Drug & supplement interaction

Sage + Atropine, Hyoscyamine, Phenobarbital

Atropine, Hyoscyamine, Phenobarbital brand name: Hypnaldyne.

Moderate Interaction
The bottom line Moderate

Atropine, Hyoscyamine, Phenobarbital 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 Atropine, Hyoscyamine, Phenobarbital

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. Atropine, Hyoscyamine, Phenobarbital 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 Atropine, Hyoscyamine, Phenobarbital

Atropine, Hyoscyamine, Phenobarbital 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

Here's the deal with this combo. Your medicine contains phenobarbital, a barbiturate that already slows down the brain and can leave you feeling drowsy, foggy, or unsteady on your feet. Some compounds in sage appear to have their own mild calming effect on the nervous system, so the worry is that stacking them could add up and make you sleepier or slower than expected.

I want to be honest about the strength of this concern. It comes from lab and animal studies, not from people, so it's more theoretical than proven. Sprinkling sage on your food almost certainly won't do much. Concentrated sage extracts or the essential oil are where I'd be more cautious. Before adding a sage supplement, just run it by your pharmacist or doctor.

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

Atropine, Hyoscyamine, Phenobarbital 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

Here's the idea behind this combination. Your medication includes atropine and hyoscyamine, which work by blocking a body chemical called acetylcholine. That blocking action is how they calm cramping, dry up secretions, and slow an overactive gut. Lab studies hint that sage may do the opposite by raising acetylcholine levels. So in theory, sage could nudge against your medicine and make it a little less effective, meaning you might notice more stomach cramping or other symptoms it normally controls.

I want to be honest about how soft this evidence is. It comes only from test-tube studies, not from people, and a sprinkle of sage in your cooking is very unlikely to matter. Concentrated sage extracts or the essential oil are more of a question mark. Before adding any sage supplement, check in with your pharmacist or doctor.

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 Atropine, Hyoscyamine, Phenobarbital 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 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 Atropine, Hyoscyamine, Phenobarbital

This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Atropine, Hyoscyamine, Phenobarbital page lists 165 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 Henbane (major).

By severity: 10 major · 134 moderate · 21 minor.

From our pharmacist’s overview on the Atropine, Hyoscyamine, Phenobarbital page

“Hypnaldyne combines atropine and hyoscyamine, both drying anticholinergic drugs, with phenobarbital, a sedating barbiturate that also controls seizures, so the 165 supplements on this list deserve real attention before you add one. Nearly half, 78 ingredients, deepen the sedation phenobarbital already causes; alcohol and kava sit among…”

Reviewed by 2 · Jul 18, 2026

Open the Atropine, Hyoscyamine, Phenobarbital 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 Atropine, Hyoscyamine, Phenobarbital 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 Atropine, Hyoscyamine, Phenobarbital 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%

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

29 days ago today
Medication Atropine, Hyoscyamine, Phenobarbital
Top 25%

#314 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
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.

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 Sage and Atropine, Hyoscyamine, Phenobarbital Together: Common Questions

Can you take Sage with Atropine, Hyoscyamine, Phenobarbital?
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 Atropine, Hyoscyamine, Phenobarbital?
Atropine, Hyoscyamine, Phenobarbital 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 Atropine, Hyoscyamine, Phenobarbital 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.