Ceylon Leadwort + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine
Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine brand names: Robitussin Cold, Suphedrine Cold/Cough, Severe Cold.
Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine falls into 4 drug categories that Ceylon Leadwort can interact with; the most serious is rated moderate. Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 2D6 (CYP2D6) in vitro.
Read the full interaction reportCeylon Leadwort and Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Ceylon Leadwort interacts with whole categories of medication. Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine falls into 4 of those categories, so it can interact with Ceylon Leadwort in 4 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 4Why this applies to Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine
Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Ceylon Leadwort interacts with.
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.
In this combination cold product, the ingredient that matters here is dextromethorphan, the cough suppressant. Your body uses an enzyme called CYP2D6 to clear it. Lab studies (test tube only, not people) suggest plumbagin from Ceylon Leadwort may slow that enzyme down. If that happened in real life, dextromethorphan could build up a bit, which might mean more drowsiness, dizziness, or feeling foggy. The acetaminophen, guaifenesin, and pseudoephedrine pieces aren't really affected by this pathway.
I want to be honest with you: this is only a theoretical concern based on early lab work, and it hasn't been reported in actual patients. Still, if you plan to use both regularly, it's worth a quick chat with your pharmacist or doctor first.
- Chen A, Zhou X, Tang S, Liu M, Wang X. Evaluation of the inhibition potential of plumbagin against cytochrome P450 using LC-MS/MS and cocktail approach. Sci Rep. 2016 Jun 22;6:28482. PubMed
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
2 of 4Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
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 honest picture with this cold and cough combo. A compound in Ceylon Leadwort called plumbagin can block a liver enzyme known as CYP1A2, at least in lab dish studies. Of the ingredients in your product, that mostly matters for the dextromethorphan (the cough suppressant), since its breakdown partly runs through that pathway. In theory, slowing that enzyme could let dextromethorphan build up a bit, which might mean more drowsiness, dizziness, or feeling foggy.
That said, this is only seen in test tubes so far, never reported in real people, so I wouldn't lose sleep over it. The acetaminophen, guaifenesin, and pseudoephedrine aren't really driven by this enzyme. Still, run it by your pharmacist before combining them, especially if you take other sedating medicines.
- Chen A, Zhou X, Tang S, Liu M, Wang X. Evaluation of the inhibition potential of plumbagin against cytochrome P450 using LC-MS/MS and cocktail approach. Sci Rep. 2016 Jun 22;6:28482. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
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 practical picture with this combination cold product. One ingredient, dextromethorphan (the cough suppressant), is partly broken down by the liver enzyme CYP3A4. A compound in Ceylon Leadwort called plumbagin can slow that enzyme down, at least in lab dishes. In theory, that could let dextromethorphan build up a bit, which might mean more drowsiness, dizziness, or a foggy, lightheaded feeling.
The important caveat: this is based only on test-tube research, not real people, so the actual risk looks low. The other ingredients (acetaminophen, guaifenesin, pseudoephedrine) aren't mainly cleared this way. None of these are prodrugs needing CYP3A4 to work. Still, if you take Ceylon Leadwort regularly, check with your pharmacist or doctor first.
- Chen A, Zhou X, Tang S, Liu M, Wang X. Evaluation of the inhibition potential of plumbagin against cytochrome P450 using LC-MS/MS and cocktail approach. Sci Rep. 2016 Jun 22;6:28482. PubMed
CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES
4 of 4Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.
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 piece that matters in your cold combo: the acetaminophen part is handled by a liver enzyme called CYP2E1. A compound in Ceylon Leadwort, plumbagin, has slowed down that enzyme in lab dish studies. If that held true in people, your body might clear acetaminophen a bit more slowly, so levels could run higher than expected. The main worry there is on the liver, especially if you're already taking acetaminophen in other products or drinking alcohol.
Honestly though, this is only seen in test-tube work, not in real patients, so I wouldn't lose sleep over an occasional dose. The decongestant, cough, and mucus parts aren't really affected. Just keep total acetaminophen under control and check with your pharmacist before adding this herb regularly.
- Chen A, Zhou X, Tang S, Liu M, Wang X. Evaluation of the inhibition potential of plumbagin against cytochrome P450 using LC-MS/MS and cocktail approach. Sci Rep. 2016 Jun 22;6:28482. 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.
