Drug & supplement interaction

Cabbage + Acetaminophen, Dichlorophenazone, Isometheptane

Acetaminophen, Dichlorophenazone, Isometheptane brand name: Isocom.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Dichlorophenazone, Isometheptane falls into 3 drug categories that Cabbage can interact with; the most serious is rated moderate. Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cabbage and Acetaminophen, Dichlorophenazone, Isometheptane

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

Why Are There 3 Interactions?

Cabbage interacts with whole categories of medication. Acetaminophen, Dichlorophenazone, Isometheptane falls into 3 of those categories, so it can interact with Cabbage 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 Acetaminophen, Dichlorophenazone, Isometheptane

Acetaminophen, Dichlorophenazone, Isometheptane falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Cabbage interacts with.

Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Some animal research suggests that cabbage or its constituent indole-3-carbinol might increase drug metabolism and elimination by stimulating CYP1A2 activity.
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

This headache combo (you may know it as Isocom) pairs acetaminophen for pain, dichloralphenazone to relax tension, and isometheptene to ease blood vessel throbbing. Here's the idea behind the cabbage note: cabbage and its natural compound indole-3-carbinol might gently speed up a liver enzyme called CYP1A2. In theory, that could clear part of this medicine a little faster, which might make it work less well for stopping a migraine or tension headache.

The important part: this is based only on lab and animal studies, not people, so it's quite weak and uncertain. Normal cabbage on your plate is very unlikely to cause any problem. If you're taking concentrated cabbage or indole-3-carbinol supplements, just mention it to your pharmacist or doctor first.

References
  1. Balk JL. Indole-3-carbinol for cancer prevention. Altern Med Alert 2000; 3:105-7.
  2. He YH, Friesen MD, Ruch RJ, Schut HA. Indole-3-carbinol as a chemopreventive agent in 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) carcinogenesis: inhibition of PhIP-DNA adduct formation, acceleration of PhIP metabolism, and induction of cytoch
  3. Steinkellner, H., Rabot, S., Freywald, C., Nobis, E., Scharf, G., Chabicovsky, M., Knasmuller, S., and Kassie, F. Effects of cruciferous vegetables and their constituents on drug metabolizing enzymes involved in the bioactivation of DNA-reactive dietary c
Moderate

GLUCURONIDATED DRUGS

2 of 3

Acetaminophen, Dichlorophenazone, Isometheptane also falls under GLUCURONIDATED DRUGS.

Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases levels of some drugs metabolized 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 gist for Isocom, which combines acetaminophen (a pain reliever) with isometheptene and dichloralphenazone. The piece worth knowing about is the acetaminophen part. Your liver clears acetaminophen partly through a process called glucuronidation, and eating a lot of cabbage (or Brussels sprouts) may speed that process up a bit. In plain terms, your body could clear the acetaminophen a little faster, which might make this headache combo feel slightly less effective.

I want to keep this in perspective. This comes from a small study, and it's largely theoretical. Normal amounts of cabbage in your meals are very unlikely to cause a problem. If you're eating large daily servings or using cabbage as a remedy and notice your headaches aren't responding as well, 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
Cabbage might increase clearance and reduce the effects of acetaminophen.
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases acetaminophen levels by as much as 16%, with some evidence suggesting that this effect is due to increased 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

This combination medicine (often sold as Isocom) is used for tension and migraine headaches, and one of its three ingredients is acetaminophen, the same pain reliever found in Tylenol. Here's the connection: eating a lot of cabbage (and other cruciferous veggies like Brussels sprouts) seems to speed up how your body clears acetaminophen. In one small study, blood levels of acetaminophen dropped by about 16%. That's because cabbage may nudge the liver to process acetaminophen a bit faster.

In plain terms, heavy cabbage intake could make the acetaminophen part work slightly less well, so your headache relief might not be quite as strong. The good news is this is a modest effect, and normal amounts of cabbage as food are unlikely to cause real trouble. If your headache medicine seems less effective, chat with your pharmacist or doctor rather than changing anything yourself.

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

Cabbage Also Interacts With Other Medications

Cabbage has 324 moderate known drug interactions in our database — the Acetaminophen, Dichlorophenazone, Isometheptane 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 Cabbage

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Dichlorophenazone, Isometheptane

This page covers Cabbage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dichlorophenazone, Isometheptane page lists 250 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 Ephedra (major).

By severity: 13 major · 196 moderate · 41 minor.

Open the Acetaminophen, Dichlorophenazone, Isometheptane interaction page

One more smart check

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

We hold 2,304 real supplement products containing Cabbage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cabbage. Your product may carry other ingredients that interact with Acetaminophen, Dichlorophenazone, Isometheptane too, on top of Cabbage — 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 Cabbage and Acetaminophen, Dichlorophenazone, Isometheptane 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 Cabbage
Top 25%

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

29 days ago today
Medication Acetaminophen, Dichlorophenazone, Isometheptane
Top 25%

#647 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 Cabbage

What is Cabbage?

Cabbage
  • Breast engorgement during breastfeeding
  • Joint pain and swelling (topical)
  • Digestive and stomach upset
  • General nutrition and antioxidant support
  • Skin and minor inflammation (topical)

Cabbage is a nutritious, low-calorie vegetable that is safe to eat as food and is sometimes applied to the skin as a leaf wrap for breast engorgement or sore joints. Most medicinal claims are based on tradition or limited research, with the strongest (though still modest) evidence being for cooling cabbage leaves on engorged breasts. Talk to your pharmacist or doctor before using cabbage in large amounts or as a treatment.

Read the full Cabbage monograph & all interactions
Keep checking

Other Drugs & Cabbage

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

0Major
324Moderate
0Minor
2,505No known interaction
Moderate

324 interactions

Showing 60 of 324 moderate interactions — see all 324 on the Cabbage page.

No interaction 2,505 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

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Pharmacist Counseling Corner

Taking Cabbage and Acetaminophen, Dichlorophenazone, Isometheptane Together: Common Questions

Can you take Cabbage with Acetaminophen, Dichlorophenazone, Isometheptane?
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 Cabbage and Acetaminophen, Dichlorophenazone, Isometheptane?
Acetaminophen, Dichlorophenazone, Isometheptane belongs to more than one drug category, and Cabbage 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 Cabbage and Acetaminophen, Dichlorophenazone, Isometheptane 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

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