Adrafinil + 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 Adrafinil can interact with; the most serious is rated moderate. Theoretically, adrafinil might reduce the levels and clinical effects of CYP1A2 substrates.
Read the full interaction reportAdrafinil and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Adrafinil interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls into 3 of those categories, so it can interact with Adrafinil in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 3Why this applies to Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Adrafinil interacts with.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP1A2 activity in vitro.
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.
This combo cold product mixes a pain reliever (acetaminophen), an antihistamine (chlorpheniramine), a cough suppressant (dextromethorphan), and a decongestant (pseudoephedrine). The concern here is mostly on paper. Once your liver turns adrafinil into modafinil, that modafinil may slightly speed up an enzyme called CYP1A2, which could nudge the levels of some of these ingredients down a bit.
In plain terms, the worry is that your cold medicine might work a touch less effectively, not that it becomes dangerous. Honestly, this is theoretical and based only on lab data, so for most people it's unlikely to be noticeable with occasional cold-medicine use. Since adrafinil is unregulated and hard on the liver, please run this past your pharmacist or doctor before combining them.
- Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
- Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed
- Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP3A4 activity.
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.
This cold and cough combo (Tylenol Cold) packs four ingredients: acetaminophen for pain and fever, chlorpheniramine for runny nose, dextromethorphan for cough, and pseudoephedrine to clear congestion. Once your liver turns adrafinil into modafinil, that modafinil can mildly speed up a liver enzyme called CYP3A4, which helps process some of these ingredients.
In plain terms, your body might clear parts of this medicine a little faster, so your cold relief could feel slightly weaker. Honestly, this concern is theoretical and based on how the chemistry works, not on real reports of problems, and modafinil is only a weak booster of that enzyme. I wouldn't lose sleep over it, but since adrafinil is unregulated and hard on the liver, run it by your pharmacist first.
- Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
- Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
STIMULANT DRUGS
3 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine also falls under STIMULANT DRUGS.
Adrafinil is a precursor to the prescription drug modafinil, which has 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.
This cold and cough product is a mix of four ingredients, and the one that matters here is pseudoephedrine, the decongestant. Pseudoephedrine is itself a mild stimulant. Adrafinil turns into modafinil in your body, which also revs things up. Stacked together, the concern is simply too much stimulation at once.
What that could feel like: a faster or pounding heartbeat, higher blood pressure, jitteriness, anxiety, and trouble sleeping (pseudoephedrine already keeps some people up at night). Keep in mind this is a theoretical concern based on how these drugs work, not strong human studies, so it is more about being aware than panicking. Still, if you take adrafinil, please check with your pharmacist or doctor before adding a decongestant cold medicine.
- Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
- Chariot J, Appia F, Vaille C, Rozé C. Effect of modafinil on pancreatic exocrine secretion in rats. A comparison with adrafinil and related drugs. Fundam Clin Pharmacol 1987;1(4):243-52. 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.
Adrafinil Also Interacts With Other Medications
Adrafinil has 1 major, 1,055 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 Adrafinil
We haven’t checked that one against Adrafinil yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Adrafinil. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
This page covers Adrafinil 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
Taking Adrafinil as Part of a Dietary Supplement Product? Check It for Interactions
We hold 7 real supplement products containing Adrafinil, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Adrafinil. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine too, on top of Adrafinil — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Adrafinil 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.
#658 of 1,452 supplements looked up here in the last 7 days
#105 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 Adrafinil
What is Adrafinil?
- Wakefulness and alertness
- Fatigue
- Focus and concentration
- Cognitive enhancement (nootropic)
- Daytime sleepiness
Adrafinil is a synthetic compound that the body converts into modafinil, a prescription wakefulness-promoting drug. It is sometimes sold as a nootropic supplement, but it is unregulated, carries real risks (especially to the liver), and is banned in some sports and countries. Talk with a doctor or pharmacist before using it.
Other Drugs & Adrafinil
Browse every other medication we’ve checked against Adrafinil — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1 interaction
1,055 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Phentermine ›
- Hydrocortisone ›
- Methylphenidate ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Phenylpropanolamine ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Nicotine ›
- Orphenadrine ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Miconazole ›
- Phenylephrine ›
- Pseudoephedrine ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Diethylpropion ›
- Everolimus ›
Showing 60 of 1,055 moderate interactions — see all 1,055 on the Adrafinil page.
No interaction 1,773 drugs checked — show the list
We also checked Adrafinil against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Ivermectin ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Tirzepatide ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Semaglutide ›
- Metformin ›
- Amoxicillin ›
- Isotretinoin ›
- Methotrexate ›
- Doxycycline ›
- Acyclovir ›
- Azithromycin ›
- Lamotrigine ›
- Pregabalin ›
- Gabapentin ›
- Levothyroxine, Liothyronine ›
- Methylene Blue ›
- Duloxetine ›
- Amoxicillin, Clavulanate Potassium ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Cyclopentolate ›
- Cephalexin ›
- Levetiracetam ›
- Ezetimibe ›
- Acetylsalicylic Acid ›
- Phentermine, Topiramate ›
- Levothyroxine Sodium ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Pizotifen ›
- Venlafaxine ›
- Daptomycin ›
- Levodopa ›
- Hexobarbitone ›
- Lenvatinib ›
- Mitomycin ›
- Canagliflozin, Metformin ›
- Flutemetamol F-18 ›
- Magnesium Hydroxide (otc Drug) ›
- Insulin Degludec, Liraglutide ›
- Pegunigalsidase Alfa-iwxj ›
- Bentoquatam ›
- Cefaclor ›
- Alglucosidase Alpha ›
- Factor 7a ›
- Salbutamol Sulfate ›
- Azelaic Acid ›
- Insulin Human, Sodium Chloride ›
- Tocainide ›
- Ribavirin Aerosol ›
- Hydroxychloroquine ›
- Bleomycin ›
- Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide ›
- Casanthranol, Docusate ›
Showing the 60 most looked-up of 1,773 medications checked with no known interaction — see the full Adrafinil 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 Adrafinil — 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 Adrafinil and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Together: Common Questions
Can you take Adrafinil with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
Why are there 3 interactions listed for Adrafinil and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
How serious is the Adrafinil 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 Adrafinil?
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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.