Drug & supplement interaction

Black Pepper + Theophylline

Theophylline brand names: T-Phyl, Duraphyl, Aerolate JR, Aerolate SR, Theo-Dur, and others.

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

Theophylline falls into 2 drug categories that Black Pepper can interact with; the most serious is rated moderate. Black pepper might increase blood levels of theophylline.

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

Black Pepper and Theophylline

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

Why Are There 2 Interactions?

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

Moderate

THEOPHYLLINE

1 of 2
Black pepper might increase blood levels of theophylline.
Clinical research shows that piperine, a constituent of black pepper, seems to increase absorption and slow elimination of theophylline.
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: theophylline already needs careful dosing because the gap between a helpful amount and too much is narrow. The piperine in concentrated black pepper supplements may help your body absorb more theophylline and clear it out more slowly, so levels in your blood can drift upward. Theophylline isn't a prodrug, it works as-is, so higher levels mean stronger effects and a bigger chance of side effects.

If that happens, you might notice nausea, a jittery or racing heartbeat, trouble sleeping, or feeling shaky. This is based mostly on how piperine behaves in lab and pharmacology studies, not big patient trials, and a little pepper on dinner is unlikely to matter. Supplement-strength piperine is the real question, so check with your pharmacist or doctor before adding it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Bano G, et al. Effect of piperine on bioavailability and pharmacokinetics of propranolol and theophylline in healthy volunteers. Eur J Clin Pharmacol 1991;41;615-7. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 2

Why this applies to Theophylline

Theophylline falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Black Pepper interacts with.

Theoretically, black pepper might decrease levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that black pepper induces CYP1A2. This has not been reported in humans.
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 theophylline: your liver clears it using an enzyme called CYP1A2. Some lab studies hint that black pepper (really its active piece, piperine) might speed that enzyme up. If that happened in people, your body could clear theophylline a little faster, which in theory might lower its levels and make it work less well. With asthma or COPD, that could mean a bit more wheezing or shortness of breath.

Now the honest part: this is only theoretical, seen in test-tube and animal studies, never confirmed in humans. The amount of pepper in your cooking is very unlikely to matter. Concentrated piperine supplements are the bigger question mark. Since theophylline is touchy with its dosing, just run any pepper or turmeric supplement past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. 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 Pepper Also Interacts With Other Medications

Black Pepper has 975 moderate, 43 minor known drug interactions in our database — the Theophylline one above is among them. If you take anything else, check it against the full list below.

Moderate 975 Minor 43 No known interaction 1,812 (incl. Theophylline)
Taking anything else?

Check Another of Your Medications Against Black Pepper

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

From our Q&A

Questions About Black Pepper or Theophylline

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 Pepper or Theophylline, 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 Theophylline

This page covers Black Pepper only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Theophylline page lists 126 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Ephedra (major), Sida Cordifolia (major), Adrafinil (moderate) and African Wild Potato (moderate).

By severity: 3 major · 89 moderate · 34 minor.

From our pharmacist’s overview on the Theophylline page

“Stop ephedra before anything else if you take theophylline (Theo-Dur, Slo-Bid, and others) for asthma or COPD. Both are stimulants, and together they raise the risk of serious heart and nervous system effects; Sida cordifolia, an herb that contains ephedrine, carries the same major rating.”

Reviewed by 2 · Jul 18, 2026

Open the Theophylline interaction page

One more smart check

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

We hold 5,528 real supplement products containing Black Pepper, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Black Pepper. Your product may carry other ingredients that interact with Theophylline too, on top of Black Pepper — 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 Black Pepper and 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 Black Pepper
Top 5%

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

29 days ago today
Medication Theophylline
Steady interest

#1,501 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 Pepper

What is Black Pepper?

Black Pepper
  • Flavoring and culinary use
  • Digestive complaints like bloating and indigestion
  • Boosting absorption of other supplements
  • Antioxidant and anti-inflammatory support
  • Cold and congestion remedies

Black pepper is a common kitchen spice that is generally safe in the amounts used in food. Its extract, piperine, is mostly added to supplements to help the body absorb other ingredients (like curcumin from turmeric). Strong human evidence for black pepper treating specific health conditions is limited, so use supplement-strength products with care and check with your pharmacist.

Read the full Black Pepper monograph & all interactions
Medication

About Theophylline

What Is Theophylline Used For?

Brand names: T-Phyl, Duraphyl, Aerolate JR, Aerolate SR, Theo-Dur, Slo-Bid, Theo-24, Uniphyl, Slo-phyllin Gyrocaps, Theolair, Theolair SR, Quibron-T/SR, Quibron-T, Aerolate III, Theo-X, Bronkodyl, Theoclear LA-130, Constant-T, Theoclear LA-260, Elixophyllin, Theovent, Theobid Jr Duracap, Respbid, Theobid Duracap

Theophylline — available as extended-release capsules (Theo-24), extended-release tablets, and oral solution (Elixophyllin) — is used to treat symptoms and reversible airflow obstruction caused by chronic asthma, emphysema, and chronic bronchitis.

All supported formulations share these indications. Theophylline is intended for patients with ongoing or recurring symptoms, not for sudden (acute) breathing attacks, which need faster-acting treatments.

See full Theophylline drug information
Keep checking

Other Drugs & Black Pepper

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

0Major
975Moderate
43Minor
1,811No known interaction
975 Moderate 43 Minor 1,811 No interaction
Moderate

975 interactions

Showing 60 of 975 moderate interactions — see all 975 on the Black Pepper page.

Minor

43 interactions

No interaction 1,811 drugs checked — show the list

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

Showing the 60 most looked-up of 1,811 medications checked with no known interaction — see the full Black Pepper list.

See the full Black Pepper interactions page
See every supplement checked against Theophylline, 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 Pepper monograph › Uses, safety, and every drug interaction in one place Theophylline supplement interactions › Every supplement checked against Theophylline, ranked by severity Theophylline 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 Pepper and Theophylline Together: Common Questions

Can you take Black Pepper with 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 Black Pepper and Theophylline?
Theophylline belongs to more than one drug category, and Black Pepper 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 Pepper and 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

Still Have a Question About Theophylline and Black Pepper?

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.