Drug & supplement interaction

Mountain Ash + Acetaminophen

Acetaminophen brand names: Tylenol Ex Strength, Children's Tylenol, Tylenol, Children's Tylenol Meltaways.

Moderate Interaction
The bottom line Moderate

Mountain Ash has a moderate interaction with Acetaminophen. Taking large amounts of fresh mountain ash berries may cause kidney damage due to its parasorbic acid constituent.

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

Mountain Ash and Acetaminophen

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

Moderate

NEPHROTOXIC DRUGS

Why this applies to Acetaminophen

Acetaminophen falls under NEPHROTOXIC DRUGS — the group Mountain Ash interacts with.

Taking large amounts of fresh mountain ash berries may cause kidney damage due to its parasorbic acid constituent. Theoretically, taking mountain ash berries with nephrotoxic drugs might increase the risk for kidney damage. Until more is known, advise patients to avoid taking mountain ash berries if they are taking other potentially nephrotoxic drugs.
Some potentially nephrotoxic drugs include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); 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 gist: this isn't about acetaminophen building up or wearing off faster. The concern is purely additive stress on your kidneys. Fresh, raw mountain ash berries contain a compound called parasorbic acid that may irritate the kidneys, and acetaminophen, especially in high doses or with long-term heavy use, can also be tough on them. Stacking two kidney stressors together is the worry.

I'll be honest, this is a theoretical concern based on the chemistry, not on real human studies, so I wouldn't lose sleep over it. Cooked berries in a jam or tea are very different from concentrated raw berries. Still, if you take acetaminophen regularly or have any kidney issues, check with your pharmacist or doctor before adding mountain ash.

References
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

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

Mountain Ash Also Interacts With Other Medications

Mountain Ash has 354 moderate known drug interactions in our database — the Acetaminophen one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Mountain Ash

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

From our Q&A

Questions About Mountain Ash or Acetaminophen

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Mountain Ash or Acetaminophen, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Acetaminophen

This page covers Mountain Ash only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen page lists 155 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), Siberian Cocklebur (major) and Wine (major).

By severity: 5 major · 114 moderate · 36 minor.

From our pharmacist’s overview on the Acetaminophen page

“Acetaminophen (Tylenol) feels harmless because it sits on every shelf, but this list deserves real attention, mostly because of your liver. Of the 155 supplements and herbs on file, five carry a major rating, and the largest serious group, 38 ingredients, adds liver strain on top of acetaminophen's own well-known potential to harm the…”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen interaction page

One more smart check

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

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

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

29 days ago today
Medication Acetaminophen
Top 1%

#24 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 Mountain Ash

What is Mountain Ash?

Mountain Ash
  • Sore throat and hoarseness
  • Digestive upset and constipation
  • Cough and chest congestion
  • Mild urinary complaints
  • Source of vitamin C in folk medicine

Mountain ash (rowan) is a northern-hemisphere tree whose bright red berries are traditionally cooked into jams, syrups, and teas. There is very little reliable human research to support any medical use, and raw berries contain compounds that can cause stomach upset, so cooking is important. If you want to try it, talk with your pharmacist or doctor first.

Read the full Mountain Ash monograph & all interactions
Medication

About Acetaminophen

What Is Acetaminophen Used For?

Brand names: Tylenol Ex Strength, Children's Tylenol, Tylenol, Children's Tylenol Meltaways

Acetaminophen temporarily relieves minor aches and pains caused by headaches, the common cold, backaches, muscle aches, toothaches, minor arthritis pain, and premenstrual or menstrual cramps. It also temporarily reduces fever.

These uses apply across oral tablet, suspension, and oral liquid products. The intravenous (IV) injection form is used in clinical settings to treat acute pain and fever, including in pediatric patients 2 years and older.

See full Acetaminophen drug information
Keep checking

Other Drugs & Mountain Ash

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

0Major
354Moderate
0Minor
2,475No known interaction
Moderate

354 interactions

Showing 60 of 354 moderate interactions — see all 354 on the Mountain Ash page.

No interaction 2,475 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 Mountain Ash and Acetaminophen Together: Common Questions

Can you take Mountain Ash with Acetaminophen?
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 Mountain Ash and Acetaminophen 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.