Phellodendron + Amitriptyline, Perphenazine
Amitriptyline, Perphenazine brand names: Triavil, Etrafon, Etrafon-A, Etrafon-Forte.
Amitriptyline, Perphenazine falls into 4 drug categories that Phellodendron can interact with; the most serious is rated moderate. Theoretically, phellodendron might increase the sedative effects of CNS depressants.
Read the full interaction reportPhellodendron and Amitriptyline, Perphenazine
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Phellodendron interacts with whole categories of medication. Amitriptyline, Perphenazine falls into 4 of those categories, so it can interact with Phellodendron in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CNS DEPRESSANTS
1 of 4Why this applies to Amitriptyline, Perphenazine
Amitriptyline, Perphenazine falls under CNS DEPRESSANTS — the group Phellodendron interacts with.
Phellodendron contains berberine. Animal research suggests that berberine may have sedative effects. Theoretically, phellodendron might also have CNS depressants effects.
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.
This combination pill pairs amitriptyline (an older antidepressant) with perphenazine (an antipsychotic). Both already tend to make people drowsy and a little foggy on their own. Phellodendron contains berberine, and in animal studies berberine appeared to have its own calming, sedating effect. So the worry here is simple math: layering this herb on top could deepen the drowsiness rather than cause something brand new.
In practice that might mean more daytime sleepiness, grogginess, dizziness on standing, or trouble concentrating. I'll be honest, this is a theoretical concern based on lab and animal data, not strong human proof, so don't panic. Still, since both medicines are real sedatives, it's worth a quick chat with your pharmacist or doctor before adding phellodendron.
- Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
- Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
- Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
- Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 4Amitriptyline, Perphenazine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
Phellodendron contains berberine. In vitro research and preliminary clinical evidence show that berberine can inhibit CYP2D6. Theoretically, phellodendron might also inhibit CYP2D6.
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.
Both of the active ingredients in this combo pill, amitriptyline (an antidepressant) and perphenazine (an antipsychotic), are cleared from your body partly by a liver enzyme called CYP2D6. Phellodendron contains berberine, which lab and early human studies suggest can slow that same enzyme down. If the enzyme works slower, these two drugs may clear out less quickly and build up a bit higher than expected.
In real life, that could mean more of their usual side effects: drowsiness, dry mouth, constipation, blurry vision, dizziness on standing, or a faster heartbeat. This is only a theoretical concern based on how the drugs work, not proven harm, but since this medication affects mood and movement, I'd run it by your pharmacist or doctor before adding phellodendron.
- Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
- Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
- Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
3 of 4Amitriptyline, Perphenazine also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
Phellodendron contains berberine. Preliminary clinical research shows that berberine can inhibit CYP2C9. Theoretically, phellodendron might also inhibit CYP2C9.
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.
If you're taking the combination pill Triavil or Etrafon (that's amitriptyline plus perphenazine) and thinking about Phellodendron, here's the gist. This herb contains berberine, which in early studies appears to slow down a liver enzyme called CYP2C9. Since your medication is partly cleared through that pathway, the theory is that levels could creep up a bit and make the drug's effects stronger.
With amitriptyline and perphenazine, that could mean more of the usual side effects: drowsiness, dry mouth, constipation, blurry vision, dizziness on standing, or a faster heartbeat. I want to stress this is theoretical, based on how things work in the lab, not proven in real patients. Still, since you'd be combining two sedating compounds, it's worth a quick chat with your pharmacist or doctor before adding it. Please don't change your dose on your own.
- Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
4 of 4Amitriptyline, Perphenazine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Phellodendron contains berberine. In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, phellodendron might also inhibit CYP3A4.
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.
This combo pill pairs amitriptyline (an older antidepressant) with perphenazine (an antipsychotic). Both rely partly on the liver enzyme CYP3A4 to be broken down and cleared. Phellodendron contains berberine, which lab and early human studies suggest can mildly slow that same enzyme. So in theory, taking it alongside this medication could let a bit more drug build up in your system.
