Drug & supplement interaction

Bael + Tacrine

Tacrine brand name: Cognex.

Moderate Interaction
The bottom line Moderate

Tacrine falls into 2 drug categories that Bael can interact with; the most serious is rated moderate. Bael leaf extract shows acetylcholinesterase (AChE) inhibitory activity in vitro.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Bael and Tacrine

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

Why Are There 2 Interactions?

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

Moderate

CHOLINERGIC DRUGS

1 of 2

Why this applies to Tacrine

Tacrine falls under CHOLINERGIC DRUGS — the group Bael interacts with.

Bael leaf extract shows acetylcholinesterase (AChE) inhibitory activity in vitro. Theoretically, bael might have additive effects with cholinergic drugs and increase the risk of cholinergic side effects.
Cholinergic drugs include bethanechol (Urecholine), donepezil (Aricept), echothiophate (Phospholine Iodide), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmin), physostigmine (Antilirium), pyridostigmine (Mestinon, Regonol), succinylcholine (Anectine, Quelicin), and tacrine (Cognex).
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

Tacrine (Cognex) works by blocking an enzyme called acetylcholinesterase, which raises the level of a brain chemical involved in memory. Here's the thing: in lab studies, bael leaf extract appears to block that same enzyme. So in theory, taking the two together could stack their effects and push your cholinergic activity higher than intended.

If that happened, you might notice more of tacrine's usual side effects, like nausea, diarrhea, stomach cramps, drooling, sweating, a slow heartbeat, or muscle twitching. I want to be honest though: this concern comes only from test-tube work, not from people, so we really don't know if it matters in real life. To be safe, please check with your pharmacist or doctor before adding bael while you're on tacrine.

References
  1. Asaduzzaman M, Uddin MJ, Kader MA, et al. In vitro acetylcholinesterase inhibitory activity and the antioxidant properties of Aegle marmelos leaf extract: implications for the treatment of Alzheimer's disease. Psychogeriatrics. 2014;14(1):1-10.
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 2

Tacrine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Bael extract and its constituent marmesinin inhibited cytochrome P450 1A2 (CYP1A2) activity in vitro. So far, this interaction has not been reported in humans. Theoretically, bael might increase levels of drugs metabolized by CYP1A2.
Some drugs metabolized by CYP1A2 include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), and others. Use bael 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 gist for Tacrine (Cognex): your liver clears it mainly through an enzyme called CYP1A2. In lab dish studies, bael (and one of its compounds, marmesinin) slowed that same enzyme down. If that held true in people, your body might break down tacrine a little more slowly, letting it build up. With tacrine that could mean stronger cholinergic effects, things like nausea, vomiting, diarrhea, stomach cramps, and (importantly) raised liver enzymes, which tacrine is already known for.

That said, this is only test-tube evidence and hasn't been seen in real patients, so I wouldn't panic. Just don't start bael supplements without first checking with your pharmacist or doctor.

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

Bael Also Interacts With Other Medications

Bael has 110 moderate, 708 minor known drug interactions in our database — the Tacrine 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 Bael

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

Everything else you take

See Every Supplement That Interacts With Tacrine

This page covers Bael only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tacrine page lists 156 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Adrafinil (moderate).

By severity: 4 major · 118 moderate · 34 minor.

Open the Tacrine interaction page

One more smart check

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

We hold 94 real supplement products containing Bael, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bael. Your product may carry other ingredients that interact with Tacrine too, on top of Bael — 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 Bael and Tacrine 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 Bael
Top half

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

29 days ago today
Medication Tacrine
Steady interest

#2,758 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 Bael

What is Bael?

Bael
  • Diarrhea and dysentery
  • Indigestion and other digestive complaints
  • Constipation
  • Blood sugar support
  • General wellness in traditional medicine

Bael is a fruit-bearing tree long used in traditional Indian (Ayurvedic) medicine, mostly for digestive problems like diarrhea and indigestion. Modern human evidence for its medicinal benefits is very limited, so it should be viewed mainly as a food and traditional remedy rather than a proven treatment. Talk to your pharmacist or doctor before using bael as a supplement, especially if you are pregnant, breastfeeding, or have a health condition.

Read the full Bael monograph & all interactions
Keep checking

Other Drugs & Bael

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

0Major
110Moderate
708Minor
2,011No known interaction
Moderate

110 interactions

Showing 60 of 110 moderate interactions — see all 110 on the Bael page.

Minor

708 interactions

Showing 60 of 708 minor interactions — see all 708 on the Bael page.

No interaction 2,011 drugs checked — show the 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

Keep exploring
Pharmacist Counseling Corner

Taking Bael and Tacrine Together: Common Questions

Can you take Bael with Tacrine?
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 Bael and Tacrine?
Tacrine belongs to more than one drug category, and Bael 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 Bael and Tacrine 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

Still Have a Question About Tacrine and Bael?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.