Drug & supplement interaction

L-tryptophan + Chlorpheniramine, Hydrocodone, Pseudoephedrine

Chlorpheniramine, Hydrocodone, Pseudoephedrine brand name: Tussend.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Chlorpheniramine, Hydrocodone, Pseudoephedrine falls into 2 drug categories that L-tryptophan can interact with; the most serious is rated major. Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

L-tryptophan and Chlorpheniramine, Hydrocodone, Pseudoephedrine

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

Why Are There 2 Interactions?

L-tryptophan interacts with whole categories of medication. Chlorpheniramine, Hydrocodone, Pseudoephedrine falls into 2 of those categories, so it can interact with L-tryptophan in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

CNS DEPRESSANTS

1 of 2

Why this applies to Chlorpheniramine, Hydrocodone, Pseudoephedrine

Chlorpheniramine, Hydrocodone, Pseudoephedrine falls under CNS DEPRESSANTS — the group L-tryptophan interacts with.

Theoretically, concomitant use of L-tryptophan with CNS depressants might cause additive sedative effects.
Clinical research shows that L-tryptophan can cause fatigue and drowsiness.
Severity Major Likelihood Probable Evidence B

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

Here's the simple version: this combination product already has two ingredients that can make you sleepy. Chlorpheniramine is a sedating antihistamine, and hydrocodone is an opioid cough/pain ingredient. Both calm down the central nervous system. L-tryptophan can add to that drowsy effect because your body turns it into serotonin and melatonin, which on their own tend to make people tired.

Stacking them together could leave you more drowsy, foggy, dizzy, or unsteady than expected, and in larger amounts opioids can slow breathing, so extra sedation is something to take seriously. The pseudoephedrine part is a stimulant, but it won't reliably cancel out that sleepiness. This is a reasonable concern, not just lab theory, so please check with your pharmacist or doctor before combining them, and never drive until you know how you react.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lieberman HR, Corkin S, Spring BJ. The effects of dietary neurotransmitter precursors on human behavior. Am J Clin Nutr 1985;42:366-70. PubMed
Moderate

SEROTONERGIC DRUGS

2 of 2

Chlorpheniramine, Hydrocodone, Pseudoephedrine also falls under SEROTONERGIC DRUGS.

Theoretically, combining L-tryptophan with serotonergic drugs might cause additive serotonergic effects.
L-tryptophan is a precursor to serotonin. Theoretically, combining serotonergic drugs with L-tryptophan might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders.
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 Tussend combination blends a cough opioid (hydrocodone), an antihistamine (chlorpheniramine), and a decongestant (pseudoephedrine). The piece that matters here is that both hydrocodone and chlorpheniramine can nudge serotonin levels a bit. Since L-tryptophan is the raw material your body turns into serotonin, stacking them together could, in theory, push serotonin higher than you want.

To be honest, this is a theoretical concern based on how these ingredients work, not something commonly reported. Still, it's worth knowing the warning signs of too much serotonin: agitation, fast heartbeat, sweating, shivering, tremor, or muscle twitching. If you ever feel those, get help. Before pairing tryptophan with Tussend, check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Messiha FS. Fluoxetine: adverse effects and drug-drug interactions. J Toxicol Clin Toxicol 1993;31:603-30. PubMed
  2. Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. 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

L-tryptophan Also Interacts With Other Medications

L-tryptophan has 247 major, 146 moderate known drug interactions in our database — the Chlorpheniramine, Hydrocodone, Pseudoephedrine one above is among them. If you take anything else, check it against the full list below.

Major 247 Moderate 146 No known interaction 2,437 (incl. Chlorpheniramine, Hydrocodone, Pseudoephedrine)
Taking anything else?

Check Another of Your Medications Against L-tryptophan

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

Everything else you take

See Every Supplement That Interacts With Chlorpheniramine, Hydrocodone, Pseudoephedrine

This page covers L-tryptophan only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Chlorpheniramine, Hydrocodone, Pseudoephedrine page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Ephedra (major) and Gamma-hydroxybutyrate (ghb) (major).

By severity: 16 major · 228 moderate · 41 minor.

From our pharmacist’s overview on the Chlorpheniramine, Hydrocodone, Pseudoephedrine page

“Tussend combines three drugs in one cough medicine, the opioid hydrocodone, the antihistamine chlorpheniramine, and the decongestant pseudoephedrine, so supplements can collide with it from several directions. I treat its list of 285 interacting ingredients as one that deserves real respect, and the 16 rated major are what to understan…”

Reviewed by 2 · Jul 18, 2026

Open the Chlorpheniramine, Hydrocodone, Pseudoephedrine interaction page

One more smart check

Taking L-tryptophan as Part of a Dietary Supplement Product? Check It for Interactions

We hold 5 real supplement products containing L-tryptophan, each one broken down to its full ingredient list — and combination products often carry several ingredients besides L-tryptophan. Your product may carry other ingredients that interact with Chlorpheniramine, Hydrocodone, Pseudoephedrine too, on top of L-tryptophan — 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 L-tryptophan and Chlorpheniramine, Hydrocodone, 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.

Supplement L-tryptophan
Steady interest

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

29 days ago today
Medication Chlorpheniramine, Hydrocodone, Pseudoephedrine
Top 25%

#670 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 L-tryptophan

What is L-tryptophan?

L-tryptophan
  • Sleep problems
  • Low mood and depression
  • Anxiety
  • Premenstrual symptoms
  • Appetite and food cravings

L-tryptophan is an essential amino acid the body uses to make serotonin and melatonin, and people take it to support sleep and mood. The evidence for supplement use is limited and mixed, and there are real safety concerns, so talk to a pharmacist or doctor before trying it.

Read the full L-tryptophan monograph & all interactions
Keep checking

Other Drugs & L-tryptophan

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

247Major
146Moderate
0Minor
2,436No known interaction
247 Major 146 Moderate 2,436 No interaction
Major

247 interactions

Showing 60 of 247 major interactions — see all 247 on the L-tryptophan page.

Moderate

146 interactions

Showing 60 of 146 moderate interactions — see all 146 on the L-tryptophan page.

No interaction 2,436 drugs checked — show the list

We also checked L-tryptophan against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,436 medications checked with no known interaction — see the full L-tryptophan list.

See the full L-tryptophan interactions page
See every supplement checked against Chlorpheniramine, Hydrocodone, Pseudoephedrine, ranked by severity
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

Keep exploring
L-tryptophan monograph › Uses, safety, and every drug interaction in one place Chlorpheniramine, Hydrocodone, Pseudoephedrine supplement interactions › Every supplement checked against Chlorpheniramine, Hydrocodone, Pseudoephedrine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking L-tryptophan and Chlorpheniramine, Hydrocodone, Pseudoephedrine Together: Common Questions

Can you take L-tryptophan with Chlorpheniramine, Hydrocodone, Pseudoephedrine?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for L-tryptophan and Chlorpheniramine, Hydrocodone, Pseudoephedrine?
Chlorpheniramine, Hydrocodone, Pseudoephedrine belongs to more than one drug category, and L-tryptophan 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 L-tryptophan and Chlorpheniramine, Hydrocodone, Pseudoephedrine interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Chlorpheniramine, Hydrocodone, Pseudoephedrine and L-tryptophan?

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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.