Rauwolscine + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine brand names: Tylenol Cold Ex Strength, Children's Tylenol Cold Plus Cough.
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls into 3 drug categories that Rauwolscine can interact with; the most serious is rated moderate. Theoretically, taking rauwolscine with seizure threshold lowering drugs might increase the risk of adverse convulsant effects.
Read the full interaction reportRauwolscine and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Rauwolscine interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls into 3 of those categories, so it can interact with Rauwolscine in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
SEIZURE THRESHOLD LOWERING DRUGS
1 of 3Why this applies to Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls under SEIZURE THRESHOLD LOWERING DRUGS — the group Rauwolscine interacts with.
In animal research, intraperitoneal rauwolscine lowered the seizure threshold level of the drug metrazol.
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 situation with this multi-symptom cold and cough product. The concern isn't about how your body breaks down the medicine. Instead, it's that rauwolscine, a stimulant found in fat-burner and pre-workout products, may slightly lower the seizure threshold (the point at which the brain becomes more prone to a seizure). A couple of ingredients here can do something similar, especially dextromethorphan at higher doses, and pseudoephedrine, which is itself a stimulant that can rev up your heart rate and blood pressure.
Honestly, this warning is theoretical and comes only from animal lab work, so for most healthy people it's a low real-world worry. But if you have a seizure history, anxiety, or a heart condition, the combined stimulant load matters more. Run it by your pharmacist before pairing them.
- Aziz TA, Hussain SA, Mahwi TO, Ahmed ZA, Rahman HS, Rasedee A. The efficacy and safety of Ginkgo biloba extract as an adjuvant in type 2 diabetes mellitus patients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial.
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
Rauwolscine is structurally related to yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
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 cold and cough combo has a few moving parts, but the one that matters here is dextromethorphan, the cough suppressant. Your body relies on an enzyme called CYP2D6 to clear it. Rauwolscine is a close cousin of yohimbine, and lab studies hint that yohimbine can slow that same enzyme down. If that holds true, dextromethorphan could build up a bit, which might mean more dizziness, drowsiness, or feeling off-balance.
I want to be upfront: this is theoretical, based on test-tube data, not real cases in people, so it may not amount to much. Still, rauwolscine on its own can raise your heart rate and blood pressure, and the pseudoephedrine here does the same. That overlap is worth mentioning to your pharmacist or doctor before combining them.
- VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed
STIMULANT DRUGS
3 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine also falls under STIMULANT DRUGS.
Rauwolscine has demonstrated stimulant effects in animal research.
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 this cold combo to keep an eye on is the pseudoephedrine, which is itself a stimulant decongestant. Rauwolscine can boost the release of norepinephrine, your body's natural "rev up" chemical, so stacking it with pseudoephedrine could pile one stimulant on top of another. In real life that might mean a faster or pounding heartbeat, higher blood pressure, jitteriness, trouble sleeping, or feeling anxious or wired.
I'll be honest with you: this concern is mostly theoretical and based on animal research, not solid human studies, so it isn't a sure thing. Still, if you have heart issues, high blood pressure, or anxiety, please run this combination by your pharmacist or doctor before taking them together.
- Aziz TA, Hussain SA, Mahwi TO, Ahmed ZA, Rahman HS, Rasedee A. The efficacy and safety of Ginkgo biloba extract as an adjuvant in type 2 diabetes mellitus patients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial.
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.
Rauwolscine Also Interacts With Other Medications
Rauwolscine has 676 moderate known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Rauwolscine
We haven’t checked that one against Rauwolscine yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Rauwolscine. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
This page covers Rauwolscine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page lists 301 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 · 242 moderate · 45 minor.
From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page
“Because Tylenol Cold Extra Strength packs four drugs into one dose (acetaminophen, chlorpheniramine, dextromethorphan, and pseudoephedrine), its supplement list runs to 301 ingredients, and 14 carry a major rating, so I'd approach this one with real care. The biggest hazards mirror the drugs themselves.”
Reviewed by 2 · Jul 18, 2026
Open the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction page
Taking Rauwolscine as Part of a Dietary Supplement Product? Check It for Interactions
We hold 196 real supplement products containing Rauwolscine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rauwolscine. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine too, on top of Rauwolscine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Rauwolscine and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine 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.
