Drug & supplement interaction

Eleuthero + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine

Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine brand name: Anatuss.

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

Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine falls into 3 drug categories that Eleuthero can interact with; the most serious is rated moderate. Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Eleuthero and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Eleuthero interacts with whole categories of medication. Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine falls into 3 of those categories, so it can interact with Eleuthero in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 3

Why this applies to Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine

Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Eleuthero interacts with.

Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
In vitro and animal research suggest that standardized extracts of eleuthero inhibit CYP1A2. This effect has not been reported in humans.
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

This is one of those combinations that looks scarier on paper than it is in real life. Anatuss is a cold and cough combo with several ingredients, and the concern here is that eleuthero might slow down a liver enzyme called CYP1A2. If that enzyme runs slower, some medicines cleared through it could hang around a little longer than usual.

Honestly though, this is only based on test-tube and animal studies, and it has never actually been seen in people. If anything were to happen, you might feel a touch more drowsy or jittery from these cold-medicine ingredients. The good news is most folks use Anatuss for just a few days. If you take eleuthero regularly or have any concerns, just run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Harkey MR, Henderson GL, Zhou L, et al. Effects of Siberian ginseng (Eleutherococcus senticosus) on c-DNA-expressed P450 drug metabolizing enzymes. Alt Ther 2001;7:S14.
Minor

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 3

Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2D6. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP2D6 drug metabolism.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This combo cold-and-cough product (Anatuss) includes dextromethorphan, the cough suppressant, which the body clears through a liver enzyme called CYP2D6. The theory here is that eleuthero might slow that enzyme down a little, which could let dextromethorphan build up and possibly cause more of its usual effects, like drowsiness, dizziness, or feeling a bit foggy.

Here's the reassuring part: this concern comes mostly from lab and animal studies. When researchers actually gave eleuthero to healthy people for two weeks, it did not meaningfully change CYP2D6 activity. So a real-world problem is unlikely and would be mild at most. Still, if you take eleuthero regularly, it's worth a quick word with your pharmacist or doctor to be safe.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Harkey MR, Henderson GL, Zhou L, et al. Effects of Siberian ginseng (Eleutherococcus senticosus) on c-DNA-expressed P450 drug metabolizing enzymes. Alt Ther 2001;7:S14.
  2. Donovan JL, DeVane CL, Chavin KD, et al. Siberian Ginseng (Eleutheroccus senticosus) Effects on CYP2D6 and CYP3A4 Activity in Normal Volunteers. Drug Metab Dispos 2003;31:519-22.. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP3A4. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP3A4 drug metabolism.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This combination cold-and-cough product (Anatuss) is the kind of medicine where one ingredient, dextromethorphan, is partly handled by a liver enzyme called CYP3A4. In lab dishes and animal studies, eleuthero looked like it might slow that enzyme down. In theory, that could let dextromethorphan build up a little, which might mean more drowsiness, dizziness, or a foggy feeling.

Here's the reassuring part: when researchers actually tested eleuthero in healthy people, it did not meaningfully block CYP3A4. So this is mostly a theoretical concern, rated minor and unlikely. For most folks taking this medicine for a few days, it shouldn't be a real problem. Still, if you take eleuthero regularly or feel unusually groggy, just run it by your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Harkey MR, Henderson GL, Zhou L, et al. Effects of Siberian ginseng (Eleutherococcus senticosus) on c-DNA-expressed P450 drug metabolizing enzymes. Alt Ther 2001;7:S14.
  2. Donovan JL, DeVane CL, Chavin KD, et al. Siberian Ginseng (Eleutheroccus senticosus) Effects on CYP2D6 and CYP3A4 Activity in Normal Volunteers. Drug Metab Dispos 2003;31:519-22.. 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

Eleuthero Also Interacts With Other Medications

Eleuthero has 679 moderate, 461 minor known drug interactions in our database — the Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine one above is among them. If you take anything else, check it against the full list below.

Moderate 679 Minor 461 No known interaction 1,690 (incl. Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine)
Taking anything else?

Check Another of Your Medications Against Eleuthero

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

From our Q&A

Questions About Eleuthero or Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Eleuthero or Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine, 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 Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine

This page covers Eleuthero only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine page lists 261 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 · 206 moderate · 43 minor.

From our pharmacist’s overview on the Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine page

“Anatuss combines acetaminophen, dextromethorphan, guaifenesin, and phenylpropanolamine, and its supplement list is not one to skim, since 12 of the 261 ingredients on file carry a major rating. Two hazards top the pile.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interaction page

One more smart check

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

We hold 3,795 real supplement products containing Eleuthero, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eleuthero. Your product may carry other ingredients that interact with Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine too, on top of Eleuthero — 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 Eleuthero and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine 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 Eleuthero
Top 5%

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

29 days ago today
Medication Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine
Top 5%

#93 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 Eleuthero

What is Eleuthero?

Eleuthero
  • Fatigue and low energy
  • Physical and athletic performance
  • Stress resistance (adaptogen)
  • Immune support
  • Mental focus and alertness

Eleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence behind these uses is limited and mixed, so it should not replace proven treatments. It is generally well tolerated short-term, but pregnant and breastfeeding people and those with certain conditions should avoid it or check with a healthcare provider first.

Read the full Eleuthero monograph & all interactions
Keep checking

Other Drugs & Eleuthero

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

0Major
679Moderate
461Minor
1,689No known interaction
679 Moderate 461 Minor 1,689 No interaction
Moderate

679 interactions

Showing 60 of 679 moderate interactions — see all 679 on the Eleuthero page.

Minor

461 interactions

Showing 60 of 461 minor interactions — see all 461 on the Eleuthero page.

No interaction 1,689 drugs checked — show the list

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

Showing the 60 most looked-up of 1,689 medications checked with no known interaction — see the full Eleuthero list.

See the full Eleuthero interactions page
See every supplement checked against Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine, 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
Eleuthero monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine supplement interactions › Every supplement checked against Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine, 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 Eleuthero and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine Together: Common Questions

Can you take Eleuthero with Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine?
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.
Why are there 3 interactions listed for Eleuthero and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine?
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine belongs to more than one drug category, and Eleuthero interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Eleuthero and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine 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 Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine and Eleuthero?

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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.