Ceylon Leadwort Also Interacts With Other Medications
Ceylon Leadwort has 1,098 moderate known drug interactions in our database — the Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Ceylon Leadwort
We haven’t checked that one against Ceylon Leadwort yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Ceylon Leadwort. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine
This page covers Ceylon Leadwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan, Guaifenesin, 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.
Open the Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interaction page
Taking Ceylon Leadwort as Part of a Dietary Supplement Product? Check It for Interactions
We hold 96 real supplement products containing Ceylon Leadwort, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ceylon Leadwort. Your product may carry other ingredients that interact with Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine too, on top of Ceylon Leadwort — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Ceylon Leadwort and Acetaminophen, Dextromethorphan, Guaifenesin, 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.
#528 of 1,452 supplements looked up here in the last 7 days
#194 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 Ceylon Leadwort
What is Ceylon Leadwort?
- Digestive complaints and poor appetite
- Skin conditions and wounds (applied to the skin)
- Joint pain and swelling
- Traditional 'metabolism-boosting' tonics
- Antimicrobial folk remedy
Ceylon Leadwort (Plumbago zeylanica) is a plant long used in Ayurvedic and other traditional medicine systems, mainly for digestion, skin problems, and pain. Solid human studies are lacking, and the plant contains plumbagin, a compound that can irritate skin and tissues and may be unsafe in larger amounts. Talk to a pharmacist or doctor before using it, and avoid it in pregnancy.
Other Drugs & Ceylon Leadwort
Browse every other medication we’ve checked against Ceylon Leadwort — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,098 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Orphenadrine ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ketoprofen ›
Showing 60 of 1,098 moderate interactions — see all 1,098 on the Ceylon Leadwort page.
No interaction 1,731 drugs checked — show the list
We also checked Ceylon Leadwort against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Rosuvastatin ›
- Levothyroxine, Liothyronine ›
- Isotretinoin ›
- Docusate ›
- Sumatriptan ›
- Amoxicillin ›
- Lisinopril ›
- Valacyclovir ›
- Hydroxyurea ›
- Methotrexate ›
- Azithromycin ›
- Doxycycline ›
- Pregabalin ›
- Gabapentin ›
- Lamotrigine ›
- Acyclovir ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aminophylline, Amobarbital, Ephedrine ›
- Atenolol, Chlorthalidone ›
- Enalapril Maleate ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Ezetimibe ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Cephalexin ›
- Ephedrine, Phenobarbital, Theophylline ›
- Candesartan Cilexetil, Hydrochlorothiazide ›
- Levetiracetam ›
- Daunorubicin, Cytarabine ›
- Carbidopa, Levodopa ›
- Levodopa ›
- Atenolol ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Sodium Bicarbonate (otc Drug) ›
- Atropine Methyl Nitrate, Digestive Enzymes ›
- Cytomegalovirus Immune Globulin ›
- Cyclopentolate ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Fosinopril, Hydrochlorothiazide ›
- Amobarbital, Ephedrine Sulfate ›
- Thyroid Hormone ›
- Measles, Mumps, Rubella Virus Live ›
- Aminolevulinic Acid Hydrochloride ›
- Alginic Acid, Aluminum Hydroxide ›
- Pyrilamine Maleate ›
- Vestronidase Alfa-vjbk ›
- Glycerol Phenylbutyrate ›
- Mannitol ›
- Psyllium , Senna (otc Drug) ›
- Neomycin, Polymyxin B, Gramicidin ›
- Lonapegsomatropin-tcgd ›
- Tubocurarine ›
- Human Papillomavirus Vaccine ›
Showing the 60 most looked-up of 1,731 medications checked with no known interaction — see the full Ceylon Leadwort 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, Dextromethorphan, Guaifenesin, Pseudoephedrine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine as a medicine that can lower these. This is not an interaction with Ceylon Leadwort — 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 Ceylon Leadwort and Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine Together: Common Questions
Can you take Ceylon Leadwort with Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine?
Why are there 4 interactions listed for Ceylon Leadwort and Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine?
How serious is the Ceylon Leadwort and Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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