Garcinia - Acetaminophen, Dextromethorphan, Pseudoephedrine Interaction
Herbal: Garcinia
Also Known As: Garcinia gummi-gutta, Acide Hydroxycitrique, AHC, Brindal Berry, Brindle Berry, Gorikapuli, HCA, Hydroxycitrate, Hydroxycitric Acid, Kankusta, Kudam puli, Malabar Tamarind, Tamarinier de Malabar, Vrikshamla
Drug: 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

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 04, 2025
Interaction Details
Acetaminophen, Dextromethorphan, Pseudoephedrine is classified as belonging to the following category: Serotonergic Drugs
Theoretically, combining garcinia with other serotonergic drugs might increase the risk of serotonergic side effects, including serotonin syndrome.
In one report, a patient experienced serotonin syndrome after taking garcinia extract (60% hydroxycitric acid) 1000 mg daily in combination with escitalopram 20 mg, which had been taken for a year. The patient was switched to sertraline 50 mg daily and again experienced serotonin syndrome.
Interaction Rating
Likelihood of Occurrence
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
References
- Lopez AM, Kornegay J, Hendrickson RG. Serotonin Toxicity Associated with Garcinia cambogia Over-the-counter Supplement. J Med Toxicol. 2014 Apr 4. [Epub ahead of print].
Interaction Details
Acetaminophen, Dextromethorphan, Pseudoephedrine is classified as belonging to the following category: Hepatotoxic Drugs
Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
There have been reports of acute hepatitis with elevated liver enzymes associated with garcinia, when taken alone or in combination with other ingredients. Case reports collected from the Drug Induced Liver Injury Network suggest this risk may be greater in people who carry the HLA B*35:01 allele.
Interaction Rating
Likelihood of Occurrence
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
References
- Stevens T, Qadri A, Zein NN. Two patients with acute liver injury associated with use of the herbal weight-loss supplement hydroxycut. Ann Intern Med 2005;142:477-8.
- Bunchorntavakul, C. and Reddy, K. R. Review article: herbal and dietary supplement hepatotoxicity. Aliment.Pharmacol.Ther 2013;37(1):3-17.
- Dara L, Hewett J, Lim JK. Hydroxycut hepatotoxicity: a case series and review of liver toxicity from herbal weight loss supplements. World J Gastroenterol. 2008 Dec 7;14(45):6999-7004.
- Sharma T, Wong L, Tsai N, Wong RD. Hydroxycut(®) (herbal weight loss supplement) induced hepatotoxicity: a case report and review of literature. Hawaii Med J. 2010 Aug;69(8):188-90.
- Rashid NN, Grant J. Hydroxycut hepatotoxicity. Med J Aust. 2010 Feb 1;192(3):173-4.
- Corey R, Werner KT, Singer A, Moss A, Smith M, Noelting J, Rakela J. Acute liver failure associated with Garcinia cambogia use. Ann Hepatol. 2016 Jan-Feb;15(1):123-6.
- Melendez-Rosado J, Snipelisky D, Matcha G, Stancampiano F. Acute hepatitis induced by pure Garcinia cambogia. J Clin Gastroenterol. 2015 May-Jun;49(5):449-50.
- García-Cortés M, Robles-Díaz M, Ortega-Alonso A, Medina-Caliz I, Andrade RJ. Hepatotoxicity by Dietary Supplements: A Tabular Listing and Clinical Characteristics. Int J Mol Sci. 2016 Apr 9;17(4):537.
- Yousaf MN, Chaudhary FS, Hodanazari SM, Sittambalam CD. Hepatotoxicity associated with Garcinia cambogia: a case report. World J Hepatol 2019;11(11):735-42.
- Mas Ordeig A, Bordón García N. Hepatotoxicity caused by Garcinia cambogia. Gastroenterol Hepatol 2020;43(3):134-5.
- Vuppalanchi R, Bonkovsky HL, Ahmad J, et al. Garcinia cambogia, Either Alone or in Combination With Green Tea, Causes Moderate to Severe Liver Injury. Clin Gastroenterol Hepatol 2021.
Garcinia Overview

Garcinia - More Interactions
Garcinia interacts with 672 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
Unknown | No interactions have been reported or no interaction data is currently available. |
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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
Drug descriptions are provided by MedlinePlus.