Sage + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium brand name: Hista-Derfule.
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium falls into 4 drug categories that Sage can interact with; the most serious is rated moderate. Theoretically, taking sage might increase the sedative and adverse effects of CNS depressants.
Read the full interaction reportSage and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Sage interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium falls into 4 of those categories, so it can interact with Sage in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CNS DEPRESSANTS
1 of 4Why this applies to Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium falls under CNS DEPRESSANTS — the group Sage interacts with.
Some constituents of sage have CNS depressant 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 combination product already has two ingredients that can make you drowsy: the antihistamine (chlorpheniramine) and the opium component, which acts like a mild opioid. The concern here is that some of sage's natural compounds may have a mild calming effect on the brain too. So in theory, layering concentrated sage on top of this medicine could add to the sleepiness, leaving you more groggy, foggy, or slow to react than usual.
Honestly, this is a theoretical worry based only on lab and animal studies, not real patient reports, so I wouldn't lose sleep over it. Sage used as a kitchen spice is very unlikely to matter. Strong sage extracts or essential oil are the bigger question. If you take those regularly, just run it by your pharmacist or doctor first.
- Perry NS, Bollen C, Perry EK, Ballard C. Salvia for dementia therapy: review of pharmacological activity and pilot tolerability clinical trial. Pharmacol Biochem Behav 2003;75:651-9.. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 4Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP3A4. So far, this interaction has not been reported in humans.
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 combination product mixes a pain reliever (acetaminophen), an antihistamine (chlorpheniramine), a decongestant (phenylpropanolamine), and opium, a narcotic for cough or pain. The idea here is that sage, in lab dish studies, seemed to slow down a liver enzyme called CYP3A4 that helps clear some of these ingredients. If that slowing happened in real life, the medicine could build up a bit and hit harder, meaning more drowsiness, dizziness, constipation, or feeling foggy.
Here's the honest part: this is only theoretical, seen in test tubes, not in actual people. Cooking with sage almost certainly won't matter. Concentrated sage extracts or the essential oil are where I'd be more cautious. If you take this regularly, just run it past your pharmacist or doctor first.
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.
ANTICHOLINERGIC DRUGS
3 of 4Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium also falls under ANTICHOLINERGIC DRUGS.
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) can inhibit acetylcholinesterase and might increase acetylcholine levels.
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 combo product includes chlorpheniramine, an antihistamine that works partly by blocking acetylcholine (that's the anticholinergic piece here). Sage may do the opposite: lab studies hint it can raise acetylcholine levels by slowing the enzyme that breaks it down. So in theory, concentrated sage could slightly dampen the drying, antihistamine-type effects of this medicine.
I want to be honest, though, this is only test-tube evidence, not something proven in people. A bit of sage on your dinner won't matter. Even strong sage supplements would likely have a small effect at most. If you take this product regularly and want to add a sage extract, just run it by your pharmacist or doctor first. Don't change anything on your own.
- Orhan, I., Kartal, M., Kan, Y., and Sener, B. Activity of essential oils and individual components against acetyl- and butyrylcholinesterase. Z.Naturforsch.C. 2008;63(7-8):547-553.
- Perry, N. S., Houghton, P. J., Theobald, A., Jenner, P., and Perry, E. K. In-vitro inhibition of human erythrocyte acetylcholinesterase by salvia lavandulaefolia essential oil and constituent terpenes. J Pharm Pharmacol 2000;52(7):895-902.
- Savelev, S. U., Okello, E. J., and Perry, E. K. Butyryl- and acetyl-cholinesterase inhibitory activities in essential oils of Salvia species and their constituents. Phytother Res 2004;18(4):315-324.
- Kennedy, D. O., Pace, S., Haskell, C., Okello, E. J., Milne, A., and Scholey, A. B. Effects of cholinesterase inhibiting sage (Salvia officinalis) on mood, anxiety and performance on a psychological stressor battery. Neuropsychopharmacology 2006;31(4):84 PubMed
CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES
4 of 4Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.
Animal research suggests that drinking common sage (Salvia officinalis) tea increases the expression of CYP2E1. So far, this interaction has not been reported in humans.
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 combination product contains acetaminophen (Tylenol) along with an antihistamine, a decongestant, and a small amount of opium. The piece that matters here is the acetaminophen, because part of it is handled by a liver enzyme called CYP2E1. Animal studies hint that drinking sage tea may rev up that enzyme. In theory, a faster CYP2E1 could shift more acetaminophen down a pathway that produces a liver-stressing byproduct, especially at higher doses or with regular use.
