Cannabidiol (cbd) + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide
Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide brand name: Coricidin HBP Maximum Strength Flu.
Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide falls into 5 drug categories that Cannabidiol (cbd) can interact with; the most serious is rated moderate. Theoretically, cannabidiol might increase levels of drugs metabolized by CYP2D6.
Read the full interaction reportCannabidiol (cbd) and Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide
These two interact in 5 distinct ways. Each one is explained separately below.
Why Are There 5 Interactions?
Cannabidiol (cbd) interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide falls into 5 of those categories, so it can interact with Cannabidiol (cbd) in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 5Why this applies to Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide
Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Cannabidiol (cbd) interacts with.
In vitro research shows that cannabidiol inhibits CYP2D6. Theoretically, concomitant use of cannabidiol with CYP2D6 substrates might increase the risk for adverse effects from these substrates. However, a clinical crossover trial in healthy adults shows that cannabidiol does not inhibit dextromethorphan, a substrate of CYP2D6.
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 combo medicine (Coricidin HBP Cold & Flu) contains a couple of ingredients that the liver enzyme CYP2D6 helps clear, including the cough suppressant dextromethorphan and the antihistamine chlorpheniramine. In a lab setting, CBD can slow that enzyme down, which in theory could let these ingredients build up and make their effects stronger. With dextromethorphan that might mean more drowsiness or dizziness, and chlorpheniramine can add to that sleepy, dry-mouth feeling.
Here's the reassuring part: this concern is mostly theoretical. A real human study found that CBD did not meaningfully block dextromethorphan's breakdown. So a serious interaction seems unlikely, but since both products can cause sleepiness, it's worth a quick chat with your pharmacist before pairing them.
- Yamaori S, Okamoto Y, Yamamoto I, Watanabe K. Cannabidiol, a major phytocannabinoid, as a potent atypical inhibitor for CYP2D6. Drug Metab Dispos 2011;39(11):2049-56. PubMed
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
- Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
2 of 5Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro research shows that cannabidiol inhibits CYP1A2. Furthermore, clinical studies show that cannabidiol may inhibit the metabolism of caffeine, a CYP1A2 substrate. Two pharmacokinetic studies in healthy adults show that taking cannabidiol dosed 640 mg once up to 750 twice daily increases the area under the curve of caffeine. However, results are mixed over whether cannabidiol impacts peak serum levels of caffeine.
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..
This Coricidin product is a combo of three medicines: acetaminophen (a pain and fever reducer), chlorpheniramine (an antihistamine), and dextromethorphan (a cough suppressant). CBD can block a liver enzyme called CYP1A2, which can slow down how certain drugs are cleared from your body. None of these three are strong CYP1A2 drugs, so this particular interaction is more of a theoretical concern than something I'd expect to cause real trouble at normal cold-medicine doses.
Still, if any of these did build up a bit, you might notice more drowsiness, dizziness, or dry mouth (mostly from the chlorpheniramine). High CBD doses are where this matters most, not occasional use. Before combining them, just run it by your pharmacist or doctor, especially if you take other sedating medicines.
- Yamaori S, Kushihara M, Yamamoto I, Watanabe K. Characterization of major phytocannabinoids, cannabidiol and cannabinol, as isoform-selective potent inhibitors of human CYP1 enzymes. Biochem Pharmacol 2010;79(11):1691-8.
- Thai C, Tayo B, Critchley D. A Phase 1 Open-Label, Fixed-Sequence Pharmacokinetic Drug Interaction Trial to Investigate the Effect of Cannabidiol on the CYP1A2 Probe Caffeine in Healthy Subjects. Clin Pharmacol Drug Dev. 2021. PubMed
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
- Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 5Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro and animal research shows that cannabidiol inhibits CYP3A4. In human studies and case reports, cannabidiol has been associated with an increase in plasma levels of the CYP3A4 substrates zonisamide, tacrolimus, everolimus, citalopram, midazolam, and methadone.
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..
