Drug & supplement interaction

Hu Zhang + Acetaminophen, Codeine, Methocarbamol

Acetaminophen, Codeine, Methocarbamol brand names: Acetaminophen, Codeine, Methocarbamol, Robaxacet 8.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Codeine, Methocarbamol falls into 2 drug categories that Hu Zhang can interact with; the most serious is rated moderate. Theoretically, hu zhang might increase levels of drugs metabolized by CYP1A2.

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

Hu Zhang and Acetaminophen, Codeine, Methocarbamol

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Acetaminophen, Codeine, Methocarbamol

Acetaminophen, Codeine, Methocarbamol falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Hu Zhang interacts with.

Theoretically, hu zhang might increase levels of drugs metabolized by CYP1A2.
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP1A2 enzyme. This interaction 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 situation with this combo product. The lab concern is that resveratrol in Hu Zhang might slow down a liver enzyme called CYP1A2. For your Robaxacet-type product, that enzyme matters most for the methocarbamol piece, the muscle relaxant. If it clears a little slower, you could feel more of its usual effects, like drowsiness, dizziness, or a foggy, sluggish feeling. The codeine and acetaminophen parts are handled mostly by different enzymes, so they're less of a worry here.

I want to be honest about the strength of this: it's theoretical, based only on test-tube research, and has never been reported in real people. So I wouldn't panic. Still, if you take both regularly, give your pharmacist or doctor a heads-up and watch for extra sleepiness.

References
  1. Chang, T. K., Chen, J., and Lee, W. B. Differential inhibition and inactivation of human CYP1 enzymes by trans-resveratrol: evidence for mechanism-based inactivation of CYP1A2. J.Pharmacol.Exp.Ther. 2001;299(3):874-882.
Moderate

CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES

2 of 2

Acetaminophen, Codeine, Methocarbamol also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.

Theoretically, hu zhang might increase levels of drugs metabolized by CYP2E1.
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP2E1 enzyme. Also, a pharmacokinetic study shows that taking resveratrol 500 mg daily for 10 days prior to taking a single dose of chlorzoxazone 250 mg increases the maximum concentration of chlorzoxazone by about 54%, the area under the curve of chlorzoxazone by about 72%, and the half-life of chlorzoxazone by about 35%. Chlorzoxazone is used as a probe drug for CYP2E1.
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 most with this particular combo product: the acetaminophen part of Robaxacet 8 is partly broken down by an enzyme called CYP2E1. The resveratrol in Hu Zhang may slow that enzyme down a bit. On paper, that could shift how acetaminophen is processed. The good news is this is theoretical, based mostly on lab work and one small study using a different drug, so it's not a strong, proven concern at normal doses.

For most people, this won't cause obvious problems. Still, since acetaminophen is hard on the liver in large amounts, I wouldn't stack it with concentrated Hu Zhang supplements without checking first. Please run it by your pharmacist or doctor, especially if you drink alcohol or take other acetaminophen products.

References
  1. Piver B, Berthou F, Dreano Y, Lucas D. Inhibition of CYP3A, CYP1A and CYP2E1 activities by resveratrol and other non volatile red wine components. Toxicol Lett 2001;125:83-91. PubMed
  2. Yu, C., Shin, Y. G., Kosmeder, J. W., Pezzuto, J. M., and van Breemen, R. B. Liquid chromatography/tandem mass spectrometric determination of inhibition of human cytochrome P450 isozymes by resveratrol and resveratrol-3-sulfate. Rapid Commun.Mass Spectro PubMed
  3. Bedada SK, Neerati P. Resveratrol Pretreatment Affects CYP2E1 Activity of Chlorzoxazone in Healthy Human Volunteers. Phytother Res. 2016;30(3):463-8. 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

Hu Zhang Also Interacts With Other Medications

Hu Zhang has 825 moderate known drug interactions in our database — the Acetaminophen, Codeine, Methocarbamol 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 Hu Zhang

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Codeine, Methocarbamol

This page covers Hu Zhang only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Codeine, Methocarbamol page lists 243 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 · 193 moderate · 40 minor.

Open the Acetaminophen, Codeine, Methocarbamol interaction page

One more smart check

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

We hold 1,014 real supplement products containing Hu Zhang, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hu Zhang. Your product may carry other ingredients that interact with Acetaminophen, Codeine, Methocarbamol too, on top of Hu Zhang — 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 Hu Zhang and Acetaminophen, Codeine, Methocarbamol 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 Hu Zhang
Top 25%

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

29 days ago today
Medication Acetaminophen, Codeine, Methocarbamol
Top 5%

#107 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 Hu Zhang

What is Hu Zhang?

  • Source of resveratrol
  • Heart and circulation support
  • Inflammation
  • Liver and digestive complaints (traditional)
  • Cough and respiratory symptoms (traditional)
  • Skin and joint conditions (traditional topical use)

Hu Zhang (Japanese knotweed root) is a traditional Chinese herb that is one of the richest natural sources of resveratrol and emodin. Some lab and early human research looks interesting for inflammation and heart health, but high-quality evidence in people is limited. Talk to your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Hu Zhang monograph & all interactions
Keep checking

Other Drugs & Hu Zhang

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

0Major
825Moderate
0Minor
2,004No known interaction
Moderate

825 interactions

Showing 60 of 825 moderate interactions — see all 825 on the Hu Zhang page.

No interaction 2,004 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 Hu Zhang and Acetaminophen, Codeine, Methocarbamol Together: Common Questions

Can you take Hu Zhang with Acetaminophen, Codeine, Methocarbamol?
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 Hu Zhang and Acetaminophen, Codeine, Methocarbamol?
Acetaminophen, Codeine, Methocarbamol belongs to more than one drug category, and Hu Zhang 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 Hu Zhang and Acetaminophen, Codeine, Methocarbamol 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.