Hibiscus Sabdariffa - Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine Interaction
Herbal: Hibiscus Sabdariffa
Also Known As: Hibiscus sabdariffa, Agua de Jamaica, Ambashthaki, Bissap, Erragogu, Flor de Jamaica, Florida cranberry, Gongura, Groseille de Guinée, Guinea Sorrel, Hibisco, Hibiscus Calyx, Jamaica Sorrel, Karkade, Karkadé, Kenaf, Lo Shen, Oseille de Guinée, Oseille Rouge
Drug: Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine
Brand names:
Conar-A
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 04, 2025
Interaction Details
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine is classified as belonging to the following category: Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP1A2 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP1A2. This interaction has not been reported in humans.
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
- Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Interaction Details
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine is classified as belonging to the following category: Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2D6 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2D6. This interaction has not been reported in humans.
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
- Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Interaction Details
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP3A4 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP3A4. This interaction has not been reported in humans.
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
- Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Interaction Details
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine is classified as belonging to the following category: Acetaminophen (Tylenol, Others)
Theoretically, taking Hibiscus sabdariffa with acetaminophen might decrease the clinical effects of acetaminophen.
There is some evidence that consuming a Hibiscus sabdariffa beverage (Zobo drink) before taking acetaminophen can decrease the elimination half-life of acetaminophen. Hibiscus sabdariffa does not seem to decrease maximum concentration or area under the curve of acetaminophen. The clinical significance of this is unknown.
Interaction Rating
Likelihood of Occurrence
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.
References
- Kolawole JA, Maduenyi A. Effect of zobo drink (Hibiscus sabdariffa water extract) on pharmacokinetics of acetaminophen in human volunteers. Eur J Drug Metab Pharmacokinet 2004;29:25-9.
Interaction Details
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine is classified as belonging to the following category: Cytochrome P450 2E1 (Cyp2E1) Substrates
Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2E1 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2E1. This interaction has not been reported in humans.
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
- Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Hibiscus Sabdariffa Overview
Hibiscus sabdariffa, also known as roselle or red sorrel, is a plant that belongs to the Malvaceae family and is native to several tropical regions of the world, including Africa, Asia, and the Caribbean. It is a perennial plant that has large flowers and a tart, cranberry-like flavor. It is a popular ingredient in beverages and is rich in antioxidants, vitamins and minerals, including vitamin C, calcium, and iron. Hibiscus sabdariffa is used in traditional medicine and is claimed to have a number of potential health benefits, including reducing blood pressure, improving digestion, and relieving stress and anxiety. It has also been used for improving liver health as well as a fever-reducer.
Hibiscus Sabdariffa - More Interactions
Hibiscus Sabdariffa interacts with 1058 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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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
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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