Drug & supplement interaction

Calabar Bean + Dextromethorphan HBr, Guaifenesin

Dextromethorphan HBr, Guaifenesin brand names: Vicks Formula 44E Cough & Chest Congestion Relief, Pediatric Vicks Formula 44e Cough & Chest Congesti.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 13, 2026

The bottom line No known interaction

We found no known interaction between Calabar Bean and Dextromethorphan HBr, Guaifenesin in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Calabar Bean and Dextromethorphan HBr, Guaifenesin

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Dextromethorphan HBr, Guaifenesin and Calabar Bean in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Calabar Bean safety at a glance

Calabar Bean overall Avoid The raw bean is poisonous and can cause severe, even fatal, poisoning.

Pregnancy Unsafe When used orally; avoid using. Read the full pregnancy detail

Breastfeeding Unsafe When used orally; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Dextromethorphan HBr, Guaifenesin and Calabar Bean? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Dextromethorphan HBr, Guaifenesin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Dextromethorphan HBr, Guaifenesin is filed under 6 classifications — including serotonergic drugs, serotonergic drugs, cytochrome p450 2d6 (cyp2d6) substrates. Calabar Bean has documented interactions with 1 drug class — the most serious being anticholinergic drugs (minor) — and none of Dextromethorphan HBr, Guaifenesin’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Calabar Bean Does Interact With Other Medications

Calabar Bean has 195 minor known drug interactions in our database — Dextromethorphan HBr, Guaifenesin isn’t one of them. If you take anything else, check it against the full list below.

Minor 195 No known interaction 2,635 (incl. Dextromethorphan HBr, Guaifenesin)

Taking anything else?

Check Another of Your Medications Against Calabar Bean

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

What to actually watch for

What Calabar Bean Itself Has Been Linked To

This is not an interaction — nothing below involves Dextromethorphan HBr, Guaifenesin. It is the side-effect record for Calabar Bean on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Calabar Bean, this list is the first place to look. 3 entries are worth acting on rather than waiting out — marked below.

Muscle weakness / A slow heartbeat / Confusion Worth acting on Additional detail
“Orally, physostigmine, a constituent of calabar bean, can cause cholinergic crisis, including paralysis, coma, and death. Other symptoms of cholinergic crisis may include bradycardia, confusion, diarrhea, miosis, muscle weakness, salivation, sweating, and vomiting (15).”

Calabar Bean · Natural Medicines adverse-effect record, reported in diarrhea.
1 source cited

15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Seizures Worth acting on Additional detail

Recorded for Calabar Bean in the same Natural Medicines adverse-effect record shown under Muscle weakness / A slow heartbeat / Confusion above.
Raised blood pressure Worth acting on Additional detail
“Orally, calabar bean can cause bradycardia, tachycardia, hypotension, and hypertension (15).”

Calabar Bean · Natural Medicines adverse-effect record, reported in hypertension.
1 source cited

15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Sweating / Diarrhea / Vomiting Additional detail

Recorded for Calabar Bean in the same Natural Medicines adverse-effect record shown under Muscle weakness / A slow heartbeat / Confusion above.
A fast or pounding heartbeat / Low blood pressure Additional detail

Recorded for Calabar Bean in the same Natural Medicines adverse-effect record shown under Muscle weakness / A slow heartbeat / Confusion above.

Everything above comes from the Natural Medicines adverse-effect record for Calabar Bean — expand a row for the licensed statement it rests on. We haven’t matched Dextromethorphan HBr, Guaifenesin to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Dextromethorphan HBr, Guaifenesin.

Special populations

Calabar Bean in Pregnancy & Breastfeeding

Pregnancy And Lactation Unsafe

When used orally; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Dextromethorphan HBr, Guaifenesin

This page covers Calabar Bean only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dextromethorphan HBr, Guaifenesin page lists 171 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lithium (major), St. John's Wort (major) and 1,3-dmaa (moderate).

By severity: 4 major · 125 moderate · 42 minor.

From our pharmacist’s overview on the Dextromethorphan HBr, Guaifenesin page

“A bad cough tends to hit when supplements are already on the counter, and anyone reaching for Vicks Formula 44E (dextromethorphan HBr and guaifenesin) should treat this list with real care, since 4 of its 171 entries carry a major rating. Two themes dominate.”

