Drug & supplement interaction

Marshmallow + Naproxen, Pseudoephedrine

Naproxen, Pseudoephedrine brand name: Aleve Cold and Sinus.

Minor Interaction
The bottom line Minor

Naproxen, Pseudoephedrine falls into 2 drug categories that Marshmallow can interact with; the most serious is rated minor. Theoretically, mucilage in marshmallow might impair absorption of oral drugs.

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

Marshmallow and Naproxen, Pseudoephedrine

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

Why Are There 2 Interactions?

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

Minor

ORAL DRUGS

1 of 2

Why this applies to Naproxen, Pseudoephedrine

Naproxen, Pseudoephedrine falls under ORAL DRUGS — the group Marshmallow interacts with.

Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.
Severity Minor 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 Aleve Cold and Sinus (naproxen plus pseudoephedrine) and marshmallow root. Marshmallow is full of a slippery fiber called mucilage that swells into a gel in your stomach. The thinking is that this gel could form a coating that slows or partially blocks how well your pill is absorbed. If that happened, you might notice your combo working a little less well, meaning less pain and inflammation relief from the naproxen and less stuffy-nose relief from the pseudoephedrine.

I want to keep this in perspective though. This is a theoretical concern based on how mucilage behaves, not something well documented in people, and it's rated minor. A simple fix is to space them out: take your medicine first, then your marshmallow about 30 to 60 minutes later. Any questions, just ask your pharmacist.

References
  1. Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Minor

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Naproxen, Pseudoephedrine also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the practical picture for Aleve Cold and Sinus, which combines naproxen (an anti-inflammatory pain reliever) with pseudoephedrine (a decongestant). The naproxen part already has a mild blood-thinning effect on its own, since it makes platelets a little less sticky. The concern on file is that marshmallow flower might add a small extra antiplatelet nudge, which could in theory raise the chance of bruising or bleeding, like a nosebleed or stomach upset that lingers.

That said, this is very weak, theory-only evidence based on animal studies of the flower, not the root or leaf that you'll actually find in most marshmallow supplements. For occasional, short-term use, this isn't something I'd lose sleep over. Still, if you take naproxen regularly or have any bleeding concerns, it's worth a quick word with your pharmacist or doctor.

References
  1. Hage-Sleiman R, Mroueh M, Daher CF. Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon. Pharm Biol 2011;49(3):327-33.

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

Marshmallow Also Interacts With Other Medications

Marshmallow has 1 moderate, 2,038 minor known drug interactions in our database — the Naproxen, Pseudoephedrine 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 Marshmallow

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

Everything else you take

See Every Supplement That Interacts With Naproxen, Pseudoephedrine

This page covers Marshmallow only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Naproxen, Pseudoephedrine page lists 334 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), Danshen (major) and Ephedra (major).

By severity: 11 major · 279 moderate · 44 minor.

From our pharmacist’s overview on the Naproxen, Pseudoephedrine page

“Aleve Cold and Sinus pairs naproxen, an anti-inflammatory painkiller, with pseudoephedrine, a decongestant that acts as a mild stimulant, and that combination is why its supplement list runs to 334 entries and deserves real vigilance. The two biggest themes mirror the two drugs.”

Reviewed by 2 · Jul 18, 2026

Open the Naproxen, Pseudoephedrine interaction page

One more smart check

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

We hold 1,622 real supplement products containing Marshmallow, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Marshmallow. Your product may carry other ingredients that interact with Naproxen, Pseudoephedrine too, on top of Marshmallow — 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 Marshmallow and Naproxen, 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 Marshmallow
Top 10%

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

29 days ago today
Medication Naproxen, Pseudoephedrine
Steady interest

#1,791 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 Marshmallow

What is Marshmallow?

Marshmallow
  • Cough and sore throat
  • Dry mouth and throat irritation
  • Digestive upset and heartburn
  • Skin irritation
  • Soothing inflamed tissue

Marshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for these uses is mostly traditional and preliminary, but it is generally considered gentle and well-tolerated for short-term use. As with any supplement, check with your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Marshmallow monograph & all interactions
Keep checking

Other Drugs & Marshmallow

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

0Major
1Moderate
2,038Minor
790No known interaction
Moderate

1 interaction

Minor

2,038 interactions

Showing 60 of 2,038 minor interactions — see all 2,038 on the Marshmallow page.

No interaction 790 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 Marshmallow and Naproxen, Pseudoephedrine Together: Common Questions

Can you take Marshmallow with Naproxen, Pseudoephedrine?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Marshmallow and Naproxen, Pseudoephedrine?
Naproxen, Pseudoephedrine belongs to more than one drug category, and Marshmallow 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 Marshmallow and Naproxen, Pseudoephedrine interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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.