Drug & supplement interaction

Garcinia + Acetaminophen, Meperidine

Acetaminophen, Meperidine brand name: Demerol APAP.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Meperidine falls into 2 drug categories that Garcinia can interact with; the most serious is rated moderate. Theoretically, combining garcinia with other serotonergic drugs might increase the risk of serotonergic side effects, including serotonin syndrome.

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

Garcinia and Acetaminophen, Meperidine

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

Why Are There 2 Interactions?

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

Moderate

SEROTONERGIC DRUGS

1 of 2

Why this applies to Acetaminophen, Meperidine

Acetaminophen, Meperidine falls under SEROTONERGIC DRUGS — the group Garcinia interacts with.

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.
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 thing to know about this combo: the meperidine part of Demerol APAP has serotonin-boosting activity in the body, on top of being a strong opioid painkiller. Garcinia has been linked, in a small number of reports, to extra serotonin activity too. Stacking the two could theoretically nudge serotonin levels too high.

If that happened, you might notice agitation, a racing heart, sweating, shivering, muscle twitching, or feeling confused, which together can signal serotonin syndrome. I want to be honest, though: this is based on weak, anecdotal evidence, not strong studies, so for most people it's a low-likelihood concern. Still, since meperidine is a serious medication, please run this past your pharmacist or doctor before adding Garcinia.

References
  1. 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]. PubMed
Moderate

HEPATOTOXIC DRUGS

2 of 2

Acetaminophen, Meperidine also falls under 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.
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 concern with this combo. Demerol APAP contains acetaminophen, which is one of the most common causes of liver strain when taken in higher amounts or alongside other things that tax the liver. Garcinia has its own reports of liver trouble, including rare cases of acute hepatitis with raised liver enzymes. So the worry is simply two liver stressors stacking up at once.

To be honest, this is a theoretical concern based on how each is processed, not proven harm from taking them together. Still, watch for warning signs like yellowing skin or eyes, dark urine, belly pain, nausea, or unusual tiredness. Before pairing Garcinia with this medication, please check with your pharmacist or doctor, especially if you already have any liver issues.

References
  1. 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. PubMed
  2. Bunchorntavakul, C. and Reddy, K. R. Review article: herbal and dietary supplement hepatotoxicity. Aliment.Pharmacol.Ther 2013;37(1):3-17. PubMed
  3. 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. PubMed
  4. 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.
  5. Rashid NN, Grant J. Hydroxycut hepatotoxicity. Med J Aust. 2010 Feb 1;192(3):173-4. PubMed
  6. 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. PubMed
  7. 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. PubMed
  8. 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. PubMed
  9. Yousaf MN, Chaudhary FS, Hodanazari SM, Sittambalam CD. Hepatotoxicity associated with Garcinia cambogia: a case report. World J Hepatol 2019;11(11):735-42.
  10. Mas Ordeig A, Bordón García N. Hepatotoxicity caused by Garcinia cambogia. Gastroenterol Hepatol 2020;43(3):134-5. DOI
  11. 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. 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

Garcinia Also Interacts With Other Medications

Garcinia has 703 moderate known drug interactions in our database — the Acetaminophen, Meperidine 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 Garcinia

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Meperidine

This page covers Garcinia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Meperidine page lists 250 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Gamma-hydroxybutyrate (ghb) (major).

By severity: 10 major · 199 moderate · 41 minor.

From our pharmacist’s overview on the Acetaminophen, Meperidine page

“Demerol APAP pairs meperidine, an opioid painkiller, with acetaminophen, and that combination earns real caution with the 250 supplement entries below. Ten carry a major rating, and most of the danger runs through a single theme: anything else that quiets the brain.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Meperidine interaction page

One more smart check

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

We hold 1,374 real supplement products containing Garcinia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Garcinia. Your product may carry other ingredients that interact with Acetaminophen, Meperidine too, on top of Garcinia — 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 Garcinia and Acetaminophen, Meperidine 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 Garcinia
Top 25%

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

29 days ago today
Medication Acetaminophen, Meperidine
Top half

#874 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 Garcinia

What is Garcinia?

Garcinia
  • Weight loss
  • Appetite suppression
  • Curbing sugar and carb cravings
  • Supporting metabolism
  • Traditional cooking and souring agent

Garcinia is a tropical fruit whose rind contains hydroxycitric acid (HCA), widely marketed for weight loss and appetite control. The scientific evidence is weak and mixed, with most studies showing only small or no meaningful weight effects, and rare reports of liver problems raise safety concerns. Talk to a pharmacist or doctor before trying it, especially if you have liver issues, are pregnant, or are breastfeeding.

Read the full Garcinia monograph & all interactions
Keep checking

Other Drugs & Garcinia

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

0Major
703Moderate
0Minor
2,126No known interaction
Moderate

703 interactions

Showing 60 of 703 moderate interactions — see all 703 on the Garcinia page.

No interaction 2,126 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 Garcinia and Acetaminophen, Meperidine Together: Common Questions

Can you take Garcinia with Acetaminophen, Meperidine?
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 Garcinia and Acetaminophen, Meperidine?
Acetaminophen, Meperidine belongs to more than one drug category, and Garcinia 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 Garcinia and Acetaminophen, Meperidine 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.