Published: 4 June 2026

Publications

Reported adverse reactions to ashwagandha

Published: 4 June 2026
Prescriber Update 47(2): 31
June 2026

Medsafe has received a number of reports of adverse reactions associated with ashwagandha-containing natural health products.

Ashwagandha, also known as Withania somnifera, is a herbal ingredient in some natural health products.

Since 2010, there have been 24 reports to the New Zealand Pharmacovigilance Database that included an ashwagandha-containing product. Of the 24 reports, 11 described gastrointestinal symptoms including nausea, vomiting and diarrhoea, which in some cases were severe or resulted in hospitalisation. There were 4 reports of liver-related adverse events. Liver toxicity attributed to ashwagandha has also been reported in the literature.¹

Consider natural health products as a cause of undesirable effects in patients. Report any suspected reactions to the New Zealand Pharmacovigilance Database. Reporting is easiest online.

Educate patients about the risks of buying natural health products or medicines via social media or unverified websites. These may be falsified products that contain harmful ingredients or impurities not listed on the label or promote misleading health claims that are not supported by clinical evidence. There is no regulatory assessment of the quality, safety or health claims of natural health products in New Zealand.

Reference

1. Koturbash I, Yeager RP, Mitchell CA, et al. 2024. Botanical-induced toxicity: Liver injury and botanical-drug interactions. A report on a society of Toxicology Annual Meeting symposium. Regulatory Toxicology and Pharmacology 153: 105708. DOI: 10.1016/j.yrtph.2024.105708 (accessed 10 April 2025).