Drug & supplement interaction

Black Hoof Mushroom + Acetaminophen

Acetaminophen brand names: Tylenol Ex Strength, Children's Tylenol, Tylenol, Children's Tylenol Meltaways.

Moderate Interaction
Medically reviewed by · Updated October 2026
The bottom line Moderate

Acetaminophen falls into 2 drug categories that Black Hoof Mushroom can interact with; the most serious is rated moderate. Theoretically, black hoof mushroom might increase the levels and clinical 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

Black Hoof Mushroom and Acetaminophen

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

Why Are There 2 Interactions?

Black Hoof Mushroom interacts with whole categories of medication. Acetaminophen falls into 2 of those categories, so it can interact with Black Hoof Mushroom 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 Acetaminophen

Acetaminophen falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Black Hoof Mushroom interacts with.

Theoretically, black hoof mushroom might increase the levels and clinical effects of CYP1A2 substrates.
In vitro, polysaccharides from black hoof mushroom grown in culture inhibit CYP1A2. This effect has not been reported in humans.
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

Here's the gist for Tylenol and this mushroom. In lab dishes, compounds from black hoof mushroom slowed down an enzyme called CYP1A2, which is one of the pathways your liver uses to process acetaminophen. If that enzyme runs slower, in theory a bit more acetaminophen could hang around in your body, which could mean slightly stronger effects or a little more strain on the liver.

But I want to keep this in perspective. This is only seen in test-tube studies, not in real people, so we genuinely don't know if it matters when you take them together. Acetaminophen is its own active drug, not a prodrug, so the direction here would be toward more drug, not less. The bigger everyday tip with acetaminophen is simply not exceeding the daily dose limit. If you take this mushroom regularly, just mention it to your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Shon, Y. H. and Nam, K. S. Inhibition of cytochrome P450 isozymes in rat liver microsomes by polysaccharides derived from Phellinus linteus. Biotechnol Lett 2003;25(2):167-172. PubMed
Moderate

CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES

2 of 2

Acetaminophen also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.

Theoretically, black hoof mushroom might increase the levels and clinical effects of CYP2E1 substrates.
In vitro, polysaccharides from black hoof mushroom grown in culture inhibit CYP2E1. This effect has not been reported in humans.
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

Here's the gist for Tylenol (acetaminophen) and Black Hoof Mushroom. Acetaminophen is partly handled by a liver enzyme called CYP2E1. In lab dish studies, compounds from this mushroom seemed to slow that enzyme down. If that happened in people, slowing CYP2E1 could actually be a good thing, because CYP2E1 is the pathway that creates the toxic byproduct linked to acetaminophen liver damage when you take too much.

That said, this is purely theoretical and based on test-tube work only, with nothing shown in humans. At normal, label-correct acetaminophen doses I wouldn't lose sleep over it. The bigger everyday rule still applies: don't exceed the recommended dose and go easy on alcohol. If you take both regularly, just check in with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Shon, Y. H. and Nam, K. S. Inhibition of cytochrome P450 isozymes in rat liver microsomes by polysaccharides derived from Phellinus linteus. Biotechnol Lett 2003;25(2):167-172. PubMed

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

Black Hoof Mushroom Also Interacts With Other Medications

Black Hoof Mushroom has 307 moderate known drug interactions in our database — the Acetaminophen one above is among them. If you take anything else, check it against the full list below.

Moderate 307 No known interaction 2,523 (incl. Acetaminophen)
Taking anything else?

Check Another of Your Medications Against Black Hoof Mushroom

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

From our Q&A

Questions About Black Hoof Mushroom or Acetaminophen

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Black Hoof Mushroom or Acetaminophen, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Acetaminophen

This page covers Black Hoof Mushroom only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen page lists 155 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), Siberian Cocklebur (major) and Wine (major).

By severity: 5 major · 114 moderate · 36 minor.

From our pharmacist’s overview on the Acetaminophen page

“Acetaminophen (Tylenol) feels harmless because it sits on every shelf, but this list deserves real attention, mostly because of your liver. Of the 155 supplements and herbs on file, five carry a major rating, and the largest serious group, 38 ingredients, adds liver strain on top of acetaminophen's own well-known potential to harm the…”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen interaction page

How much people look this up

Where Black Hoof Mushroom and 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 Black Hoof Mushroom
Steady interest

#1,233 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Acetaminophen
Top 1%

#15 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 Black Hoof Mushroom

What is Black Hoof Mushroom?

Black Hoof Mushroom
  • Immune system support
  • Antioxidant support
  • General wellness
  • Traditional cancer-supportive use
  • Inflammation

Black Hoof Mushroom (Phellinus linteus) is a medicinal mushroom long used in East Asian traditional medicine, mainly for immune support. Most of the supporting evidence comes from laboratory and animal studies, and high-quality human research is limited. Talk to your pharmacist or doctor before using it, especially if you have a health condition or take other medicines.

Read the full Black Hoof Mushroom monograph & all interactions
Medication

About Acetaminophen

What Is Acetaminophen Used For?

Brand names: Tylenol Ex Strength, Children's Tylenol, Tylenol, Children's Tylenol Meltaways

Across the oral products (tablets and suspensions), acetaminophen temporarily relieves minor aches and pains and temporarily reduces fever.

The aches and pains named include the common cold, headache, backache, minor arthritis pain, toothache, muscle aches, and menstrual and premenstrual cramps. Robitussin Direct Sore Throat Pain tablets also list sore throat pain.

See full Acetaminophen drug information
Keep checking

Other Drugs & Black Hoof Mushroom

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

0Major
307Moderate
0Minor
2,522No known interaction
307 Moderate 2,522 No interaction
Moderate

307 interactions

Showing 60 of 307 moderate interactions — see all 307 on the Black Hoof Mushroom page.

No interaction 2,522 drugs checked — show the list

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

Showing the 60 most looked-up of 2,522 medications checked with no known interaction — see the full Black Hoof Mushroom list.

See the full Black Hoof Mushroom interactions page
See every supplement checked against 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
Black Hoof Mushroom monograph › Uses, safety, and every drug interaction in one place Acetaminophen supplement interactions › Every supplement checked against Acetaminophen, ranked by severity Acetaminophen drug information › The full plain-English guide to this medication 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 Black Hoof Mushroom and Acetaminophen Together: Common Questions

Can you take Black Hoof Mushroom with Acetaminophen?
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 Black Hoof Mushroom and Acetaminophen?
Acetaminophen belongs to more than one drug category, and Black Hoof Mushroom 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 Black Hoof Mushroom and Acetaminophen 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 Acetaminophen and Black Hoof Mushroom?

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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.