Drug & supplement interaction

Calotropis + Acetaminophen, Pamabrom, Pyrilamine

Acetaminophen, Pamabrom, Pyrilamine brand names: Midol Max Strength PMS, Pamprin, Pamprin ES.

Moderate Interaction
The bottom line Moderate

Calotropis has a moderate interaction with Acetaminophen, Pamabrom, Pyrilamine. Theoretically, concomitant use of calotropis and potassium depleting diuretics can increase the risk of cardiac glycoside toxicity due to potassium depletion.

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

Calotropis and Acetaminophen, Pamabrom, Pyrilamine

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

Moderate

DIURETIC DRUGS

Why this applies to Acetaminophen, Pamabrom, Pyrilamine

Acetaminophen, Pamabrom, Pyrilamine falls under DIURETIC DRUGS — the group Calotropis interacts with.

Theoretically, concomitant use of calotropis and potassium depleting diuretics can increase the risk of cardiac glycoside toxicity due to potassium depletion. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), 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 connection worth knowing. Products like Midol Max Strength PMS and Pamprin combine acetaminophen, pyrilamine (an antihistamine), and pamabrom, which is a mild diuretic, or water pill, meant to ease bloating. Diuretics can lower your body's potassium a bit. Calotropis naturally contains cardiac glycosides, heart-active compounds similar to digoxin, and low potassium makes those compounds more likely to disturb your heart's rhythm.

So in theory, pairing the two could raise the chance of heart-related side effects from the calotropis, like an irregular or pounding heartbeat. I'll be honest though: this is a theoretical concern based on how these things work, not proven cases, and the pamabrom dose here is small. Still, since calotropis can be genuinely toxic, I'd skip taking it internally and check with your doctor or pharmacist first.

References
  1. Robbers JE, Speedie MK, Tyler VE. Pharmacognosy and Pharmacobiotechnology. Baltimore, MD: Williams & Wilkins, 1996.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

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

Calotropis Also Interacts With Other Medications

Calotropis has 97 moderate known drug interactions in our database — the Acetaminophen, Pamabrom, Pyrilamine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Calotropis

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Pamabrom, Pyrilamine

This page covers Calotropis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Pamabrom, Pyrilamine page lists 274 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 Henbane (major).

By severity: 14 major · 218 moderate · 42 minor.

Open the Acetaminophen, Pamabrom, Pyrilamine interaction page

How much people look this up

Where Calotropis and Acetaminophen, Pamabrom, Pyrilamine 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 Calotropis
Steady interest

#1,191 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Acetaminophen, Pamabrom, Pyrilamine
Top 10%

#174 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 Calotropis

What is Calotropis?

  • Skin conditions and wounds (traditional, topical)
  • Joint pain and inflammation
  • Digestive complaints
  • Coughs and respiratory issues
  • Traditional Ayurvedic and folk remedies

Calotropis is a milkweed-family plant long used in traditional medicine, but its milky latex and other parts are potentially toxic and can harm the eyes, skin, and heart. Human evidence for any health benefit is very limited, and the risk of poisoning is real, so it should not be taken internally without expert medical supervision.

Read the full Calotropis monograph & all interactions
Keep checking

Other Drugs & Calotropis

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

0Major
97Moderate
0Minor
2,732No known interaction
Moderate

97 interactions

Showing 60 of 97 moderate interactions — see all 97 on the Calotropis page.

No interaction 2,732 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 Calotropis and Acetaminophen, Pamabrom, Pyrilamine Together: Common Questions

Can you take Calotropis with Acetaminophen, Pamabrom, Pyrilamine?
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 Calotropis and Acetaminophen, Pamabrom, Pyrilamine 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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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.