Drug & supplement interaction

Pennyroyal + Salmeterol

Salmeterol brand name: Serevent.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 20, 2026

The bottom line No known interaction

We found no known interaction between Pennyroyal and Salmeterol in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Salmeterol states a food rule worth keeping to.

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Interaction report

Pennyroyal and Salmeterol

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Salmeterol and Pennyroyal in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Pennyroyal safety at a glance

Pennyroyal overall Avoid Pennyroyal oil is highly toxic and has caused liver failure and death.

Pregnancy Likely Unsafe When used orally or topically. Pennyroyal essential oil has been used traditionally as an abortifacient. Pennyroyal leaf tea is reported to cause onset of mense... Read the full pregnancy detail

Breastfeeding Likely Unsafe When used orally or topically; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Salmeterol and Pennyroyal? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Salmeterol

Interactions in our licensed database are recorded against drug classes, not just single drug names. Salmeterol is filed under 3 classifications — beta-adrenergic agonists, qt interval-prolonging drugs, cytochrome p450 3a4 (cyp3a4) substrates. Pennyroyal has documented interactions with 1 drug class — the most serious being acetaminophen (tylenol, others) (moderate) — and none of Salmeterol’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Pennyroyal Does Interact With Other Medications

Pennyroyal has 69 moderate known drug interactions in our database — Salmeterol isn’t one of them. If you take anything else, check it against the full list below.

Moderate 69 No known interaction 2,761 (incl. Salmeterol)

Taking anything else?

Check Another of Your Medications Against Pennyroyal

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

What to actually watch for

What Pennyroyal Itself Has Been Linked To

This is not an interaction — nothing below involves Salmeterol. It is the side-effect record for Pennyroyal on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Pennyroyal, this list is the first place to look. 5 entries are worth acting on rather than waiting out — marked below.

Hallucinations / Confusion Worth acting on Additional detail
“Orally, pennyroyal essential oil can cause agitation, auditory and visual hallucinations, confusion, delirium, and lethargy (12,5601).”

Pennyroyal · Natural Medicines adverse-effect record, reported in delirium.
2 sources cited

12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

5601. Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI
An irregular heartbeat Worth acting on Additional detail
“The main constituent of pennyroyal essential oil, pulegone, and its metabolite menthofuran, are hepatotoxic (12). Orally, pennyroyal essential oil can cause liver failure (12,5601). A case report describes a 76-year-old adult who developed liver failure with duodenitis, hypotension, and cardiac arrhythmias after taking pennyroyal and acetaminophen concurrently.”

Pennyroyal · Natural Medicines adverse-effect record, reported in arrhythmia.
3 sources cited

12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

5601. Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI

101477. 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]. PubMed
Seizures Worth acting on Additional detail
“Orally, herbal teas prepared with pennyroyal leaves can cause dizziness (12). Orally, pennyroyal essential oil can cause coma, dizziness, restlessness, and seizures (12,5601).”

Pennyroyal · Natural Medicines adverse-effect record, reported in epilepsy.
2 sources cited

12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

5601. Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI
Kidney problems Worth acting on Additional detail
“Orally, pennyroyal essential oil can cause kidney failure (12,5601).”

Pennyroyal · Natural Medicines adverse-effect record, reported in kidney failure.
2 sources cited

12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

5601. Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI
Raised blood pressure Worth acting on Additional detail
“Orally, pennyroyal essential oil can cause hypertension, shock, and tachycardia (12,5601).”

Pennyroyal · Natural Medicines adverse-effect record, reported in hypertension.
2 sources cited

12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

5601. Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI
A fast or pounding heartbeat Additional detail

Recorded for Pennyroyal in the same Natural Medicines adverse-effect record shown under Raised blood pressure above.
Low blood pressure Additional detail

Recorded for Pennyroyal in the same Natural Medicines adverse-effect record shown under An irregular heartbeat above.
Anxiety or restlessness Additional detail

Recorded for Pennyroyal in the same Natural Medicines adverse-effect record shown under Hallucinations / Confusion above.
Stomach pain Additional detail
“Orally, herbal teas prepared with pennyroyal leaves can cause nausea and abdominal cramping (12). Pennyroyal essential oil causes more severe gastrointestinal effects, including abdominal pain, burning of the throat, and vomiting (12,5601).”

Pennyroyal · Natural Medicines adverse-effect record, reported in nausea and vomiting.
2 sources cited

12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

5601. Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI

Showing the 10 most notable of 15 recorded effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

Everything above comes from the Natural Medicines adverse-effect record for Pennyroyal — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Salmeterol’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Salmeterol column appears here.

Special populations

Pennyroyal in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally or topically. Pennyroyal essential oil has been used traditionally as an abortifacient. Pennyroyal leaf tea is reported to cause onset of menses.

Lactation Likely Unsafe

When used orally or topically; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Salmeterol Products Have a Food Rule — Pennyroyal Should Not Break It

At least one FDA label for a product containing Salmeterol says to take it on an empty stomach. Most supplements — Pennyroyal included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Salmeterol on its own and move Pennyroyal to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Salmeterol products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

One inhalation of SEREVENT DISKUS at least 30 minutes before exercise has been shown to protect patients against EIB.

