Drug & supplement interaction

Eurycoma Longifolia + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr

Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr brand name: Vicks Formula 44M Cough, Cold & Flu Relief.

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

Eurycoma Longifolia has a minor interaction with Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr. Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.

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

Eurycoma Longifolia and Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr

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

Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr

Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Eurycoma Longifolia interacts with.

Theoretically, Eurycoma longifolia might increase levels CYP1A2 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP1A2 enzymes. This effect has not been reported in humans.
Severity Minor 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 short version: tongkat ali (Eurycoma longifolia) might slightly slow down a liver enzyme called CYP1A2. That same enzyme helps clear part of your cold-and-flu combo. If clearance were nudged down, levels of these ingredients could creep up a little, which in theory might mean more drowsiness or grogginess from the chlorpheniramine, or a bit more sedation overall.

But honestly, I wouldn't lose sleep over this one. The concern comes only from a lab dish, where the effect was weak, and it has never actually been seen in real people. It's rated minor and theoretical. Since this cough/cold mix already makes many folks sleepy on its own, just go easy with alcohol and driving, and check with your pharmacist if you have questions.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Han YM, Kim IS, Rehman SU, Choe K, Yoo HH. In vitro evaluation of the effects of Eurycoma longifolia extract on CYP-mediated drug metabolism. Evid Based Complement Alternat Med 2015;2015:631329.

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

Eurycoma Longifolia Also Interacts With Other Medications

Eurycoma Longifolia has 3 moderate, 245 minor known drug interactions in our database — the Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr one above is one of them. If you take anything else, check it against the full list below.

Moderate 3 Minor 245 No known interaction 2,582 (incl. Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr)
Taking anything else?

Check Another of Your Medications Against Eurycoma Longifolia

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr

This page covers Eurycoma Longifolia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr page lists 275 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), Grapefruit (major) and Henbane (major).

By severity: 10 major · 220 moderate · 45 minor.

From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr page

“A three-drug cold formula like Vicks Formula 44M (acetaminophen, chlorpheniramine, and dextromethorphan) gives supplements three separate targets, so its interaction list warrants real vigilance, starting with the ten major-rated entries. The dominant patterns track each ingredient.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr interaction page

One more smart check

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

We hold 1,122 real supplement products containing Eurycoma Longifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eurycoma Longifolia. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr too, on top of Eurycoma Longifolia — 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 Eurycoma Longifolia and Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr 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 Eurycoma Longifolia
Top 25%

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

29 days ago today
Medication Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr
Top 10%

#253 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 Eurycoma Longifolia

What is Eurycoma Longifolia?

Eurycoma Longifolia
  • Low testosterone or low libido in men
  • Male fertility support
  • Athletic performance and muscle strength
  • Energy and fatigue
  • Stress and mood
  • General male enhancement

Eurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small human studies suggesting possible benefits. However, the overall evidence is still limited and product quality varies widely, so talk with your pharmacist or doctor before using it, and avoid it if you are pregnant or breastfeeding.

Read the full Eurycoma Longifolia monograph & all interactions
Keep checking

Other Drugs & Eurycoma Longifolia

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

0Major
3Moderate
245Minor
2,581No known interaction
3 Moderate 245 Minor 2,581 No interaction
Moderate

3 interactions

Minor

245 interactions

Showing 60 of 245 minor interactions — see all 245 on the Eurycoma Longifolia page.

No interaction 2,581 drugs checked — show the list

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

Showing the 60 most looked-up of 2,581 medications checked with no known interaction — see the full Eurycoma Longifolia list.

See the full Eurycoma Longifolia interactions page
See every supplement checked against Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr, 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
Eurycoma Longifolia monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr supplement interactions › Every supplement checked against Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr, 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 Eurycoma Longifolia and Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr Together: Common Questions

Can you take Eurycoma Longifolia with Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Eurycoma Longifolia and Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HBr and Eurycoma Longifolia?

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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.