Drug & supplement interaction

Rosemary + Acetaminophen, Dextromethorphan

Acetaminophen, Dextromethorphan brand name: Tylenol Cough Ex Strength.

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

Rosemary has a minor interaction with Acetaminophen, Dextromethorphan. Theoretically, rosemary might decrease the levels and clinical effects of CYP1A2 substrates.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Rosemary and Acetaminophen, Dextromethorphan

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Acetaminophen, Dextromethorphan

Acetaminophen, Dextromethorphan falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Rosemary interacts with.

Theoretically, rosemary might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that rosemary induces CYP1A2 enzymes. This effect has not been reported in humans.
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 short version: this one is mostly a lab-bench curiosity, not something I'd lose sleep over. In test-tube studies, rosemary appears to speed up a liver enzyme called CYP1A2. If that happened in real people, it could in theory cause your body to clear certain medicines a little faster, making them slightly less effective. For your Tylenol Cough (acetaminophen plus dextromethorphan), that might mean a touch less cough or pain relief, though honestly the effect on these two drugs is minor and has never actually been shown in humans.

Neither of these is a prodrug here, so we're not worried about a dangerous buildup. Cooking with rosemary is totally fine. If you take concentrated rosemary capsules or oil, just mention it to your pharmacist so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Debersac P, Heydel JM, Amiot MJ, et al. Induction of cytochrome P450 and/or detoxication enzymes by various extracts of rosemary: description of specific patterns. Food Chem Toxicol 2001;39(9):907-18. PubMed
  2. Debersac P, Vernevaut MF, Amiot MJ, et al. Effects of a water-soluble extract of rosemary and its purified component rosmarinic acid on xenobiotic-metabolizing enzymes in rat liver. Food Chem Toxicol 2001;39(2):109-17. PubMed

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

Rosemary Also Interacts With Other Medications

Rosemary has 212 moderate, 159 minor known drug interactions in our database — the Acetaminophen, Dextromethorphan one above is one of them. If you take anything else, check it against the full list below.

Moderate 212 Minor 159 No known interaction 2,459 (incl. Acetaminophen, Dextromethorphan)
Taking anything else?

Check Another of Your Medications Against Rosemary

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Dextromethorphan

This page covers Rosemary only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan page lists 236 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), Grapefruit (major) and Lithium (major).

By severity: 8 major · 185 moderate · 43 minor.

From our pharmacist’s overview on the Acetaminophen, Dextromethorphan page

“Alcohol tops my worry list for Acetaminophen with Dextromethorphan (Tylenol Cough Ex Strength). Beer and wine both carry major ratings, since acetaminophen already asks a lot of the liver and regular drinking compounds that strain.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Dextromethorphan interaction page

One more smart check

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

We hold 1,786 real supplement products containing Rosemary, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rosemary. Your product may carry other ingredients that interact with Acetaminophen, Dextromethorphan too, on top of Rosemary — 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 Rosemary and Acetaminophen, 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 Rosemary
Top 25%

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

29 days ago today
Medication Acetaminophen, Dextromethorphan
Top 5%

#79 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 Rosemary

What is Rosemary?

Rosemary
  • Memory and concentration
  • Digestive upset
  • Hair growth
  • Anxiety and stress (aromatherapy)
  • Muscle and joint discomfort
  • Antioxidant support

Rosemary is a fragrant Mediterranean herb that is safe and flavorful in normal food amounts. Some early research suggests possible benefits for memory, mood, and hair growth, but the evidence is limited and far from conclusive. Concentrated supplements and the essential oil should be used carefully, and the essential oil should never be swallowed.

Read the full Rosemary monograph & all interactions
Keep checking

Other Drugs & Rosemary

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

0Major
212Moderate
159Minor
2,458No known interaction
212 Moderate 159 Minor 2,458 No interaction
Moderate

212 interactions

Showing 60 of 212 moderate interactions — see all 212 on the Rosemary page.

Minor

159 interactions

Showing 60 of 159 minor interactions — see all 159 on the Rosemary page.

No interaction 2,458 drugs checked — show the list

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

Showing the 60 most looked-up of 2,458 medications checked with no known interaction — see the full Rosemary list.

See the full Rosemary interactions page
See every supplement checked against Acetaminophen, Dextromethorphan, 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
Rosemary monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Dextromethorphan supplement interactions › Every supplement checked against Acetaminophen, Dextromethorphan, 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 Rosemary and Acetaminophen, Dextromethorphan Together: Common Questions

Can you take Rosemary with Acetaminophen, Dextromethorphan?
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.
How serious is the Rosemary and Acetaminophen, Dextromethorphan 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

Still Have a Question About Acetaminophen, Dextromethorphan and Rosemary?

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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.