Bulbine Natalensis + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine brand names: Tylenol Cold Ex Strength, Children's Tylenol Cold Plus Cough.
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls into 2 drug categories that Bulbine Natalensis can interact with; the most serious is rated moderate. Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP1A2 substrates.
Read the full interaction reportBulbine Natalensis and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
These two interact in 2 distinct ways. Each one is explained separately below.
Why Are There 2 Interactions?
Bulbine Natalensis interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls into 2 of those categories, so it can interact with Bulbine Natalensis in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 2Why this applies to Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Bulbine Natalensis interacts with.
In vitro research shows that Bulbine natalensis stem extract slightly induces CYP1A2 mRNA expression and enzyme activity. Theoretically, this may increase the metabolism of CYP1A2 substrates; however, this has not been studied in humans.
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.
This cold and cough combo (Tylenol Cold and similar products) contains four ingredients, and a couple of them lean on a liver enzyme called CYP1A2 to be broken down. In lab dishes, Bulbine natalensis seemed to slightly speed up that enzyme. In theory, that could clear some of these ingredients a little faster, possibly making them feel a touch weaker, like less cough relief from the dextromethorphan or less stuffiness relief.
Honestly, I wouldn't lose sleep over this one. The evidence is only from test-tube and animal work, never confirmed in people, and the effect looked mild. My bigger worry is that Bulbine itself has raised liver concerns in animals, and acetaminophen is hard on the liver too. Please check with your pharmacist before combining them.
- Husain I, Manda V, Alhusban M, et al. Modulation of CYP3A4 and CYP2C9 activity by Bulbine natalensis and its constituents: An assessment of HDI risk of B. natalensis containing supplements. Phytomedicine 2021;81:153416. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 2Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that Bulbine natalensis stem extract induces CYP3A4 mRNA expression and enzyme activity. Theoretically, this may increase the metabolism of CYP3A4 substrates, but this has not been studied in humans.
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.
This cold and cough combo includes a few ingredients that the body partly clears through a liver enzyme called CYP3A4 (dextromethorphan, the cough suppressant, is the main one handled this way). Lab and animal studies hint that Bulbine natalensis may speed up that enzyme. If that happened in people, your body might break down these medicines a little faster, which could make the cough or congestion relief feel weaker or shorter-lasting.
Keep this in perspective though. This is only a theory from test-tube and rodent research, never confirmed in humans, so I would not lose sleep over it. The bigger concern with Bulbine itself is possible liver and kidney strain, and Tylenol products are already hard on the liver. Please check with your pharmacist or doctor before combining them.
- Husain I, Dale OR, Manda V, et al. Bulbine natalensis (currently Bulbine latifolia) and select bulbine knipholones modulate the activity of AhR, CYP1A2, CYP2B6, and P-gp. Planta Med 2022;88(12):975-984. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Bulbine Natalensis Also Interacts With Other Medications
Bulbine Natalensis has 918 moderate known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Bulbine Natalensis
We haven’t checked that one against Bulbine Natalensis yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Bulbine Natalensis. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
This page covers Bulbine Natalensis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page lists 301 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), Ephedra (major) and Grapefruit (major).
By severity: 14 major · 242 moderate · 45 minor.
From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page
“Because Tylenol Cold Extra Strength packs four drugs into one dose (acetaminophen, chlorpheniramine, dextromethorphan, and pseudoephedrine), its supplement list runs to 301 ingredients, and 14 carry a major rating, so I'd approach this one with real care. The biggest hazards mirror the drugs themselves.”
Reviewed by 2 · Jul 18, 2026
Open the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction page
Taking Bulbine Natalensis as Part of a Dietary Supplement Product? Check It for Interactions
We hold 51 real supplement products containing Bulbine Natalensis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bulbine Natalensis. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine too, on top of Bulbine Natalensis — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Bulbine Natalensis and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine 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.
#462 of 1,452 supplements looked up here in the last 7 days
#88 of 2,830 medications looked up here in the last 7 days
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.
About Bulbine Natalensis
What is Bulbine Natalensis?
- Boosting testosterone
- Improving libido
- Muscle building and athletic performance
- General male vitality
Bulbine natalensis is a South African plant marketed mainly as a testosterone-boosting and libido supplement, but the human evidence is essentially absent and most claims come from animal studies. Animal research has also raised concerns about possible liver and kidney harm at higher doses, so caution is warranted. Talk to your pharmacist or doctor before trying it.
Other Drugs & Bulbine Natalensis
Browse every other medication we’ve checked against Bulbine Natalensis — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
918 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Methyltestosterone ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Acetaminophen ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ivermectin ›
- Ketoprofen ›
- Lofepramine ›
Showing 60 of 918 moderate interactions — see all 918 on the Bulbine Natalensis page.
No interaction 1,911 drugs checked — show the list
We also checked Bulbine Natalensis against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Rosuvastatin ›
- Escitalopram ›
- Metoprolol ›
- Isotretinoin ›
- Tirzepatide ›
- Methamphetamine ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Metformin ›
- Sumatriptan ›
- Semaglutide ›
- Lisdexamfetamine ›
- Levothyroxine, Liothyronine ›
- Amphetamine ›
- Methotrexate ›
- Amoxicillin ›
- Lisinopril ›
- Bupropion ›
- Azithromycin ›
- Pregabalin ›
- Gabapentin ›
- Dextroamphetamine ›
- Lamotrigine ›
- Acyclovir ›
- Duloxetine ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Bisoprolol ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Insulin Degludec, Liraglutide ›
- Ezetimibe ›
- Cephalexin ›
- Cyclopentolate ›
- Atenolol, Chlorthalidone ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Levetiracetam ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Mannitol ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Levodopa ›
- Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate ›
- Enalapril Maleate ›
- Canagliflozin, Metformin ›
- Acarbose ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Spironolactone ›
- Alginic Acid, Aluminum Hydroxide ›
- Ephedrine, Phenobarbital, Theophylline ›
- Amobarbital, Ephedrine Sulfate ›
- Venlafaxine ›
- Mitomycin ›
- Roxithromycin ›
- Atenolol ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
Showing the 60 most looked-up of 1,911 medications checked with no known interaction — see the full Bulbine Natalensis list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine as a medicine that can lower these. This is not an interaction with Bulbine Natalensis — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Bulbine Natalensis and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Together: Common Questions
Can you take Bulbine Natalensis with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
Why are there 2 interactions listed for Bulbine Natalensis and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
How serious is the Bulbine Natalensis and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine and Bulbine Natalensis?
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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.