Drug & supplement interaction

Rooibos + Dextromethorphan

Dextromethorphan brand names: Hold, Benylin Adult, Benylin Pediatric, Theraflu Thin Strips Long Acting Cough, Neo Citran Thin Strips Cough.

Moderate Interaction
The bottom line Moderate

Dextromethorphan 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?
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Interaction report

Rooibos and Dextromethorphan

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. Dextromethorphan 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 Dextromethorphan

Dextromethorphan 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

Your body relies on an enzyme called CYP2D6 to break down dextromethorphan, the cough suppressant in products like Benylin and Theraflu. In lab tests, an extract of rooibos appeared to slow that enzyme down a bit. If that held true in people, dextromethorphan could clear more slowly and build up, which might mean a little more drowsiness, dizziness, or stomach upset than usual.

Here's the reassuring part: this is only test-tube evidence, not something shown in real patients, and a normal cup of rooibos tea is very unlikely to cause trouble. Concentrated rooibos extracts are more of a question mark. If you take cough medicine often or use a rooibos supplement, just check with your pharmacist or doctor first.

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

Dextromethorphan 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 the gist with rooibos and your cough medicine. Your body partly uses a liver enzyme called CYP3A4 to break down dextromethorphan and clear it out. Some lab work suggests rooibos may slow that enzyme down. In theory, if dextromethorphan is cleared more slowly, a bit more could hang around, which might bump up its usual effects like drowsiness, dizziness, or feeling a little foggy.

That said, I want to be honest about how weak this evidence is. It comes only from test tube and animal studies, not real people, and it likely needed concentrated rooibos extract. A regular cup or two of rooibos tea almost certainly won't cause trouble. If you're using strong rooibos extracts, just run it by your pharmacist or doctor first.

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 Dextromethorphan one above is among them. If you take anything else, check it against the full list below.

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.

From our Q&A

Questions About Rooibos or Dextromethorphan

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Rooibos or Dextromethorphan, 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

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

From our pharmacist’s overview on the Dextromethorphan page

“A glass of grapefruit juice can push dextromethorphan (Benylin, Hold, and other cough medicines) to higher levels than intended, one of four major-rated entries among the 171 supplements and herbs on file, and the list as a whole warrants real care. Most interactions trace back to the liver enzymes (CYP3A4 and CYP2D6) that clear dextro…”

Reviewed by 2 · Jul 18, 2026

Open the Dextromethorphan 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 Dextromethorphan 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 Dextromethorphan 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

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

29 days ago today
Medication Dextromethorphan
Top 5%

#80 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
Medication

About Dextromethorphan

What Is Dextromethorphan Used For?

Brand names: Hold, Benylin Adult, Benylin Pediatric, Theraflu Thin Strips Long Acting Cough, Neo Citran Thin Strips Cough

Dextromethorphan temporarily relieves cough due to minor throat and bronchial irritation, such as the kind that comes with the common cold or breathing in irritants. It also helps reduce the urge to cough so you — or your child — can get to sleep.

Some products, including CVS Long Acting Cough and Premier Value Tussin Cough oral liquids, are also indicated to help loosen phlegm (mucus) and thin bronchial secretions to help drain the airways.

See full Dextromethorphan drug information
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
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
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

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Pharmacist Counseling Corner

Taking Rooibos and Dextromethorphan Together: Common Questions

Can you take Rooibos with Dextromethorphan?
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 Dextromethorphan?
Dextromethorphan 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 Dextromethorphan 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.