I want to be honest: this is only seen in lab and animal work, never confirmed in people, so I would not lose sleep over occasional sage in cooking. The bigger picture is just being careful with how much acetaminophen you take overall. If you use concentrated sage extracts or take this medicine often, check in with your pharmacist or doctor first.
- Lima, C. F., Fernandes-Ferreira, M., and Pereira-Wilson, C. Drinking of Salvia officinalis tea increases CCl(4)-induced hepatotoxicity in mice. Food Chem.Toxicol. 2007;45(3):456-464.
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.
Sage Also Interacts With Other Medications
Sage has 1,295 moderate known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Sage
We haven’t checked that one against Sage yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Sage. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium
This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium page lists 332 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), Asarabacca (major), Beer (major) and Ephedra (major).
By severity: 18 major · 267 moderate · 47 minor.
From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium page
“Hista-Derfule is really four medicines at once: acetaminophen, the antihistamine chlorpheniramine, the decongestant phenylpropanolamine, and opium. That mix is why I read its 332 supplement interactions with genuine care, starting with the 18 rated major.”
Reviewed by 2 · Jul 18, 2026
Open the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interaction page
Taking Sage as Part of a Dietary Supplement Product? Check It for Interactions
We hold 718 real supplement products containing Sage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sage. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium too, on top of Sage — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Sage and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium 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.
#235 of 1,452 supplements looked up here in the last 7 days
#142 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 Sage
What is Sage?
- Sore throat and mouth irritation
- Digestive upset
- Excessive sweating
- Memory and thinking
- Menopause symptoms (hot flashes)
- General antioxidant support
Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.
Other Drugs & Sage
Browse every other medication we’ve checked against Sage — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,295 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Glycopyrrolate ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Insulin (human) ›
- Ipratropium ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
Showing 60 of 1,295 moderate interactions — see all 1,295 on the Sage page.
No interaction 1,534 drugs checked — show the list
We also checked Sage against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Isotretinoin ›
- Docusate ›
- Sumatriptan ›
- Valacyclovir ›
- Hydroxyurea ›
- Amoxicillin ›
- Methotrexate ›
- Levothyroxine, Liothyronine ›
- Bupropion ›
- Bendamustine ›
- Azithromycin ›
- Acyclovir ›
- Methylene Blue ›
- Ciprofloxacin ›
- Amoxicillin, Clavulanate Potassium ›
- Acetylsalicylic Acid ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Ezetimibe ›
- Cyclopentolate ›
- Cephalexin ›
- Thyroid Hormone ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Carbidopa, Levodopa ›
- Roxithromycin ›
- Levodopa ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Magnesium Hydroxide (otc Drug) ›
- Mitomycin ›
- Alginic Acid, Aluminum Hydroxide ›
- Flutemetamol F-18 ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Aspirin, Butalbital ›
- Levothyroxine Sodium ›
- Charcoal (otc Drug) ›
- Dexmethylphenidate ›
- Articaine, Epinephrine ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Peginterferon Alfa-2a, Ribavirin ›
- Daunorubicin, Cytarabine ›
- Alpha-1 Proteinase Inhibitor ›
- Cefaclor ›
- Efgartigimod Alfa-fcab ›
- Aminolevulinic Acid Hydrochloride ›
- Daptomycin ›
- Acenocoumarol ›
- Cytomegalovirus Immune Globulin ›
- Colistin, Neomycin, Hydrocortisone ›
- Sodium Bicarbonate (otc Drug) ›
- Alendronate Sodium, Cholecalciferol ›
- Hydroxychloroquine ›
- Rosuvastatin Calcium, Ezetimibe ›
- Imipenem, Cilastatin, Relebactam ›
- Tubocurarine ›
- Factor 7a ›
- Dihydroxyaluminum Sodium Carbonate ›
Showing the 60 most looked-up of 1,534 medications checked with no known interaction — see the full Sage 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, Phenylpropanolamine, Opium Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium as a medicine that can lower these. This is not an interaction with Sage — 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 Sage and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium Together: Common Questions
Can you take Sage with Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium?
Why are there 4 interactions listed for Sage and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium?
How serious is the Sage and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium and Sage?
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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.