Drug & supplement interaction

Higenamine + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine

Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine brand name: Vicks NyQuil.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine falls into 3 drug categories that Higenamine can interact with; the most serious is rated moderate. Theoretically, higenamine might increase the levels and clinical effects of drugs metabolized by CYP2D6.

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

Higenamine and Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine

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

Why Are There 3 Interactions?

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

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

1 of 3

Why this applies to Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine

Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Higenamine interacts with.

Theoretically, higenamine might increase the levels and clinical effects of drugs metabolized by CYP2D6.
In vitro research shows that higenamine inhibits CYP2D6 enzymes. However, this effect has not been reported in humans.
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 piece that matters in NyQuil: the dextromethorphan (the cough suppressant) is broken down by a liver enzyme called CYP2D6. In lab studies, higenamine appears to slow that enzyme down. If that happened in a person, dextromethorphan could build up a bit more than usual, which might mean extra drowsiness, dizziness, or, in higher amounts, feeling foggy or restless.

I want to be honest about the evidence though: this has only been seen in a test tube, never confirmed in real people, so it's more of a theoretical caution than a proven problem. On top of that, higenamine itself can rev up heart rate and blood pressure, and NyQuil's pseudoephedrine does the same, so that combination is worth watching. Please run it by your pharmacist before pairing them.

References
  1. Liu Y, Santillo MF. Cytochrome P450 2D6 and 3A4 enzyme inhibition by amine stimulants in dietary supplements. Drug Test Anal. 2016;8(3-4):307-10. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, higenamine might increase the levels and clinical effects drugs metabolized by CYP3A4.
In vitro research shows that higenamine inhibits CYP3A4 enzymes by 21%. However, this effect has not been reported in humans.
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

Let's talk about mixing higenamine with NyQuil. In lab dishes, higenamine slightly blocked an enzyme called CYP3A4, which helps clear several of the ingredients in NyQuil, including dextromethorphan (the cough suppressant). In theory, if that enzyme slows down, those ingredients could build up a bit and hit you harder. With dextromethorphan that might mean more drowsiness, dizziness, or feeling foggy, on top of the sleepiness already coming from doxylamine.

Here's the honest part: this was only seen in a test tube, the blocking was minor (about 21 percent), and it has never been confirmed in people. So I wouldn't lose sleep over it. My bigger concern is that higenamine is a stimulant that can raise heart rate and blood pressure, and NyQuil's pseudoephedrine does the same. Please check with your pharmacist before combining them.

References
  1. Liu Y, Santillo MF. Cytochrome P450 2D6 and 3A4 enzyme inhibition by amine stimulants in dietary supplements. Drug Test Anal. 2016;8(3-4):307-10. PubMed
Moderate

STIMULANT DRUGS

3 of 3

Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine also falls under STIMULANT DRUGS.

Theoretically, higenamine might increase the risk of cardiovascular toxicity when taken with stimulant drugs.
Higenamine has stimulant effects due to agonist activity at beta2-adrenoreceptors. In cardiac muscle, higenamine appears to have a positive inotropic effect and increase heart rate. However, it does not appear to increase blood pressure.
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

The ingredient I want to focus on here is the pseudoephedrine in your NyQuil-type product. Pseudoephedrine is a decongestant that already revs up your heart and can nudge your blood pressure up. Higenamine acts on similar adrenaline-type receptors, so stacking the two could add up. In theory, that combination might raise your odds of a racing heartbeat, palpitations, jitteriness, trouble sleeping, or elevated blood pressure.

I'll be honest with you: this is a theoretical concern based on how these compounds work, not on strong human studies. Still, since higenamine products are poorly regulated and often mislabeled, I'd play it safe. If you have any heart or blood pressure issues, please check with your pharmacist or doctor before combining them.

References
  1. Wagner H, Reiter M, Ferstl W. New drugs with cardiotonic activity. Part 1. Chemistry and pharmacology of the cardiotonic active principle of Annona squamosa L. Planta Med 1980;40:77-85.
  2. Park CW, Chang KC, Lim JK. Effects of higenamine on isolated heart adrenoceptor of rabbit. Arch Int Pharmacodyn Ther 1984;267:279-88.
  3. Liu WH, Zhou YP, Zeng GY. Effects of dl-demethylcoclaurine on experimental heart failure. Acta Pharm Sinica 1988;23:81-5.
  4. Zhang Z, Liu X, Tao Z, et al. Effects of higeramine on hemodynamics and its tolerability and safety, an experimental study. Zhonghua Yi Xue Za Zhi 2002;82:352-5.

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

Higenamine Also Interacts With Other Medications

Higenamine has 890 moderate known drug interactions in our database — the Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine 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 Higenamine

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine

This page covers Higenamine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine page lists 286 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 Grapefruit (major).

By severity: 14 major · 227 moderate · 45 minor.

Open the Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interaction page

One more smart check

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

We hold 154 real supplement products containing Higenamine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Higenamine. Your product may carry other ingredients that interact with Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine too, on top of Higenamine — 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 Higenamine and Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine 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 Higenamine
Top half

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

29 days ago today
Medication Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine
Top half

#959 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 Higenamine

What is Higenamine?

  • Weight loss and fat burning
  • Pre-workout energy and performance
  • Appetite suppression
  • Athletic stimulant
  • Traditional medicine remedies

Higenamine is a plant-based stimulant compound added to many weight-loss and pre-workout supplements, but there is very little human evidence that it works and real concerns about heart and blood pressure effects. It is banned in sports by the World Anti-Doping Agency (WADA), and product labels often list inaccurate amounts, so most people should approach it with caution and talk to a pharmacist or doctor first.

Read the full Higenamine monograph & all interactions
Keep checking

Other Drugs & Higenamine

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

0Major
890Moderate
0Minor
1,939No known interaction
Moderate

890 interactions

Showing 60 of 890 moderate interactions — see all 890 on the Higenamine page.

No interaction 1,939 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 Higenamine and Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine Together: Common Questions

Can you take Higenamine with Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine?
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 3 interactions listed for Higenamine and Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine?
Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine belongs to more than one drug category, and Higenamine 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 Higenamine and Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine 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.