Drug & supplement interaction

Bacopa + Ephedrine Sulfate, Hydroxyzine, Theophylline

Ephedrine Sulfate, Hydroxyzine, Theophylline brand name: Hydroxy Compound.

Moderate Interaction
The bottom line Moderate

Ephedrine Sulfate, Hydroxyzine, Theophylline falls into 2 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 report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bacopa and Ephedrine Sulfate, Hydroxyzine, Theophylline

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Bacopa interacts with whole categories of medication. Ephedrine Sulfate, Hydroxyzine, Theophylline falls into 2 of those categories, so it can interact with Bacopa in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Ephedrine Sulfate, Hydroxyzine, Theophylline

Ephedrine Sulfate, Hydroxyzine, Theophylline falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Bacopa interacts with.

Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
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.
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

Out of this combination product, the one to watch with bacopa is the theophylline. Your liver uses an enzyme called CYP1A2 to clear theophylline from your body. In lab and animal studies, bacopa may slow that same enzyme a bit. If it does, theophylline could build up, and since theophylline already has a narrow safety window, even small increases can matter. That might show up as nausea, a racing or pounding heartbeat, jitteriness, trouble sleeping, or in larger amounts, tremor.

Now the reassuring part: this is theoretical, and the studies actually disagree on whether bacopa affects this enzyme in real people. So I wouldn't panic. Still, theophylline is worth being careful with, so check with your pharmacist or doctor before adding bacopa.

References
  1. 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
  2. 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
Moderate

ANTICHOLINERGIC DRUGS

2 of 2

Ephedrine Sulfate, Hydroxyzine, Theophylline also falls under ANTICHOLINERGIC DRUGS.

Theoretically, concurrent use might decrease the effectiveness of both agents.
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.
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

In this combination product, the piece that matters here is hydroxyzine, an antihistamine with anticholinergic activity (it works partly by blocking acetylcholine). Bacopa seems to do the opposite in lab studies, gently raising acetylcholine levels. In theory, the two could work against each other, so hydroxyzine might calm allergy symptoms, itching, or anxiety a little less effectively, and bacopa's brain effects could be blunted too.

I want to be honest with you: this is a theoretical concern based on how these things work, not something proven in people. The ephedrine and theophylline parts aren't really involved. For most folks it's unlikely to cause trouble, but if you notice hydroxyzine isn't working as well, mention it to your pharmacist or doctor before changing anything.

References
  1. 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.

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

Bacopa Also Interacts With Other Medications

Bacopa has 916 moderate, 13 minor known drug interactions in our database — the Ephedrine Sulfate, Hydroxyzine, Theophylline one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Bacopa

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

Everything else you take

See Every Supplement That Interacts With Ephedrine Sulfate, Hydroxyzine, Theophylline

This page covers Bacopa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ephedrine Sulfate, Hydroxyzine, Theophylline page lists 199 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Ephedra (major), Henbane (major), Peyote (major) and Rauvolfia Vomitoria (major).

By severity: 7 major · 153 moderate · 39 minor.

From our pharmacist’s overview on the Ephedrine Sulfate, Hydroxyzine, Theophylline page

“Someone taking Hydroxy Compound (ephedrine sulfate, hydroxyzine, and theophylline) for breathing problems is juggling three drugs at once, and the supplement list shows it: 199 interacting ingredients, seven of them rated major, and this page deserves genuine seriousness. The sharpest risks come from stimulant botanicals, ephedra above…”

Reviewed by 2 · Jul 18, 2026

Open the Ephedrine Sulfate, Hydroxyzine, Theophylline interaction page

One more smart check

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 Ephedrine Sulfate, Hydroxyzine, Theophylline 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:

How much people look this up

Where Bacopa and Ephedrine Sulfate, Hydroxyzine, Theophylline 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 Bacopa
Top 10%

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

29 days ago today
Medication Ephedrine Sulfate, Hydroxyzine, Theophylline
Top 25%

#389 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 Bacopa

What is Bacopa?

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.

Read the full Bacopa monograph & all interactions
Keep checking

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.

0Major
916Moderate
13Minor
1,900No known interaction
Moderate

916 interactions

Showing 60 of 916 moderate interactions — see all 916 on the Bacopa page.

Minor

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.

Showing the 60 most looked-up of 1,900 medications checked with no known interaction — see the full Bacopa 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 Bacopa and Ephedrine Sulfate, Hydroxyzine, Theophylline Together: Common Questions

Can you take Bacopa with Ephedrine Sulfate, Hydroxyzine, Theophylline?
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.
Why are there 2 interactions listed for Bacopa and Ephedrine Sulfate, Hydroxyzine, Theophylline?
Ephedrine Sulfate, Hydroxyzine, Theophylline belongs to more than one drug category, and Bacopa interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Bacopa and Ephedrine Sulfate, Hydroxyzine, Theophylline 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

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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.