Ceylon Leadwort + Benzhydrocodone, Acetaminophen
Benzhydrocodone, Acetaminophen brand name: Apadaz.
Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen
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. Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen
Benzhydrocodone, Acetaminophen 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.
Here's the wrinkle with Apadaz: the benzhydrocodone part is a prodrug. Your body has to convert it into hydrocodone, and then an enzyme called CYP2D6 turns some of that into hydromorphone, which adds to the pain relief. Ceylon Leadwort contains plumbagin, which (in lab dishes only) appears to slow CYP2D6 down.
If that slowdown happened in people, it could mean less of that active form, so the medication might not control your pain as well. But honestly, this is only test-tube data and hasn't been seen in real patients, so I wouldn't lose sleep over it. Still, since opioids are serious medicines, please run any use of this supplement past 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 4Benzhydrocodone, Acetaminophen 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 gist with Apadaz (benzhydrocodone and acetaminophen) and Ceylon Leadwort. A compound in the plant called plumbagin can slow down a liver enzyme known as CYP1A2 in lab dishes. In theory, blocking that enzyme could let certain medicines build up a bit more than expected. So far this has only been seen in test tubes, never in real people, so the concern is more of a maybe than a sure thing.
If levels of this pain medicine did climb, you might notice stronger opioid effects like extra drowsiness, dizziness, constipation, or slowed breathing. Because that's a meaningful risk with any opioid, I'd play it safe. Please check with your pharmacist or doctor before pairing these, and don't change how you take your medicine on your own.
- 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 4Benzhydrocodone, Acetaminophen 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 key thing about Apadaz: the benzhydrocodone part is a prodrug. Your body has to convert it into hydrocodone before it can ease your pain, and CYP3A4 is one of the enzymes involved in that opioid's breakdown. Ceylon Leadwort contains plumbagin, which slowed down CYP3A4 in lab dishes. In theory, blocking that enzyme could let more active opioid linger in your system, raising the odds of side effects like heavy drowsiness, dizziness, constipation, nausea, or slowed breathing.
I want to be honest with you, though: this is only based on test-tube research, not real people taking the two together, so it stays theoretical. Still, since opioids carry real risks, please run it by your pharmacist or doctor before combining them.
- 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 4Benzhydrocodone, Acetaminophen 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 for Apadaz: the acetaminophen half of this combo is partly handled by a liver enzyme called CYP2E1. In lab (test tube) studies, the plumbagin in Ceylon Leadwort slowed that enzyme down. In theory, blocking it could shift how acetaminophen is processed. The honest truth, though, is that this has never been shown in real people, and it's based only on early lab work, so I wouldn't lose sleep over it.
Interestingly, CYP2E1 is the same path that turns acetaminophen into a byproduct that's hard on the liver, so slowing it isn't automatically a bad thing. Still, since high or daily doses of acetaminophen already stress the liver, it's worth a quick chat with your pharmacist before adding this supplement, especially if you drink alcohol or take other acetaminophen products.
- 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 1,096 moderate known drug interactions in our database — the Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen
This page covers Ceylon Leadwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Benzhydrocodone, Acetaminophen page lists 299 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Gamma-hydroxybutyrate (ghb) (major).
By severity: 14 major · 239 moderate · 46 minor.
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 Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen 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.
#548 of 1,452 supplements looked up here in the last 7 days
#2,150 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.
About Benzhydrocodone and Acetaminophen
What Is Benzhydrocodone and Acetaminophen Used For?
Brand name: Apadaz
Apadaz is indicated for the short-term management of acute pain — up to 14 days — that is severe enough to require an opioid and for which non-opioid treatments have not worked or are not expected to work. It combines benzhydrocodone (a prodrug that converts to the opioid hydrocodone) with acetaminophen.
Because of serious risks including addiction, abuse, and misuse, Apadaz is reserved for patients who have not tolerated or have not gotten adequate relief from alternative pain treatments. It should not be used for an extended period of time unless the pain remains severe enough to require an opioid and alternatives remain inadequate.
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 “”.
1,096 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 1,096 moderate interactions — see all 1,096 on the Ceylon Leadwort page.
No interaction 1,733 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 ›
- Escitalopram ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Amoxicillin ›
- Lisinopril ›
- Acyclovir ›
- Doxycycline ›
- Methotrexate ›
- Lamotrigine ›
- Gabapentin ›
- Pregabalin ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Levetiracetam ›
- Spironolactone ›
- Factor 7a ›
- Phentermine, Topiramate ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Minoxidil ›
- Mitomycin ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Phenylephrine ›
- Vancomycin ›
- Lenvatinib ›
- Hethylphenidate Hcl ›
- Dirithromycin ›
- Pentobarbitone ›
- Bentoquatam ›
- Amoxicillin, Clavulanate Potassium ›
- Procainamide ›
- Hydroxychloroquine ›
- Azelaic Acid ›
- Triptorelin ›
- Digoxin ›
- Dextrothyroxine ›
- Lomustine ›
- Pizotifen ›
Showing the 60 most looked-up of 1,733 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
Benzhydrocodone, Acetaminophen Is Linked to Lower Levels of One Nutrient
Natural Medicines records Benzhydrocodone, Acetaminophen 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:
Read the full Benzhydrocodone, Acetaminophen 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 Ceylon Leadwort and Benzhydrocodone, Acetaminophen Together: Common Questions
Can you take Ceylon Leadwort with Benzhydrocodone, Acetaminophen?
Why are there 4 interactions listed for Ceylon Leadwort and Benzhydrocodone, Acetaminophen?
How serious is the Ceylon Leadwort and Benzhydrocodone, Acetaminophen interaction?
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.