Cannabidiol (cbd) + Acetaminophen, Phenylpropanolamine, Phenyltoloxamine
Acetaminophen, Phenylpropanolamine, Phenyltoloxamine brand name: Sinubid.
Acetaminophen, Phenylpropanolamine, Phenyltoloxamine falls into 3 drug categories that Cannabidiol (cbd) can interact with; the most serious is rated moderate. Cannabidiol may increase levels of drugs metabolized by CYP1A2.
Read the full interaction reportCannabidiol (cbd) and Acetaminophen, Phenylpropanolamine, Phenyltoloxamine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Cannabidiol (cbd) interacts with whole categories of medication. Acetaminophen, Phenylpropanolamine, Phenyltoloxamine falls into 3 of those categories, so it can interact with Cannabidiol (cbd) in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 3Why this applies to Acetaminophen, Phenylpropanolamine, Phenyltoloxamine
Acetaminophen, Phenylpropanolamine, Phenyltoloxamine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Cannabidiol (cbd) interacts with.
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..
Here's the practical picture with Sinubid, which combines acetaminophen (pain and fever reliever), phenylpropanolamine (a decongestant), and phenyltoloxamine (an antihistamine). CBD can slow down a liver enzyme called CYP1A2. When that enzyme is blocked, certain medicines it normally clears can hang around a little longer and build up slightly, which may nudge their effects and side effects upward.
For this particular combo, none of these three are prodrugs that need activating, so the concern is mild buildup rather than lost effect. Realistically that might mean a bit more drowsiness, dry mouth, jitteriness or trouble sleeping from the decongestant, or a faster heartbeat. The effect is usually modest, and it's most likely with concentrated CBD doses, not tiny amounts. Still, run it past your pharmacist or doctor first, especially if you have high blood pressure.
- 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.
GLUCURONIDATED DRUGS
2 of 3Acetaminophen, Phenylpropanolamine, Phenyltoloxamine 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.
Sinubid combines three ingredients, and the one that matters most here is the acetaminophen (the same drug as Tylenol). Your body clears acetaminophen partly through a process called glucuronidation. Lab studies suggest CBD can slow down some of the enzymes that handle that step, which in theory could let acetaminophen build up a bit higher than usual.
I want to be honest with you: this is based only on test-tube research, not real people, so the actual risk is likely small. Still, since too much acetaminophen can stress the liver, it's worth being mindful, especially if you use CBD regularly or take other products that also contain acetaminophen. Keep your total daily acetaminophen in check, and check with your pharmacist before pairing these two.
- 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
3 of 3Acetaminophen, Phenylpropanolamine, Phenyltoloxamine 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.
Here's the short version on combining CBD with Sinubid, which is a combo product containing acetaminophen (the pain and fever reducer), phenylpropanolamine (a decongestant), and phenyltoloxamine (an antihistamine). The piece we're watching is the acetaminophen. Lab studies in test tubes suggest CBD can slow down an enzyme called CYP2E1, which is one pathway your liver uses to process acetaminophen. In theory, slowing that pathway could nudge acetaminophen levels a bit higher.
I want to be honest about the strength here: this is only seen in lab and animal work, and it has not actually been reported in real people. So I wouldn't lose sleep over an occasional dose. Still, because acetaminophen is hard on the liver in large amounts, it's smart to avoid stacking extra acetaminophen products and to check in with your pharmacist before adding CBD.
- 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, Phenylpropanolamine, Phenyltoloxamine 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, Phenylpropanolamine, Phenyltoloxamine
This page covers Cannabidiol (cbd) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Phenylpropanolamine, Phenyltoloxamine page lists 196 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 Peyote (major).
By severity: 9 major · 148 moderate · 39 minor.
Open the Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interaction page
Where Cannabidiol (cbd) and Acetaminophen, Phenylpropanolamine, Phenyltoloxamine 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.
#383 of 1,452 supplements looked up here in the last 7 days
#155 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 ›
- Levothyroxine, Liothyronine ›
- Tirzepatide ›
- Metformin ›
- Docusate ›
- Semaglutide ›
- Lisinopril ›
- Sumatriptan ›
- Amoxicillin ›
- Valacyclovir ›
- Hydroxyurea ›
- Methotrexate ›
- Azithromycin ›
- Doxycycline ›
- Acyclovir ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Acetylsalicylic Acid ›
- Insulin Degludec, Liraglutide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aspirin, Butalbital ›
- Atenolol, Chlorthalidone ›
- Enalapril Maleate ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Ezetimibe ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Cephalexin ›
- Insulin Aspart, Insulin Degludec ›
- Canagliflozin, Metformin ›
- Candesartan Cilexetil, Hydrochlorothiazide ›
- Daunorubicin, Cytarabine ›
- Atenolol ›
- Levodopa ›
- Carbidopa, Levodopa ›
- Saxagliptin, Metformin Xr ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Sodium Bicarbonate (otc Drug) ›
- Cyclopentolate ›
- Efgartigimod Alfa-fcab ›
- Atropine Methyl Nitrate, Digestive Enzymes ›
- Cytomegalovirus Immune Globulin ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Measles, Mumps, Rubella Virus Live ›
- Pyrilamine Maleate ›
- Alginic Acid, Aluminum Hydroxide ›
- Thyroid Hormone ›
- Fosinopril, Hydrochlorothiazide ›
- Aminolevulinic Acid Hydrochloride ›
- Vestronidase Alfa-vjbk ›
- Glycerol Phenylbutyrate ›
- Psyllium , Senna (otc Drug) ›
- Mannitol ›
- Acarbose ›
- Neomycin, Polymyxin B, Gramicidin ›
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, Phenylpropanolamine, Phenyltoloxamine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Phenylpropanolamine, Phenyltoloxamine 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:
Read the full Acetaminophen, Phenylpropanolamine, Phenyltoloxamine nutrient depletion report ›
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, Phenylpropanolamine, Phenyltoloxamine Together: Common Questions
Can you take Cannabidiol (cbd) with Acetaminophen, Phenylpropanolamine, Phenyltoloxamine?
Why are there 3 interactions listed for Cannabidiol (cbd) and Acetaminophen, Phenylpropanolamine, Phenyltoloxamine?
How serious is the Cannabidiol (cbd) and Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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