Drug & supplement interaction

Calcium D-glucarate + Acetaminophen, Dextromethorphan, Pseudoephedrine

Acetaminophen, Dextromethorphan, Pseudoephedrine brand names: Alka-Seltzer PLUS Flu Liquid Gels, Tylenol Flu Daytime Ex Strength, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Ex Strength.

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

Calcium D-glucarate has a moderate interaction with Acetaminophen, Dextromethorphan, Pseudoephedrine. Theoretically, calcium D-glucarate might increase the clearance of drugs that undergo glucuronidation.

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

Calcium D-glucarate and Acetaminophen, Dextromethorphan, Pseudoephedrine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

GLUCURONIDATED DRUGS

Why this applies to Acetaminophen, Dextromethorphan, Pseudoephedrine

Acetaminophen, Dextromethorphan, Pseudoephedrine falls under GLUCURONIDATED DRUGS — the group Calcium D-glucarate interacts with.

Theoretically, calcium D-glucarate might increase the clearance of drugs that undergo glucuronidation.
The calcium D-glucarate metabolite, D-glucaro-1,4-lactone, inhibits the enzyme beta-glucuronidase, reducing deconjugation of glucuronides in the intestine and thereby reducing reabsorption of the drugs.
Severity Moderate Likelihood Possible Evidence B

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 with this combo cold-and-flu product (which mixes acetaminophen, dextromethorphan, and pseudoephedrine). Your liver tags certain drugs and worn-out compounds with a molecule so they can leave the body. Calcium D-glucarate may block a gut enzyme that normally undoes that tagging, so a little less of the drug gets reabsorbed back into your system. In theory, that could slightly lower levels of a medicine like acetaminophen, which is partly cleared this way.

In real life, this is mostly a theoretical concern based on lab work, not strong human studies. For an occasional cold medicine, it's unlikely to be a big deal. Still, if you take calcium D-glucarate regularly, mention it to your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Dwivedi C, Heck WJ, Downie AA, et al. Effect of calcium glucarate on B-glucuronidase activity and glucarate content on certain vegetables and fruits. Biochem Med Metab Bio 1990;43:83-92.
  2. 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
  3. Anon. Calcium-D-Glucarate. Altern Med Review 2002;7(4):336-9.

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

Calcium D-glucarate Also Interacts With Other Medications

Calcium D-glucarate has 124 moderate, 1 minor known drug interactions in our database — the Acetaminophen, Dextromethorphan, Pseudoephedrine one above is one of them. If you take anything else, check it against the full list below.

Moderate 124 Minor 1 No known interaction 2,705 (incl. Acetaminophen, Dextromethorphan, Pseudoephedrine)
Taking anything else?

Check Another of Your Medications Against Calcium D-glucarate

Covers the 2,830 medications we’ve checked against Calcium D-glucarate. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Dextromethorphan, Pseudoephedrine

This page covers Calcium D-glucarate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan, Pseudoephedrine page lists 262 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: 12 major · 207 moderate · 43 minor.

From our pharmacist’s overview on the Acetaminophen, Dextromethorphan, Pseudoephedrine page

“Ephedra is the ingredient to notice first here. Pseudoephedrine, the decongestant in Tylenol Flu, Alka-Seltzer PLUS Flu, and other acetaminophen, dextromethorphan, and pseudoephedrine combinations, is itself a stimulant, and 44 entries push the same direction, raising the odds of high blood pressure and a racing heart.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Dextromethorphan, Pseudoephedrine interaction page

One more smart check

Taking Calcium D-glucarate as Part of a Dietary Supplement Product? Check It for Interactions

We hold 369 real supplement products containing Calcium D-glucarate, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Calcium D-glucarate. Your product may carry other ingredients that interact with Acetaminophen, Dextromethorphan, Pseudoephedrine too, on top of Calcium D-glucarate — 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 Calcium D-glucarate and Acetaminophen, 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.

Supplement Calcium D-glucarate
Top half

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

29 days ago today
Medication Acetaminophen, Dextromethorphan, Pseudoephedrine
Top 25%

#371 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 Calcium D-glucarate

What is Calcium D-glucarate?

Calcium D-glucarate
  • Detoxification support
  • Hormone balance
  • Estrogen metabolism
  • Liver support
  • General wellness

Calcium D-glucarate is a supplement form of a natural compound found in fruits and vegetables that is promoted for 'detoxification' and helping the body clear excess hormones. Human evidence for these benefits is very limited, and most research comes from laboratory or animal studies. Talk to your pharmacist or doctor before using it, especially if you have a hormone-related condition.

Read the full Calcium D-glucarate monograph & all interactions
Keep checking

Other Drugs & Calcium D-glucarate

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

0Major
124Moderate
1Minor
2,704No known interaction
124 Moderate 1 Minor 2,704 No interaction
Moderate

124 interactions

Showing 60 of 124 moderate interactions — see all 124 on the Calcium D-glucarate page.

Minor

1 interaction

No interaction 2,704 drugs checked — show the list

We also checked Calcium D-glucarate against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,704 medications checked with no known interaction — see the full Calcium D-glucarate list.

See the full Calcium D-glucarate interactions page
See every supplement checked against Acetaminophen, Dextromethorphan, Pseudoephedrine, 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
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Pharmacist Counseling Corner

Taking Calcium D-glucarate and Acetaminophen, Dextromethorphan, Pseudoephedrine Together: Common Questions

Can you take Calcium D-glucarate with Acetaminophen, Dextromethorphan, Pseudoephedrine?
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.
How serious is the Calcium D-glucarate and Acetaminophen, Dextromethorphan, Pseudoephedrine 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 Acetaminophen, Dextromethorphan, Pseudoephedrine and Calcium D-glucarate?

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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.