Psilocybin + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine
Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine brand name: Theracaps.
Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine falls into 2 drug categories that Psilocybin can interact with; the most serious is rated moderate. Theoretically, combining psilocybin with serotonergic drugs might cause additive serotonergic effects.
Read the full interaction reportPsilocybin and Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine
These two interact in 2 distinct ways. Each one is explained separately below.
Why Are There 2 Interactions?
Psilocybin interacts with whole categories of medication. Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine falls into 2 of those categories, so it can interact with Psilocybin in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
SEROTONERGIC DRUGS
1 of 2Why this applies to Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine
Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine falls under SEROTONERGIC DRUGS — the group Psilocybin interacts with.
Psilocybin has serotonin 2A (5-HT2A) receptor agonist activity. Theoretically, combining serotonergic drugs with psilocybin might increase the risk of serotonergic side effects, including serotonin syndrome. However, this interaction has not been reported in humans.
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 piece worth knowing about Theracaps: it's a combo cold product, and one of its ingredients, dextromethorphan (the cough suppressant), nudges serotonin activity in the brain. Psilocybin works on serotonin too, mainly the 5-HT2A receptor. So in theory, stacking the two could pile on serotonin effects together.
When serotonin runs too high, people can feel agitated, shaky, sweaty, fast-hearted, or sick to their stomach, and in rare cases it builds into something more serious. I'll be honest though: this is a theoretical concern based on how these compounds behave, not something actually reported in people. The bigger issue is simply that psilocybin is investigational and not legal in most places. Please talk with your pharmacist or doctor before mixing anything like this.
- Rosenbaum D, Weissman C, Anderson T, et al. Microdosing psychedelics: Demographics, practices, and psychiatric comorbidities. J Psychopharmacol 2020;34(6):612-622. PubMed
- Higgins GA, Carroll NK, Brown M, et al. Low Doses of Psilocybin and Ketamine Enhance Motivation and Attention in Poor Performing Rats: Evidence for an Antidepressant Property. Front Pharmacol 2021;12:640241. PubMed
- Hesselgrave N, Troppoli TA, Wulff AB, Cole AB, Thompson SM. Harnessing psilocybin: antidepressant-like behavioral and synaptic actions of psilocybin are independent of 5-HT2R activation in mice. Proc Natl Acad Sci U S A 2021;118(17):e2022489118. PubMed
- Winter JC, Rice KC, Amorosi DJ, Rabin RA. Psilocybin-induced stimulus control in the rat. Pharmacol Biochem Behav 2007;87(4):472-80. PubMed
- Kometer M, Schmidt A, Bachmann R, Studerus E, Seifritz E, Vollenweider FX. Psilocybin biases facial recognition, goal-directed behavior, and mood state toward positive relative to negative emotions through different serotonergic subreceptors. Biol Psychia PubMed
STIMULANT DRUGS
2 of 2Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine also falls under STIMULANT DRUGS.
Due to the central nervous system (CNS) stimulant effects of psilocybin, concomitant use with stimulant drugs may increase the risk of adverse effects.
Interaction 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..
Theracaps is a combo cold product. Two pieces matter most here: phenylpropanolamine, a decongestant that gently revs up your system, and dextromethorphan, a cough suppressant that nudges serotonin. Psilocybin works on serotonin pathways in the brain and has its own stimulating, mind-altering effects.
On paper, stacking them could pile on stimulant-type problems like a racing heart, higher blood pressure, jitteriness, sweating, or trouble sleeping, and there's a theoretical worry about too much serotonin activity from the dextromethorphan side. To be clear, this is based on how these compounds behave, not on solid studies, so the real risk is uncertain. Since psilocybin isn't legal or supervised outside a clinical trial, please run any cold medicine plans past your pharmacist or doctor first.
