Kratom - Acetaminophen, Dexbrompheniramine, Pseudoephedrine Interaction
Herbal: Kratom
Also Known As: Mitragyna speciosa, Biak-Biak, Cratom, Gratom, Ithang, Kakuam, Katawn, Kedemba, Ketum, Krathom, Kraton, Kratum, Madat, Maeng Da Leaf, Mambog, Mitragynine, Mitragynine Extract, Thang, Thom
Drug: Acetaminophen, Dexbrompheniramine, Pseudoephedrine
Brand names:
Sinadrin Plus
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 25, 2025
Interaction Details
Acetaminophen, Dexbrompheniramine, Pseudoephedrine is classified as belonging to the following category: Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, kratom might increase the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that kratom extract inhibits the activity of CYP1A2. In one case report, a 63-year-old male presented with possible serotonin syndrome after taking an unknown dose of kratom for up to 3 months along with serotonergic prescription medications bupropion, buspirone, desvenlafaxine, trazodone, and ziprasidone. It was hypothesized that kratom inhibited CYP1A2-mediaed metabolism of ziprasidone which consequently increased systemic exposure to serotonin.
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
- Kong WM, Chik Z, Ramachandra M, et al. Evaluation of the effects of Mitragyna speciosa alkaloid extract on cytochrome P450 enzymes using a high throughput assay. Molecules. 2011;16(9):7344-7356.
- Eudaley ST, Brooks SP, Hamilton LA. Case Report: Possible Serotonin Syndrome in a Patient Taking Kratom and Multiple Serotonergic Agents. J Pharm Pract 2022.
Kratom Overview
Kratom is a tropical tree from Southeast Asia, and its leaves are known for their potent effects. The leaves contain mitragynine and 7-hydroxymitragynine, which interact with the brain's opioid receptors, producing effects similar to opioids. Mitragynine acts as a partial agonist, providing pain relief and mood enhancement, while 7-hydroxymitragynine is even more potent, estimated to be about 10 times stronger than morphine. These compounds can stimulate opioid receptors, leading to effects such as euphoria and pain relief at lower doses, while higher doses can cause sedation and opioid-like effects. Kratom's safety and legal status are hotly debated, and it's banned or restricted in many places.
Kratom - More Interactions
Kratom interacts with 967 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. |
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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.
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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!
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