Drug & supplement interaction

Coleus + Hydroxyzine

Hydroxyzine brand names: Atarax, Vistaril, Ucerax.

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

Coleus has a moderate interaction with Hydroxyzine. Theoretically, taking coleus might decrease serum 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

Coleus and Hydroxyzine

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Hydroxyzine

Hydroxyzine falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Coleus interacts with.

Theoretically, taking coleus might decrease serum levels of drugs metabolized by CYP3A4.
In vitro research shows that coleus can activate the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of coleus and other drugs affected by these enzymes.
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 for Coleus and hydroxyzine (Atarax, Vistaril). Your body partly clears hydroxyzine using a liver enzyme called CYP3A4. In lab studies, the forskolin in Coleus seems to rev that enzyme up, which could, in theory, break hydroxyzine down a little faster. If that happened, you might notice it working less well, meaning a bit more itching, anxiety, or restlessness than usual.

The important thing to know is that this is theoretical, based only on test-tube research, not real people taking both together. So I wouldn't lose sleep over it. Still, if you take hydroxyzine regularly and want to try a Coleus supplement, just run it by your pharmacist or doctor first so they can keep an eye on how well things are working.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ding, X. and Staudinger, J. L. Induction of drug metabolism by forskolin: the role of the pregnane X receptor and the protein kinase a signal transduction pathway. J Pharmacol Exp Ther 2005;312(2):849-856. PubMed
  2. Staudinger, J. L., Ding, X., and Lichti, K. Pregnane X receptor and natural products: beyond drug-drug interactions. Expert.Opin Drug Metab Toxicol 2006;2(6):847-857. 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

Coleus Also Interacts With Other Medications

Coleus has 29 major, 887 moderate known drug interactions in our database — the Hydroxyzine one above is one of them. If you take anything else, check it against the full list below.

Major 29 Moderate 887 No known interaction 1,914 (incl. Hydroxyzine)
Taking anything else?

Check Another of Your Medications Against Coleus

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

From our Q&A

Questions About Coleus or Hydroxyzine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Coleus or Hydroxyzine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Hydroxyzine

This page covers Coleus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydroxyzine page lists 183 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Henbane (major), Scopolia (major) and St. John's Wort (major).

By severity: 5 major · 135 moderate · 43 minor.

From our pharmacist’s overview on the Hydroxyzine page

“Hydroxyzine (Atarax, Vistaril) is a sedating antihistamine for itching and anxiety, so read this list closely before pairing it with any supplement. Five of the 183 ingredients on file rate major, and those come first: grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Hydroxyzine interaction page

One more smart check

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

We hold 803 real supplement products containing Coleus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Coleus. Your product may carry other ingredients that interact with Hydroxyzine too, on top of Coleus — 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 Coleus and Hydroxyzine 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 Coleus
Top 25%

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

29 days ago today
Medication Hydroxyzine
Top 25%

#498 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 Coleus

What is Coleus?

Coleus
  • Weight management
  • Asthma and breathing
  • High blood pressure
  • Heart conditions
  • Glaucoma (eye pressure)
  • Exercise and body composition

Coleus is a plant from the mint family whose root contains a compound called forskolin, often marketed for weight loss, asthma, and heart health. While early lab and small human studies are interesting, solid proof that Coleus supplements help any of these conditions is limited. Talk to your pharmacist or doctor before using it, especially if you have heart problems or low blood pressure.

Read the full Coleus monograph & all interactions
Medication

About Hydroxyzine

What Is Hydroxyzine Used For?

Brand names: Atarax, Vistaril, Ucerax

Hydroxyzine by mouth (tablets, capsules, oral solution and syrup) is used for short-term relief of anxiety and tension linked to psychoneurosis (long-standing anxiety-type emotional conditions). It is also used when anxiety is part of another physical illness.

It helps with itching from allergic conditions such as chronic urticaria (hives) and atopic and contact dermatoses (eczema-type and irritant or allergic skin rashes). It is also used as a sedative before and after general anesthesia. Hydroxyzine hydrochloride intramuscular injection has additional uses, including acutely disturbed patients, alcohol withdrawal anxiety, delirium tremens, nausea and vomiting (not pregnancy-related), and as an add-on around surgery and childbirth.

See full Hydroxyzine drug information Hydroxyzine NDC codes and packages
Keep checking

Other Drugs & Coleus

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

29Major
887Moderate
0Minor
1,913No known interaction
29 Major 887 Moderate 1,913 No interaction
Major

29 interactions

Moderate

887 interactions

Showing 60 of 887 moderate interactions — see all 887 on the Coleus page.

No interaction 1,913 drugs checked — show the list

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

Showing the 60 most looked-up of 1,913 medications checked with no known interaction — see the full Coleus list.

See the full Coleus interactions page
See every supplement checked against Hydroxyzine, 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
Coleus monograph › Uses, safety, and every drug interaction in one place Hydroxyzine supplement interactions › Every supplement checked against Hydroxyzine, ranked by severity Hydroxyzine drug information › The full plain-English guide to this medication Hydroxyzine NDC codes and packages › Every package, labeler and price in the FDA directory 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 Coleus and Hydroxyzine Together: Common Questions

Can you take Coleus with Hydroxyzine?
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 Coleus and Hydroxyzine 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 Hydroxyzine and Coleus?

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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.