Fo-ti + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine brand name: Anatuss.
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine falls into 4 drug categories that Fo-ti can interact with; the most serious is rated moderate. Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full interaction reportFo-ti and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Fo-ti interacts with whole categories of medication. Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine falls into 4 of those categories, so it can interact with Fo-ti in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 4Why this applies to Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Fo-ti interacts with.
Animal research suggests that fo-ti might inhibit CYP2D6. Additionally, an in vitro study suggests that the degree of CYP2D6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
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.
In this combination cold medicine, the one ingredient that really matters here is dextromethorphan (the cough suppressant). Your body relies on a liver enzyme called CYP2D6 to clear it. Lab and animal studies hint that Fo-ti, especially the raw root, might slow that enzyme down. If it does, dextromethorphan could build up a bit and lead to more drowsiness, dizziness, or feeling foggy.
I want to be honest about the evidence: this is theoretical and has never actually been reported in people, so I wouldn't lose sleep over it. The acetaminophen, guaifenesin, and phenylpropanolamine aren't really driven by this pathway. Still, if you take Fo-ti regularly, mention it to your pharmacist or doctor so they can keep an eye on things.
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
2 of 4Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.
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.
This combo cold-and-cough product (Anatuss) is a multivitamin of ingredients, and the one that leans on the CYP1A2 enzyme is acetaminophen. Lab and animal studies hint that fo-ti might slow that enzyme down (and oddly, some extracts may speed it up). If fo-ti blocked it, a little more acetaminophen could linger, which matters mainly because acetaminophen already stresses the liver, and fo-ti itself has been tied to liver injury in some reports.
Here's the honest part: none of this has been shown in actual people, so it's theoretical. Still, since both can be hard on the liver, I'd run it past your pharmacist before pairing them, and never double up on acetaminophen from other products.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
HEPATOTOXIC DRUGS
3 of 4Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine also falls under HEPATOTOXIC DRUGS.
Fo-ti has been linked to liver damage in many reports.
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.
Here's the piece worth knowing: this combo product (Anatuss) contains acetaminophen, the same active ingredient as Tylenol. Acetaminophen is processed by your liver, and at high doses or with heavy alcohol use it can stress the liver. Fo-ti, especially the processed root, has been tied to reports of liver injury in some people. So the concern is simply that two things hard on the liver could add up.
To be fair, this is theoretical and based on scattered case reports, not strong studies. Most people taking a normal short course of a cold medicine won't run into trouble. Still, if you take Fo-ti regularly or use acetaminophen often, mention it to your pharmacist or doctor first. Watch for yellowing skin, dark urine, or belly pain, and don't double up on acetaminophen products.
- Park GJ, Mann SP, Ngu MC. Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum. J Gastroenterol Hepatol 2001;16:115-7.
- But PP, Tomlinson B, Lee KL. Hepatitis related to the Chinese medicine Shou-wu-pian manufactured from Polygonum multiflorum. Vet Hum Toxicol 1996;38:280-2.
- UK Medicines and Healthcare Products Regulatory Agency. Polygonum multiflorum and liver reactions. April 2006. Available at: www.mhra.gov.uk/home/idcplg?IdcService= SS_GET_PAGE&useSecondary=true&ssDocName= CON2023590&ssTargetNodeId= 833 (Accessed 10 May 2
- Panis B, Wong DR, Hooymans PM, De Smet PA, Rosias PP. Recurrent toxic hepatitis in a Caucasian girl related to the use of Shou-Wu-Pian, a Chinese herbal preparation. J Pediatr Gastroenterol Nutr 2005;41:256-8. PubMed
- Mazzanti G, Battinelli L, Daniele C, et al. New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese herbal product derived from Polygonum multiflorum. Ann Intern Med 2004;140:E589-90.
- Cardenas A, Restrepo JC, Sierra F, Correa G. Acute hepatitis due to shen-min: a herbal product derived from Polygonum multiflorum. J Clin Gastroenterol 2006;40:629-32. PubMed
- Laird AR, Ramchandani N, deGoma EM, et al. Acute hepatitis associated with the use of an herbal supplement (Polygonum multiflorum) mimicking iron-overload syndrome. J Clin Gastroenterol 2008;42:861-2. PubMed
- Jung KA, Min HJ, Yoo SS, et al. Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb. Gut Liver 2011;5(4):493-9. PubMed
- Yuen, M. F., Tam, S., Fung, J., Wong, D. K., Wong, B. C., and Lai, C. L. Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1-year prospective study. Aliment.Pharmacol.Ther 10-15-2006;24(8):1179-1186. PubMed
- Bae, S. H., Kim, D. H., Bae, Y. S., Lee, K. J., Kim, D. W., Yoon, J. B., Hong, J. H., and Kim, S. H. [Toxic hepatitis associated with Polygoni multiflori]. Korean J.Hepatol. 2010;16(2):182-186. PubMed
- Furukawa, M., Kasajima, S., Nakamura, Y., Shouzushima, M., Nagatani, N., Takinishi, A., Taguchi, A., Fujita, M., Niimi, A., Misaka, R., and Nagahara, H. Toxic hepatitis induced by show-wu-pian, a Chinese herbal preparation. Intern.Med. 2010;49(15):1537-1 PubMed
- Dong H, Slain D, Cheng J, Ma W, Liang W. Eighteen cases of liver injury following ingestion of Polygonum multiflorum. Complement Ther Med 2014;22(1):70-4. PubMed
- Lei X, Chen J, Ren J, et al. Liver damage associated with Polygonum multiflorum Thunb.: a systematic review of case reports and case series. Evid Based Complement Alternat Med 2015;2015:459749.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
4 of 4Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction has not been reported in humans.
