Acacia Rigidula + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine brand names: Tylenol Cold Ex Strength, Children's Tylenol Cold Plus Cough.
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls into 3 drug categories that Acacia Rigidula can interact with; the most serious is rated moderate. Theoretically, Acacia rigidula products that are adulterated with beta-methylphenylethylamine (BMPEA) might increase the levels of CYP2D6 substrates.
Read the full interaction reportAcacia Rigidula and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Acacia Rigidula interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls into 3 of those categories, so it can interact with Acacia Rigidula in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 3Why this applies to Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Acacia Rigidula interacts with.
In vitro research shows that BMPEA, an adulterant found in many Acacia rigidula products, strongly inhibits CYP2D6 enzyme.
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.
Here's the thing with this combo cold medicine: one of its ingredients, dextromethorphan (the cough suppressant), is broken down by a liver enzyme called CYP2D6. Some Acacia rigidula products have been found spiked with a stimulant called BMPEA, and in lab tests BMPEA can block that same enzyme. If it slows the breakdown of dextromethorphan, levels could creep up, which may mean more drowsiness, dizziness, or feeling foggy.
I'll be honest though, this is theoretical and based only on test-tube research, so I wouldn't lose sleep over it. The bigger worry is that pseudoephedrine and a hidden stimulant together could raise your heart rate and blood pressure. Please check with your pharmacist before mixing these.
- 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
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that BMPEA, an adulterant found in many Acacia rigidula products, inhibits CYP3A4 enzyme by 37%.
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.
Here's the bigger picture with this combo. Some Acacia rigidula products have been found spiked with a hidden stimulant called BMPEA. In lab dishes, BMPEA slowed down the CYP3A4 enzyme by about a third. That's the same enzyme that helps clear dextromethorphan (the cough suppressant in this product), so in theory levels could creep up and bring more dizziness, drowsiness, or feeling foggy.
But there's another angle that worries me more. Acacia rigidula acts like a stimulant, and so does the pseudoephedrine in this cold medicine. Stacking two stimulants can push your heart rate and blood pressure up and leave you jittery or unable to sleep. The CYP3A4 piece is only lab-level evidence, so it's theoretical. Even so, I'd skip the Acacia product and check with your pharmacist first.
- 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
STIMULANT DRUGS
3 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine also falls under STIMULANT DRUGS.
Constituents and adulterants found in Acacia rigidula can have stimulant effects.
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.
Here's the thing to watch with this combination cold medicine: one of its four ingredients, pseudoephedrine, is itself a stimulant. It bumps up your heart rate and can tighten blood vessels, which is why a stuffy nose clears but your heart may also race a little. Acacia rigidula products often contain their own stimulant-like compounds, and some have even been found spiked with an unapproved stimulant called BMPEA.
Stacking two stimulants together can theoretically push things too far, think a pounding or racing heartbeat, higher blood pressure, jitteriness, or trouble sleeping. This concern is based on how these ingredients work, not on solid human studies, so it's more caution than proven danger. Honestly, I'd steer clear of Acacia rigidula altogether, but please run it by your pharmacist or doctor first.
- Pawar RS, Grundel E, Fardin-Kia AR, Rader JI. Determination of selected biogenic amines in Acacia rigidula plant materials and dietary supplements using LC-MS/MS methods. J Pharm Biomed Anal. 2014 Jan;88:457-66. doi: 10.1016/j.jpba.2013.09.012. Epub 2013 PubMed
- Cohen PA, Bloszies C, Yee C, Gerona R. An amphetamine isomer whose efficacy and safety in humans has never been studied, ß-methylphenylethylamine (BMPEA), is found in multiple dietary supplements. Drug Test Anal. 2015 Apr 7. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Acacia Rigidula Also Interacts With Other Medications
Acacia Rigidula has 812 moderate known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Acacia Rigidula
We haven’t checked that one against Acacia Rigidula yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Acacia Rigidula. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
This page covers Acacia Rigidula only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page lists 301 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Ephedra (major) and Grapefruit (major).
