Pennyroyal - Acetaminophen, Butalbital, Codeine Phosphate Interaction
Herbal: Pennyroyal
Drug: Acetaminophen, Butalbital, Codeine Phosphate
Brand names:
Phrenilin #3
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 25, 2025
Interaction Details
Acetaminophen, Butalbital, Codeine Phosphate is classified as belonging to the following category: Acetaminophen (Tylenol, Others)
Concomitant use of pennyroyal essential oil and acetaminophen might increase the risk of acetaminophen-induced hepatotoxicity.
Pennyroyal is hepatotoxic and depletes hepatic glutathione levels in a similar manner to acetaminophen. A case report describes hepatic failure in a female who took pennyroyal and acetaminophen concurrently.
Interaction Rating
Likelihood of Occurrence
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
References
- Bakerink JA, Gospe SM Jr, Dimand RJ, Eldridge MW. Multiple organ failure after ingestion of pennyroyal oil from herbal tea in two infants. Pediatrics 1996;98:944-7.
- Sudekum M, Poppenga RH, Raju N, Braselton WE Jr. Pennyroyal oil toxicosis in a dog. J Am Vet Med Assoc 1992;200:817-8..
- Anderson IB, Mullen WH, Meeker JE, et al. Pennyroyal toxicity: measurement of toxic metabolite levels in two cases and review of the literature. Ann Intern Med 1996;124:726-34.
- Fozard J, Hieger M. Hepatic failure from pennyroyal tea interaction with medications metabolized by the cytochrome P450 enzymes. Am J Ther 2019 Aug 13. doi: 10.1097/MJT.0000000000001052. [Epub ahead of print].
Pennyroyal - More Interactions
Pennyroyal interacts with 69 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.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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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
Drug descriptions are provided by MedlinePlus.
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In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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