Drug & supplement interaction

Catechu + Ephedrine Sulfate, Hydroxyzine, Theophylline

Ephedrine Sulfate, Hydroxyzine, Theophylline brand name: Hydroxy Compound.

Moderate Interaction
The bottom line Moderate

Ephedrine Sulfate, Hydroxyzine, Theophylline falls into 2 drug categories that Catechu can interact with; the most serious is rated moderate. Theoretically, black catechu may increase the levels and clinical effects of CYP1A2 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Catechu and Ephedrine Sulfate, Hydroxyzine, Theophylline

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Catechu interacts with whole categories of medication. Ephedrine Sulfate, Hydroxyzine, Theophylline falls into 2 of those categories, so it can interact with Catechu in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Ephedrine Sulfate, Hydroxyzine, Theophylline

Ephedrine Sulfate, Hydroxyzine, Theophylline falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Catechu interacts with.

Theoretically, black catechu may increase the levels and clinical effects of CYP1A2 substrates.
Animal research shows that black catechu can increase theophylline concentrations in the blood, possibly by inhibiting CYP1A2. Theophylline is a CYP1A2 substrate.
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

The piece of this combo product I want to focus on is the theophylline. Your liver clears theophylline using an enzyme called CYP1A2, and catechu may slow that enzyme down. If clearance slows, theophylline can build up in your blood. That matters a lot because theophylline has a narrow safety window, so even a small bump can push you from helpful into too much. Watch for things like nausea, a racing or pounding heart, jitteriness, trouble sleeping, or tremors, which could overlap with the ephedrine in this product too.

Honestly, this warning comes only from animal lab work, not human studies, so it is theoretical. Still, with theophylline I'd play it safe. Please check with your pharmacist or doctor before adding catechu.

References
  1. Al-Mohizea AM, Raish M, Ahad A, et al. Pharmacokinetic interaction of Acacia catechu with CYP1A substrate theophylline in rabbits. J Tradit Chin Med 2015;35(5):588-93. PubMed
Moderate

THEOPHYLLINE

2 of 2

Ephedrine Sulfate, Hydroxyzine, Theophylline also falls under THEOPHYLLINE.

Theoretically, black catechu may increase the levels and clinical effects of theophylline.
Animal research shows that black catechu can increase theophylline concentrations in the blood, possibly by inhibiting cytochrome P450 1A2.
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

The piece of your combo product I want to talk about here is the theophylline. Theophylline is cleared from your body mainly by a liver enzyme called CYP1A2. In animal studies, the tannins in catechu appear to slow that enzyme down, which could let theophylline build up to higher levels than usual.

Theophylline has a narrow safety window, so even modest increases can matter. If levels creep up, you might notice nausea, a jittery or racing heartbeat, trouble sleeping, or in larger amounts, shakiness. To be honest, this is based only on lab and animal data, so it is more of a theoretical concern than a proven problem. Still, before adding catechu, it is worth a quick chat with your pharmacist or doctor.

References
  1. Al-Mohizea AM, Raish M, Ahad A, et al. Pharmacokinetic interaction of Acacia catechu with CYP1A substrate theophylline in rabbits. J Tradit Chin Med 2015;35(5):588-93. PubMed

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

Catechu Also Interacts With Other Medications

Catechu has 474 moderate known drug interactions in our database — the Ephedrine Sulfate, Hydroxyzine, Theophylline one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Catechu

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

Everything else you take

See Every Supplement That Interacts With Ephedrine Sulfate, Hydroxyzine, Theophylline

This page covers Catechu only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ephedrine Sulfate, Hydroxyzine, Theophylline page lists 199 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Ephedra (major), Henbane (major), Peyote (major) and Rauvolfia Vomitoria (major).

By severity: 7 major · 153 moderate · 39 minor.

From our pharmacist’s overview on the Ephedrine Sulfate, Hydroxyzine, Theophylline page

“Someone taking Hydroxy Compound (ephedrine sulfate, hydroxyzine, and theophylline) for breathing problems is juggling three drugs at once, and the supplement list shows it: 199 interacting ingredients, seven of them rated major, and this page deserves genuine seriousness. The sharpest risks come from stimulant botanicals, ephedra above…”

Reviewed by 2 · Jul 18, 2026

Open the Ephedrine Sulfate, Hydroxyzine, Theophylline interaction page

One more smart check

Taking Catechu as Part of a Dietary Supplement Product? Check It for Interactions

We hold 122 real supplement products containing Catechu, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Catechu. Your product may carry other ingredients that interact with Ephedrine Sulfate, Hydroxyzine, Theophylline too, on top of Catechu — 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 Catechu and Ephedrine Sulfate, Hydroxyzine, Theophylline 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 Catechu
Top half

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

29 days ago today
Medication Ephedrine Sulfate, Hydroxyzine, Theophylline
Top 10%

#266 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 Catechu

What is Catechu?

Catechu
  • Mouth and throat soreness
  • Diarrhea and digestive upset
  • Skin wounds and bleeding gums
  • Astringent gargles and rinses
  • Traditional remedy for inflammation

Catechu is an astringent extract made from the heartwood of the Acacia (Senegalia) catechu tree, used traditionally for mouth sores, sore throat, diarrhea, and minor skin problems. Strong human evidence is lacking for most uses, so it should be viewed as a traditional remedy rather than a proven treatment. Talk to your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Catechu monograph & all interactions
Keep checking

Other Drugs & Catechu

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

0Major
474Moderate
0Minor
2,355No known interaction
Moderate

474 interactions

Showing 60 of 474 moderate interactions — see all 474 on the Catechu page.

No interaction 2,355 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 Catechu and Ephedrine Sulfate, Hydroxyzine, Theophylline Together: Common Questions

Can you take Catechu with Ephedrine Sulfate, Hydroxyzine, Theophylline?
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.
Why are there 2 interactions listed for Catechu and Ephedrine Sulfate, Hydroxyzine, Theophylline?
Ephedrine Sulfate, Hydroxyzine, Theophylline belongs to more than one drug category, and Catechu interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Catechu and Ephedrine Sulfate, Hydroxyzine, Theophylline 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.