Bacopa + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium brand name: Hista-Derfule.
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium 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, Phenylpropanolamine, Opium
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, Phenylpropanolamine, Opium 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, Phenylpropanolamine, Opium
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium 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.
This combination product mixes a pain reliever (acetaminophen), an antihistamine (chlorpheniramine), a decongestant (phenylpropanolamine), and a mild opioid (opium). The concern on file is that bacopa might slightly slow a liver enzyme called CYP1A2, which could in theory let some medicines clear a little more slowly and build up. If that happened, you might notice more drowsiness, dizziness, dry mouth, or constipation from the antihistamine and opioid pieces.
Honestly, the evidence here is weak. It comes only from lab studies, and even those disagree, with some suggesting no meaningful effect at all. So I would not panic. Still, since this product already causes sedation, it is worth a quick chat with your pharmacist or doctor before pairing it with regular bacopa.
- 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, Phenylpropanolamine, Opium 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 combination product mixes a pain reliever (acetaminophen), an antihistamine (chlorpheniramine), a decongestant (phenylpropanolamine), and opium, which works like a mild opioid. The thinking here is that bacopa might slow down a liver enzyme called CYP3A4 that helps clear some of these ingredients. In theory, that could let the opioid portion build up a bit, nudging up effects like drowsiness, dizziness, constipation, or feeling foggy.
The honest part: this is only based on lab studies, and even those disagree, so a real-world problem is far from certain. I wouldn't lose sleep over it, but since this medicine already causes sedation on its own, it's worth a quick chat with your pharmacist or doctor before pairing it with bacopa.
- 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, Phenylpropanolamine, Opium 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.
This combination product contains chlorpheniramine, an antihistamine that works in part by blocking acetylcholine, one of the brain's chemical messengers. Bacopa seems to push acetylcholine levels in the opposite direction, so in theory the two could partly cancel each other out. Practically, that might mean the antihistamine does a bit less for your runny nose or congestion, and bacopa may do a bit less for memory.
I want to be honest that this is a theoretical concern based on how these work, not something proven in people, so I wouldn't lose sleep over it. The acetaminophen, phenylpropanolamine, and opium parts aren't really involved here. If you take bacopa regularly, just mention it to your pharmacist or doctor so they can keep an eye on how well things are working.
- 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 916 moderate, 13 minor known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium 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, Phenylpropanolamine, Opium
This page covers Bacopa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium page lists 332 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 Ephedra (major).
By severity: 18 major · 267 moderate · 47 minor.
From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium page
“Hista-Derfule is really four medicines at once: acetaminophen, the antihistamine chlorpheniramine, the decongestant phenylpropanolamine, and opium. That mix is why I read its 332 supplement interactions with genuine care, starting with the 18 rated major.”
Reviewed by 2 · Jul 18, 2026
Open the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium 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, Phenylpropanolamine, Opium 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, Phenylpropanolamine, Opium 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.
#135 of 1,452 supplements looked up here in the last 7 days
#163 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 “”.
916 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 916 moderate interactions — see all 916 on the Bacopa page.
13 interactions
No interaction 1,900 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 ›
- Aspirin ›
- Rosuvastatin ›
- Metoprolol ›
- Escitalopram ›
- Methamphetamine ›
- Isotretinoin ›
- Tirzepatide ›
- Docusate ›
- Sumatriptan ›
- Valacyclovir ›
- Hydroxyurea ›
- Metformin ›
- Semaglutide ›
- Lisdexamfetamine ›
- Amphetamine ›
- Methotrexate ›
- Amoxicillin ›
- Lisinopril ›
- Bupropion ›
- Doxycycline ›
- Azithromycin ›
- Pregabalin ›
- Lamotrigine ›
- Gabapentin ›
- Dextroamphetamine ›
- Acyclovir ›
- Duloxetine ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Bisoprolol ›
- Acetylsalicylic Acid ›
- Ezetimibe ›
- Cyclopentolate ›
- Cephalexin ›
- Insulin Degludec, Liraglutide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Mannitol ›
- Levetiracetam ›
- Levodopa ›
- Carbidopa, Levodopa ›
- Roxithromycin ›
- Alginic Acid, Aluminum Hydroxide ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide ›
- Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide ›
- Spironolactone ›
- Magnesium Hydroxide (otc Drug) ›
- Mitomycin ›
- Atenolol, Chlorthalidone ›
- Canagliflozin, Metformin ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Avatrombopag Maleate ›
- Venlafaxine ›
- Atenolol ›
- Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate ›
Showing the 60 most looked-up of 1,900 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, Phenylpropanolamine, Opium Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium 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, Phenylpropanolamine, Opium Together: Common Questions
Can you take Bacopa with Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium?
Why are there 3 interactions listed for Bacopa and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium?
How serious is the Bacopa and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.