#273 of 1,452 supplements looked up here in the last 7 days
#126 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 Rauwolscine
What is Rauwolscine?
- Fat loss and weight management
- Bodybuilding and physique support
- Energy and stimulant effects
- Athletic performance
- Libido support
Rauwolscine (alpha-yohimbine) is a stimulant alkaloid closely related to yohimbine that is marketed mainly in fat-burning and pre-workout supplements. Human evidence for its benefits is very limited, and it can raise heart rate and blood pressure and cause anxiety, so it should be used with caution and is not recommended for people with heart conditions, anxiety, or during pregnancy or breastfeeding.
Other Drugs & Rauwolscine
Browse every other medication we’ve checked against Rauwolscine — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
676 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Phentermine ›
- Diphenhydramine ›
- Aspirin ›
- Methylphenidate ›
- Naproxen ›
- Doxycycline ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Amoxicillin ›
- Verapamil ›
- Phenylpropanolamine ›
- Quinidine ›
- Cyclosporine ›
- Bupropion ›
- Chloroquine ›
- Ciprofloxacin ›
- Fentanyl ›
- Nicotine ›
- Oxycodone ›
- Penicillin V Potassium ›
- Phenytoin ›
- Tacrolimus ›
- Amphotericin B ›
- Ampicillin ›
- Carbamazepine ›
- Ceftazidime ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Formoterol ›
- Indomethacin ›
- Morphine Sulfate ›
- Penicillin G Potassium ›
- Phenylephrine ›
- Pseudoephedrine ›
- Acyclovir ›
- Amphetamine ›
- Baclofen ›
- Buprenorphine ›
- Cephalexin ›
- Dicloxacillin Sodium ›
- Diethylpropion ›
- Dimenhydrinate ›
- Famotidine ›
- Ketoprofen ›
- Lofepramine ›
- Methotrexate ›
- Nortriptyline ›
- Ofloxacin ›
- Oxymorphone ›
- Propoxyphene ›
- Sotalol ›
- Aripiprazole ›
Showing 60 of 676 moderate interactions — see all 676 on the Rauwolscine page.
No interaction 2,153 drugs checked — show the list
We also checked Rauwolscine against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Ivermectin ›
- Abemaciclib ›
- Testosterone ›
- Losartan Potassium ›
- Acetaminophen ›
- Rosuvastatin ›
- Escitalopram ›
- Atorvastatin ›
- Isotretinoin ›
- Tirzepatide ›
- Docusate ›
- Prednisone ›
- Metformin ›
- Tadalafil ›
- Hydroxyurea ›
- Levothyroxine, Liothyronine ›
- Sumatriptan ›
- Semaglutide ›
- Lisinopril ›
- Azithromycin ›
- Pregabalin ›
- Gabapentin ›
- Bendamustine ›
- Lamotrigine ›
- Clonazepam ›
- Buspirone ›
- Omeprazole ›
- Letrozole ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Insulin Degludec, Liraglutide ›
- Diazepam ›
- Dapsone ›
- Ezetimibe ›
- Avatrombopag Maleate ›
- Cyclopentolate ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Levetiracetam ›
- Sacubitril, Valsartan ›
- Ado-trastuzumab Emtansine ›
- Enalapril Maleate ›
- Canagliflozin, Metformin ›
- Thyroid Hormone ›
- Hydrochlorothiazide, Losartan Potassium ›
- Belladonna, Ergotamine, Phenobarbital ›
- Sulfamethoxazole, Trimethoprim ›
- Mannitol ›
- Rosiglitazone Maleate ›
- Atorvastatin Calcium ›
- Valsartan ›
- Alginic Acid, Aluminum Hydroxide ›
- Progestin, Oral Contraceptive ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Azelastine Hydrochloride, Fluticasone Propionate ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Acarbose ›
- Spironolactone ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Efgartigimod Alfa-fcab ›
Showing the 60 most looked-up of 2,153 medications checked with no known interaction — see the full Rauwolscine 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, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine as a medicine that can lower these. This is not an interaction with Rauwolscine — 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 Rauwolscine and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine Together: Common Questions
Can you take Rauwolscine with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
Why are there 3 interactions listed for Rauwolscine and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
How serious is the Rauwolscine and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine and Rauwolscine?
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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.