Drug & supplement interaction

Sage + Aspirin, Diphenhydramine, Phenylpropanolamine

Aspirin, Diphenhydramine, Phenylpropanolamine brand name: Alka Seltzer Plus Night Time Effervescent.

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

Aspirin, Diphenhydramine, Phenylpropanolamine falls into 2 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 report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Sage and Aspirin, Diphenhydramine, Phenylpropanolamine

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

Why Are There 2 Interactions?

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

Moderate

CNS DEPRESSANTS

1 of 2

Why this applies to Aspirin, Diphenhydramine, Phenylpropanolamine

Aspirin, Diphenhydramine, Phenylpropanolamine falls under CNS DEPRESSANTS — the group Sage interacts with.

Theoretically, taking sage might increase the sedative and adverse effects of CNS depressants.
Some constituents of sage have CNS depressant 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

The combo product you asked about contains diphenhydramine, the same antihistamine found in Benadryl. On its own it already makes most people drowsy, foggy, and a little dizzy. Some compounds in sage appear to have mild calming activity of their own, so the concern here is simple: stacking the two could leave you more sleepy and slowed down than you expected. You might also notice that classic drowsy-medicine feeling more strongly, like dry mouth, sluggish thinking, or trouble focusing.

Be honest though, this warning is theoretical and comes only from lab and animal studies, so I would not panic. A bit of sage in cooking is unlikely to matter. Concentrated sage extracts or sage oil are a different story. If you take those regularly, check with your pharmacist or doctor first.

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

ANTICHOLINERGIC DRUGS

2 of 2

Aspirin, Diphenhydramine, Phenylpropanolamine also falls under ANTICHOLINERGIC DRUGS.

Theoretically, sage might decrease the clinical effects of anticholinergic drugs.
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) can inhibit acetylcholinesterase and might increase acetylcholine levels.
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

The piece of this combo product that matters here is the diphenhydramine, the antihistamine that helps you sleep and dries you up. It works partly by blocking acetylcholine, a signaling chemical in your body. Sage seems to do the opposite in lab tests, it may raise acetylcholine levels. So in theory, sage could slightly blunt how well the diphenhydramine works, meaning a little less drowsiness or less drying effect.

I want to be honest with you though: this is only seen in test-tube studies, not in real people, so I wouldn't lose sleep over it. Everyday culinary sage in cooking is very unlikely to matter. If you're using concentrated sage extracts or the essential oil, just run it by your pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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.
  2. 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.
  3. 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.
  4. 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

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

Sage Also Interacts With Other Medications

Sage has 1,296 moderate known drug interactions in our database — the Aspirin, Diphenhydramine, Phenylpropanolamine one above is among them. If you take anything else, check it against the full list below.

Moderate 1,296 No known interaction 1,534 (incl. Aspirin, Diphenhydramine, Phenylpropanolamine)
Taking anything else?

Check Another of Your Medications Against Sage

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

Everything else you take

See Every Supplement That Interacts With Aspirin, Diphenhydramine, Phenylpropanolamine

This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Diphenhydramine, Phenylpropanolamine page lists 361 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 Danshen (major).

By severity: 17 major · 308 moderate · 36 minor.

From our pharmacist’s overview on the Aspirin, Diphenhydramine, Phenylpropanolamine page

“A cold remedy used for a few nights can still collide with supplements taken daily, and Alka Seltzer Plus Night Time (aspirin, diphenhydramine, phenylpropanolamine) is one to treat with genuine care. Its three ingredients thin the blood, sedate, and stimulate all at once, which is why 361 supplements and herbs are on file here.”

Reviewed by 2 · Jul 18, 2026

Open the Aspirin, Diphenhydramine, Phenylpropanolamine interaction page

One more smart check

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 Aspirin, Diphenhydramine, Phenylpropanolamine 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:

How much people look this up

Where Sage and Aspirin, Diphenhydramine, Phenylpropanolamine 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 Sage
Top 25%

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

29 days ago today
Medication Aspirin, Diphenhydramine, Phenylpropanolamine
Top 10%

#201 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 Sage

What is Sage?

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.

Read the full Sage monograph & all interactions
Keep checking

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.

0Major
1,296Moderate
0Minor
1,533No known interaction
1,296 Moderate 1,533 No interaction
Moderate

1,296 interactions

Showing 60 of 1,296 moderate interactions — see all 1,296 on the Sage page.

No interaction 1,533 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.

Showing the 60 most looked-up of 1,533 medications checked with no known interaction — see the full Sage list.

See the full Sage interactions page
See every supplement checked against Aspirin, Diphenhydramine, Phenylpropanolamine, 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
Sage monograph › Uses, safety, and every drug interaction in one place Aspirin, Diphenhydramine, Phenylpropanolamine supplement interactions › Every supplement checked against Aspirin, Diphenhydramine, Phenylpropanolamine, 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 Sage and Aspirin, Diphenhydramine, Phenylpropanolamine Together: Common Questions

Can you take Sage with Aspirin, Diphenhydramine, Phenylpropanolamine?
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 Sage and Aspirin, Diphenhydramine, Phenylpropanolamine?
Aspirin, Diphenhydramine, Phenylpropanolamine belongs to more than one drug category, and Sage 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 Sage and Aspirin, Diphenhydramine, Phenylpropanolamine 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 Aspirin, Diphenhydramine, Phenylpropanolamine 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.