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.
This combination cold-and-cough product has one piece worth noting: dextromethorphan, the cough suppressant, is partly broken down by a liver enzyme called CYP3A4. In lab dishes, Fo-ti seems to slow that enzyme down. In theory, that could let dextromethorphan build up a bit, which might mean more drowsiness, dizziness, or a foggy, lightheaded feeling.
Here is the honest part: this is only seen in test-tube studies, and animal research didn't agree. It has never actually been reported in people, so I wouldn't lose sleep over it. The acetaminophen, guaifenesin, and phenylpropanolamine pieces aren't really driven by this enzyme. Still, since Fo-ti has been tied to liver concerns and acetaminophen is hard on the liver too, it's smart to run this pairing by your pharmacist or doctor first.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Fo-ti Also Interacts With Other Medications
Fo-ti has 1,258 moderate 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.
Check Another of Your Medications Against Fo-ti
We haven’t checked that one against Fo-ti yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Fo-ti. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine
This page covers Fo-ti 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
Taking Fo-ti as Part of a Dietary Supplement Product? Check It for Interactions
We hold 976 real supplement products containing Fo-ti, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fo-ti. Your product may carry other ingredients that interact with Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine too, on top of Fo-ti — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Fo-ti 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.
#206 of 1,452 supplements looked up here in the last 7 days
#80 of 2,830 medications looked up here in the last 7 days
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.
About Fo-ti
What is Fo-ti?
- Anti-aging and longevity
- Hair graying and hair loss
- General tonic for vitality
- Constipation
- High cholesterol
Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these benefits is limited, and processed Fo-ti has been linked to reports of liver injury, so caution and professional guidance are important.
Other Drugs & Fo-ti
Browse every other medication we’ve checked against Fo-ti — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,258 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Amoxicillin ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Fenofibrate ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Methyltestosterone ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Allopurinol ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
Showing 60 of 1,258 moderate interactions — see all 1,258 on the Fo-ti page.
No interaction 1,571 drugs checked — show the list
We also checked Fo-ti against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Levothyroxine, Liothyronine ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Lisinopril ›
- Azithromycin ›
- Pregabalin ›
- Gabapentin ›
- Lamotrigine ›
- Acyclovir ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aminophylline, Amobarbital, Ephedrine ›
- Enalapril Maleate ›
- Ephedrine, Phenobarbital, Theophylline ›
- Cephalexin ›
- Ezetimibe ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Levetiracetam ›
- Cyclopentolate ›
- Levodopa ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Amobarbital, Ephedrine Sulfate ›
- Alginic Acid, Aluminum Hydroxide ›
- Efgartigimod Alfa-fcab ›
- Sodium Bicarbonate (otc Drug) ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Measles, Mumps, Rubella Virus Live ›
- Peginterferon Alfa-2a, Ribavirin ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Atropine Methyl Nitrate, Digestive Enzymes ›
- Aminolevulinic Acid Hydrochloride ›
- Cytomegalovirus Immune Globulin ›
- Tubocurarine ›
- Alpha-1 Proteinase Inhibitor ›
- Atenolol ›
- Glycerol Phenylbutyrate ›
- Sulfadiazine, Trimethoprim ›
- Lonapegsomatropin-tcgd ›
- Articaine, Epinephrine ›
- Daxibotulinumtoxina-lanm ›
- Roxithromycin ›
- Human Papillomavirus Vaccine ›
- Charcoal (otc Drug) ›
- Neomycin, Polymyxin B, Gramicidin ›
- Levothyroxine Sodium ›
- Pyrilamine Maleate ›
- Olmesartan Medoxomil ›
- Imipenem, Cilastatin, Relebactam ›
- Minoxidil ›
- Cefaclor ›
- Dihydroxyaluminum Sodium Carbonate ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Mitomycin ›
Showing the 60 most looked-up of 1,571 medications checked with no known interaction — see the full Fo-ti list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine as a medicine that can lower these. This is not an interaction with Fo-ti — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Fo-ti and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine Together: Common Questions
Can you take Fo-ti with Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine?
Why are there 4 interactions listed for Fo-ti and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine?
How serious is the Fo-ti and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine and Fo-ti?
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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.