Drug & supplement interaction

Aconite + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide

Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide brand names: Rhinogesic JR, Rhinogesic.

Moderate Interaction
The bottom line Moderate

Aconite has a moderate interaction with Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide. Theoretically, combining aconite with other stimulant drugs might alter the effects of the stimulant drug or increase the risk of cardiovascular toxicity.

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

Aconite and Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide

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

Moderate

STIMULANT DRUGS

Why this applies to Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide

Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide falls under STIMULANT DRUGS — the group Aconite interacts with.

Theoretically, combining aconite with other stimulant drugs might alter the effects of the stimulant drug or increase the risk of cardiovascular toxicity.
Aconite and its constituents have stimulant effects due to agonist activity at beta-2-adrenoreceptors. In cardiac muscle, aconite appears to have a positive inotropic effect and increases heart rate and blood pressure. However, some constituents of aconite can reduce heart rate and blood pressure.
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

The cold and allergy combo you're asking about contains phenylephrine, a decongestant that can nudge up your heart rate and blood pressure on its own. The concern here is that aconite can also act on the heart and blood vessels, sometimes speeding the heart up and raising blood pressure. Stacking the two could, in theory, add to that strain and raise the risk of heart-related problems like a racing heartbeat, palpitations, or higher blood pressure.

To be honest, this warning rests on lab and animal studies, not solid human data, so it's more of a caution than a proven danger. The bigger issue is aconite itself, which is genuinely toxic and best avoided. None of the medicine ingredients (acetaminophen, chlorpheniramine, salicylamide) need activating, so this isn't a prodrug situation. Please check with your pharmacist or doctor before mixing these.

References
  1. Yeih DF, Chiang FT, Huang SKS. Successful treatment of aconitine induced life threatening ventricular tachyarrhythmia with amiodarone. Heart 2000;84:E8. PubMed
  2. Lin CC, Chan TY, Deng JF. Clinical features and management of herb-induced aconitine poisoning. Ann Emerg Med 2004;43:574-9. PubMed
  3. Telang, B. V. and Ng'ang'a, J. N. Involvement of Central adrenergic mechanisms in the induction of cardiac arrhythmias by aconitine nitrate administered intraventricularly. Indian J Physiol Pharmacol. 1975;19(1):1-10.
  4. Kimura, I., Takada, M., and Nojima, H. Aconitine induces bradycardia through a transmission pathway including the anterior hypothalamus in conscious mice. Biol.Pharm Bull. 1997;20(8):856-860. PubMed
  5. Zhao D, Wang J, Cui Y, Wu X. Pharmacological effects of Chinese herb aconite (fuzi) on cardiovascular system. J Tradit Chin Med. 2012 Sep;32(3):308-13. 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

Aconite Also Interacts With Other Medications

Aconite has 277 moderate known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide 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 Aconite

Covers the 2,830 medications we’ve checked against Aconite. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide

This page covers Aconite only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide page lists 292 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 · 232 moderate · 46 minor.

From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide page

“I would slow down before pairing supplements with Rhinogesic (acetaminophen, chlorpheniramine, phenylephrine, salicylamide). Each part of this cold remedy opens a different door to trouble, so supplements can collide with it from several directions at once.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interaction page

One more smart check

Taking Aconite as Part of a Dietary Supplement Product? Check It for Interactions

We hold 56 real supplement products containing Aconite, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Aconite. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide too, on top of Aconite — 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 Aconite and Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide 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 Aconite
Steady interest

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

29 days ago today
Medication Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide
Top 25%

#500 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 Aconite

What is Aconite?

Aconite
  • Pain and nerve pain
  • Fever and cold or flu symptoms
  • Anxiety and restlessness (homeopathic use)
  • Inflammation and joint pain
  • Heart-related complaints (traditional use)

Aconite is a highly poisonous plant, and even small amounts of the raw or improperly processed root can cause severe, life-threatening reactions. There is no good scientific evidence that it safely treats any condition, and the only forms generally considered acceptable are extremely diluted homeopathic preparations. We strongly recommend avoiding raw or unprocessed aconite entirely and talking to a pharmacist or doctor before using any product containing it.

Read the full Aconite monograph & all interactions
Keep checking

Other Drugs & Aconite

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

0Major
277Moderate
0Minor
2,552No known interaction
Moderate

277 interactions

Showing 60 of 277 moderate interactions — see all 277 on the Aconite page.

No interaction 2,552 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 Aconite and Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide Together: Common Questions

Can you take Aconite with Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide?
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 Aconite and Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide 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

Still Have a Question About Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide and Aconite?

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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.