- Griffiths RR, Johnson MW, Carducci MA, et al. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol 2016;30(12):1181-1197. PubMed
- Bogenschutz MP, Forcehimes AA, Pommy JA, Wilcox CE, Barbosa PC, Strassman RJ. Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. J Psychopharmacol 2015;29(3):289-99. PubMed
- Grob CS, Danforth AL, Chopra GS, et al. Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Arch Gen Psychiatry 2011;68(1):71-8. PubMed
- Brown RT, Nicholas CR, Cozzi NV, et al. Pharmacokinetics of Escalating Doses of Oral Psilocybin in Healthy Adults. Clin Pharmacokinet 2017;56(12):1543-1554. PubMed
- Carbonaro TM, Bradstreet MP, Barrett FS, et al. Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences. J Psychopharmacol 2016;30(12):1268-1278. PubMed
- Hasler F, Grimberg U, Benz MA, Huber T, Vollenweider FX. Acute psychological and physiological effects of psilocybin in healthy humans: a double-blind, placebo-controlled dose-effect study. Psychopharmacology (Berl) 2004;172(2):145-56. PubMed
- Bienemann B, Ruschel NS, Campos ML, Negreiros MA, Mograbi DC. Self-reported negative outcomes of psilocybin users: A quantitative textual analysis. PLoS One 2020;15(2):e0229067. PubMed
- Carbonaro TM, Johnson MW, Griffiths RR. Subjective features of the psilocybin experience that may account for its self-administration by humans: a double-blind comparison of psilocybin and dextromethorphan. Psychopharmacology (Berl) 2020;237(8):2293-2304. PubMed
- Anderson BT, Danforth A, Daroff PR, et al. Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: An open-label safety and feasibility pilot study. EClinicalMedicine 2020;27:100538. PubMed
- Carbonaro TM, Johnson MW, Hurwitz E, Griffiths RR. Double-blind comparison of the two hallucinogens psilocybin and dextromethorphan: similarities and differences in subjective experiences. Psychopharmacology (Berl) 2018;235(2):521-534. PubMed
- Bravermanová A, Viktorinová M, Tyl š F, et al. Psilocybin disrupts sensory and higher order cognitive processing but not pre-attentive cognitive processing-study on P300 and mismatch negativity in healthy volunteers. Psychopharmacology (Berl) 201 PubMed
- Wackermann J, Wittmann M, Hasler F, Vollenweider FX. Effects of varied doses of psilocybin on time interval reproduction in human subjects. Neurosci Lett 2008;435(1):51-5. PubMed
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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.
Psilocybin Also Interacts With Other Medications
Psilocybin has 292 moderate known drug interactions in our database — the Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Psilocybin
We haven’t checked that one against Psilocybin yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Psilocybin. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine
This page covers Psilocybin only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine page lists 282 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Ephedra (major) and Grapefruit (major).
By severity: 14 major · 223 moderate · 45 minor.
From our pharmacist’s overview on the Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine page
“Of everything on this page, ephedra worries me most for anyone using Theracaps (acetaminophen, dextromethorphan, phenylpropanolamine, and pyrilamine), because the decongestant in this cold formula is itself a stimulant. Adding ephedra or any of the 44 stimulant entries can push blood pressure and heart rate to unsafe levels.”
Reviewed by 2 · Jul 18, 2026
Open the Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interaction page
Where Psilocybin and Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine 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.
#436 of 1,452 supplements looked up here in the last 7 days
#934 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 Psilocybin
What is Psilocybin?
- Depression
- Anxiety (including in serious illness)
- Substance use disorders
- Post-traumatic stress
- Spiritual or psychological exploration
Psilocybin is a powerful psychedelic compound found in certain mushrooms and is being studied for hard-to-treat depression, anxiety, and addiction, but it is still investigational and not an approved supplement. It is illegal in most places, can cause intense and unpredictable mental effects, and should never be used outside of a supervised clinical setting.