This combo cold product has three active ingredients, and the one that matters most here is dextromethorphan (the cough suppressant). Your body partly clears it through an enzyme called CYP3A4, and CBD can slow that enzyme down. When that happens, dextromethorphan can build up a bit higher than usual, which may bring on more drowsiness, dizziness, or in larger amounts feeling spacey or foggy.
The acetaminophen and chlorpheniramine pieces aren't a big concern through this pathway, though chlorpheniramine already causes its own sleepiness, so things can add up. This is an occasional-use cold medicine, so a single dose isn't likely to cause real trouble, but it's smart to run it by your pharmacist first, especially with concentrated CBD products.
- Yamaori S, Ebisawa J, Okushima Y, et al. Potent inhibition of human cytochrome P450 3A isoforms by cannabidiol: role of phenolic hydroxyl groups in the resorcinol moiety. Life Sci 2011;88(15-16):730-6. PubMed
- Harvey DJ. Absorption, distribution, and biotransformation of the cannabinoids. Marijuana and Medicine. 1999;91-103. DOI
- Bornheim LM, Everhart ET, Li J, Correia MA. Characterization of cannabidiol-mediated cytochrome P450 inactivation. Biochem Pharmacol 1993;45(6):1323-31. PubMed
- Gaston TE, Bebin EM, Cutter GR, Liu Y, Szaflarski JP; UAB CBD Program. Interactions between cannabidiol and commonly used antiepileptic drugs. Epilepsia. 2017 Sep;58(9):1586-92. PubMed
- Leino AD, Emoto C, Fukuda T, Privitera M, Vinks AA, Alloway RR. Evidence of a clinically significant drug-drug interaction between cannabidiol and tacrolimus. Am J Transplant. 2019;19(10):2944-2948. PubMed
- Wiemer-Kruel A, Stiller B, Bast T. Cannabidiol Interacts Significantly with Everolimus-Report of a Patient with Tuberous Sclerosis Complex. Neuropediatrics. 2019. PubMed
- Madden K, Tanco K, Bruera E. Clinically Significant Drug-Drug Interaction Between Methadone and Cannabidiol. Pediatrics. 2020;e20193256. PubMed
- Anderson LL, Doohan PT, Oldfield L, et al. Citalopram and Cannabidiol: In Vitro and In Vivo Evidence of Pharmacokinetic Interactions Relevant to the Treatment of Anxiety Disorders in Young People. J Clin Psychopharmacol. 2021. PubMed
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
- Treyer A, Reinhardt JK, Eigenmann DE, Oufir M, Hamburger M. Phytochemical comparison of medicinal cannabis extracts and study of their CYP-mediated interactions with coumarinic oral anticoagulants. Med Cannabis Cannabinoids. 2023;6(1):21-31. PubMed
- Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.
GLUCURONIDATED DRUGS
4 of 5Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide also falls under GLUCURONIDATED DRUGS.
In vitro research shows that cannabidiol inhibits uridine diphosphoglucuronosyl transferase (UGT) 1A9 and UGT2B7, enzymes responsible for glucuronidation. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs.
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 Coricidin HBP product is a combo of three ingredients, and one of them, acetaminophen (Tylenol), is partly cleared by a process called glucuronidation. In lab studies (not in people yet), CBD has been shown to slow down some of the enzymes that handle this step. The theory is that CBD could let a bit more acetaminophen linger in your system.
I want to be honest with you: this is based only on test-tube data, so it's a possible concern, not a proven one. At normal label doses it's unlikely to cause obvious problems. Still, since acetaminophen can stress the liver in higher amounts, it's smart not to double up on other acetaminophen products and to check with your pharmacist before pairing this cold medicine with regular CBD use.
- Epidiolex (cannabidiol) prescribing information. Greenwich Biosciences, Inc., Carlsbad, CA, 2019. Available at: https://www.epidiolex.com/sites/default/files/EPIDIOLEX_Full_Prescribing_Information.pdf (accessed 5/9/2019)
CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES
5 of 5Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.
