Drug & supplement interaction

Rooibos + Chlorpheniramine Polistirex, Codeine Polistirex

Chlorpheniramine Polistirex, Codeine Polistirex brand name: Tuzistra XR.

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

Chlorpheniramine Polistirex, Codeine Polistirex falls into 2 drug categories that Rooibos can interact with; the most serious is rated moderate. Theoretically, taking rooibos with CYP2D6 substrates may increase the effects of CYP2D6 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Rooibos and Chlorpheniramine Polistirex, Codeine Polistirex

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

Why Are There 2 Interactions?

Rooibos interacts with whole categories of medication. Chlorpheniramine Polistirex, Codeine Polistirex falls into 2 of those categories, so it can interact with Rooibos in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

1 of 2

Why this applies to Chlorpheniramine Polistirex, Codeine Polistirex

Chlorpheniramine Polistirex, Codeine Polistirex falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Rooibos interacts with.

Theoretically, taking rooibos with CYP2D6 substrates may increase the effects of CYP2D6 substrates.
In vitro research shows that the methanol extract of rooibos leaves and stems 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 Tuzistra XR: the codeine part is actually a prodrug. Your body uses an enzyme called CYP2D6 to turn codeine into morphine, which is what does the pain relief and cough work. Some lab research hints that rooibos may slow that same enzyme down. If that held true in people, you could actually get less pain and cough relief from the codeine, since less of it would convert to morphine.

The good news is this is very early, test-tube level evidence only, not something seen in real patients. A cup or two of rooibos tea is unlikely to cause trouble. I'd be a little more cautious with concentrated rooibos extracts. If you're using either regularly, just run it by your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Chlorpheniramine Polistirex, Codeine Polistirex also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, taking rooibos with CYP3A4 substrates may increase the effects of CYP3A4 substrates.
In vitro research shows that the methanol extract of rooibos leaves and stems strongly inhibits CYP3A4 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 something worth knowing about Tuzistra XR, which combines codeine with the antihistamine chlorpheniramine. Codeine is what we call a prodrug. Your body has to convert it (mostly through an enzyme called CYP2D6) into morphine to get pain or cough relief. The CYP3A4 enzyme mentioned in this interaction handles a different, secondary pathway for codeine, and chlorpheniramine is also partly broken down by CYP3A4.

In lab dishes, a concentrated rooibos extract slowed down CYP3A4. In theory, that could let a bit more of these drugs linger, possibly adding to drowsiness, dizziness, constipation, or feeling foggy. But this is only test-tube evidence, and a normal cup of rooibos tea is very unlikely to cause trouble. If you're using strong extracts, just check with your pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.

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

Rooibos Also Interacts With Other Medications

Rooibos has 878 moderate known drug interactions in our database — the Chlorpheniramine Polistirex, Codeine Polistirex one above is among them. If you take anything else, check it against the full list below.

Moderate 878 No known interaction 1,952 (incl. Chlorpheniramine Polistirex, Codeine Polistirex)
Taking anything else?

Check Another of Your Medications Against Rooibos

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

Everything else you take

See Every Supplement That Interacts With Chlorpheniramine Polistirex, Codeine Polistirex

This page covers Rooibos only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Chlorpheniramine Polistirex, Codeine Polistirex page lists 259 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), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 12 major · 205 moderate · 42 minor.

Open the Chlorpheniramine Polistirex, Codeine Polistirex interaction page

One more smart check

Taking Rooibos as Part of a Dietary Supplement Product? Check It for Interactions

We hold 142 real supplement products containing Rooibos, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rooibos. Your product may carry other ingredients that interact with Chlorpheniramine Polistirex, Codeine Polistirex too, on top of Rooibos — 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 Rooibos and Chlorpheniramine Polistirex, Codeine Polistirex 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 Rooibos
Top half

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

29 days ago today
Medication Chlorpheniramine Polistirex, Codeine Polistirex
Top 10%

#185 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 Rooibos

What is Rooibos?

Rooibos
  • Caffeine-free beverage
  • Antioxidant support
  • Heart health
  • Blood sugar support
  • Digestive upset
  • General wellness

Rooibos is a caffeine-free herbal tea from South Africa that is rich in antioxidants and generally considered safe as a beverage. While lab and early studies suggest possible benefits for heart health, blood sugar, and inflammation, strong human evidence is lacking for most medical uses. Enjoy it as a tea, but talk to your pharmacist or doctor before using concentrated extracts for health reasons.

Read the full Rooibos monograph & all interactions
Keep checking

Other Drugs & Rooibos

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

0Major
878Moderate
0Minor
1,951No known interaction
878 Moderate 1,951 No interaction
Moderate

878 interactions

Showing 60 of 878 moderate interactions — see all 878 on the Rooibos page.

No interaction 1,951 drugs checked — show the list

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

Showing the 60 most looked-up of 1,951 medications checked with no known interaction — see the full Rooibos list.

See the full Rooibos interactions page
See every supplement checked against Chlorpheniramine Polistirex, Codeine Polistirex, 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
Rooibos monograph › Uses, safety, and every drug interaction in one place Chlorpheniramine Polistirex, Codeine Polistirex supplement interactions › Every supplement checked against Chlorpheniramine Polistirex, Codeine Polistirex, 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 Rooibos and Chlorpheniramine Polistirex, Codeine Polistirex Together: Common Questions

Can you take Rooibos with Chlorpheniramine Polistirex, Codeine Polistirex?
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 2 interactions listed for Rooibos and Chlorpheniramine Polistirex, Codeine Polistirex?
Chlorpheniramine Polistirex, Codeine Polistirex belongs to more than one drug category, and Rooibos 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 Rooibos and Chlorpheniramine Polistirex, Codeine Polistirex 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

Still Have a Question About Chlorpheniramine Polistirex, Codeine Polistirex and Rooibos?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.