Drug & supplement interaction

English Ivy + Acetaminophen, Dextromethorphan, Pseudoephedrine

Acetaminophen, Dextromethorphan, Pseudoephedrine brand names: Alka-Seltzer PLUS Flu Liquid Gels, Tylenol Flu Daytime Ex Strength, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Ex Strength.

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

English Ivy has a moderate interaction with Acetaminophen, Dextromethorphan, Pseudoephedrine. Theoretically, English ivy might increase the levels of drugs metabolized by CYP2D6.

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

English Ivy and Acetaminophen, Dextromethorphan, Pseudoephedrine

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

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Acetaminophen, Dextromethorphan, Pseudoephedrine

Acetaminophen, Dextromethorphan, Pseudoephedrine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group English Ivy interacts with.

Theoretically, English ivy might increase the levels of drugs metabolized by CYP2D6.
In vitro research shows that English ivy inhibits CYP2D6 enzymes. So far, this interaction 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 interesting twist with these cold and flu combo products: the ingredient that matters most here is the dextromethorphan (the cough suppressant). Your body relies on a liver enzyme called CYP2D6 to break it down. Lab studies suggest English ivy might slow that enzyme a little, which in theory could let dextromethorphan build up and cause more of its typical effects, like drowsiness, dizziness, or a foggy, lightheaded feeling.

I want to be honest about the strength of this: it's only based on test-tube research, and it has never actually been reported in real people. So I wouldn't lose sleep over it. The acetaminophen and pseudoephedrine pieces aren't really affected by this pathway. Still, since both are often used for the same cough, it's worth a quick word with your pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Rehman SU, Kim IS, Choi MS, Kim SH, Zhang Y, Yoo HH. Time-dependent Inhibition of CYP2C8 and CYP2C19 by Hedera helix Extracts, A Traditional Respiratory Herbal Medicine. Molecules. 2017;22(7). 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

English Ivy Also Interacts With Other Medications

English Ivy has 279 moderate known drug interactions in our database — the Acetaminophen, Dextromethorphan, Pseudoephedrine one above is one of them. If you take anything else, check it against the full list below.

Moderate 279 No known interaction 2,551 (incl. Acetaminophen, Dextromethorphan, Pseudoephedrine)
Taking anything else?

Check Another of Your Medications Against English Ivy

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Dextromethorphan, Pseudoephedrine

This page covers English Ivy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan, Pseudoephedrine page lists 262 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 · 207 moderate · 43 minor.

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

“Ephedra is the ingredient to notice first here. Pseudoephedrine, the decongestant in Tylenol Flu, Alka-Seltzer PLUS Flu, and other acetaminophen, dextromethorphan, and pseudoephedrine combinations, is itself a stimulant, and 44 entries push the same direction, raising the odds of high blood pressure and a racing heart.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Dextromethorphan, Pseudoephedrine interaction page

One more smart check

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

We hold 118 real supplement products containing English Ivy, each one broken down to its full ingredient list — and combination products often carry several ingredients besides English Ivy. Your product may carry other ingredients that interact with Acetaminophen, Dextromethorphan, Pseudoephedrine too, on top of English Ivy — 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 English Ivy and Acetaminophen, Dextromethorphan, Pseudoephedrine 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 English Ivy
Steady interest

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

29 days ago today
Medication Acetaminophen, Dextromethorphan, Pseudoephedrine
Steady interest

#2,295 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 English Ivy

What is English Ivy?

English Ivy
  • Cough and chest congestion
  • Bronchitis
  • Asthma symptoms
  • Sore throat
  • Skin irritation

English ivy leaf extract is most commonly used in cough and cold syrups to help loosen mucus and ease coughing, and it is a popular ingredient in many European herbal products. Some research suggests it may help with certain coughs, but the evidence is still limited and mixed. The raw plant is poisonous if eaten and can irritate skin, so only use properly prepared commercial products and check with your pharmacist first.

Read the full English Ivy monograph & all interactions
Keep checking

Other Drugs & English Ivy

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

0Major
279Moderate
0Minor
2,550No known interaction
279 Moderate 2,550 No interaction
Moderate

279 interactions

Showing 60 of 279 moderate interactions — see all 279 on the English Ivy page.

No interaction 2,550 drugs checked — show the list

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

Showing the 60 most looked-up of 2,550 medications checked with no known interaction — see the full English Ivy list.

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

Can you take English Ivy with Acetaminophen, Dextromethorphan, Pseudoephedrine?
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 English Ivy and Acetaminophen, Dextromethorphan, Pseudoephedrine 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, Pseudoephedrine and English Ivy?

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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.