By severity: 14 major · 242 moderate · 45 minor.
From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page
“Because Tylenol Cold Extra Strength packs four drugs into one dose (acetaminophen, chlorpheniramine, dextromethorphan, and pseudoephedrine), its supplement list runs to 301 ingredients, and 14 carry a major rating, so I'd approach this one with real care. The biggest hazards mirror the drugs themselves.”
Reviewed by 2 · Jul 18, 2026
Open the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction page
Where Acacia Rigidula and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine 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.
#604 of 1,452 supplements looked up here in the last 7 days
#75 of 2,830 medications looked up here in the last 7 days
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.
About Acacia Rigidula
What is Acacia Rigidula?
- Weight loss
- Energy and stimulation
- Boosting metabolism
- Appetite control
- Pre-workout/athletic performance
Acacia rigidula is a shrub from Texas and Mexico that is marketed in weight-loss and energy supplements. There is very little reliable human evidence that it works, and some products have been found to contain an unapproved stimulant drug (BMPEA), which raises real safety concerns. Most people should avoid it and talk to a pharmacist or doctor before trying any product containing it.
Other Drugs & Acacia Rigidula
Browse every other medication we’ve checked against Acacia Rigidula — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
812 interactions
- Diltiazem ›
- Nifedipine ›
- Phentermine ›
- Hydrocortisone ›
- Methylphenidate ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Phenylpropanolamine ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Nicotine ›
- Oxybutynin ›
- Oxycodone ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Miconazole ›
- Morphine Sulfate ›
- Phenylephrine ›
- Pseudoephedrine ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Diethylpropion ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Nortriptyline ›
- Propoxyphene ›
- Rifampin ›
- Testosterone Undecanoate ›
- Aripiprazole ›
- Caffeine (otc Drug) ›
- Ciclesonide ›
- Clonazepam ›
- Cyclobenzaprine ›
- Dapsone ›
- Desipramine ›
Showing 60 of 812 moderate interactions — see all 812 on the Acacia Rigidula page.
No interaction 2,017 drugs checked — show the list
We also checked Acacia Rigidula against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Ivermectin ›
- Acetaminophen ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Tirzepatide ›
- Docusate ›
- Ibuprofen ›
- Sumatriptan ›
- Valacyclovir ›
- Hydroxyurea ›
- Isotretinoin ›
- Semaglutide ›
- Metformin ›
- Methotrexate ›
- Amoxicillin ›
- Lisinopril ›
- Bupropion ›
- Bendamustine ›
- Doxycycline ›
- Pregabalin ›
- Azithromycin ›
- Lamotrigine ›
- Acyclovir ›
- Levothyroxine, Liothyronine ›
- Gabapentin ›
- Naproxen ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Acetaminophen, Aspirin ›
- Acetylsalicylic Acid ›
- Cephalexin ›
- Cyclopentolate ›
- Ezetimibe ›
- Carbidopa, Levodopa ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Roxithromycin ›
- Levetiracetam ›
- Mannitol ›
- Thyroid Hormone ›
- Insulin Degludec, Liraglutide ›
- Levodopa ›
- Spironolactone ›
- Valsartan ›
- Mitomycin ›
- Canagliflozin, Metformin ›
- Alginic Acid, Aluminum Hydroxide ›
- Levothyroxine Sodium ›
- Atenolol ›
- Magnesium Hydroxide (otc Drug) ›
- Phentermine, Topiramate ›
- Minoxidil ›
- Acetaminophen, Ibuprofen ›
- Abrocitinib ›
- Acenocoumarol ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Acarbose ›
Showing the 60 most looked-up of 2,017 medications checked with no known interaction — see the full Acacia Rigidula list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine as a medicine that can lower these. This is not an interaction with Acacia Rigidula — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Acacia Rigidula and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Together: Common Questions
Can you take Acacia Rigidula with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
Why are there 3 interactions listed for Acacia Rigidula and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
How serious is the Acacia Rigidula and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine and Acacia Rigidula?
Our pharmacists answer your medication & supplement questions — free.
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.