Drug & supplement interaction

Sage + Celecoxib, Tramadol

Celecoxib, Tramadol brand name: Seglentis.

Moderate Interaction
The bottom line Moderate

Celecoxib, Tramadol 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 report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Sage and Celecoxib, Tramadol

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. Celecoxib, Tramadol 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).

Moderate

CNS DEPRESSANTS

1 of 4

Why this applies to Celecoxib, Tramadol

Celecoxib, Tramadol 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

Seglentis combines celecoxib with tramadol, and it's really the tramadol part that matters here. Tramadol works on your brain and can make you feel drowsy, dizzy, or foggy. Sage contains a few natural compounds that may have their own mild calming, sedative-like effect. So the worry is simple: stacking the two could leave you sleepier, less steady on your feet, or slower to react than tramadol alone would.

I'll be honest though, this concern comes from lab and animal studies, not from people, so it's more theoretical than proven. A little sage in cooking is very unlikely to do anything. Concentrated sage capsules or the essential oil are where I'd be more cautious. If you take a sage supplement, check with your pharmacist or doctor first.

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

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 4

Celecoxib, Tramadol also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2D6.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2D6. So far, this interaction has not been reported in humans.
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

Seglentis combines two medicines, and the tramadol half is the one that matters here. Tramadol leans on an enzyme called CYP2D6 to turn into its stronger, more active pain-relieving form. In a lab setting, water-based sage extracts seemed to slow that enzyme down. If that happened in your body, you would actually get less of the active painkiller, so your pain might not be controlled as well as expected.

The honest part: this is only a test-tube finding and has never been reported in real people, so I would not lose sleep over it. Cooking with sage is no concern at all. If you take concentrated sage capsules or oil regularly, just mention it to your pharmacist or doctor so they can keep an eye on how well your pain relief is working.

References
  1. 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
  2. Hellum BH, Nilsen OG. The in vitro inhibitory potential of trade herbal products on human CYP2D6-mediated metabolism and the influence of ethanol. Basic Clin Pharmacol Toxicol. 2007 Nov;101:350-8.
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

3 of 4

Celecoxib, Tramadol also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C9.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2C9. So far, this interaction has not been reported in humans.
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

Seglentis combines two medicines: celecoxib (an anti-inflammatory) and tramadol (a pain reliever). The celecoxib part is cleared mainly by a liver enzyme called CYP2C9. In lab dish studies, sage extracts seem to slow that enzyme down. If that happened in your body, celecoxib could build up a bit, which might mean more stomach upset, fluid retention, higher blood pressure, or a small added risk of stomach or kidney problems.

Here's the reassuring part: this is only test-tube evidence, and it has never actually been reported in real people. Cooking with sage almost certainly won't matter. Concentrated sage pills or oils are where I'd be more cautious. If you use sage regularly, just mention it to your pharmacist or doctor so they can keep an eye on things.

References
  1. 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
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

4 of 4

Celecoxib, Tramadol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP3A4. So far, this interaction has not been reported in humans.
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

Seglentis combines two medicines: celecoxib (an anti-inflammatory pain reliever) and tramadol (an opioid-type pain reliever). Both pass through a liver enzyme called CYP3A4. In lab dishes, sage extracts have slowed this enzyme down. If that happened in real life, your body might clear these drugs a little slower, so more could build up.

For celecoxib, that could mean more stomach upset, fluid retention, or blood pressure changes. For tramadol, it could mean more drowsiness, dizziness, nausea, or constipation. Here's the reassuring part: this is only a theoretical concern from test-tube studies, never reported in people, and ordinary cooking amounts of sage almost certainly don't matter. If you take concentrated sage supplements, just mention it to your pharmacist or doctor.

References
  1. 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
  2. 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.

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 1,295 moderate known drug interactions in our database — the Celecoxib, Tramadol 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 Celecoxib, Tramadol

This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Celecoxib, Tramadol page lists 261 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 Gamma-hydroxybutyrate (ghb) (major).

By severity: 12 major · 205 moderate · 44 minor.

From our pharmacist’s overview on the Celecoxib, Tramadol page

“Seglentis combines celecoxib and tramadol for pain, and tramadol is why this list deserves real respect. Of the 261 supplements and herbal ingredients on file, 12 rate major, and most of those cluster around two dangers.”

Reviewed by 2 · Jul 18, 2026

Open the Celecoxib, Tramadol 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 Celecoxib, Tramadol 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 Celecoxib, Tramadol 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%

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

29 days ago today
Medication Celecoxib, Tramadol
Top half

#1,013 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
1,295Moderate
0Minor
1,534No known interaction
Moderate

1,295 interactions

Showing 60 of 1,295 moderate interactions — see all 1,295 on the Sage page.

No interaction 1,534 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

Keep exploring
Pharmacist Counseling Corner

Taking Sage and Celecoxib, Tramadol Together: Common Questions

Can you take Sage with Celecoxib, Tramadol?
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 4 interactions listed for Sage and Celecoxib, Tramadol?
Celecoxib, Tramadol 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 Celecoxib, Tramadol 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 Celecoxib, Tramadol and Sage?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.