Drug & supplement interaction

Eleuthero + Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen brand name: Apadaz.

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

Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen

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. Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen 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

Here's the gist with Apadaz (benzhydrocodone and acetaminophen) and eleuthero. Lab and animal studies hint that eleuthero may slow down a liver enzyme called CYP1A2. The theory is that if this enzyme is blocked, certain drugs it handles could build up a bit more than usual. In practice, the main opioid effects of this medicine run through a different enzyme system, so the real-world impact here is likely small.

I want to be honest: this interaction has only been seen in test tubes and animals, never confirmed in people. Still, since this product is an opioid, it's worth being alert for extra drowsiness, dizziness, slowed breathing, or nausea. Don't change anything on your own. A quick chat with your pharmacist or doctor is the safest move.

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

Benzhydrocodone, Acetaminophen 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

Here's the key thing about 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 a stronger painkiller. On paper, eleuthero might slow CYP2D6 down a bit. If that happened, it could shift how much active drug you make and, in theory, change pain relief or add to opioid effects like drowsiness, constipation, or slowed breathing.

But here's the reassuring part: when actual people took eleuthero for two weeks, it did not meaningfully block CYP2D6. So this concern is mostly theoretical and unlikely to cause trouble. Still, since opioids are serious medicine, run any new supplement past 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.
  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

Benzhydrocodone, Acetaminophen 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

Here's the short version: this is a mostly theoretical concern. Benzhydrocodone is a prodrug, meaning your body converts it into hydrocodone, the active painkiller. That process and the breakdown of the medication involve the CYP3A4 enzyme. In lab and animal studies, eleuthero looked like it might slow CYP3A4 down, which in theory could let more of the opioid build up and lead to stronger effects like deep drowsiness, dizziness, constipation, or slowed breathing.

The reassuring part is that a study in healthy people taking eleuthero twice daily for two weeks did not show any real effect on CYP3A4. So for most folks this combination is unlikely to cause trouble. Still, since opioids are serious medicines, run it by your pharmacist or doctor before pairing them.

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 678 moderate, 461 minor 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.

Moderate 678 Minor 461 No known interaction 1,691 (incl. Benzhydrocodone, Acetaminophen)
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 Benzhydrocodone, Acetaminophen

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 Benzhydrocodone, Acetaminophen, 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 Benzhydrocodone, Acetaminophen

This page covers Eleuthero 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.

Open the Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen 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 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.

Supplement Eleuthero
Top 5%

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

29 days ago today
Medication Benzhydrocodone, Acetaminophen
Steady interest

#2,281 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
Medication

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.

See full Benzhydrocodone and Acetaminophen drug information
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
678Moderate
461Minor
1,690No known interaction
678 Moderate 461 Minor 1,690 No interaction
Moderate

678 interactions

Showing 60 of 678 moderate interactions — see all 678 on the Eleuthero page.

Minor

461 interactions

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

No interaction 1,690 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 1,690 medications checked with no known interaction — see the full Eleuthero list.

See the full Eleuthero interactions page
See every supplement checked against Benzhydrocodone, Acetaminophen, 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 Benzhydrocodone, Acetaminophen supplement interactions › Every supplement checked against Benzhydrocodone, Acetaminophen, ranked by severity Benzhydrocodone and Acetaminophen drug information › The full plain-English guide to this medication 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 Benzhydrocodone, Acetaminophen Together: Common Questions

Can you take Eleuthero with Benzhydrocodone, Acetaminophen?
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 Benzhydrocodone, Acetaminophen?
Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen 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 Benzhydrocodone, Acetaminophen 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.