Iboga + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine
Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine brand name: Theracaps.
Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine falls into 2 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, Dextromethorphan, Phenylpropanolamine, Pyrilamine
These two interact in 2 distinct ways. Each one is explained separately below.
Why Are There 2 Interactions?
Iboga interacts with whole categories of medication. Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine falls into 2 of those categories, so it can interact with Iboga in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
SEROTONERGIC DRUGS
1 of 2Why this applies to Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine
Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine 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.
Here's the piece that matters in this combo product: the dextromethorphan, the cough suppressant. On its own it nudges serotonin upward in the brain. Iboga (through ibogaine) does the same thing. Stack the two and you could push serotonin too high, which is what we call serotonin syndrome. Watch for agitation, a racing heart, shakiness or muscle twitching, sweating, fever, or confusion.
To be honest, this concern is theoretical, based on how these substances behave rather than real case reports together. But ibogaine carries its own serious heart and safety risks and isn't legal here, so I wouldn't pair them. Please check with your pharmacist or doctor before combining anything with iboga.
- 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 2Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine 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.
Your Theracaps combo includes pyrilamine, an antihistamine that works partly by blocking acetylcholine, a nerve signaling chemical. The concern here is theoretical and comes only from lab dish studies, not from people. In those studies, Iboga raised acetylcholine levels, which could in principle work against pyrilamine and slightly blunt its drying, calming effect. Interestingly, ibogaine itself (Iboga's main active alkaloid) did not show this effect.
In real life this is very weak, uncertain evidence, so I would not lose sleep over the antihistamine piece. The bigger issue is that Iboga itself is unsafe and illegal here, with risks of dangerous heart rhythms. Please talk with your pharmacist or doctor before mixing anything with it.
- Alper K, Reith ME, Sershen H. Ibogaine and the inhibition of acetylcholinesterase. J Ethnopharmacol. 2012;139(3):879-82. 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, Dextromethorphan, Phenylpropanolamine, Pyrilamine 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, Dextromethorphan, Phenylpropanolamine, Pyrilamine
This page covers Iboga only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine page lists 282 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 · 223 moderate · 45 minor.
From our pharmacist’s overview on the Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine page
“Of everything on this page, ephedra worries me most for anyone using Theracaps (acetaminophen, dextromethorphan, phenylpropanolamine, and pyrilamine), because the decongestant in this cold formula is itself a stimulant. Adding ephedra or any of the 44 stimulant entries can push blood pressure and heart rate to unsafe levels.”
Reviewed by 2 · Jul 18, 2026
Open the Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interaction page
Where Iboga and Acetaminophen, Dextromethorphan, Phenylpropanolamine, 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.
#663 of 1,452 supplements looked up here in the last 7 days
#127 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 ›
- Ivermectin ›
- Abemaciclib ›
- Testosterone ›
- Losartan Potassium ›
- Acetaminophen ›
- Rosuvastatin ›
- Aspirin ›
- Metoprolol ›
- Clopidogrel ›
- Atorvastatin ›
- Rivaroxaban ›
- Isotretinoin ›
- Tirzepatide ›
- Ibuprofen ›
- Warfarin Sodium ›
- Amlodipine Besylate ›
- Levothyroxine, Liothyronine ›
- Docusate ›
- Prednisone ›
- Metformin ›
- Valacyclovir ›
- Tadalafil ›
- Hydroxyurea ›
- Semaglutide ›
- Amphetamine ›
- Propranolol ›
- Methotrexate ›
- Amoxicillin ›
- Lisinopril ›
- Pregabalin ›
- Doxycycline ›
- Gabapentin ›
- Bendamustine ›
- Acetaminophen, Aspirin, Caffeine ›
- Naproxen ›
- Lamotrigine ›
- Acyclovir ›
- Clonazepam ›
- Omeprazole ›
- Letrozole ›
- Ciprofloxacin ›
- Acetaminophen, Codeine ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Acetaminophen, Butalbital, Caffeine ›
- Acetylsalicylic Acid ›
- Amlodipine Besylate, Benazepril ›
- Acetaminophen, Caffeine, Codeine ›
- Perindopril Arginine, Amlodipine ›
- Bisoprolol ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Acetaminophen, Aspirin ›
- Insulin Degludec, Liraglutide ›
- Amlodipine Besilate ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aspirin, Caffeine, Orphenadrine ›
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, Dextromethorphan, Phenylpropanolamine, Pyrilamine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine 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, Dextromethorphan, Phenylpropanolamine, Pyrilamine Together: Common Questions
Can you take Iboga with Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine?
Why are there 2 interactions listed for Iboga and Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine?
How serious is the Iboga and Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine 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.