Phellodendron + Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride
Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride brand name: Hycofenix.
Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride falls into 3 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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Phellodendron interacts with whole categories of medication. Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride falls into 3 of those categories, so it can interact with Phellodendron in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CNS DEPRESSANTS
1 of 3Why this applies to Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride
Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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.
The piece of Hycofenix that matters here is the hydrocodone, which is an opioid that can make you drowsy and slow your breathing. Phellodendron contains berberine, and in animal studies berberine seemed to have a mild calming or sedating effect. So the worry is simple: stacking the two together could leave you more sleepy, foggy, or lightheaded than the medicine alone.
Be honest though, this is a theoretical concern based on lab and animal work, not real patient cases, so I don't want to alarm you. Still, since this combo already includes an opioid, it's worth a quick chat with your pharmacist or doctor before pairing it with Phellodendron, and don't drive until you know how you feel.
- 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 3Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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.
Here's the wrinkle with this combo product. The hydrocodone piece is what matters, and it's a bit of a special case. Hydrocodone is partly turned into a stronger painkiller (hydromorphone) by an enzyme called CYP2D6. Phellodendron contains berberine, which lab and early human studies suggest can slow down that same enzyme. So in theory, you might convert less hydrocodone into its more potent form, which could mean a bit less cough or pain relief than expected. The flip side is that parent hydrocodone may linger, so effects are a little unpredictable.
Keep in mind this is theoretical, based on pharmacology rather than solid real-world reports, so don't panic. Still, since opioids deserve respect, check with your pharmacist or doctor before pairing them.
- 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 3A4 (CYP3A4) SUBSTRATES
3 of 3Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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.
Your Hycofenix combo contains hydrocodone, an opioid cough and pain medicine that your liver partly handles using an enzyme called CYP3A4. Phellodendron supplies berberine, which lab and early human studies suggest can mildly slow that same enzyme. In theory, that could let a bit more hydrocodone build up than usual, nudging up its effects like extra drowsiness, dizziness, constipation, or slowed breathing. This is only a theoretical concern based on how the chemistry works, not proven harm, so I don't want you to panic.
The guaifenesin and pseudoephedrine pieces aren't really cleared this way. Still, since opioids carry real risks, please check with your pharmacist or doctor before pairing them, and don't change your dose on your own.
- 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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride
This page covers Phellodendron only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride page lists 241 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), Beer (major), Ephedra (major) and Gamma-hydroxybutyrate (ghb) (major).
By severity: 13 major · 190 moderate · 38 minor.
From our pharmacist’s overview on the Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride page
“Hycofenix combines guaifenesin with hydrocodone, an opioid, and pseudoephedrine, a decongestant, so supplements can collide with it from two directions at once. That is why this list of 241 ingredients deserves real caution, starting with the 13 rated major.”
Reviewed by 2 · Jul 18, 2026
Open the Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride interaction page
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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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.
#268 of 1,452 supplements looked up here in the last 7 days
#1,925 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 ›
- Acetaminophen ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Amoxicillin ›
- Isotretinoin ›
- Methotrexate ›
- Bupropion ›
- Bendamustine ›
- Doxycycline ›
- Acyclovir ›
- Azithromycin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Ciprofloxacin ›
- Amoxicillin, Clavulanate Potassium ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Ezetimibe ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Pizotifen ›
- Daptomycin ›
- Pegunigalsidase Alfa-iwxj ›
- Mitomycin ›
- Levodopa ›
- Hexobarbitone ›
- Flutemetamol F-18 ›
- Magnesium Hydroxide (otc Drug) ›
- Bentoquatam ›
- Cefaclor ›
- Factor 7a ›
- Hethylphenidate Hcl ›
- Azelaic Acid ›
- Alglucosidase Alpha ›
- Salbutamol Sulfate ›
- Lenvatinib ›
- Tocainide ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Ribavirin Aerosol ›
- Acetaminophen, Brompheniramine, Phenylpropanolamine ›
- Casanthranol, Docusate ›
- Rocuronium ›
- Vancomycin ›
- Digoxin ›
- Procainamide ›
- Triptorelin ›
- Paracetamol ›
- Dirithromycin ›
- Isoniazid, Pyrazinamide, Rifampin ›
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
Taking Phellodendron and Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride Together: Common Questions
Can you take Phellodendron with Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride?
Why are there 3 interactions listed for Phellodendron and Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride?
How serious is the Phellodendron and Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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