Drug & supplement interaction

Brussels Sprout + Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen brand name: Apadaz.

Moderate Interaction
The bottom line Moderate

Benzhydrocodone, Acetaminophen falls into 3 drug categories that Brussels Sprout can interact with; the most serious is rated moderate. Animal research suggests that Brussels sprout can induce cytochrome P450 1A2 (CYP1A2) activity.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Brussels Sprout and Benzhydrocodone, Acetaminophen

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Brussels Sprout interacts with whole categories of medication. Benzhydrocodone, Acetaminophen falls into 3 of those categories, so it can interact with Brussels Sprout in 3 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 3

Why this applies to Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Brussels Sprout interacts with.

Animal research suggests that Brussels sprout can induce cytochrome P450 1A2 (CYP1A2) activity. Theoretically, Brussels sprout might increase the clearance and decrease the effects of drugs metabolized by CYP1A2. Some drugs metabolized by CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
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 honest picture on Apadaz (benzhydrocodone with acetaminophen) and Brussels sprouts. The concern on file is that Brussels sprouts may gently speed up a liver enzyme called CYP1A2. But this is only based on lab and animal research, not real people, so I wouldn't lose sleep over it. Benzhydrocodone is actually a prodrug, meaning your body has to convert it into hydrocodone (its active pain-relieving form), and that step relies mostly on a different enzyme, not CYP1A2.

So in practice, eating Brussels sprouts as food is very unlikely to change how well your pain medicine works. Enjoy them as part of a healthy diet. If you ever feel your pain relief is weaker than expected, or you have other questions, just check in with your pharmacist or doctor.

References
  1. Wortelboer HM, de Kruif CA, van Iersel AAJ, et al. Effects of cooked Brussels sprouts on cytochrome P-450 profile and phase II enzymes in liver and small intestinal mucosa of the rat. Food Chem Toxicol 1992;30(1):17-27. PubMed
Moderate

GLUCURONIDATED DRUGS

2 of 3

Benzhydrocodone, Acetaminophen also falls under GLUCURONIDATED DRUGS.

A cabbage and Brussels sprout-containing diet seems to boost elimination through glucuronide conjugation. Theoretically, these foods might also lower levels of other drugs that are metabolized through glucuronide conjugation, including acetaminophen (Tylenol, others) and oxazepam (Serax), haloperidol (Haldol), lamotrigine (Lamictal), morphine (MS Contin, Roxanol), zidovudine (AZT, Retrovir), and others.
Severity Moderate Likelihood Probable Evidence B

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Apadaz, which pairs benzhydrocodone with acetaminophen. The acetaminophen half is cleared partly through a process called glucuronidation. Eating a lot of Brussels sprouts seems to speed that process up, so in theory your body could clear acetaminophen a bit faster. That might mean the acetaminophen portion does slightly less to dull your pain or bring down a fever.

Honestly, this is mostly based on diet studies and is on the gentle side, so a normal helping of Brussels sprouts at dinner is very unlikely to change how your medicine works. The bigger thing with Apadaz is the opioid side (drowsiness, slowed breathing, constipation), which sprouts don't affect. If you're eating large amounts daily and notice your pain control slipping, check in with your pharmacist or doctor.

References
  1. Pantuck EJ, Pantuck CB, Anderson KE, et al. Effect of brussels sprouts and cabbage on drug conjugation. Clin Pharmacol Ther 1984;35:161-9. PubMed
Moderate

ACETAMINOPHEN (Tylenol, others)

3 of 3
A cabbage and Brussels sprout-containing diet can increase metabolism and decrease levels of acetaminophen. In clinical research, a diet that includes daily consumption of cabbage and Brussels sprout decreases acetaminophen levels by as much as 16%. This appears to occur due to a boost of elimination through glucuronide conjugation.
Severity Moderate Likelihood Probable Evidence B

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the practical picture with Apadaz, which pairs benzhydrocodone (an opioid for pain) with acetaminophen. Brussels sprouts contain natural compounds that can gently speed up how your liver clears the acetaminophen part. In one clinical study, regularly eating cabbage and Brussels sprouts dropped acetaminophen levels by up to about 16%. So the direction here is a slightly weaker acetaminophen effect, not a buildup.

Honestly, a 16% dip is small, and the opioid piece isn't affected by this. For most people enjoying sprouts as a normal part of dinner, this won't change your pain relief in any meaningful way. If you ever feel your pain isn't well controlled, don't adjust doses on your own. Just check in with your pharmacist or doctor first.

References
  1. Pantuck EJ, Pantuck CB, Anderson KE, et al. Effect of brussels sprouts and cabbage on drug conjugation. Clin Pharmacol Ther 1984;35:161-9. 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

Brussels Sprout Also Interacts With Other Medications

Brussels Sprout has 240 moderate known drug interactions in our database — the Benzhydrocodone, Acetaminophen 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 Brussels Sprout

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

Everything else you take

See Every Supplement That Interacts With Benzhydrocodone, Acetaminophen

This page covers Brussels Sprout only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Benzhydrocodone, Acetaminophen page lists 299 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 Gamma-hydroxybutyrate (ghb) (major).

By severity: 14 major · 239 moderate · 46 minor.

Open the Benzhydrocodone, Acetaminophen interaction page

How much people look this up

Where Brussels Sprout and Benzhydrocodone, 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 Brussels Sprout
Steady interest

#1,206 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Benzhydrocodone, Acetaminophen
Steady interest

#2,249 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 Brussels Sprout

What is Brussels Sprout?

  • General nutrition and fiber
  • Antioxidant support
  • Digestive health
  • Heart health support
  • Cancer-prevention interest

Brussels sprouts are a nutritious cruciferous vegetable rich in fiber, vitamin C, vitamin K, and plant compounds called glucosinolates. Eating them as part of a balanced diet is healthy and safe for most people, but supplement-style claims (like preventing cancer) are not well proven. If you take blood thinners or have thyroid concerns, talk with your pharmacist or doctor about your intake.

Read the full Brussels Sprout monograph & all interactions
Medication

About Benzhydrocodone and Acetaminophen

What Is Benzhydrocodone and Acetaminophen Used For?

Brand name: Apadaz

Apadaz is indicated for the short-term management of acute pain — up to 14 days — that is severe enough to require an opioid and for which non-opioid treatments have not worked or are not expected to work. It combines benzhydrocodone (a prodrug that converts to the opioid hydrocodone) with acetaminophen.

Because of serious risks including addiction, abuse, and misuse, Apadaz is reserved for patients who have not tolerated or have not gotten adequate relief from alternative pain treatments. It should not be used for an extended period of time unless the pain remains severe enough to require an opioid and alternatives remain inadequate.

See full Benzhydrocodone and Acetaminophen drug information
Keep checking

Other Drugs & Brussels Sprout

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

0Major
240Moderate
0Minor
2,589No known interaction
Moderate

240 interactions

Showing 60 of 240 moderate interactions — see all 240 on the Brussels Sprout page.

No interaction 2,589 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 Brussels Sprout and Benzhydrocodone, Acetaminophen Together: Common Questions

Can you take Brussels Sprout with Benzhydrocodone, 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 3 interactions listed for Brussels Sprout and Benzhydrocodone, Acetaminophen?
Benzhydrocodone, Acetaminophen belongs to more than one drug category, and Brussels Sprout 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 Brussels Sprout and Benzhydrocodone, 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 Benzhydrocodone, Acetaminophen and Brussels Sprout?

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.