Padang Cassia - Acetaminophen, Dextromethorphan, Pseudoephedrine Interaction

Interaction Details

Acetaminophen, Dextromethorphan, Pseudoephedrine is classified as belonging to the following category: Hepatotoxic Drugs

There is some concern that ingesting large amounts of Padang cassia might cause hepatotoxicity in some people. Padang cassia contains coumarin. Coumarin has caused hepatotoxicity in animal models. In otherwise healthy humans, very high doses of coumarin, from 50-7000 mg daily, can result in hepatotoxicity that resolves when coumarin use is discontinued. Lower amounts might also cause liver problems in sensitive people, such as those with liver disease or those taking potentially hepatotoxic agents.

Interaction Rating

Likelihood of Occurrence

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

References

• Press release. Cinnamon capsules to reduce blood sugar are medicinal products! Efficacy has not been scientifically proven - some products contain high levels of coumarin. Federal Institute of Risk Assessment (BfM), Germany, November 11, 2006. Available a
• Felter SP, Vassallo JD, Carlton BD, Daston GP. A safety assessment of coumarin taking into account species-specificity of toxicokinetics. Food Chem Toxicol 2006;44:462-75.
• Choi, J., Lee, K. T., Ka, H., Jung, W. T., Jung, H. J., and Park, H. J. Constituents of the essential oil of the Cinnamomum cassia stem bark and the biological properties. Arch Pharm Res 2001;24(5):418-423.
• Wang R, Wang R, Yan B. Extraction of essential oils from five cinnamon leaves and identification of their volatile compound compositions. Innovative Food Science and Emerging Technologies 2009;10:289-92.
• Wang YH, Avula B, Nanayakkara NP, et al. Cassia cinnamon as a source of coumarin in cinnamon-flavored food and food supplements in the United States. J Agric Food Chem 2013;61(18):4470-6.
• Woehrlin F, Fry H, Abraham K, Preiss-Weigert A. Quantification of flavoring constituents in cinnamon: high variation of coumarin in cassia bark from the German retail market and in authentic samples from Indonesia. J Agric Food Chem 2010;58(19):10568-75.

Interaction Details

Acetaminophen, Dextromethorphan, Pseudoephedrine is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

In vitro research shows that a methanol extract of Padang cassia inhibits cytochrome P450 3A4 (CYP3A4) activity. Theoretically, taking Padang cassia with CYP3A4 substrates might increase the effects and side effects of these substrates.

Interaction Rating

Likelihood of Occurrence

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

References

• Subehan S, Kadota S, Tezuka Y. In vitro mechanism-based inactivation of cytochrome P450 3A4 by a new constituent of Cinnamomum burmani. Planta Med 2008;74(12):1474-80.

Padang Cassia - More Interactions

Padang Cassia interacts with 895 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.