Drug & supplement interaction

Costus + Loperamide, Simethicone

Loperamide, Simethicone brand name: Imodium Advanced.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Costus and Loperamide, Simethicone in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Loperamide, Simethicone states a food rule worth keeping to.

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Interaction report

Costus and Loperamide, Simethicone

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Loperamide, Simethicone and Costus in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Costus at all — not against Loperamide, Simethicone, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Costus safety at a glance

Costus overall Use caution Human safety data are limited, and quality and purity of products vary widely.
Pregnancy Avoid Traditionally believed to stimulate the uterus, so it is best avoided during pregnancy.
Breastfeeding Avoid There is not enough safety information, so avoid use while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Loperamide, Simethicone and Costus? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

What Costus Itself Has Been Linked To

This is not an interaction — nothing below involves Loperamide, Simethicone. It is the side-effect record for Costus on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Costus, this list is the first place to look. One entry is worth acting on rather than waiting out — marked below.

  • An allergic reaction Worth acting on Additional detail

    “Orally and topically, costus might cause allergic reactions, including contact dermatitis (11,73140,73155,73281,73284,73288).”

    Costus · Natural Medicines adverse-effect record, reported in dermatitis.

    6 sources cited
    1. 11. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
    2. 73140. Marzulli, F. N. and Maibach, H. I. Effects of vehicles and elicitation concentration in contact dermatitis testing. I. Experimental contact sensitization in humans. Contact Dermatitis 1976;2(6):325-329. PubMed
    3. 73155. Mitchell, J. C. Contact hypersensitivity to some perfume materials. Contact Dermatitis 1975;1(4):196-199. PubMed
    4. 73281. Benezra, C. and Epstein, W. L. Molecular recognition patterns of sesquiterpene lactones in costus-sensitive patients. Contact Dermatitis 1986;15(4):223-230. PubMed
    5. 73284. Mitchell, J. C. and Epstein, W. L. Contact hypersensitivity to a perfume material, Costus Absolute. The role of sesquiterpene lactones. Arch.Dermatol 1974;110(6):871-873. DOI
    6. 73288. Cheminat, A., Stampf, J. L., Benezra, C., Farrall, M. J., and Frechet, J. M. Allergic contact dermatitis to costus: removal of haptens with polymers. Acta Derm.Venereol. 1981;61(6):525-529. DOI
  • A skin rash Additional detail

    Recorded for Costus in the same Natural Medicines adverse-effect record shown under An allergic reaction above.

Everything above comes from the Natural Medicines adverse-effect record for Costus — expand a row for the licensed statement it rests on. We haven’t matched Loperamide, Simethicone to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Loperamide, Simethicone.

How to take them

Some Loperamide, Simethicone Products Have a Food Rule — Costus Should Not Break It

At least one FDA label for a product containing Loperamide, Simethicone says to take it on an empty stomach. Most supplements — Costus included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Loperamide, Simethicone on its own and move Costus to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Loperamide, Simethicone products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Directions drink plenty of clear fluids to help prevent dehydration caused by diarrhea take only on an empty stomach (1 hour before or 2 hours after a meal) take with a full (8 oz.) glass of water find right dose on chart below.

From the Dosage and Administration section of the FDA label we read for Loperamide, Simethicone — where that label names a specific product, the instruction is that product's.

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Loperamide, Simethicone

This page covers Costus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Loperamide, Simethicone page lists 82 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 4 major · 59 moderate · 19 minor.

From our pharmacist’s overview on the Loperamide, Simethicone page

“Imodium Advanced combines loperamide, an anti-diarrheal opioid that normally stays out of the brain thanks to a transporter called P-glycoprotein, with simethicone for gas, and I treat its interaction list with more respect than most over-the-counter medicines warrant. Thirty-seven of the 82 interacting ingredients on file affect that…”

Reviewed by 2 · Jul 18, 2026

Open the Loperamide, Simethicone interaction page

One more smart check

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

We hold 113 real supplement products containing Costus, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Costus. Even though Costus itself has no known interaction with Loperamide, Simethicone, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Costus and Loperamide, Simethicone 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 Costus
Top half

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

29 days ago today
Medication Loperamide, Simethicone
Top 25%

#415 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Costus reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Costus and Loperamide, Simethicone records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Costus

What is Costus?

  • Digestive upset and gas
  • Cough and breathing complaints
  • Skin conditions (topical)
  • Worm and parasite remedies (traditional)
  • General tonic in traditional medicine

Costus (Saussurea costus) is a root used in Ayurvedic, Unani, and traditional Chinese medicine, mostly for digestive and respiratory complaints. High-quality human evidence is very limited, so its benefits are not well proven. Talk with a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Saussurea costus · Asteraceae · Dried roots and root essential oil · Dried root powder, capsules, decoctions (teas), essential oil, and topical pastes

An interaction check asks whether these two react with each other — it does not ask whether Costus is a good idea for someone in your situation. Here is what our Costus record says about it on its own.

Costus: dosing

There is no well-established or standardized dose of costus for any health condition. Traditional preparations vary widely, and the strength of commercial products is not consistent.If you choose to use a costus product, follow the directions on the label and do not exceed them. The essential oil is very concentrated and should not be taken by mouth without professional guidance.

From our Costus monograph — the full record covers uses, side effects and every documented interaction.

Read the full Costus monograph & all interactions
Keep checking

Other Drugs & Costus

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

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Costus References

The 6 references that drive our Costus monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Marzulli, F. N. and Maibach, H. I. Effects of vehicles and elicitation concentration in contact dermatitis testing. I. Experimental contact sensitization in humans. Contact Dermatitis 1976;2(6):325-329. PubMed
  3. Mitchell, J. C. Contact hypersensitivity to some perfume materials. Contact Dermatitis 1975;1(4):196-199. PubMed
  4. Benezra, C. and Epstein, W. L. Molecular recognition patterns of sesquiterpene lactones in costus-sensitive patients. Contact Dermatitis 1986;15(4):223-230. PubMed
  5. Mitchell, J. C. and Epstein, W. L. Contact hypersensitivity to a perfume material, Costus Absolute. The role of sesquiterpene lactones. Arch.Dermatol 1974;110(6):871-873. DOI
  6. Cheminat, A., Stampf, J. L., Benezra, C., Farrall, M. J., and Frechet, J. M. Allergic contact dermatitis to costus: removal of haptens with polymers. Acta Derm.Venereol. 1981;61(6):525-529. DOI

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Costus and Loperamide, Simethicone Together: Common Questions

Is it safe to take Costus with Loperamide, Simethicone?
We do not list a known interaction between Costus and Loperamide, Simethicone. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Should I take Costus and Loperamide, Simethicone at the same time of day?
At least one FDA label for a product containing Loperamide, Simethicone says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Loperamide, Simethicone on its own and move Costus to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.
Does Loperamide, Simethicone interact with any supplements?
Yes. Loperamide, Simethicone has documented interactions with 82 supplements in our database — Costus is not one of them. The Loperamide, Simethicone interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Loperamide, Simethicone and Costus?

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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.