From the Dosage and Administration section of the FDA label we read for Salmeterol — where that label names a specific product, the instruction is that product's. See the Salmeterol drug page ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Salmeterol

This page covers Pennyroyal only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Salmeterol page lists 141 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: American Hellebore (major), Arsenic (major), Cesium (major), Ephedra (major) and Grapefruit (major).

By severity: 7 major · 105 moderate · 29 minor.

From our pharmacist’s overview on the Salmeterol page

“Salmeterol (Serevent) is the long-acting inhaler taken twice daily for asthma or COPD, and its supplement list is one I would approach with real caution. Seven of the 141 ingredients on file rate major: grapefruit can raise salmeterol levels by blocking the enzyme that clears it, St.”

Reviewed by 2 · Jul 18, 2026

Open the Salmeterol interaction page

One more smart check

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

We hold 11 real supplement products containing Pennyroyal, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Pennyroyal. Even though Pennyroyal itself has no known interaction with Salmeterol, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Pennyroyal and Salmeterol 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 Pennyroyal

Steady interest

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

29 days ago today

Medication Salmeterol

Steady interest

#2,047 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.

Where does our data come from?

Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Pennyroyal reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Pennyroyal and Salmeterol records this page draws on were last updated July 11, 2026.
What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.

Data structure & sourcing designed and verified by Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Pennyroyal

What is Pennyroyal?

Digestive upset
Menstrual cramps
Inducing menstruation or abortion (dangerous)
Colds and coughs
Insect repellent

Pennyroyal is a mint-family plant whose essential oil is highly toxic and has caused serious poisonings and deaths, especially when used to try to bring on a period or end a pregnancy. There is no reliable evidence that it safely treats any condition, and the oil should never be swallowed. Avoid pennyroyal and talk to your pharmacist or doctor about safer options.

Mentha pulegium · Lamiaceae · Leaves, flowering tops, and essential oil · Tea, dried herb, tincture, essential oil

An interaction check asks whether these two react with each other — it does not ask whether Pennyroyal is a good idea for someone in your situation. Here is what our Pennyroyal record says about it on its own.

Pennyroyal: dosing

There is no established safe dose for pennyroyal, and health experts generally advise against using it at all because of its toxicity.The essential oil should never be swallowed, and even teas made from the herb carry risk. Because of these dangers, we do not recommend a dose.

From our Pennyroyal monograph — the full record covers uses, side effects and every documented interaction.

Read the full Pennyroyal monograph & all interactions

Medication

About Salmeterol Oral Inhalation

What Is Salmeterol Oral Inhalation Used For?

Brand name: Serevent

Serevent Diskus (salmeterol inhalation powder) is used for three main purposes: treating asthma in patients aged 4 and older alongside an inhaled corticosteroid (ICS), preventing exercise-induced bronchospasm (EIB) in patients aged 4 and older, and providing long-term maintenance treatment of bronchospasm associated with COPD — including chronic bronchitis and emphysema — in adults.

Important: Serevent Diskus is not a rescue inhaler. It will not relieve a sudden asthma or COPD attack. For asthma, it must always be used together with an inhaled corticosteroid — using it alone for asthma is contraindicated due to a serious risk of asthma-related death.

See full Salmeterol Oral Inhalation drug information

Keep checking

Other Drugs & Pennyroyal

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

0Major

69Moderate

0Minor

2,760No known interaction

69 Moderate 2,760 No interaction

Moderate

69 interactions

Showing 60 of 69 moderate interactions — see all 69 on the Pennyroyal page.

No interaction 2,760 drugs checked — show the list

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

Showing the 60 most looked-up of 2,760 medications checked with no known interaction — see the full Pennyroyal list.

See the full Pennyroyal interactions page

See every supplement checked against Salmeterol, ranked by severity

Evidence & sources

Pennyroyal References

The 8 references that drive our Pennyroyal monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
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. DOI
Sudekum M, Poppenga RH, Raju N, Braselton WE Jr. Pennyroyal oil toxicosis in a dog. J Am Vet Med Assoc 1992;200:817-8.. DOI
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. PubMed
Sullivan JB Jr, Rumack BH, Thomas H Jr, et al. Pennyroyal oil poisoning and hepatotoxicity. JAMA 1979;242:2873-4. DOI
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]. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Pennyroyal and Salmeterol Together: Common Questions

Is it safe to take Pennyroyal with Salmeterol?

We do not list a known interaction between Pennyroyal and Salmeterol. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.

Should I take Pennyroyal and Salmeterol at the same time of day?

At least one FDA label for a product containing Salmeterol says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Salmeterol on its own and move Pennyroyal to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.

How was the Pennyroyal and Salmeterol combination checked?

Interactions in our licensed database are recorded against drug classes. Salmeterol is filed under 3 classifications, and Pennyroyal has documented interactions with 1 drug class — none of Salmeterol's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.

Does Pennyroyal interact with any other medications?

Yes. Pennyroyal has 69 documented drug interactions in our database — Salmeterol is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

Does Salmeterol interact with any supplements?

Yes. Salmeterol has documented interactions with 141 supplements in our database — Pennyroyal is not one of them. The Salmeterol interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Pennyroyal monograph Uses, safety profile, and every drug interaction in one place Salmeterol Oral Inhalation drug information The full plain-English guide to this medication Salmeterol supplement interactions Every supplement checked against Salmeterol, 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 References The 8 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Salmeterol and Pennyroyal?

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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.