Drug & supplement interaction

Ipriflavone + Ephedrine, Hydroxyzine, Theophylline

Ephedrine, Hydroxyzine, Theophylline brand names: Marax, Ami Rax.

Moderate Interaction
The bottom line Moderate

Ephedrine, Hydroxyzine, Theophylline falls into 2 drug categories that Ipriflavone can interact with; the most serious is rated moderate. Ipriflavone is thought to competitively inhibit cytochrome P450 1A2 (CYP1A2).

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

Ipriflavone and Ephedrine, Hydroxyzine, Theophylline

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

Why Are There 2 Interactions?

Ipriflavone interacts with whole categories of medication. Ephedrine, Hydroxyzine, Theophylline falls into 2 of those categories, so it can interact with Ipriflavone 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 Ephedrine, Hydroxyzine, Theophylline

Ephedrine, Hydroxyzine, Theophylline falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Ipriflavone interacts with.

Ipriflavone is thought to competitively inhibit cytochrome P450 1A2 (CYP1A2). Theoretically, concurrent use of ipriflavone and drugs metabolized by these enzymes might result in decreased drug elimination, increased serum levels, and potential toxicity. Some drugs metabolized by CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), Pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline (Slo-bid, Theo-Dur, others), zileuton (Zyflo), Zolmitriptan (Zomig), and others.
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

This combination product contains theophylline, and that's the piece I'd keep an eye on here. Your liver clears theophylline using an enzyme called CYP1A2. Ipriflavone appears to slow that same enzyme down, so in theory theophylline could clear more slowly and build up in your blood. Theophylline already has a narrow safe range, so even a modest rise can matter. Higher levels can cause a racing heart, nausea, jitteriness, trouble sleeping, or in serious cases tremors and irregular heartbeats, and the ephedrine in this product can add to that stimulant feeling.

That said, this concern comes only from lab-type studies, not real patient cases, so it's more theoretical than proven. Still, please check with your pharmacist or doctor before pairing these.

References
  1. Monostory K, Vereczkey L, Levai F, et al. Ipriflavone as an inhibitor of human cytochrome P450 enzymes. Br J Pharmacol 1998;123:605-10. PubMed
Moderate

THEOPHYLLINE

2 of 2

Ephedrine, Hydroxyzine, Theophylline also falls under THEOPHYLLINE.

Concomitant use of theophylline and ipriflavone can increase serum theophylline levels. Increased theophylline levels have occurred in two cases after patients started taking ipriflavone. Ipriflavone is thought to decrease theophylline metabolism through competitive inhibition of the cytochrome P450 1A2 (CYP1A2) enzyme.
Severity Moderate Likelihood Probable Evidence D

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

The piece of this combination pill I want to flag is the theophylline. Your liver clears theophylline mainly through an enzyme called CYP1A2, and ipriflavone appears to slow that enzyme down. When clearance slows, theophylline can build up in your blood. It already has a narrow safety window, so even a modest rise can tip you into trouble.

If levels climb too high, you might notice a racing or pounding heartbeat, jitteriness, nausea, trouble sleeping, or in serious cases tremors or seizures. To be fair, this is based on only a couple of reported cases, so it is not rock-solid evidence. Still, with a drug this sensitive, please run it by your pharmacist or doctor before combining them.

References
  1. Monostory K, Vereczkey L, Levai F, et al. Ipriflavone as an inhibitor of human cytochrome P450 enzymes. Br J Pharmacol 1998;123:605-10. PubMed
  2. Takahashi J, Kawakatsu K, Wakayama T, Sawaoka H. Elevation of serum theophylline levels by ipriflavone in a patient with chronic obstructive pulmonary disease. Eur J Clin Pharmacol 1992;43:207-8. 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

Ipriflavone Also Interacts With Other Medications

Ipriflavone has 390 moderate known drug interactions in our database — the Ephedrine, Hydroxyzine, Theophylline 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 Ipriflavone

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

Everything else you take

See Every Supplement That Interacts With Ephedrine, Hydroxyzine, Theophylline

This page covers Ipriflavone only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ephedrine, Hydroxyzine, Theophylline page lists 199 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Black Tea (major), Caffeine (major), Coffee (major) and Ephedra (major).

By severity: 17 major · 143 moderate · 39 minor.

From our pharmacist’s overview on the Ephedrine, Hydroxyzine, Theophylline page

“For anyone taking Marax (ephedrine, hydroxyzine, theophylline), nothing on this page matters more than caffeine. Paired with the ephedrine in this combination, caffeine from coffee, teas, guarana, and similar herbs has been linked to dangerous blood pressure spikes, heart attack, and stroke, and those stimulant pairings account for mos…”

Reviewed by 2 · Jul 18, 2026

Open the Ephedrine, Hydroxyzine, Theophylline interaction page

One more smart check

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

We hold 204 real supplement products containing Ipriflavone, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ipriflavone. Your product may carry other ingredients that interact with Ephedrine, Hydroxyzine, Theophylline too, on top of Ipriflavone — 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 Ipriflavone and Ephedrine, Hydroxyzine, Theophylline 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 Ipriflavone
Top half

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

29 days ago today
Medication Ephedrine, Hydroxyzine, Theophylline
Top 10%

#150 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 Ipriflavone

What is Ipriflavone?

Ipriflavone
  • Bone density and osteoporosis
  • Postmenopausal bone loss
  • Athletic performance
  • Tinnitus related to bone disorders

Ipriflavone is a synthetic isoflavone studied mainly for bone health and osteoporosis, but high-quality research has not shown that it reliably prevents fractures or builds strong bone. Because it can lower white blood cell counts in some people and its long-term safety is not well established, talk with your pharmacist or doctor before using it.

Read the full Ipriflavone monograph & all interactions
Keep checking

Other Drugs & Ipriflavone

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

0Major
390Moderate
0Minor
2,439No known interaction
Moderate

390 interactions

Showing 60 of 390 moderate interactions — see all 390 on the Ipriflavone page.

No interaction 2,439 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 Ipriflavone and Ephedrine, Hydroxyzine, Theophylline Together: Common Questions

Can you take Ipriflavone with Ephedrine, Hydroxyzine, Theophylline?
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 Ipriflavone and Ephedrine, Hydroxyzine, Theophylline?
Ephedrine, Hydroxyzine, Theophylline belongs to more than one drug category, and Ipriflavone 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 Ipriflavone and Ephedrine, Hydroxyzine, Theophylline 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.