Drug & supplement interaction

Gotu Kola + Acetaminophen, Meperidine

Acetaminophen, Meperidine brand name: Demerol APAP.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Meperidine falls into 2 drug categories that Gotu Kola can interact with; the most serious is rated moderate. Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.

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

Gotu Kola and Acetaminophen, Meperidine

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

Why Are There 2 Interactions?

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

Moderate

CNS DEPRESSANTS

1 of 2

Why this applies to Acetaminophen, Meperidine

Acetaminophen, Meperidine falls under CNS DEPRESSANTS — the group Gotu Kola interacts with.

Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.
In vitro research suggests that gotu kola may have sedative effects via binding of GABA receptors.
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

This combination pairs a calming herb with a medicine that already slows down your brain and body. Demerol APAP contains meperidine, an opioid painkiller, plus acetaminophen (Tylenol). Lab studies hint that gotu kola may have a mild sedative effect by acting on GABA receptors, the same calming system many sleep and anxiety drugs use. So in theory, taking the two together could leave you feeling extra drowsy, foggy, dizzy, or unsteady on your feet.

Keep in mind this is only a theoretical concern based on lab work, not real-world reports, so don't panic. Still, since meperidine can already cause heavy sedation and slowed breathing, it's worth running this combo past your pharmacist or doctor before mixing them.

References
  1. Brinkhaus B, Lindner M, Schuppan D, Hahn EG. Chemical, pharmacological and clinical profile of the east Asian medical plant Centella asiatica. Phytomedicine 2000;7:427-48.
  2. Bradwejn J, Zhou Y, Koszycki D, Shlik J. A double-blind, placebo-controlled study on the effects of Gotu Kola (Centella asiatica) on acoustic startle response in healthy subjects. J Clin Psychopharmacol 2000;20:680-4. PubMed
Moderate

HEPATOTOXIC DRUGS

2 of 2

Acetaminophen, Meperidine also falls under HEPATOTOXIC DRUGS.

Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
There are at least four case reports of hepatotoxicity associated with the use of gotu kola. However, more information is needed to determine if gotu kola was the causative factor in these cases.
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 short version on combining gotu kola with Demerol APAP (the acetaminophen plus meperidine combo). The concern is really about the acetaminophen part. Acetaminophen is processed by your liver, and in higher doses or with other liver stressors it can be hard on liver cells. There are a handful of case reports where gotu kola itself was linked to liver irritation, so the worry is that the two together might add up and put extra strain on your liver.

I want to be honest: this is theoretical and based on weak, anecdotal evidence, so it's not a reason to panic. Still, signs like nausea, belly pain, dark urine, or yellowing of the skin or eyes are worth knowing. Please check with your pharmacist or doctor before pairing them, especially if you already have any liver concerns.

References
  1. Jorge OA, Jorge AD. Hepatotoxicity associated with the ingestion of Centella asiatica. Rev Esp Enferm Dig 2005;97:115-24. PubMed
  2. Dantuluri S, North-lewis P, Karthik SV. Gotu Kola induced hepatotoxicity in a child - need for caution with alternative remedies. Dig Liver Dis. 2011;43(6):500. 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

Gotu Kola Also Interacts With Other Medications

Gotu Kola has 578 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 Gotu Kola

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Meperidine

This page covers Gotu Kola 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 Gotu Kola as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,832 real supplement products containing Gotu Kola, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Gotu Kola. Your product may carry other ingredients that interact with Acetaminophen, Meperidine too, on top of Gotu Kola — 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 Gotu Kola 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 Gotu Kola
Top 25%

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

29 days ago today
Medication Acetaminophen, Meperidine
Top half

#873 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 Gotu Kola

What is Gotu Kola?

Gotu Kola
  • Wound healing
  • Varicose veins and poor circulation
  • Anxiety and stress
  • Memory and mental clarity
  • Skin health and scarring

Gotu kola is a traditional Ayurvedic and Asian herb that people use for wound healing, circulation, skin problems, and as a calming or memory-supporting herb. Some early studies suggest possible benefits for vein health and skin, but the overall evidence is limited and not strong. Talk to your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or have liver problems.

Read the full Gotu Kola monograph & all interactions
Keep checking

Other Drugs & Gotu Kola

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

0Major
578Moderate
0Minor
2,251No known interaction
Moderate

578 interactions

Showing 60 of 578 moderate interactions — see all 578 on the Gotu Kola page.

No interaction 2,251 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 Gotu Kola and Acetaminophen, Meperidine Together: Common Questions

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