Drug & supplement interaction

Manchurian Thorn + Codeine, Paracetamol

Codeine, Paracetamol brand name: Co-codamol.

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

Manchurian Thorn has a moderate interaction with Codeine, Paracetamol. Animal research suggests that high doses of Manchurian thorn can induce liver damage.

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

Manchurian Thorn and Codeine, Paracetamol

Here is the interaction we found between these two, with the evidence behind it.

Moderate

HEPATOTOXIC DRUGS

Why this applies to Codeine, Paracetamol

Codeine, Paracetamol falls under HEPATOTOXIC DRUGS — the group Manchurian Thorn interacts with.

Animal research suggests that high doses of Manchurian thorn can induce liver damage. Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage.
Some of these drugs include acarbose (Precose, Prandase), amiodarone (Cordarone), atorvastatin (Lipitor), azathioprine (Imuran), carbamazepine (Tegretol), cerivastatin (Baycol), diclofenac (Voltaren), felbamate (Felbatol), fenofibrate (Tricor), fluvastatin (Lescol), gemfibrozil (Lopid), isoniazid, itraconazole, (Sporanox), ketoconazole (Nizoral), leflunomide (Arava), lovastatin (Mevacor), methotrexate (Rheumatrex), nevirapine (Viramune), niacin, nitrofurantoin (Macrodantin), pioglitazone (Actos), pravastatin (Pravachol), pyrazinamide, rifampin (Rifadin), ritonavir (Norvir), rosiglitazone (Avandia), simvastatin (Zocor), tacrine (Cognex), tamoxifen, terbinafine (Lamisil), valproic acid, and zileuton (Zyflo).
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 thing to know with co-codamol: the part that matters for this combo is the paracetamol (acetaminophen). Paracetamol is one of the most common causes of liver strain when taken in high amounts. In animal studies, large doses of Manchurian Thorn have also been linked to liver damage. So the worry is simply additive: two things that can each stress the liver, working at the same time.

I want to be honest that this is a theoretical concern based on pharmacology and animal data, not strong human proof, so there's no need to panic. Still, since liver injury can be quiet at first (think tiredness, nausea, yellowing of the skin or eyes, or dark urine), I'd run it past your pharmacist or doctor before pairing them. Please don't stop your co-codamol on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Burgos R, Hancke J, Caceres DD, et al. Hepatotoxic effect of Aralia mandshurica dried root extract in pigs. Phytotherapy Res 1997;11(1):59-61. DOI
  2. Burgos R, Hancke J, Wikman G, et al. Toxicological assessment of Aralia mandshurica (Araliaceae) root extract after subchronic administration in rats. A biochemical and histological study. Phytotherapy Res 1994;8(1):1-9.

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

Manchurian Thorn Also Interacts With Other Medications

Manchurian Thorn has 441 moderate known drug interactions in our database — the Codeine, Paracetamol one above is one of them. If you take anything else, check it against the full list below.

Moderate 441 No known interaction 2,389 (incl. Codeine, Paracetamol)
Taking anything else?

Check Another of Your Medications Against Manchurian Thorn

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

Everything else you take

See Every Supplement That Interacts With Codeine, Paracetamol

This page covers Manchurian Thorn only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Codeine, Paracetamol page lists 240 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), Asarabacca (major), Beer (major) and Gamma-hydroxybutyrate (ghb) (major).

By severity: 9 major · 191 moderate · 40 minor.

From our pharmacist’s overview on the Codeine, Paracetamol page

“Co-codamol pairs codeine, an opioid that slows breathing, with paracetamol, which can strain the liver, so I read its supplement list warily. Nine of the 240 ingredients on file carry a major rating, and most of those pile extra sedation onto the codeine.”

Reviewed by 2 · Jul 18, 2026

Open the Codeine, Paracetamol interaction page

One more smart check

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

We hold 5 real supplement products containing Manchurian Thorn, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Manchurian Thorn. Your product may carry other ingredients that interact with Codeine, Paracetamol too, on top of Manchurian Thorn — 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 Manchurian Thorn and Codeine, Paracetamol 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 Manchurian Thorn
Top half

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

29 days ago today
Medication Codeine, Paracetamol
Top half

#1,137 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 Manchurian Thorn

What is Manchurian Thorn?

  • Blood sugar support
  • Joint and arthritis discomfort
  • Fatigue and general weakness
  • Digestive complaints
  • General tonic / adaptogen-like use

Manchurian Thorn (Aralia elata) is a thorny shrub or small tree used in traditional East Asian medicine, mainly for blood sugar, joint pain, and as a general tonic. Human evidence is very limited, so its benefits are not well proven. If you are considering it, talk with your pharmacist or doctor first, and avoid it during pregnancy and breastfeeding.

Read the full Manchurian Thorn monograph & all interactions
Keep checking

Other Drugs & Manchurian Thorn

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

0Major
441Moderate
0Minor
2,388No known interaction
441 Moderate 2,388 No interaction
Moderate

441 interactions

Showing 60 of 441 moderate interactions — see all 441 on the Manchurian Thorn page.

No interaction 2,388 drugs checked — show the list

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

Showing the 60 most looked-up of 2,388 medications checked with no known interaction — see the full Manchurian Thorn list.

See the full Manchurian Thorn interactions page
See every supplement checked against Codeine, Paracetamol, 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
Manchurian Thorn monograph › Uses, safety, and every drug interaction in one place Codeine, Paracetamol supplement interactions › Every supplement checked against Codeine, Paracetamol, 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 Manchurian Thorn and Codeine, Paracetamol Together: Common Questions

Can you take Manchurian Thorn with Codeine, Paracetamol?
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.
How serious is the Manchurian Thorn and Codeine, Paracetamol 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

Still Have a Question About Codeine, Paracetamol and Manchurian Thorn?

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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.