Drug & supplement interaction

1,3-dmaa + Dextromethorphan HBr

Dextromethorphan HBr brand name: Vicks Formula 44 Cough Relief.

Moderate Interaction
The bottom line Moderate

1,3-dmaa has a moderate interaction with Dextromethorphan HBr. 1,3-DMAA strongly inhibits cytochrome P450 2D6 (CYP2D6) enzymes in vitro.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

1,3-dmaa and Dextromethorphan HBr

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Dextromethorphan HBr

Dextromethorphan HBr falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group 1,3-dmaa interacts with.

1,3-DMAA strongly inhibits cytochrome P450 2D6 (CYP2D6) enzymes in vitro. Theoretically, 1,3-DMAA can increase levels of CYP2D6 substrates. Some of drugs that are CYP2D6 substrates include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for your cough medicine. Dextromethorphan (the active ingredient in Vicks Formula 44) is cleared from your body mainly by a liver enzyme called CYP2D6. In lab studies, DMAA appears to block that enzyme. If that holds true in people, the dextromethorphan could hang around longer and build up, which may bring on more of its usual effects like drowsiness, dizziness, nausea, or even feeling confused or oddly stimulated.

I want to be honest, though: this is based only on test-tube data, so it's more of a theoretical concern than something we've watched happen in real patients. The bigger worry is DMAA itself, which regulators have pulled from the market as unsafe. I'd skip the DMAA entirely and check with your pharmacist before combining anything like this.

References
  1. Liu Y, Santillo MF. Cytochrome P450 2D6 and 3A4 enzyme inhibition by amine stimulants in dietary supplements. Drug Test Anal. 2016;8(3-4):307-10. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

1,3-dmaa Also Interacts With Other Medications

1,3-dmaa has 320 moderate known drug interactions in our database — the Dextromethorphan HBr one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against 1,3-dmaa

Covers the 2,830 medications we’ve checked against 1,3-dmaa. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Dextromethorphan HBr

This page covers 1,3-dmaa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dextromethorphan HBr page lists 171 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lithium (major), St. John's Wort (major) and 5-htp (moderate).

By severity: 4 major · 125 moderate · 42 minor.

From our pharmacist’s overview on the Dextromethorphan HBr page

“Dextromethorphan, the cough suppressant in Vicks Formula 44, feels too ordinary to worry about, yet this list warrants real care, and the four major entries among its 171 ingredients are the ones to understand first. Grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Dextromethorphan HBr interaction page

One more smart check

Taking 1,3-dmaa as Part of a Dietary Supplement Product? Check It for Interactions

We hold 94 real supplement products containing 1,3-dmaa, each one broken down to its full ingredient list — and combination products often carry several ingredients besides 1,3-dmaa. Your product may carry other ingredients that interact with Dextromethorphan HBr too, on top of 1,3-dmaa — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where 1,3-dmaa and Dextromethorphan HBr Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement 1,3-dmaa
Top half

#424 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Dextromethorphan HBr
Top 25%

#494 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About 1,3-dmaa

What is 1,3-dmaa?

1,3-dmaa
  • Energy and stimulation
  • Pre-workout performance
  • Weight loss
  • Appetite suppression
  • Focus and concentration

DMAA (1,3-dimethylamylamine) is a synthetic stimulant that was sold in pre-workout and weight-loss supplements but has been linked to serious harm, including high blood pressure, heart problems, strokes, and deaths. The U.S. FDA and regulators in many countries have declared it illegal and unsafe in dietary supplements, so it should be avoided.

Read the full 1,3-dmaa monograph & all interactions
Keep checking

Other Drugs & 1,3-dmaa

Browse every other medication we’ve checked against 1,3-dmaa — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
320Moderate
0Minor
2,509No known interaction
Moderate

320 interactions

Showing 60 of 320 moderate interactions — see all 320 on the 1,3-dmaa page.

No interaction 2,509 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking 1,3-dmaa and Dextromethorphan HBr Together: Common Questions

Can you take 1,3-dmaa with Dextromethorphan HBr?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the 1,3-dmaa and Dextromethorphan HBr interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.