Drug & supplement interaction

Rauwolscine + Hydrocodone, Pseudoephedrine

Hydrocodone, Pseudoephedrine brand names: P-V-Tussin, Rezira.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Hydrocodone, 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 report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Rauwolscine and Hydrocodone, 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. Hydrocodone, 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).

Moderate

SEIZURE THRESHOLD LOWERING DRUGS

1 of 3

Why this applies to Hydrocodone, Pseudoephedrine

Hydrocodone, Pseudoephedrine falls under SEIZURE THRESHOLD LOWERING DRUGS — the group Rauwolscine interacts with.

Theoretically, taking rauwolscine with seizure threshold lowering drugs might increase the risk of adverse convulsant effects.
In animal research, intraperitoneal rauwolscine lowered the seizure threshold level of the drug metrazol.
Severity Moderate 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: rauwolscine is a stimulant that ramps up your body's natural "go" chemical, norepinephrine, and some lab research suggests it can make the brain a little more prone to seizures. Your combo product contains pseudoephedrine, which is itself a stimulant decongestant, plus hydrocodone, an opioid cough suppressant. Stacking a stimulant like rauwolscine on top of pseudoephedrine could add up to a jittery, racing-heart, anxious feeling and higher blood pressure, and in rare cases stimulant overload can lower the threshold for a seizure.

I want to be honest that this seizure concern comes only from animal studies, not people, so it's theoretical. Still, if you have any history of seizures, heart trouble, or high blood pressure, please check with your pharmacist or doctor before combining these.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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.
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 3

Hydrocodone, Pseudoephedrine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, rauwolscine might increase levels of drugs metabolized by CYP2D6.
Rauwolscine is structurally related to yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
Severity Moderate 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 wrinkle with this combo product. The hydrocodone part is actually a prodrug that your liver turns into hydromorphone using an enzyme called CYP2D6. Rauwolscine, a cousin of yohimbine, may gently block that same enzyme in lab studies. If it does, less hydrocodone gets converted, which could mean weaker pain relief. On the flip side, slowed breakdown of the parent drug could leave you a bit more drowsy or constipated for some people.

Just as important, both rauwolscine and the pseudoephedrine in this product are stimulants. Stacking them can push up your heart rate and blood pressure and trigger jitteriness or anxiety. This interaction is only theoretical, but please run it past your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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
Moderate

STIMULANT DRUGS

3 of 3

Hydrocodone, Pseudoephedrine also falls under STIMULANT DRUGS.

Theoretically, taking rauwolscine with stimulant drugs might increase the risk of adverse stimulant effects.
Rauwolscine has demonstrated stimulant effects in animal research.
Severity Moderate 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 piece that matters in your combo product: the pseudoephedrine part is a decongestant that works a lot like a mild stimulant, nudging up heart rate and blood pressure. Rauwolscine is also a stimulant that can do the same thing. Stacking the two together could, in theory, add up to a stronger jolt, things like a racing or pounding heart, jitteriness, higher blood pressure, trouble sleeping, or anxiety.

I'll be honest with you though, this concern comes mostly from animal research, so it's more of a caution than a proven problem. The hydrocodone (the cough and pain part) isn't the worry here. If you have any heart issues, high blood pressure, or anxiety, please run this by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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.

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

Rauwolscine Also Interacts With Other Medications

Rauwolscine has 676 moderate known drug interactions in our database — the Hydrocodone, Pseudoephedrine one above is among them. If you take anything else, check it against the full list below.

Moderate 676 No known interaction 2,154 (incl. Hydrocodone, Pseudoephedrine)
Taking anything else?

Check Another of Your Medications Against Rauwolscine

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

Everything else you take

See Every Supplement That Interacts With Hydrocodone, Pseudoephedrine

This page covers Rauwolscine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrocodone, Pseudoephedrine 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 Hydrocodone, Pseudoephedrine page

“Rezira and P-V-Tussin pair hydrocodone, an opioid, with pseudoephedrine, a decongestant, so the 241 supplements here pull in two directions and I would handle this combination with real care. Most entries either deepen the opioid's sedation (78 ingredients are CNS depressants, alcohol included) or stack stimulant effects onto the pseud…”

Reviewed by 2 · Jul 18, 2026

Open the Hydrocodone, Pseudoephedrine interaction page

One more smart check

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 Hydrocodone, 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:

How much people look this up

Where Rauwolscine and Hydrocodone, 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.

Supplement Rauwolscine
Top 25%

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

29 days ago today
Medication Hydrocodone, Pseudoephedrine
Top 10%

#256 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 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.

Read the full Rauwolscine monograph & all interactions
Keep checking

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.

0Major
676Moderate
0Minor
2,153No known interaction
676 Moderate 2,153 No interaction
Moderate

676 interactions

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.

Showing the 60 most looked-up of 2,153 medications checked with no known interaction — see the full Rauwolscine list.

See the full Rauwolscine interactions page
See every supplement checked against Hydrocodone, Pseudoephedrine, 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
Rauwolscine monograph › Uses, safety, and every drug interaction in one place Hydrocodone, Pseudoephedrine supplement interactions › Every supplement checked against Hydrocodone, Pseudoephedrine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Rauwolscine and Hydrocodone, Pseudoephedrine Together: Common Questions

Can you take Rauwolscine with Hydrocodone, Pseudoephedrine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Rauwolscine and Hydrocodone, Pseudoephedrine?
Hydrocodone, Pseudoephedrine belongs to more than one drug category, and Rauwolscine 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 Rauwolscine and Hydrocodone, Pseudoephedrine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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.