Iboga + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine brand names: Tylenol Cold Ex Strength, Children's Tylenol Cold Plus Cough.
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls into 3 drug categories that Iboga can interact with; the most serious is rated moderate. Theoretically, taking iboga with serotonergic drugs might increase levels of serotonin, resulting in additive effects with serotonergic drugs.
Read the full interaction reportIboga and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Iboga interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls into 3 of those categories, so it can interact with Iboga in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
SEROTONERGIC DRUGS
1 of 3Why this applies to Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls under SEROTONERGIC DRUGS — the group Iboga interacts with.
Ibogaine, a constituent in iboga, has serotonergic effects. Theoretically, combining serotonergic drugs with iboga might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders. Monitor patients for signs of serotonin syndrome and other serotonergic side effects if using iboga with serotonergic drugs.
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.
In this cold-and-cough combo, the ingredient I'd zero in on is dextromethorphan (the cough suppressant). It nudges serotonin levels up, and Iboga (through its main compound, ibogaine) does the same thing. Stack the two and you could get an additive serotonin effect. In rare cases that can build toward serotonin syndrome, with symptoms like agitation, a racing heart, sweating, shivering, muscle twitching, or confusion.
I'll be honest: this concern is theoretical, based on how these substances work rather than real-world reports, so don't panic. That said, Iboga carries serious heart-rhythm risks of its own and is illegal in the U.S. We don't recommend using it. Please run any combination past your pharmacist or doctor first.
- Glick SD, Maisonneuve IS. Mechanisms of antiaddictive actions of ibogaine. Ann N Y Acad Sci 1998;844:214-26.
- Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. PubMed
- Litjens RP, Brunt TM. How toxic is ibogaine? Clin Toxicol (Phila). 2016;54(4):297-302. PubMed
ANTICHOLINERGIC DRUGS
2 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine also falls under ANTICHOLINERGIC DRUGS.
In vitro research shows that iboga can inhibit acetylcholinesterase and might increase acetylcholine levels. However, the constituent ibogaine does not appear to have this effect.
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.
Here's the piece that matters for this combo product: it contains chlorpheniramine, an antihistamine with anticholinergic (drying) effects. Lab studies suggest Iboga may raise acetylcholine levels, which is the opposite of what chlorpheniramine does. In theory, that could blunt some of the antihistamine's action, so you might notice your runny nose or sneezing isn't quite as controlled. The rest of the ingredients (acetaminophen for pain/fever, dextromethorphan for cough, pseudoephedrine for congestion) aren't really the focus here.
I'll be honest with you: this is theoretical, based only on test-tube research, and the main Iboga compound (ibogaine) didn't show this effect. Frankly, Iboga's serious heart and safety risks are the far bigger concern. Please talk with your pharmacist before mixing them.
- Alper K, Reith ME, Sershen H. Ibogaine and the inhibition of acetylcholinesterase. J Ethnopharmacol. 2012;139(3):879-82. PubMed
CYTOCHROME P450 2D6 (CYP2D6) INHIBITORS
3 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine also falls under CYTOCHROME P450 2D6 (CYP2D6) INHIBITORS.
Ibogaine, the active constituent of iboga, is a substrate of CYP2D6. One pharmacokinetic study shows that taking the CYP2D6 inhibitor paroxetine prior to taking ibogaine 20 mg increases the exposure to ibogaine and its metabolite noribogaine by 2-fold when compared with ibogaine alone.
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.
Here's the key thing with this combo: one ingredient in your cold medicine, dextromethorphan (the cough suppressant), is broken down by the same liver enzyme, CYP2D6, that handles ibogaine from Iboga. Dextromethorphan is actually a known blocker of that enzyme. So in theory, taking it alongside Iboga could slow down how fast ibogaine clears, letting ibogaine and its byproduct build up to higher levels (a study with another CYP2D6 blocker showed roughly a doubling). That matters because ibogaine itself carries real dangers, including serious heart rhythm changes.
This is mostly theoretical, and honestly the bigger concern is Iboga's own risks. Ibogaine is illegal in the U.S. and not something we recommend. Please talk with your pharmacist before mixing these, and don't change any medication on your own.
- Henstra M, Wong L, Chahbouni A, et al. Toxicokinetics of ibogaine and noribogaine in a patient with prolonged multiple cardiac arrhythmias after ingestion of internet purchased ibogaine. Clin Toxicol (Phila). 2017;55(6):600-602. PubMed
- Glue P, Winter H, Garbe K, et al. Influence of CYP2D6 activity on the pharmacokinetics and pharmacodynamics of a single 20?mg dose of ibogaine in healthy volunteers. J Clin Pharmacol. 2015;55(6):680-7. PubMed
- Rodriguez P, Urbanavicius J, Prieto JP, et al. A single administration of the atypical psychedelic ibogaine or its metabolite noribogaine induces an antidepressant-like effect in rats. ACS Chem Neurosci 2020;11(11):1661-1672. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Iboga Also Interacts With Other Medications
Iboga has 1 major, 500 moderate known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Iboga
We haven’t checked that one against Iboga yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Iboga. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
This page covers Iboga only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page lists 301 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 · 242 moderate · 45 minor.
