Bacopa + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr
Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr brand name: Vicks Formula 44M Cough, Cold & Flu Relief.
Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr falls into 3 drug categories that Bacopa can interact with; the most serious is rated moderate. Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Read the full interaction reportBacopa and Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Bacopa interacts with whole categories of medication. Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr falls into 3 of those categories, so it can interact with Bacopa 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 Maleate, Dextromethorphan HBr
Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Bacopa interacts with.
Research on the effects of bacopa extracts on CYP1A2 enzymes is conflicting. Some in vitro evidence shows that bacopa extract can moderately and non-competitively inhibit CYP1A2, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
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 honest picture with this cough and cold combo (the Vicks Formula 44M product that pairs acetaminophen, chlorpheniramine, and dextromethorphan). In a test tube, bacopa has shown a mild ability to slow down a liver enzyme called CYP1A2. If that happened in your body, the ingredients cleared partly through that pathway could hang around a bit longer, which in theory might mean a little more drowsiness or grogginess from the chlorpheniramine, or more of dextromethorphan's effects like dizziness.
That said, the lab evidence is mixed, and none of these are prodrugs that bacopa would weaken. This is a theoretical concern, not something proven in people. Still, since this medicine already causes sleepiness, it's worth a quick word with your pharmacist before combining them.
- Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
- Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 3Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Research on the effects of bacopa extracts on CYP3A4 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and competitively inhibit CYP3A4, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
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 (the acetaminophen, chlorpheniramine, and dextromethorphan in Vicks Formula 44M) is partly handled by a liver enzyme called CYP3A4. In test-tube studies, bacopa might mildly slow that enzyme down. If that happened in the body, a little more of the dextromethorphan portion could linger, which could mean extra drowsiness or dizziness on top of the sleepiness chlorpheniramine already causes.
Here's the reassuring part: this is only theoretical, based on lab studies that actually disagree with each other, so a real-world problem is unlikely. None of these are prodrugs that bacopa would weaken. Still, since both can make you sleepy, go easy and check with your pharmacist if you take bacopa regularly.
- Kar A, Pandit S, Mukherjee K, Bahadur S, Mukherjee PK. Safety assessment of selected medicinal food plants used in Ayurveda through CYP450 enzyme inhibition study. J Sci Food Agric 2017;97(1):333-40. doi: 10.1002/jsfa.7739. PubMed
- Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014;19(2):2588-601. PubMed
ANTICHOLINERGIC DRUGS
3 of 3Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr also falls under ANTICHOLINERGIC DRUGS.
Bacopa seems to inhibit acetylcholinesterase and might increase acetylcholine levels, which could counteract the effects of anticholinergic drugs. Similarly, anticholinergic drugs might counteract the cholinergic effects of bacopa.
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.
The piece of this combo product that matters here is the chlorpheniramine, an antihistamine that works by blocking acetylcholine, one of the body's chemical messengers. Bacopa is thought to do the opposite, nudging acetylcholine levels up a bit. In theory, the two could partly cancel each other out, so the chlorpheniramine might not control your runny nose or sneezing quite as well, and bacopa's effects could be blunted too. The acetaminophen (pain and fever) and dextromethorphan (cough) parts aren't really involved.
Honestly, this is a theoretical concern based on how each works, not real-world reports, so I wouldn't lose sleep over it. Still, if you take bacopa regularly, mention it to your pharmacist or doctor so they can keep an eye on things.
- Morgan A, Stevens J. Does Bacopa monnieri improve memory performance in older persons? Results of a randomized, placebo-controlled, double-blind trial. J Altern Complement Med 2010;16:753-9.
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.
Bacopa Also Interacts With Other Medications
Bacopa has 918 moderate, 13 minor known drug interactions in our database — the Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Bacopa
We haven’t checked that one against Bacopa yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Bacopa. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr
This page covers Bacopa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr page lists 275 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), Grapefruit (major) and Henbane (major).
By severity: 10 major · 220 moderate · 45 minor.
From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr page
“A three-drug cold formula like Vicks Formula 44M (acetaminophen, chlorpheniramine, and dextromethorphan) gives supplements three separate targets, so its interaction list warrants real vigilance, starting with the ten major-rated entries. The dominant patterns track each ingredient.”
Reviewed by 2 · Jul 18, 2026
Open the Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr interaction page
Taking Bacopa as Part of a Dietary Supplement Product? Check It for Interactions
We hold 1,420 real supplement products containing Bacopa, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bacopa. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr too, on top of Bacopa — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Bacopa and Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr 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.
#142 of 1,452 supplements looked up here in the last 7 days
#149 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 Bacopa
What is Bacopa?
- Memory and cognitive support
- Anxiety and stress
- ADHD symptoms
- Age-related memory decline
- General brain health
Bacopa is an Ayurvedic herb most often used for memory and thinking. Some small studies suggest it may modestly help memory when taken regularly for several weeks, but the evidence is limited and quality varies. It is generally well tolerated but can cause stomach upset, and it should be avoided in pregnancy and breastfeeding due to a lack of safety data.
Other Drugs & Bacopa
Browse every other medication we’ve checked against Bacopa — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
918 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Glycopyrrolate ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Ipratropium ›
- Miconazole ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Dimenhydrinate ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Meloxicam ›
- Nortriptyline ›
- Pilocarpine ›
- Procyclidine ›
- Rifampin ›
Showing 60 of 918 moderate interactions — see all 918 on the Bacopa page.
13 interactions
No interaction 1,898 drugs checked — show the list
We also checked Bacopa against these medications and found no known interaction in our sources. Open any page to confirm.
- Methylphenidate ›
- Ivermectin ›
- Rosuvastatin ›
- Aspirin ›
- Metoprolol ›
- Tirzepatide ›
- Isotretinoin ›
- Metformin ›
- Docusate ›
- Amphetamine ›
- Semaglutide ›
- Lisdexamfetamine ›
- Methamphetamine ›
- Sumatriptan ›
- Amoxicillin ›
- Lisinopril ›
- Valacyclovir ›
- Hydroxyurea ›
- Bupropion ›
- Methotrexate ›
- Azithromycin ›
- Doxycycline ›
- Pregabalin ›
- Gabapentin ›
- Lamotrigine ›
- Dextroamphetamine ›
- Acyclovir ›
- Duloxetine ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Acetylsalicylic Acid ›
- Bisoprolol ›
- Insulin Degludec, Liraglutide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aminophylline, Amobarbital, Ephedrine ›
- Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate ›
- Aspirin, Butalbital ›
- Atenolol, Chlorthalidone ›
- Enalapril Maleate ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Ezetimibe ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Aspirin, Ethoheptazine, Meprobamate ›
- Cephalexin ›
- Ephedrine, Phenobarbital, Theophylline ›
- Canagliflozin, Metformin ›
- Insulin Aspart, Insulin Degludec ›
- Candesartan Cilexetil, Hydrochlorothiazide ›
- Levetiracetam ›
- Levodopa ›
- Daunorubicin, Cytarabine ›
- Carbidopa, Levodopa ›
- Atenolol ›
- Saxagliptin, Metformin Xr ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide ›
Showing the 60 most looked-up of 1,898 medications checked with no known interaction — see the full Bacopa 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 Maleate, Dextromethorphan HBr Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr as a medicine that can lower these. This is not an interaction with Bacopa — 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 Bacopa and Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr Together: Common Questions
Can you take Bacopa with Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr?
Why are there 3 interactions listed for Bacopa and Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr?
How serious is the Bacopa and Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr and Bacopa?
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.