Drug & supplement interaction

Aegeline + Tramadol, Acetaminophen

Tramadol, Acetaminophen brand name: Tramacet.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Aegeline has a minor interaction with Tramadol, Acetaminophen. Aegeline inhibits cytochrome P450 3A4 (CYP3A4) activity in vitro.

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

Aegeline and Tramadol, Acetaminophen

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

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Tramadol, Acetaminophen

Tramadol, Acetaminophen falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Aegeline interacts with.

Aegeline inhibits cytochrome P450 3A4 (CYP3A4) activity in vitro. So far, this interaction has not been reported in humans. Theoretically, aegeline may increase levels of drugs metabolized by CYP3A4. Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others. Use aegeline cautiously or avoid in patients taking these drugs.
Severity Minor 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

Here's the thing with Tramacet (tramadol plus acetaminophen): tramadol is partly handled by an enzyme called CYP3A4. In lab dishes, aegeline appears to slow that enzyme down. In theory, that could let a bit more tramadol hang around in your system, which might mean stronger effects like drowsiness, dizziness, nausea, or constipation. Tramadol can also lower the seizure threshold, so more drug on board is something to be mindful of.

That said, I want to keep this honest. This is only test-tube data, and it hasn't actually been seen in people. The bigger concern with aegeline is that it's been tied to serious liver injury and regulators have warned against it, so I'd steer clear of it entirely. Please check with your pharmacist or doctor before combining anything with Tramacet.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Manda VK, Avula B, Chittiboyina AG, Khan IA, Walker LA, Khan SI. Inhibition of CYP3A4 and CYP1A2 by Aegle marmelos and its constituents. Xenobiotica. 2016;46(2):117-25.

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

Aegeline Also Interacts With Other Medications

Aegeline has 642 minor known drug interactions in our database — the Tramadol, Acetaminophen one above is one of them. If you take anything else, check it against the full list below.

Minor 642 No known interaction 2,188 (incl. Tramadol, Acetaminophen)
Taking anything else?

Check Another of Your Medications Against Aegeline

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

Everything else you take

See Every Supplement That Interacts With Tramadol, Acetaminophen

This page covers Aegeline only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tramadol, Acetaminophen page lists 280 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Gamma-hydroxybutyrate (ghb) (major).

By severity: 12 major · 224 moderate · 44 minor.

From our pharmacist’s overview on the Tramadol, Acetaminophen page

“The combinations I worry about most with tramadol and acetaminophen (Tramacet) involve anything that deepens drowsiness or strains the liver. Tramadol is an opioid, so sedating supplements like kava, along with alcohol in any form, can slow breathing on top of adding sleepiness, which is why this list deserves genuine care rather than…”

Reviewed by 2 · Jul 18, 2026

Open the Tramadol, Acetaminophen interaction page

One more smart check

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

We hold 7 real supplement products containing Aegeline, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Aegeline. Your product may carry other ingredients that interact with Tramadol, Acetaminophen too, on top of Aegeline — 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 Aegeline and Tramadol, Acetaminophen 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 Aegeline
Steady interest

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

29 days ago today
Medication Tramadol, Acetaminophen
Top 25%

#553 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 Aegeline

What is Aegeline?

  • Weight loss
  • Fat burning / metabolism support
  • Sports and bodybuilding supplements
  • General 'energy' products

Aegeline is a compound originally identified in the bael tree (Aegle marmelos) that gained attention because it was added to some weight-loss and workout supplements. It is best known for being linked to serious liver injury in a product called OxyELITE Pro, and U.S. regulators warned against products containing it. There is no good evidence it safely helps with weight loss, and it should generally be avoided.

Read the full Aegeline monograph & all interactions
Keep checking

Other Drugs & Aegeline

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

0Major
0Moderate
642Minor
2,187No known interaction
642 Minor 2,187 No interaction
Minor

642 interactions

Showing 60 of 642 minor interactions — see all 642 on the Aegeline page.

No interaction 2,187 drugs checked — show the list

We also checked Aegeline against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,187 medications checked with no known interaction — see the full Aegeline list.

See the full Aegeline interactions page
See every supplement checked against Tramadol, Acetaminophen, ranked by severity
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

Keep exploring
Aegeline monograph › Uses, safety, and every drug interaction in one place Tramadol, Acetaminophen supplement interactions › Every supplement checked against Tramadol, Acetaminophen, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Aegeline and Tramadol, Acetaminophen Together: Common Questions

Can you take Aegeline with Tramadol, Acetaminophen?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Aegeline and Tramadol, Acetaminophen interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tramadol, Acetaminophen and Aegeline?

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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.