking to a doctor when taking blood-thinning medications.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Some botanicals may cause bleeding events when taken alone (e.g., garlic and Ginkgo biloba) and may have anticoagulant, antiplatelet, and/or fibrinolytic properties.
Label source:
Action type:
informational_none
Target id:
/class/serotonergic-agents
Target name:
Serotonergic Medications (SSRIs, SNRIs, etc.)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa has been shown to modulate serotonin systems. There is a theoretical risk of additive effects when combined with other serotonergic drugs, though this is not well-documented.
Actionable advice:
This is best used with caution, and it is worth monitoring for any unusual symptoms when combined with serotonergic medications.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
monitor
Target id:
/condition/urinary-retention
Target name:
Urinary Tract Obstruction / BPH
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Theoretically, increased cholinergic activity from Bacopa could worsen urinary tract obstructions.
Actionable advice:
Consulting a healthcare professional before use may help for those with a urinary tract obstruction or BPH.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
informational_none
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
minor
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
6
Hours after target:
null
Description:
Bacopa can cause fatigue or drowsiness in some individuals, which may interfere with daytime alertness if taken in the morning.
Actionable advice:
If Bacopa makes you feel tired, consider taking your full dose in the evening.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
After a thorough review, three possible pathways were identified: B. monnieri's effects on brain neurotransmitters responsible for circadian rhythm, hormonal regulation, and its effect on stress levels, which indirectly affect sleep quality.
Label source:
PubMed: Journal of medicinal food (2026)
Source url:
Exact phrase from label:
The included twenty-two clinical trials demonstrated that BM can reduce Nuclear Factor-κB phosphorylation, improve emotional function, cognitive functions, anhedonia, hyperactivity, sleep routine, depression, attention deficit, learning problems, memory retention, impulsivity, and psychiatric problems.
Label source:
PubMed: Antioxidants (Basel, Switzerland) (2024)
Source url:
Exact phrase from label:
The results showed that Bacopa monnieri can improve the cognitive performance overall score and some of its parameters, but it had no effect on sleep quality.
Label source:
PubMed: Explore (New York, N.Y.) (2024)
Action type:
informational_none
Target id:
/biomarker/thyroid-panel
Target name:
Thyroid Panel Blood Test
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Bacopa may physiologically increase T4 levels, which could lead to a misinterpretation of thyroid function tests. This is a true physiological effect, not a direct chemical interference with the test.
Actionable advice:
It is generally best to let a doctor know about Bacopa use when having thyroid levels checked.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
On the other hand, T(4) concentration was increased by B. monnieri extract suggesting its thyroid-stimulating role.
Label source:
PubMed/primary literature: https://pubmed.ncbi.nlm.nih.gov/12065164/
Action type:
monitor
Target id:
/condition/peptic-ulcer-disease
Target name:
Peptic Ulcer Disease (PUD)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Bacopa may increase gastric and intestinal secretions, which could potentially aggravate existing stomach ulcers.
Actionable advice:
Bacopa is best avoided with active peptic ulcers.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: bacopa has shown mucosal-protective/anti-ulcer activity in animal models (increased mucin, reduced ulcer index), so a harmful interaction with peptic ulcer disease is not established; net effect in humans is uncertain. Low-evidence, monitor.
Label source:
Class inference
Action type:
avoid
Temporal spacing:
Hours before target:
0
Hours after target:
0