Drug & supplement interaction

1,4-butanediol + Homatropine Methylbromide, Hydrocodone

Homatropine Methylbromide, Hydrocodone brand names: Hycodan, Tussigon.

Major Interaction
The bottom line Major

Homatropine Methylbromide, Hydrocodone falls into 2 drug categories that 1,4-butanediol can interact with; the most serious is rated major. Theoretically, concomitant use of 1,4-butanediol with CNS depressants may potentiate respiratory and CNS depression.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

1,4-butanediol and Homatropine Methylbromide, Hydrocodone

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

1,4-butanediol interacts with whole categories of medication. Homatropine Methylbromide, Hydrocodone falls into 2 of those categories, so it can interact with 1,4-butanediol in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

CNS DEPRESSANTS

1 of 2

Why this applies to Homatropine Methylbromide, Hydrocodone

Homatropine Methylbromide, Hydrocodone falls under CNS DEPRESSANTS — the group 1,4-butanediol interacts with.

Theoretically, concomitant use of 1,4-butanediol with CNS depressants may potentiate respiratory and CNS depression.
1,4-Butanediol is metabolized to gamma-hydroxybutyrate (GHB). Concomitant use of CNS depressants with GHB may cause serious CNS and respiratory depression.
Severity Major Likelihood Probable Evidence D

Interaction 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..

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

First, an honest word about 1,4-butanediol: it is not a real supplement. Once swallowed, your body turns it into GHB, a strong substance that slows down the brain and breathing. That alone makes it dangerous.

Hycodan contains hydrocodone, an opioid cough and pain medicine that already calms the brain and slows breathing. Stacking two depressants together can add up fast. The realistic worry here is deep drowsiness, confusion, very slow or shallow breathing, blue lips, and even loss of consciousness. The homatropine part can also worsen dry mouth and drowsiness. This warning is based mostly on case reports, but the danger is serious enough that I would not combine them. Please talk with your doctor or pharmacist before using either.

References
  1. Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8. DOI
  2. Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.
Major

NARCOTIC DRUGS

2 of 2

Homatropine Methylbromide, Hydrocodone also falls under NARCOTIC DRUGS.

Theoretically, concomitant use of 1,4-butanediol with narcotic drugs may potentiate respiratory and central nervous system (CNS) depression. 1,4-Butanediol is metabolized to gamma-hydroxybutyrate (GHB).
Concomitant use of narcotic drugs with GHB may cause serious CNS and respiratory depression. In one case report, concurrent use of GHB and heroin was fatal.
Severity Major Likelihood Probable Evidence D

Interaction 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..

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

Let me be blunt about this one. 1,4-butanediol is not a real supplement. Your body turns it into GHB, a powerful sedative that slows down your brain and your breathing. Hycodan contains hydrocodone, an opioid that does the very same thing. Stacking two depressants together is the dangerous part here.

Put simply, the two effects pile on top of each other. You could become very drowsy, hard to wake up, breathe too slowly, or stop breathing altogether. A real case report describes someone dying from GHB combined with another opioid (heroin), so this is not just theory. There is no safe way to combine these. Please steer clear of 1,4-butanediol entirely, and talk with your pharmacist or doctor if you have any questions.

References
  1. Anon. Important message for health professionals: Report serious adverse events associated with dietary supplements containing GBL, GHB or BD. Food and Drug Administration, Rockville, MD. August 25, 1999. Available at: http://vm.cfsan.fda.gov/~dms/mwg
  2. Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8. DOI
  3. Ferrara SD, Tedeschi L, Frison G, Rossi A. Fatality due to gamma-hydroxybutyric acid (GHB) and heroin intoxication. J Forensic Sci 1995;40:501-4. DOI
  4. Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.

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

1,4-butanediol Also Interacts With Other Medications

1,4-butanediol has 249 major, 21 moderate known drug interactions in our database — the Homatropine Methylbromide, Hydrocodone one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against 1,4-butanediol

Covers the 2,830 medications we’ve checked against 1,4-butanediol. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Homatropine Methylbromide, Hydrocodone

This page covers 1,4-butanediol only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Homatropine Methylbromide, Hydrocodone page lists 233 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Grapefruit (major) and Henbane (major).

By severity: 11 major · 181 moderate · 41 minor.

From our pharmacist’s overview on the Homatropine Methylbromide, Hydrocodone page

“Hycodan (homatropine with hydrocodone) is an opioid cough medicine, so the real danger on this list is anything that deepens sedation or slows breathing, and 78 of the 233 supplements and herbs on file do exactly that. Alcohol, whether beer or wine, sits among the 11 major-rated entries with solid human evidence behind it.”

Reviewed by 2 · Jul 18, 2026

Open the Homatropine Methylbromide, Hydrocodone interaction page

How much people look this up

Where 1,4-butanediol and Homatropine Methylbromide, Hydrocodone 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 1,4-butanediol
Steady interest

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

29 days ago today
Medication Homatropine Methylbromide, Hydrocodone
Top 10%

#226 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 1,4-butanediol

What is 1,4-butanediol?

  • Marketed illegally as a 'recreational' or party substance
  • Falsely sold as a sleep aid
  • Falsely promoted for bodybuilding or muscle growth
  • Industrial solvent and chemical manufacturing

1,4-butanediol is a toxic industrial chemical, not a safe dietary supplement. Once swallowed, the body converts it into GHB, a powerful central nervous system depressant that can cause coma, dangerous breathing problems, addiction, and death. It should never be taken as a supplement or recreational substance.

Read the full 1,4-butanediol monograph & all interactions
Keep checking

Other Drugs & 1,4-butanediol

Browse every other medication we’ve checked against 1,4-butanediol — both the ones with a known interaction and the ones without. Select any drug for the full detail.

249Major
21Moderate
0Minor
2,559No known interaction
Major

249 interactions

Showing 60 of 249 major interactions — see all 249 on the 1,4-butanediol page.

Moderate

21 interactions

No interaction 2,559 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 1,4-butanediol and Homatropine Methylbromide, Hydrocodone Together: Common Questions

Can you take 1,4-butanediol with Homatropine Methylbromide, Hydrocodone?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for 1,4-butanediol and Homatropine Methylbromide, Hydrocodone?
Homatropine Methylbromide, Hydrocodone belongs to more than one drug category, and 1,4-butanediol interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the 1,4-butanediol and Homatropine Methylbromide, Hydrocodone interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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.