Drug & supplement interaction

Lentinan + Acetaminophen, Dextromethorphan

Acetaminophen, Dextromethorphan brand name: Tylenol Cough Ex Strength.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Dextromethorphan falls into 3 drug categories that Lentinan can interact with; the most serious is rated moderate. Laboratory evidence suggests that lentinan might increase the activity of cytochrome P450 1A2 (CYP1A2).

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Lentinan and Acetaminophen, Dextromethorphan

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Lentinan interacts with whole categories of medication. Acetaminophen, Dextromethorphan falls into 3 of those categories, so it can interact with Lentinan in 3 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 3

Why this applies to Acetaminophen, Dextromethorphan

Acetaminophen, Dextromethorphan falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Lentinan interacts with.

Laboratory evidence suggests that lentinan might increase the activity of cytochrome P450 1A2 (CYP1A2). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP1A2 in patients taking lentinan.
Some drugs metabolized by CYP1A2 include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), 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

Here's the gist with your Tylenol Cough product (acetaminophen plus dextromethorphan) and lentinan. In lab and animal tests, lentinan appears to speed up an enzyme called CYP1A2. If that happened in people, drugs cleared by that enzyme could break down a bit faster, meaning slightly lower levels and possibly a weaker effect. For the dextromethorphan part, that might mean your cough isn't quite as well controlled.

The reassuring news: this has never actually been reported in humans. It comes only from test-tube and animal work, so it's mostly theoretical and the evidence is weak. Acetaminophen mainly uses other pathways, so I wouldn't expect a meaningful change there. Still, if you plan to use a lentinan supplement regularly, it's worth a quick chat with your pharmacist or doctor first.

References
  1. Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 3

Acetaminophen, Dextromethorphan also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Laboratory research suggests that lentinan might increase the activity of cytochrome P450 2D6 (CYP2D6). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP2D6 in patients taking lentinan.
Some drugs metabolized by CYP2D6 include tricyclic antidepressants such as imipramine (Tofranil) and amitriptyline (Elavil); antipsychotics such as haloperidol (Haldol), risperidone (Risperdal), and chlorpromazine (Thorazine); beta-blockers such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), and carvedilol (Coreg); tamoxifen (Nolvadex); 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

Here's the piece that matters in your cough product: the dextromethorphan. Your liver uses an enzyme called CYP2D6 to break it down. Lab research hints that lentinan may speed that enzyme up a bit. If that happened in real life, your body might clear dextromethorphan a little faster, which could make the cough-suppressing effect weaker than usual. The acetaminophen part isn't really involved here, since it's handled by different pathways.

I want to keep this in perspective, though. This is only test-tube and animal data, and it has never been reported in actual people. For occasional, short-term cough relief, I wouldn't lose sleep over it. If you use lentinan regularly or take other CYP2D6 medicines, just check in with your pharmacist or doctor first.

References
  1. Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Acetaminophen, Dextromethorphan also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Laboratory research suggests that lentinan might increase the activity of cytochrome P450 3A4 (CYP3A4). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP3A4 in patients taking lentinan.
Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous 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

Here's the short version on pairing lentinan (a shiitake mushroom extract) with this cough and pain combo. Lab studies hint that lentinan might rev up an enzyme called CYP3A4, which helps your body break down the dextromethorphan part of this product. If that enzyme works faster, dextromethorphan could clear out a little quicker, meaning your cough suppression might not last as long. The acetaminophen side is handled mostly by other pathways, so it's less of a concern here.

The big caveat: this has only been seen in test tube and animal research, never in real people, so it's mostly theoretical. For occasional cough and fever use, I wouldn't lose sleep over it. Still, it's worth a quick chat with your pharmacist if you take lentinan regularly.

References
  1. Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.

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

Lentinan Also Interacts With Other Medications

Lentinan has 813 moderate known drug interactions in our database — the Acetaminophen, Dextromethorphan 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 Lentinan

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Dextromethorphan

This page covers Lentinan only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan page lists 236 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), Grapefruit (major) and Lithium (major).

By severity: 8 major · 185 moderate · 43 minor.

From our pharmacist’s overview on the Acetaminophen, Dextromethorphan page

“Alcohol tops my worry list for Acetaminophen with Dextromethorphan (Tylenol Cough Ex Strength). Beer and wine both carry major ratings, since acetaminophen already asks a lot of the liver and regular drinking compounds that strain.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Dextromethorphan interaction page

One more smart check

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

We hold 1 real supplement products containing Lentinan, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Lentinan. Your product may carry other ingredients that interact with Acetaminophen, Dextromethorphan too, on top of Lentinan — 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 Lentinan and Acetaminophen, Dextromethorphan 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 Lentinan
Steady interest

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

29 days ago today
Medication Acetaminophen, Dextromethorphan
Top half

#1,365 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 Lentinan

What is Lentinan?

Lentinan
  • Immune support
  • Used alongside cancer treatment
  • Anti-inflammatory
  • General wellness/tonic
  • Antimicrobial support

Lentinan is a beta-glucan polysaccharide from shiitake mushrooms that is studied mainly as an immune-modulating add-on to cancer chemotherapy, where it is given by injection in a few countries. Evidence for oral supplements is limited, and quality varies widely between products. Talk with your pharmacist or doctor before using it, especially if you have a health condition or are pregnant or breastfeeding.

Read the full Lentinan monograph & all interactions
Keep checking

Other Drugs & Lentinan

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

0Major
813Moderate
0Minor
2,016No known interaction
Moderate

813 interactions

Showing 60 of 813 moderate interactions — see all 813 on the Lentinan page.

No interaction 2,016 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 Lentinan and Acetaminophen, Dextromethorphan Together: Common Questions

Can you take Lentinan with Acetaminophen, Dextromethorphan?
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 3 interactions listed for Lentinan and Acetaminophen, Dextromethorphan?
Acetaminophen, Dextromethorphan belongs to more than one drug category, and Lentinan 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 Lentinan and Acetaminophen, Dextromethorphan 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.