If levels nudged up, you might notice more of the usual side effects: drowsiness, dry mouth, constipation, blurred vision, dizziness on standing, or a faster heartbeat. Keep in mind this is theoretical, based mostly on lab work, not real-world reports. Still, since this drug affects the heart and brain, I'd run it by your pharmacist or doctor before adding phellodendron.
- Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
- Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Phellodendron Also Interacts With Other Medications
Phellodendron has 1,159 moderate known drug interactions in our database — the Amitriptyline, Perphenazine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Phellodendron
We haven’t checked that one against Phellodendron yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Phellodendron. Pick one to open its full report.
See Every Supplement That Interacts With Amitriptyline, Perphenazine
This page covers Phellodendron only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline, Perphenazine page lists 311 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).
By severity: 19 major · 235 moderate · 57 minor.
From our pharmacist’s overview on the Amitriptyline, Perphenazine page
“Alcohol is the risk I'd flag first for anyone taking amitriptyline with perphenazine (Triavil, Etrafon). Beer and wine both carry major ratings here, and 78 of the 311 ingredients on file deepen the drowsiness this antidepressant and antipsychotic combination already causes, sometimes to the point of slowed breathing.”
Reviewed by 2 · Jul 18, 2026
Taking Phellodendron as Part of a Dietary Supplement Product? Check It for Interactions
We hold 393 real supplement products containing Phellodendron, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Phellodendron. Your product may carry other ingredients that interact with Amitriptyline, Perphenazine too, on top of Phellodendron — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Phellodendron and Amitriptyline, Perphenazine 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.
#315 of 1,452 supplements looked up here in the last 7 days
#1,185 of 2,830 medications looked up here in the last 7 days
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.
About Phellodendron
What is Phellodendron?
- Digestive complaints and diarrhea
- Inflammation and joint discomfort
- Stress and weight management (in combination products)
- Skin conditions (topical, traditional)
- Antimicrobial support
Phellodendron is a traditional Chinese medicine bark (Huang Bai) that contains berberine and other plant compounds with antimicrobial and anti-inflammatory activity in lab studies. Human evidence for most uses is limited, and it is often sold in combination with other herbs, making its individual effects hard to judge. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.
Other Drugs & Phellodendron
Browse every other medication we’ve checked against Phellodendron — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,159 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Guaifenesin ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Trimipramine ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
Showing 60 of 1,159 moderate interactions — see all 1,159 on the Phellodendron page.
No interaction 1,670 drugs checked — show the list
We also checked Phellodendron against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Acetaminophen ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Bupropion ›
- Amoxicillin ›
- Acyclovir ›
- Bendamustine ›
- Doxycycline ›
- Methotrexate ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Factor 7a ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Mitomycin ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Lenvatinib ›
- Phenylephrine ›
- Vancomycin ›
- Hethylphenidate Hcl ›
- Dirithromycin ›
- Bentoquatam ›
- Procainamide ›
- Amoxicillin, Clavulanate Potassium ›
- Hydroxychloroquine ›
- Digoxin ›
- Azelaic Acid ›
- Dextrothyroxine ›
- Triptorelin ›
- Lomustine ›
- Pizotifen ›
- Tocainide ›
- Rocuronium ›
- Succimer ›
- Mitomycin C ›
- Paracetamol ›
- Halothane ›
- Gestodene ›
- Chenodiol ›
- Desflurane ›
Showing the 60 most looked-up of 1,670 medications checked with no known interaction — see the full Phellodendron list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Amitriptyline, Perphenazine Is Linked to Lower Levels of 3 Nutrients
Natural Medicines records Amitriptyline, Perphenazine as a medicine that can lower these. This is not an interaction with Phellodendron — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Amitriptyline, Perphenazine nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Phellodendron and Amitriptyline, Perphenazine Together: Common Questions
Can you take Phellodendron with Amitriptyline, Perphenazine?
Why are there 4 interactions listed for Phellodendron and Amitriptyline, Perphenazine?
How serious is the Phellodendron and Amitriptyline, Perphenazine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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