In vitro research shows that cannabidiol inhibits CYP2E1. So far, this interaction has not been reported 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 combo cold product (Coricidin HBP) contains acetaminophen (Tylenol), and that's the piece this interaction touches. Acetaminophen is partly handled by a liver enzyme called CYP2E1. In lab dish studies, CBD appears to slow that enzyme down. The theory is that if CYP2E1 is blocked, a bit more acetaminophen could linger in the body.
Here's the honest part: this has only been seen in test tubes, never reported in real people, so the concern is mostly theoretical. Still, since acetaminophen can stress the liver in higher amounts, it's worth being mindful not to overdo total acetaminophen from all sources. If you regularly use CBD and take products like this, just run it by your pharmacist or doctor first.
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. 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.
Cannabidiol (cbd) Also Interacts With Other Medications
Cannabidiol (cbd) has 1,051 moderate known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Cannabidiol (cbd)
We haven’t checked that one against Cannabidiol (cbd) yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Cannabidiol (cbd). Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide
This page covers Cannabidiol (cbd) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide page lists 275 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), Grapefruit (major) and Henbane (major).
Open the Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interaction page
Where Cannabidiol (cbd) and Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide 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.
#456 of 1,452 supplements looked up here in the last 7 days
#1,226 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 Cannabidiol (cbd)
What is Cannabidiol (cbd)?
- Anxiety and stress
- Sleep problems
- Chronic pain
- Certain seizure disorders
- Inflammation
CBD is a compound from the cannabis (hemp) plant that does not cause a 'high.' It has strong evidence only for certain rare seizure disorders (as a prescription drug), while most other popular uses are still backed by limited or early research. Product quality varies a lot, so talk with your pharmacist or doctor before using it, especially if you take other medicines.
Other Drugs & Cannabidiol (cbd)
Browse every other medication we’ve checked against Cannabidiol (cbd) — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,051 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Diphenhydramine ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Griseofulvin ›
- Ivabradine ›
Showing 60 of 1,051 moderate interactions — see all 1,051 on the Cannabidiol (cbd) page.
No interaction 1,778 drugs checked — show the list
We also checked Cannabidiol (cbd) against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Rosuvastatin ›
- Aspirin ›
- Tirzepatide ›
- Levothyroxine, Liothyronine ›
- Docusate ›
- Metformin ›
- Semaglutide ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Lisinopril ›
- Amoxicillin ›
- Methotrexate ›
- Azithromycin ›
- Doxycycline ›
- Acyclovir ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Acetylsalicylic Acid ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Insulin Degludec, Liraglutide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aspirin, Butalbital ›
- Atenolol, Chlorthalidone ›
- Enalapril Maleate ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Ezetimibe ›
- Cephalexin ›
- Levodopa ›
- Cyclopentolate ›
- Insulin Aspart, Insulin Degludec ›
- Canagliflozin, Metformin ›
- Candesartan Cilexetil, Hydrochlorothiazide ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Daunorubicin, Cytarabine ›
- Saxagliptin, Metformin Xr ›
- Sodium Bicarbonate (otc Drug) ›
- Efgartigimod Alfa-fcab ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Alginic Acid, Aluminum Hydroxide ›
- Measles, Mumps, Rubella Virus Live ›
- Cytomegalovirus Immune Globulin ›
- Mannitol ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Fosinopril, Hydrochlorothiazide ›
- Atropine Methyl Nitrate, Digestive Enzymes ›
- Peginterferon Alfa-2a, Ribavirin ›
- Pyrilamine Maleate ›
- Aminolevulinic Acid Hydrochloride ›
- Sulfadiazine, Trimethoprim ›
- Glycerol Phenylbutyrate ›
- Tubocurarine ›
- Psyllium , Senna (otc Drug) ›
- Alpha-1 Proteinase Inhibitor ›
Showing the 60 most looked-up of 1,778 medications checked with no known interaction — see the full Cannabidiol (cbd) 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 Hydrobromide Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide as a medicine that can lower these. This is not an interaction with Cannabidiol (cbd) — 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 Cannabidiol (cbd) and Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide Together: Common Questions
Can you take Cannabidiol (cbd) with Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide?
Why are there 5 interactions listed for Cannabidiol (cbd) and Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide?
How serious is the Cannabidiol (cbd) and Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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