Drug & supplement interaction

Fever Bark + Chlorpheniramine, Phenindamine, Phenylpropanolamine

Chlorpheniramine, Phenindamine, Phenylpropanolamine brand name: Nolamine.

Moderate Interaction
The bottom line Moderate

Chlorpheniramine, Phenindamine, Phenylpropanolamine falls into 2 drug categories that Fever Bark can interact with; the most serious is rated moderate. Theoretically, CYP2D6 inhibitors might increase the levels and clinical effects of yohimbine, a constituent of fever bark.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fever Bark and Chlorpheniramine, Phenindamine, Phenylpropanolamine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Fever Bark interacts with whole categories of medication. Chlorpheniramine, Phenindamine, Phenylpropanolamine falls into 2 of those categories, so it can interact with Fever Bark in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2D6 (CYP2D6) INHIBITORS

1 of 2

Why this applies to Chlorpheniramine, Phenindamine, Phenylpropanolamine

Chlorpheniramine, Phenindamine, Phenylpropanolamine falls under CYTOCHROME P450 2D6 (CYP2D6) INHIBITORS — the group Fever Bark interacts with.

Theoretically, CYP2D6 inhibitors might increase the levels and clinical effects of yohimbine, a constituent of fever bark.
In vitro and clinical research shows that the fever bark constituent, yohimbine, is metabolized by CYP2D6 isoenzymes.
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 is the twist with Nolamine (chlorpheniramine, phenindamine, and phenylpropanolamine) and fever bark: in this case it is the supplement that may get boosted, not your medicine. One ingredient in Nolamine can act as a mild CYP2D6 blocker, and fever bark contains yohimbine, which the body clears using that same CYP2D6 pathway. So in theory the yohimbine could pile up and hit harder.

What might that feel like? Yohimbine tends to push up heart rate and blood pressure and can cause jitteriness or anxiety, and the decongestant phenylpropanolamine can do the same, so the two together could stack. Keep in mind this is a theoretical concern from how the chemicals behave, not proven in people. Fever bark is potent and best avoided anyway. Please check with your pharmacist or doctor before combining them.

References
  1. Le Corre P, Parmer RJ, Kailasam MT, et al. Human sympathetic activation by alpha2-adrenergic blockade with yohimbine: Bimodal, epistatic influence of cytochrome P450-mediated drug metabolism. Clin Pharmacol Ther. 2004;76(2):139-53.
  2. Mueller-Schoell A, Michelet R, Weinelt F, Kloft C, Mikus G. CYP2D6 phenotype explains reported yohimbine concentrations in four severe acute intoxications. Arch Toxicol. 2021. PubMed
  3. Bharucha AE, Skaar T, Andrews CN, et al Relationship of cytochrome P450 pharmacogenetics to the effects of yohimbine on gastrointestinal transit and catecholamines in healthy subjects. Neurogastroenterol Motil. 2008;20(8):891-9. PubMed
Moderate

STIMULANT DRUGS

2 of 2

Chlorpheniramine, Phenindamine, Phenylpropanolamine also falls under STIMULANT DRUGS.

Theoretically, fever bark might increase or decrease the effects of stimulant drugs.
Reserpine, a constituent of fever bark, might increase or decrease effects of sympathomimetics. Also, yohimbine, another constituent of fever bark, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. It is not known if this would occur with fever bark.
Severity Moderate Likelihood Probable Evidence D

Interaction 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..

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

Here's the thing to keep in mind: Nolamine contains phenylpropanolamine, which is a stimulant-type decongestant that can raise blood pressure and heart rate on its own. Fever bark carries a mix of plant alkaloids, including yohimbine-like compounds that also push blood pressure up, plus reserpine-like compounds that can pull it in the other direction. So combining the two could either add up to a bigger blood pressure spike or pull against each other in unpredictable ways.

Honestly, this is mostly theoretical and based on weak, anecdotal reports, so I'm not trying to alarm you. But because the direction could go either way, watch for things like a pounding heart, jitteriness, headache, or a rise in blood pressure. Please check with your pharmacist or doctor before pairing these.

References
  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. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Sklar S, et al. Drug therapy screening system. Indianapolis, IN: First Data Bank 99.1-99. 2 eds.
  4. Bharucha AE, Skaar T, Andrews CN, et al Relationship of cytochrome P450 pharmacogenetics to the effects of yohimbine on gastrointestinal transit and catecholamines in healthy subjects. Neurogastroenterol Motil. 2008;20(8):891-9. 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

Fever Bark Also Interacts With Other Medications

Fever Bark has 40 major, 673 moderate, 87 minor known drug interactions in our database — the Chlorpheniramine, Phenindamine, Phenylpropanolamine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Fever Bark

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

Everything else you take

See Every Supplement That Interacts With Chlorpheniramine, Phenindamine, Phenylpropanolamine

This page covers Fever Bark only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Chlorpheniramine, Phenindamine, Phenylpropanolamine page lists 229 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Ephedra (major), Grapefruit (major), Henbane (major) and Lithium (major).

By severity: 10 major · 175 moderate · 44 minor.

From our pharmacist’s overview on the Chlorpheniramine, Phenindamine, Phenylpropanolamine page

“Nolamine combines two antihistamines, chlorpheniramine and phenindamine, with phenylpropanolamine, a decongestant with stimulant effects, and its supplement list deserves genuine care, with 229 ingredients on file and ten rated major. The biggest cluster changes how the drug is processed, where grapefruit can raise its levels and St.”

Reviewed by 2 · Jul 18, 2026

Open the Chlorpheniramine, Phenindamine, Phenylpropanolamine interaction page

How much people look this up

Where Fever Bark and Chlorpheniramine, Phenindamine, 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 Fever Bark
Steady interest

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

29 days ago today
Medication Chlorpheniramine, Phenindamine, Phenylpropanolamine
Top 10%

#166 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 Fever Bark

What is Fever Bark?

Fever Bark
  • Fever
  • Diarrhea
  • Malaria (traditional)
  • Digestive complaints
  • Bitter tonic

Fever bark is the bark of the Australian tree Alstonia constricta, used in traditional medicine for fever, diarrhea, and infections. There is very little reliable human research to support these uses, and the bark contains potent alkaloids that may cause serious side effects. It is best avoided unless used under direct medical supervision.

Read the full Fever Bark monograph & all interactions
Keep checking

Other Drugs & Fever Bark

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

40Major
673Moderate
87Minor
2,029No known interaction
Major

40 interactions

Moderate

673 interactions

Showing 60 of 673 moderate interactions — see all 673 on the Fever Bark page.

Minor

87 interactions

Showing 60 of 87 minor interactions — see all 87 on the Fever Bark page.

No interaction 2,029 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Fever Bark and Chlorpheniramine, Phenindamine, Phenylpropanolamine Together: Common Questions

Can you take Fever Bark with Chlorpheniramine, Phenindamine, 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 2 interactions listed for Fever Bark and Chlorpheniramine, Phenindamine, Phenylpropanolamine?
Chlorpheniramine, Phenindamine, Phenylpropanolamine belongs to more than one drug category, and Fever Bark 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 Fever Bark and Chlorpheniramine, Phenindamine, 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

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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.