Drug & supplement interaction

Puravive + Dextromethorphan, Guaifenesin, Pseudophedrine

Dextromethorphan, Guaifenesin, Pseudophedrine brand names: Organidin NR, Anatuss DM.

Minor Interaction
Medically reviewed by · Updated February 2024
The bottom line Minor

Dextromethorphan, Guaifenesin, Pseudophedrine falls into 2 drug categories that Puravive can interact with; the most serious is rated minor. Puravive contains Panax ginseng. Some research suggests that Panax ginseng might slow down the activity of an enzyme called CYP2D6 by about 6%.

Read the full interaction report
SeverityMinor
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Puravive and Dextromethorphan, Guaifenesin, Pseudophedrine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Puravive interacts with whole categories of medication. Dextromethorphan, Guaifenesin, Pseudophedrine falls into 2 of those categories, so it can interact with Puravive in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

Cytochrome P450 2D6 (Cyp2D6) Substrates

1 of 2

Why this applies to Dextromethorphan, Guaifenesin, Pseudophedrine

Dextromethorphan, Guaifenesin, Pseudophedrine falls under Cytochrome P450 2D6 (Cyp2D6) Substrates — the group Puravive interacts with.

Puravive contains Panax ginseng. Some research suggests that Panax ginseng might slow down the activity of an enzyme called CYP2D6 by about 6%. This enzyme plays a role in breaking down drugs in our system. One study (https://pubmed.ncbi.nlm.nih.gov/32557706/) found that Panax ginseng slows down the breakdown of dextromethorphan, a drug that is processed by CYP2D6, but only to a small extent. It is important to note that not all studies agree on these effects, and some suggest that Panax ginseng might not have a significant impact on CYP2D6 at all. Nevertheless, it's important to be cautious if you're taking medications that are processed by CYP2D6 and consider discussing it with your healthcare provider.
Severity Minor Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version. Out of the three ingredients in your cough and cold combo, only the dextromethorphan piece really interacts here. Dextromethorphan is cleared by a liver enzyme called CYP2D6, and Puravive contains Panax ginseng, which may slow that enzyme down a little. If it does, dextromethorphan can hang around slightly longer, so in theory you might notice a bit more drowsiness, dizziness, or that floaty feeling.

Honestly though, the effect measured was tiny (around 6%), the evidence is weak, and studies don't even agree it happens. The guaifenesin and pseudoephedrine aren't really involved. For most people this won't cause trouble, but if you feel extra groggy or jittery, or you take other medicines, check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
Minor

Cytochrome P450 3A4 (Cyp3A4) Substrates

2 of 2

Dextromethorphan, Guaifenesin, Pseudophedrine also falls under Cytochrome P450 3A4 (Cyp3A4) Substrates.

Puravive contains Panax ginseng. Panax ginseng has the potential to affect the breakdown of drugs that are metabolized by an enzyme called CYP3A4. One example of such a drug is imatinib. There was a case where imatinib was thought to have caused liver damage, and it was believed that this might have been due to Panax ginseng inhibiting CYP3A4, which is involved in imatinib's metabolism (https://pubmed.ncbi.nlm.nih.gov/20332334/). On the other hand, Panax ginseng has been found to increase the breakdown of another drug called midazolam, which is also metabolized by CYP3A4 (https://pubmed.ncbi.nlm.nih.gov/21646440/), suggesting Panax ginseng induces CYP3A4 in some cases (i.e., makes more potent). Given these contradictory findings, it is important to use Panax ginseng cautiously if you are taking medications that are metabolized by CYP3A4, as the interaction between Panax ginseng and these drugs is not fully understood.
Severity Minor Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version. Puravive contains Panax ginseng, which may tweak a liver enzyme called CYP3A4. The dextromethorphan part of your cold combo passes partly through that pathway, so in theory ginseng could nudge its levels up or down. The catch is that the research is contradictory: in some studies ginseng speeds CYP3A4 up, in others it seems to slow it down. So we honestly can't predict which way it would go here.

The good news is this is rated a minor interaction with weak evidence. If anything shifted, you might notice a bit more drowsiness or dizziness from the dextromethorphan, or simply less cough relief. Guaifenesin and pseudoephedrine aren't really affected this way. I wouldn't lose sleep over it, but check with your pharmacist before pairing them.

Contact Dr. Brian directly if you have additional questions on this interaction

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • 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.
Evidence the quality of the studies behind the rating (graded A–D)
  • 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.

Keep it in perspective

Puravive Also Interacts With Other Medications

Puravive has 357 moderate, 880 minor known drug interactions in our database — the Dextromethorphan, Guaifenesin, Pseudophedrine one above is among them. If you take anything else, check it against the full list below.

Moderate 357 Minor 880 No known interaction 1,593 (incl. Dextromethorphan, Guaifenesin, Pseudophedrine)
Taking anything else?

Check Another of Your Medications Against Puravive

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

From our Q&A

Questions About Puravive or Dextromethorphan, Guaifenesin, Pseudophedrine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Puravive or Dextromethorphan, Guaifenesin, Pseudophedrine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Dextromethorphan, Guaifenesin, Pseudophedrine

This page covers Puravive only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dextromethorphan, Guaifenesin, Pseudophedrine page lists 171 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lithium (major), St. John's Wort (major) and 1,3-dmaa (moderate).

By severity: 4 major · 125 moderate · 42 minor.

Open the Dextromethorphan, Guaifenesin, Pseudophedrine interaction page

How much people look this up

Where Puravive and Dextromethorphan, Guaifenesin, Pseudophedrine 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 Puravive
Top half

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

29 days ago today
Medication Dextromethorphan, Guaifenesin, Pseudophedrine
Steady interest

#1,917 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.

Supplement

About Puravive

What is Puravive?

Puravive
  • Weight management
  • Metabolism support
  • Energy levels
  • General wellness
  • Stress and brain health

Puravive is a branded, multi-ingredient capsule marketed mainly for weight loss by claiming to boost brown fat activity, but there is no published, independent clinical research showing the product itself works for this purpose. Some individual ingredients have been studied in laboratory or small human studies, but those results do not prove the finished blend is safe or effective. Talk to a pharmacist or doctor before trying it, especially if you have health conditions or take medications.

Read the full Puravive monograph & all interactions
Keep checking

Other Drugs & Puravive

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

0Major
357Moderate
880Minor
1,592No known interaction
357 Moderate 880 Minor 1,592 No interaction
Moderate

357 interactions

Showing 60 of 357 moderate interactions — see all 357 on the Puravive page.

Minor

880 interactions

Showing 60 of 880 minor interactions — see all 880 on the Puravive page.

No interaction 1,592 drugs checked — show the list

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

Showing the 60 most looked-up of 1,592 medications checked with no known interaction — see the full Puravive list.

See the full Puravive interactions page
See every supplement checked against Dextromethorphan, Guaifenesin, Pseudophedrine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

Keep exploring
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Pharmacist Counseling Corner

Taking Puravive and Dextromethorphan, Guaifenesin, Pseudophedrine Together: Common Questions

Can you take Puravive with Dextromethorphan, Guaifenesin, Pseudophedrine?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Puravive and Dextromethorphan, Guaifenesin, Pseudophedrine?
Dextromethorphan, Guaifenesin, Pseudophedrine belongs to more than one drug category, and Puravive interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Puravive and Dextromethorphan, Guaifenesin, Pseudophedrine interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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.