From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page
“Because Tylenol Cold Extra Strength packs four drugs into one dose (acetaminophen, chlorpheniramine, dextromethorphan, and pseudoephedrine), its supplement list runs to 301 ingredients, and 14 carry a major rating, so I'd approach this one with real care. The biggest hazards mirror the drugs themselves.”
Reviewed by 2 · Jul 18, 2026
Open the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction page
Where Iboga and Acetaminophen, Chlorpheniramine, Dextromethorphan, 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.
#513 of 1,452 supplements looked up here in the last 7 days
#220 of 2,830 medications looked up here in the last 7 days
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.
About Iboga
What is Iboga?
- Drug and alcohol addiction
- Opioid withdrawal
- Spiritual and ceremonial rituals
- Fatigue and stimulant effects
- Mood and emotional issues
Iboga is a Central African shrub whose root bark contains ibogaine, a powerful hallucinogenic compound studied mainly for addiction. It carries serious safety risks, including dangerous heart rhythm changes and deaths, and ibogaine is illegal in the United States and many other countries. We do not recommend its use outside of tightly controlled research settings.
Other Drugs & Iboga
Browse every other medication we’ve checked against Iboga — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1 interaction
500 interactions
- Metronidazole ›
- Diphenhydramine ›
- Methylphenidate ›
- Erythromycin ›
- Ranitidine ›
- Quinidine ›
- Glycopyrrolate ›
- Bupropion ›
- Chloroquine ›
- Fentanyl ›
- Oxybutynin ›
- Tacrolimus ›
- Carbamazepine ›
- Dextromethorphan ›
- Ipratropium ›
- Phenylephrine ›
- Procainamide ›
- Trimipramine ›
- Buprenorphine ›
- Dimenhydrinate ›
- Everolimus ›
- Lofepramine ›
- Nortriptyline ›
- Pilocarpine ›
- Procyclidine ›
- Propoxyphene ›
- Selegiline ›
- Sotalol ›
- Sumatriptan Succinate ›
- Amantadine ›
- Aripiprazole ›
- Azithromycin ›
- Cimetidine ›
- Cyclobenzaprine ›
- Desipramine ›
- Doxepin ›
- Duloxetine ›
- Edrophonium ›
- Erythromycin Ethylsuccinate ›
- Erythromycin Stearate ›
- Fluphenazine ›
- Hydroxyzine ›
- Hyoscyamine ›
- Levofloxacin ›
- Meclizine ›
- Metoclopramide ›
- Nicardipine ›
- Phenobarbital ›
- Prucalopride ›
- Scopolamine ›
- Tramadol ›
- Trihexyphenidyl ›
- Trospium ›
- Valproic Acid ›
- Vortioxetine ›
- Abiraterone Acetate ›
- Almotriptan ›
- Amiodarone ›
- Aripiprazole Lauroxil ›
- Artemether ›
Showing 60 of 500 moderate interactions — see all 500 on the Iboga page.
No interaction 2,328 drugs checked — show the list
We also checked Iboga against these medications and found no known interaction in our sources. Open any page to confirm.
- Apixaban ›
- Levothyroxine ›
- Amlodipine ›
- Warfarin ›
- Testosterone ›
- Losartan Potassium ›
- Ivermectin ›
- Metoprolol ›
- Rivaroxaban ›
- Aspirin ›
- Acetaminophen ›
- Rosuvastatin ›
- Abemaciclib ›
- Clopidogrel ›
- Tadalafil ›
- Atorvastatin ›
- Docusate ›
- Tirzepatide ›
- Ibuprofen ›
- Hydroxyurea ›
- Valacyclovir ›
- Warfarin Sodium ›
- Semaglutide ›
- Prednisone ›
- Propranolol ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Methotrexate ›
- Bendamustine ›
- Isotretinoin ›
- Amphetamine ›
- Acyclovir ›
- Doxycycline ›
- Amlodipine Besylate ›
- Lamotrigine ›
- Pregabalin ›
- Gabapentin ›
- Acetaminophen, Codeine ›
- Clonazepam ›
- Omeprazole ›
- Letrozole ›
- Naproxen ›
- Ciprofloxacin ›
- Bisoprolol ›
- Levothyroxine, Liothyronine ›
- Candesartan Cilexetil ›
- Acetaminophen, Oxycodone ›
- Diazepam ›
- Dapsone ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Acetaminophen, Aspirin, Caffeine ›
- Cyclopentolate ›
- Cephalexin ›
- Atorvastatin Calcium ›
- Amoxicillin, Clavulanate Potassium ›
- Mannitol ›
- Roxithromycin ›
- Acetaminophen, Caffeine, Codeine ›
- Levetiracetam ›
Showing the 60 most looked-up of 2,328 medications checked with no known interaction — see the full Iboga list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine as a medicine that can lower these. This is not an interaction with Iboga — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Iboga and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Together: Common Questions
Can you take Iboga with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
Why are there 3 interactions listed for Iboga and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
How serious is the Iboga and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction?
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.