Drug & supplement interaction

Chokeberry + Hydrocodone/Chlorpheniramine

Hydrocodone/Chlorpheniramine brand name: Tussionex.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Chokeberry has a moderate interaction with Hydrocodone/Chlorpheniramine. Theoretically, chokeberry might increase levels of drugs metabolized by CYP3A4.

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

Chokeberry and Hydrocodone/Chlorpheniramine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Hydrocodone/Chlorpheniramine

Hydrocodone/Chlorpheniramine falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Chokeberry interacts with.

Theoretically, chokeberry might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that chokeberry inhibits CYP3A4. In humans, there is one case report of a drug interaction with trabectedin, a CYP3A4 substrate, which is hypothesized to have been caused by chokeberry inhibition of CYP3A4.
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

Here's the gist with Tussionex (hydrocodone with chlorpheniramine) and chokeberry. The hydrocodone part is handled in your body partly by an enzyme called CYP3A4. Lab studies suggest chokeberry may slow that enzyme down a bit, which could let hydrocodone build up a little higher than usual. If that happened, you might feel more of its effects, things like extra drowsiness, dizziness, constipation, or slowed breathing.

That said, this is mostly theoretical. It comes from test-tube work and a single case report with a different drug, so the real-world risk is uncertain. A glass of chokeberry juice or some jam is unlikely to be an issue, but concentrated supplements are a bigger question mark. Since Tussionex is a strong opioid combo, please run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Bräunlich M, Christensen H, Johannesen S, Slimestad R, Wangensteen H, Malterud KE, Barsett H. In vitro inhibition of cytochrome P450 3A4 by Aronia melanocarpa constituents. Planta Med. 2013 Jan;79(2):137-41. PubMed
  2. Strippoli S, Lorusso V, Albano A, Guida M. Herbal-drug interaction induced rhabdomyolysis in a liposarcoma patient receiving trabectedin. BMC Complement Altern Med. 2013 Jul 30;13:199. 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

Chokeberry Also Interacts With Other Medications

Chokeberry has 810 moderate known drug interactions in our database — the Hydrocodone/Chlorpheniramine one above is one of them. If you take anything else, check it against the full list below.

Moderate 810 No known interaction 2,020 (incl. Hydrocodone/Chlorpheniramine)
Taking anything else?

Check Another of Your Medications Against Chokeberry

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

Everything else you take

See Every Supplement That Interacts With Hydrocodone/Chlorpheniramine

This page covers Chokeberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrocodone/Chlorpheniramine page lists 258 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), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 12 major · 204 moderate · 42 minor.

From our pharmacist’s overview on the Hydrocodone/Chlorpheniramine page

“Tussionex (hydrocodone with chlorpheniramine) pairs an opioid with a sedating antihistamine, so anything that deepens drowsiness or slows breathing is a genuine hazard, and 78 of the 258 supplements on file do exactly that. Alcohol in any form tops that group, and kava carries a major rating for the same reason.”

Reviewed by 2 · Jul 18, 2026

Open the Hydrocodone/Chlorpheniramine interaction page

One more smart check

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

We hold 493 real supplement products containing Chokeberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Chokeberry. Your product may carry other ingredients that interact with Hydrocodone/Chlorpheniramine too, on top of Chokeberry — 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 Chokeberry and Hydrocodone/Chlorpheniramine 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 Chokeberry
Top half

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

29 days ago today
Medication Hydrocodone/Chlorpheniramine
Steady interest

#1,749 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 Chokeberry

What is Chokeberry?

Chokeberry
  • Antioxidant support
  • Heart and blood vessel health
  • Blood pressure support
  • Blood sugar support
  • Common cold symptoms
  • Anti-inflammatory support

Chokeberry (aronia) is a dark berry rich in antioxidants called polyphenols, and it's widely eaten as juice, jam, and supplements. Early research hints it may support heart health, blood pressure, and blood sugar, but the evidence is still limited and far from proven. It's generally well tolerated as a food, but talk to your pharmacist or doctor before using concentrated supplements.

Read the full Chokeberry monograph & all interactions
Keep checking

Other Drugs & Chokeberry

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

0Major
810Moderate
0Minor
2,019No known interaction
810 Moderate 2,019 No interaction
Moderate

810 interactions

Showing 60 of 810 moderate interactions — see all 810 on the Chokeberry page.

No interaction 2,019 drugs checked — show the list

We also checked Chokeberry against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,019 medications checked with no known interaction — see the full Chokeberry list.

See the full Chokeberry interactions page
See every supplement checked against Hydrocodone/Chlorpheniramine, ranked by severity
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

Keep exploring
Chokeberry monograph › Uses, safety, and every drug interaction in one place Hydrocodone/Chlorpheniramine supplement interactions › Every supplement checked against Hydrocodone/Chlorpheniramine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Chokeberry and Hydrocodone/Chlorpheniramine Together: Common Questions

Can you take Chokeberry with Hydrocodone/Chlorpheniramine?
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.
How serious is the Chokeberry and Hydrocodone/Chlorpheniramine 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

Still Have a Question About Hydrocodone/Chlorpheniramine and Chokeberry?

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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.