Other Drugs & Psilocybin
Browse every other medication we’ve checked against Psilocybin — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
292 interactions
- Phentermine ›
- Methylphenidate ›
- Phenylpropanolamine ›
- Fentanyl ›
- Nicotine ›
- Carbamazepine ›
- Dextromethorphan ›
- Phenylephrine ›
- Pseudoephedrine ›
- Trimipramine ›
- Amphetamine ›
- Buprenorphine ›
- Diethylpropion ›
- Nortriptyline ›
- Selegiline ›
- Sumatriptan Succinate ›
- Aripiprazole ›
- Caffeine (otc Drug) ›
- Cyclobenzaprine ›
- Desipramine ›
- Doxepin ›
- Duloxetine ›
- Metoclopramide ›
- Modafinil ›
- Oxymetazoline Hydrochloride ›
- Paroxetine ›
- Prucalopride ›
- Tramadol ›
- Valproic Acid ›
- Vortioxetine ›
- Almotriptan ›
- Amphetamine Sulfate ›
- Aripiprazole Lauroxil ›
- Caffeine (prescription Drug) ›
- Chlorpheniramine ›
- Clozapine ›
- Cocaine Hydrochloride (prescription Drug) ›
- Desvenlafaxine ›
- Dexchlorpheniramine ›
- Dihydroergotamine ›
- Ephedrine Sulfate ›
- Fluoxetine ›
- Granisetron ›
- Imipramine ›
- Linezolid ›
- Lithium Carbonate (prescription Drug) ›
- Meperidine ›
- Methylene Blue ›
- Methylphenidate Hydrochloride ›
- Pemoline ›
- Pseudoephedrine Sulfate ›
- Quetiapine ›
- Risperidone ›
- Rizatriptan Benzoate ›
- Tapentadol ›
- Trazodone ›
- Venlafaxine ›
- Alosetron ›
- Ambenonium Chloride ›
- Amitriptyline ›
Showing 60 of 292 moderate interactions — see all 292 on the Psilocybin page.
No interaction 2,537 drugs checked — show the list
We also checked Psilocybin against these medications and found no known interaction in our sources. Open any page to confirm.
- Apixaban ›
- Levothyroxine ›
- Amlodipine ›
- Warfarin ›
- Testosterone ›
- Losartan Potassium ›
- Ivermectin ›
- Metoprolol ›
- Rivaroxaban ›
- Aspirin ›
- Rosuvastatin ›
- Acetaminophen ›
- Abemaciclib ›
- Clopidogrel ›
- Tadalafil ›
- Atorvastatin ›
- Docusate ›
- Tirzepatide ›
- Valacyclovir ›
- Ibuprofen ›
- Hydroxyurea ›
- Warfarin Sodium ›
- Semaglutide ›
- Prednisone ›
- Propranolol ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Bupropion ›
- Methotrexate ›
- Bendamustine ›
- Acyclovir ›
- Doxycycline ›
- Isotretinoin ›
- Lamotrigine ›
- Pregabalin ›
- Azithromycin ›
- Acetaminophen, Codeine ›
- Gabapentin ›
- Amlodipine Besylate ›
- Clonazepam ›
- Omeprazole ›
- Letrozole ›
- Naproxen ›
- Ciprofloxacin ›
- Bisoprolol ›
- Levothyroxine, Liothyronine ›
- Acetaminophen, Oxycodone ›
- Candesartan Cilexetil ›
- Diazepam ›
- Dapsone ›
- Cyclopentolate ›
- Cephalexin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Atorvastatin Calcium ›
- Mannitol ›
- Roxithromycin ›
- Levetiracetam ›
- Amoxicillin, Clavulanate Potassium ›
- Ezetimibe ›
Showing the 60 most looked-up of 2,537 medications checked with no known interaction — see the full Psilocybin 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
Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine as a medicine that can lower these. This is not an interaction with Psilocybin — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
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 Psilocybin and Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine Together: Common Questions
Can you take Psilocybin with Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine?
Why are there 2 interactions listed for Psilocybin and Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine?
How serious is the Psilocybin and Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.