Drug & supplement interaction

Puravive + Dextromethorphan HBr, Phenylephrine HCl

Dextromethorphan HBr, Phenylephrine HCl brand name: Vicks Formula 44D Cough & Head Congestion Relief.

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

Dextromethorphan HBr, Phenylephrine HCl falls into 3 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
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Puravive and Dextromethorphan HBr, Phenylephrine HCl

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Puravive interacts with whole categories of medication. Dextromethorphan HBr, Phenylephrine HCl falls into 3 of those categories, so it can interact with Puravive in 3 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 3

Why this applies to Dextromethorphan HBr, Phenylephrine HCl

Dextromethorphan HBr, Phenylephrine HCl 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 gist for your cough and congestion medicine. The dextromethorphan part is cleared by a liver enzyme called CYP2D6. Puravive contains Panax ginseng, which might slow that enzyme down a little (one study suggested roughly a 6% drop). If clearance slows, a bit more dextromethorphan could hang around, which in theory could nudge up side effects like drowsiness, dizziness, or an upset stomach. Dextromethorphan is not a prodrug, so blocking the enzyme means slightly more drug, not less.

Honestly, this effect is small, the evidence is weak, and studies don't even fully agree it happens. Phenylephrine isn't really affected here. Still, if you take both regularly or feel extra groggy, it's worth a quick word with your pharmacist or doctor.

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

Cytochrome P450 3A4 (Cyp3A4) Substrates

2 of 3

Dextromethorphan HBr, Phenylephrine HCl 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 gist: Puravive contains Panax ginseng, which can nudge a liver enzyme called CYP3A4 either faster or slower depending on the situation. The cough ingredient in your Vicks 44D, dextromethorphan, partly relies on that enzyme (and on another one, CYP2D6). In theory, if ginseng slowed CYP3A4 down, a little more dextromethorphan could hang around and you might feel extra drowsy, dizzy, or foggy. If it sped things up, your cough relief might feel weaker.

Honestly, this is a minor, mostly theoretical concern with thin evidence, and the phenylephrine part isn't really involved. I wouldn't lose sleep over an occasional dose. Still, since Puravive's effects aren't well studied, run it past your pharmacist before combining them.

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

Stimulant Drugs

3 of 3

Dextromethorphan HBr, Phenylephrine HCl also falls under Stimulant Drugs.

Puravive contains Panax ginseng. Panax ginseng has demonstrated stimulant effects in some studies, which could potentially heighten the effects of other stimulant drugs (source: https://pubmed.ncbi.nlm.nih.gov/8879982/). It is unlikely this would result in a significant risk of side effects, but it is important to be aware of.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the gist for your Vicks Formula 44D. The piece that matters is the phenylephrine, which is a mild decongestant that gently revs things up. Puravive contains Panax ginseng, which has shown some mild stimulant-like activity in a few studies. Stacking the two could, in theory, add a little to that stimulating effect.

What might that feel like? Possibly a slightly faster heartbeat, some jitteriness, or trouble settling down to sleep. Honestly though, this is rated minor and unlikely, and the evidence behind it is weak. The dextromethorphan (the cough part) isn't really involved here. If you have high blood pressure or a heart condition, it's worth a quick chat with your pharmacist before combining 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 HBr, Phenylephrine HCl 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 HBr, Phenylephrine HCl)
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 HBr, Phenylephrine HCl

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 HBr, Phenylephrine HCl, 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 HBr, Phenylephrine HCl

This page covers Puravive only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dextromethorphan HBr, Phenylephrine HCl page lists 197 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Ephedra (major), Grapefruit (major), Lithium (major) and Peyote (major).

By severity: 8 major · 148 moderate · 41 minor.

From our pharmacist’s overview on the Dextromethorphan HBr, Phenylephrine HCl page

“The supplement interactions with Dextromethorphan HBr and Phenylephrine HCl (Vicks Formula 44D) deserve real respect, and the small cluster of major-rated ones should be understood before you reach for the bottle. Phenylephrine is a stimulant-type decongestant, so anything with caffeine (coffee, tea, cola nut) or ephedrine-like herbs s…”

Reviewed by 2 · Jul 18, 2026

Open the Dextromethorphan HBr, Phenylephrine HCl interaction page

How much people look this up

Where Puravive and Dextromethorphan HBr, Phenylephrine HCl 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

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

29 days ago today
Medication Dextromethorphan HBr, Phenylephrine HCl
Steady interest

#2,494 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 HBr, Phenylephrine HCl, 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 HBr, Phenylephrine HCl Together: Common Questions

Can you take Puravive with Dextromethorphan HBr, Phenylephrine HCl?
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 3 interactions listed for Puravive and Dextromethorphan HBr, Phenylephrine HCl?
Dextromethorphan HBr, Phenylephrine HCl 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 HBr, Phenylephrine HCl 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.