Drug & supplement interaction

Hibiscus Sabdariffa + Acetaminophen, Pamabrom, Pyrilamine

Acetaminophen, Pamabrom, Pyrilamine brand names: Midol Max Strength PMS, Pamprin, Pamprin ES.

Minor Interaction
Medically reviewed by · Updated October 2026
The bottom line Minor

Acetaminophen, Pamabrom, Pyrilamine falls into 3 drug categories that Hibiscus Sabdariffa can interact with; the most serious is rated minor. Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP1A2 substrates.

Read the full interaction report
SeverityMinor
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hibiscus Sabdariffa and Acetaminophen, Pamabrom, Pyrilamine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Hibiscus Sabdariffa interacts with whole categories of medication. Acetaminophen, Pamabrom, Pyrilamine falls into 3 of those categories, so it can interact with Hibiscus Sabdariffa in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 3

Why this applies to Acetaminophen, Pamabrom, Pyrilamine

Acetaminophen, Pamabrom, Pyrilamine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Hibiscus Sabdariffa interacts with.

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.
Severity Minor 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 gist with this menstrual-relief combo (you'll know it as Midol or Pamprin): in a lab dish, hibiscus appeared to slow down a liver enzyme called CYP1A2. The acetaminophen in this product gets handled by several enzymes, and this isn't one of its main pathways, so even in theory the effect on the pain reliever would be small. If anything, a slower breakdown could let a little more linger, but none of this has actually been seen in real people.

Honestly, this one is very low on my worry list. Drinking hibiscus tea or taking the supplement alongside an occasional dose is unlikely to cause trouble. Just don't double up on other acetaminophen products, and check with your pharmacist if you take this regularly.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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.
Minor

ACETAMINOPHEN (Tylenol, others)

2 of 3
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.
Severity Minor Likelihood Probable Evidence B

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the deal with these PMS products like Midol or Pamprin: the active pain reliever in them is acetaminophen (the same stuff in Tylenol). There's a small study suggesting that drinking hibiscus tea, sometimes called Zobo drink, before taking acetaminophen made your body clear the acetaminophen a bit faster. In plain terms, the pain and cramp relief could fade a little sooner than expected.

Honestly, this is a minor and mostly theoretical concern. The studies didn't show a big drop in how much medicine got into the blood, so most people sipping hibiscus tea probably won't notice anything. If your headache or cramps aren't easing the way they used to, mention it to your pharmacist rather than doubling up on doses.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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.
Minor

CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES

3 of 3

Acetaminophen, Pamabrom, Pyrilamine also falls under 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.
Severity Minor 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 gist with these PMS-relief combo products (acetaminophen for pain, pamabrom as a mild water pill, and pyrilamine, an antihistamine). The piece that touches hibiscus is the acetaminophen. Your liver uses an enzyme called CYP2E1 to break down a small part of it. In test-tube studies, hibiscus extract slowed that enzyme down. In theory, less breakdown could mean a bit more acetaminophen hanging around.

The reassuring part: this has never actually been seen in people, and the rating is minor. A cup of tart hibiscus tea is very unlikely to matter. I'd just be sensible about not overdoing acetaminophen from multiple products, since it's hard on the liver in large amounts. If you take concentrated hibiscus supplements often, give your pharmacist a quick heads-up.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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.

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

Hibiscus Sabdariffa Also Interacts With Other Medications

Hibiscus Sabdariffa has 2 major, 266 moderate, 820 minor known drug interactions in our database — the Acetaminophen, Pamabrom, Pyrilamine one above is among them. If you take anything else, check it against the full list below.

Major 2 Moderate 266 Minor 820 No known interaction 1,742 (incl. Acetaminophen, Pamabrom, Pyrilamine)
Taking anything else?

Check Another of Your Medications Against Hibiscus Sabdariffa

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Pamabrom, Pyrilamine

This page covers Hibiscus Sabdariffa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Pamabrom, Pyrilamine page lists 274 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 Henbane (major).

By severity: 14 major · 218 moderate · 42 minor.

Open the Acetaminophen, Pamabrom, Pyrilamine interaction page

How much people look this up

Where Hibiscus Sabdariffa and Acetaminophen, Pamabrom, Pyrilamine 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 Hibiscus Sabdariffa
Top half

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

29 days ago today
Medication Acetaminophen, Pamabrom, Pyrilamine
Top 25%

#324 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 Hibiscus Sabdariffa

What is Hibiscus Sabdariffa?

Hibiscus Sabdariffa
  • High blood pressure
  • Heart and cholesterol health
  • Digestive upset
  • Antioxidant support
  • Fever and general wellness

Hibiscus sabdariffa is a tart, cranberry-flavored plant most often consumed as a tea, and its best-studied use is for mildly lowering blood pressure. Evidence for other uses is limited, and while hibiscus tea is generally well tolerated in food amounts, concentrated supplements should be used cautiously and avoided in pregnancy. Talk to your pharmacist or doctor before using it for a medical condition.

Read the full Hibiscus Sabdariffa monograph & all interactions
Keep checking

Other Drugs & Hibiscus Sabdariffa

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

2Major
266Moderate
820Minor
1,741No known interaction
2 Major 266 Moderate 820 Minor 1,741 No interaction
Major

2 interactions

Moderate

266 interactions

Showing 60 of 266 moderate interactions — see all 266 on the Hibiscus Sabdariffa page.

Minor

820 interactions

Showing 60 of 820 minor interactions — see all 820 on the Hibiscus Sabdariffa page.

No interaction 1,741 drugs checked — show the list

We also checked Hibiscus Sabdariffa against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,741 medications checked with no known interaction — see the full Hibiscus Sabdariffa list.

See the full Hibiscus Sabdariffa interactions page
See every supplement checked against Acetaminophen, Pamabrom, Pyrilamine, ranked by severity
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

Keep exploring
Hibiscus Sabdariffa monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Pamabrom, Pyrilamine supplement interactions › Every supplement checked against Acetaminophen, Pamabrom, Pyrilamine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Hibiscus Sabdariffa and Acetaminophen, Pamabrom, Pyrilamine Together: Common Questions

Can you take Hibiscus Sabdariffa with Acetaminophen, Pamabrom, Pyrilamine?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Hibiscus Sabdariffa and Acetaminophen, Pamabrom, Pyrilamine?
Acetaminophen, Pamabrom, Pyrilamine belongs to more than one drug category, and Hibiscus Sabdariffa 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 Hibiscus Sabdariffa and Acetaminophen, Pamabrom, Pyrilamine interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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.