Reviewed by 2 · Jul 18, 2026

Open the Dextromethorphan HBr, Guaifenesin interaction page

How much people look this up

Where Calabar Bean and Dextromethorphan HBr, Guaifenesin 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 Calabar Bean

Steady interest

#1,222 of 1,452 supplements looked up here in the last 7 days

29 days ago today

Medication Dextromethorphan HBr, Guaifenesin

Top 25%

#700 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.

Where does our data come from?

Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Calabar Bean reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Calabar Bean and Dextromethorphan HBr, Guaifenesin records this page draws on were last updated July 10, 2026.
What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.

Data structure & sourcing designed and verified by Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Calabar Bean

What is Calabar Bean?

Source of physostigmine (a prescription drug ingredient)
Historically used in 'trial by ordeal' rituals
Traditional pain relief and anti-inflammatory uses
Historically used for eye conditions (glaucoma)
Historically used as a poison

Calabar bean is a highly poisonous West African seed that contains physostigmine, a powerful cholinesterase inhibitor. It is not a safe dietary supplement, and eating the bean can cause serious poisoning or death. Only the purified, regulated drug physostigmine has a legitimate medical use, and that must be prescribed and monitored by a doctor.

Physostigma venenosum · Fabaceae · Seeds (beans) · Not available as a safe consumer supplement; historically the seed and its extracts were used, and the alkaloid physostigmine is used in prescription medicines

An interaction check asks whether these two react with each other — it does not ask whether Calabar Bean is a good idea for someone in your situation. Here is what our Calabar Bean record says about it on its own.

Calabar Bean: dosing

There is no safe or established dose of Calabar bean for self-care, and it should not be taken as a supplement. The bean is poisonous, and the amount of physostigmine it contains can vary, making any home use extremely risky.The only proper medical use of this plant's active compound is the regulated prescription drug physostigmine, which a doctor doses precisely and monitors closely. Never attempt to use the bean yourself.

From our Calabar Bean monograph — the full record covers uses, side effects and every documented interaction.

Read the full Calabar Bean monograph & all interactions

Medication

About Dextromethorphan HBr, Guaifenesin

Most-Reported Side Effects for Dextromethorphan HBr, Guaifenesin

From FAERS, the FDA’s public side-effect reporting system (1,675 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dyspnea 140 reports

Pneumonia 123 reports

Nausea 120 reports

Cough 119 reports

Fatigue 118 reports

Keep checking

Other Drugs & Calabar Bean

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

0Major

0Moderate

195Minor

2,634No known interaction

195 Minor 2,634 No interaction

Minor

195 interactions

Showing 60 of 195 minor interactions — see all 195 on the Calabar Bean page.

No interaction 2,634 drugs checked — show the list

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

Showing the 60 most looked-up of 2,634 medications checked with no known interaction — see the full Calabar Bean list.

See the full Calabar Bean interactions page

See every supplement checked against Dextromethorphan HBr, Guaifenesin, ranked by severity

Evidence & sources

Calabar Bean References

The 2 references that drive our Calabar Bean monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Calabar Bean and Dextromethorphan HBr, Guaifenesin Together: Common Questions

Is it safe to take Calabar Bean with Dextromethorphan HBr, Guaifenesin?

We do not list a known interaction between Calabar Bean and Dextromethorphan HBr, Guaifenesin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.

How was the Calabar Bean and Dextromethorphan HBr, Guaifenesin combination checked?

Interactions in our licensed database are recorded against drug classes. Dextromethorphan HBr, Guaifenesin is filed under 6 classifications, and Calabar Bean has documented interactions with 1 drug class — none of Dextromethorphan HBr, Guaifenesin's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.

Does Calabar Bean interact with any other medications?

Yes. Calabar Bean has 195 documented drug interactions in our database — Dextromethorphan HBr, Guaifenesin is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

Does Dextromethorphan HBr, Guaifenesin interact with any supplements?

Yes. Dextromethorphan HBr, Guaifenesin has documented interactions with 171 supplements in our database — Calabar Bean is not one of them. The Dextromethorphan HBr, Guaifenesin interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Calabar Bean monograph Uses, safety profile, and every drug interaction in one place Dextromethorphan HBr, Guaifenesin supplement interactions Every supplement checked against Dextromethorphan HBr, Guaifenesin, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 2 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Dextromethorphan HBr, Guaifenesin and Calabar Bean?

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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.