Indian Snakeroot - Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Interaction
Herbal: Indian Snakeroot
Also Known As: Rauvolfia serpentina, Ajmaline, Alseroxylon, Arbre aux Serpents, Arbre de Serpents, Bois de Couleuvre, Chandra, Chandrika, Chota-Chand, Covanamilpori, Dhan-barua, Dhanburua, Dhanmarna, Java Devil-Pepper, Pagla-Ka-Dawa, Patalagandhi, Preparation 1043, Racine de Couleuvre, R
Drug: Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Brand names:
Tylenol Cold Ex Strength, Children's Tylenol Cold Plus Cough
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 04, 2025
Interaction Details
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine is classified as belonging to the following category: Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Indian snakeroot might inhibit CYP2D6 enzymes and reduce the metabolism of CYP2D6 substrates.
Indian snakeroot contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
Interaction Rating
Likelihood of Occurrence
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
References
- VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53.
Interaction Details
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine is classified as belonging to the following category: Stimulant Drugs
Theoretically, concomitant use might cause additive effects.
Yohimbine, a constituent of Indian snakeroot, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. Theoretically, taking Indian snakeroot with stimulant drugs can have additive stimulant and hypertensive effects.
Interaction Rating
Likelihood of Occurrence
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
References
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Bharucha AE, Skaar T, Andrews CN, et al Relationship of cytochrome P450 pharmacogenetics to the effects of yohimbine on gastrointestinal transit and catecholamines in healthy subjects. Neurogastroenterol Motil. 2008;20(8):891-9.
Indian Snakeroot Overview
Indian snakeroot (Rauvolfia serpentina), also known as sarpagandha, is a plant that is native to India and other parts of South Asia. It is a perennial shrub and has been traditionally used in Ayurvedic and Unani medicine as a treatment for a variety of conditions, including hypertension (high blood pressure), anxiety, and insomnia.
The roots of the Indian snakeroot plant contain a number of active compounds, including reserpine, which is known to have sedative and hypotensive (blood pressure-lowering) effects. Indian snakeroot has also bene used as an antipyretic.
Indian Snakeroot - More Interactions
Indian Snakeroot interacts with 835 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
Return to the main supplement interaction checker page
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
Drug descriptions are provided by MedlinePlus.
Ask A Pharmacist About Your Herbal Questions!
Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
Ask A Pharmacist