Acacia Rigidula + Dextromethorphan, Guaifenesin, Pseudoephedrine
Dextromethorphan, Guaifenesin, Pseudoephedrine brand names: Pseudovent DM, Profen Forte DM, Profen II DM, Med Rx DM, Protuss DM, and others.
Dextromethorphan, Guaifenesin, 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 Dextromethorphan, Guaifenesin, 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. Dextromethorphan, Guaifenesin, 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 Dextromethorphan, Guaifenesin, Pseudoephedrine
Dextromethorphan, Guaifenesin, 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 concern with this combo. Some Acacia rigidula products have been found spiked with a stimulant called BMPEA, and in lab studies BMPEA blocks an enzyme called CYP2D6. Your liver uses that same enzyme to clear dextromethorphan, the cough-suppressing part of this medicine. If that breakdown slows down, dextromethorphan can build up and you may feel more drowsy, dizzy, or foggy, and rarely something more serious can happen if it stacks with other serotonin-acting drugs.
On top of that, this product already contains pseudoephedrine, a stimulant, and Acacia rigidula is also marketed as a stimulant, so together they could push your heart rate and blood pressure up. To be fair, this interaction is based only on lab data, not people. Still, I'd avoid this supplement 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
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 3Dextromethorphan, Guaifenesin, 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 thing to know about combining acacia rigidula with this cough and cold combo (which contains dextromethorphan, guaifenesin, and pseudoephedrine). Some acacia products have been found spiked with a hidden stimulant called BMPEA. In a lab dish, BMPEA slowed down a liver enzyme called CYP3A4 by about a third. Since dextromethorphan leans on that pathway, blocking it could let it build up a bit, which may mean more drowsiness, dizziness, or feeling foggy.
On top of that, both pseudoephedrine and the stimulant amines in acacia rev up the body, so stacking them could leave you with a racing heart, jitters, higher blood pressure, or trouble sleeping. This is theoretical and based only on lab work, so don't panic, but please check with your pharmacist or doctor before mixing them.
- 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 3Dextromethorphan, Guaifenesin, 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 combo. Your cold medicine already contains pseudoephedrine, which is a stimulant that can speed up your heart, nudge your blood pressure up, and leave you feeling jittery or wired. Acacia rigidula products may carry their own stimulant-like compounds (and some have even been found spiked with an unapproved drug called BMPEA). Stacking two stimulants together can stack those effects, so the worry is a faster or pounding heartbeat, a higher blood pressure, anxiety, or trouble sleeping.
To be fair, this concern is mostly theoretical, based on how these ingredients behave rather than solid studies. Still, because of the heart-related risks and the iffy quality of these products, I'd skip the Acacia and check with 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 Dextromethorphan, Guaifenesin, 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 Dextromethorphan, Guaifenesin, Pseudoephedrine
This page covers Acacia Rigidula only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dextromethorphan, Guaifenesin, Pseudoephedrine page lists 198 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Ephedra (major), Grapefruit (major), Lithium (major) and Peyote (major).
By severity: 8 major · 149 moderate · 41 minor.
Open the Dextromethorphan, Guaifenesin, Pseudoephedrine interaction page
Where Acacia Rigidula and Dextromethorphan, Guaifenesin, 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.
#624 of 1,452 supplements looked up here in the last 7 days
#700 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 ›
- Ibuprofen ›
- Docusate ›
- Sumatriptan ›
- Valacyclovir ›
- Isotretinoin ›
- Hydroxyurea ›
- Semaglutide ›
- Metformin ›
- Methotrexate ›
- Lisinopril ›
- Amoxicillin ›
- Bupropion ›
- Doxycycline ›
- Bendamustine ›
- Pregabalin ›
- Azithromycin ›
- Levothyroxine, Liothyronine ›
- Lamotrigine ›
- Acyclovir ›
- Gabapentin ›
- Naproxen ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Acetaminophen, Aspirin ›
- Acetylsalicylic Acid ›
- Cephalexin ›
- Cyclopentolate ›
- Ezetimibe ›
- Carbidopa, Levodopa ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Insulin Degludec, Liraglutide ›
- Roxithromycin ›
- Levetiracetam ›
- Mannitol ›
- Thyroid Hormone ›
- Levodopa ›
- Spironolactone ›
- Valsartan ›
- Mitomycin ›
- Canagliflozin, Metformin ›
- Alginic Acid, Aluminum Hydroxide ›
- Acetaminophen, Ibuprofen ›
- Levothyroxine Sodium ›
- Atenolol ›
- Magnesium Hydroxide (otc Drug) ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Minoxidil ›
- Phentermine, Topiramate ›
- Abrocitinib ›
- Sacubitril, Valsartan ›
- Acenocoumarol ›
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
Taking Acacia Rigidula and Dextromethorphan, Guaifenesin, Pseudoephedrine Together: Common Questions
Can you take Acacia Rigidula with Dextromethorphan, Guaifenesin, Pseudoephedrine?
Why are there 3 interactions listed for Acacia Rigidula and Dextromethorphan, Guaifenesin, Pseudoephedrine?
How serious is the Acacia Rigidula and Dextromethorphan, Guaifenesin, Pseudoephedrine interaction?
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