Drug & supplement interaction

Sage + Chlorpheniramine Maleate, Dextromethorphan Hydrobromide

Chlorpheniramine Maleate, Dextromethorphan Hydrobromide brand names: Coricidin HBP Cough & Cold, Coricidin II Cough & Cold, Pediatric Vicks Formula 44m Cough & Cold Relief.

Moderate Interaction
The bottom line Moderate

Chlorpheniramine Maleate, Dextromethorphan Hydrobromide falls into 4 drug categories that Sage can interact with; the most serious is rated moderate. Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2D6.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Sage and Chlorpheniramine Maleate, Dextromethorphan Hydrobromide

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. Chlorpheniramine Maleate, Dextromethorphan Hydrobromide 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

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

1 of 4

Why this applies to Chlorpheniramine Maleate, Dextromethorphan Hydrobromide

Chlorpheniramine Maleate, Dextromethorphan Hydrobromide falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Sage interacts with.

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

Both ingredients in this cough and cold combo lean on a liver enzyme called CYP2D6 to be cleared from your body. In lab tests (not actual people yet), water-based sage extracts seem to slow that enzyme down. In theory, that could let the dextromethorphan and chlorpheniramine linger a bit longer, which might mean more drowsiness, dizziness, dry mouth, or a foggy, sedated feeling than usual.

Here's the reassuring part: this has only been seen in a test tube, never reported in real patients, so I wouldn't lose sleep over it. The sprinkle of sage in your cooking is a non-issue. If you're using concentrated sage capsules or oil while taking this medicine, just check with your pharmacist or doctor first.

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 3A4 (CYP3A4) SUBSTRATES

2 of 4

Chlorpheniramine Maleate, Dextromethorphan Hydrobromide 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

This combo cold medicine pairs an antihistamine (chlorpheniramine) with a cough suppressant (dextromethorphan). Both are partly broken down by a liver enzyme called CYP3A4. In test-tube studies, water-based sage extracts seemed to slow that enzyme down a bit. If that happened in the body, these two ingredients could clear more slowly and build up, which might make the usual effects stronger, things like drowsiness, dizziness, dry mouth, and feeling foggy.

Here's the honest part: this is only a lab finding and has not been seen in real people. Everyday cooking amounts of sage almost certainly won't matter. Concentrated sage capsules or oils are where I'd be more cautious. If you take sage regularly, just run it by 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.
Moderate

ANTICHOLINERGIC DRUGS

3 of 4

Chlorpheniramine Maleate, Dextromethorphan Hydrobromide 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 gist for this combo cold medicine. The chlorpheniramine piece is an antihistamine that works partly by blocking a brain chemical called acetylcholine, which is why it can dry you out and make you sleepy. Lab studies suggest sage may nudge acetylcholine levels up, working in the opposite direction. In theory, that could slightly blunt how well the antihistamine part works, so you might notice a little more runny nose or less of the calming, drowsy effect.

I want to be honest though: this is based only on test-tube and animal research, not real people, so it's a weak, theoretical concern. Everyday cooking with sage almost certainly won't matter. If you're using concentrated sage extracts and take this regularly, just run it by your pharmacist or doctor first.

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
Moderate

CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES

4 of 4

Chlorpheniramine Maleate, Dextromethorphan Hydrobromide also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.

Theoretically, sage might decrease the levels and clinical effects of drugs metabolized by CYP2E1.
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.
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

Let me put your mind at ease here. The concern on file is that sage might rev up a liver enzyme called CYP2E1, which could in theory speed up the breakdown of medicines it processes. But this idea comes only from animal studies (sage tea in rodents), and it has never actually been seen in people. Neither chlorpheniramine nor dextromethorphan relies heavily on CYP2E1, so any real-world effect on your cough and cold combo is likely very small.

If anything did happen, faster clearance might make these ingredients slightly less effective, meaning a bit less cough suppression or runny-nose relief. Cooking with sage is no worry at all. If you're using strong sage extracts or oil regularly, just mention it to your pharmacist so they can keep an eye on things.

References
  1. 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.

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 Chlorpheniramine Maleate, Dextromethorphan Hydrobromide 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 Chlorpheniramine Maleate, Dextromethorphan Hydrobromide

This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Chlorpheniramine Maleate, Dextromethorphan Hydrobromide page lists 218 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Henbane (major), Lithium (major) and Scopolia (major).

By severity: 6 major · 170 moderate · 42 minor.

From our pharmacist’s overview on the Chlorpheniramine Maleate, Dextromethorphan Hydrobromide page

“Grapefruit is the interaction I would flag first for anyone taking chlorpheniramine with dextromethorphan (Coricidin HBP Cough & Cold). It blocks the enzyme that clears these ingredients, so levels and side effects can climb.”

Reviewed by 2 · Jul 18, 2026

Open the Chlorpheniramine Maleate, Dextromethorphan Hydrobromide 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 Chlorpheniramine Maleate, Dextromethorphan Hydrobromide 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 Chlorpheniramine Maleate, Dextromethorphan Hydrobromide 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%

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

29 days ago today
Medication Chlorpheniramine Maleate, Dextromethorphan Hydrobromide
Top 25%

#616 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

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Pharmacist Counseling Corner

Taking Sage and Chlorpheniramine Maleate, Dextromethorphan Hydrobromide Together: Common Questions

Can you take Sage with Chlorpheniramine Maleate, Dextromethorphan Hydrobromide?
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 Chlorpheniramine Maleate, Dextromethorphan Hydrobromide?
Chlorpheniramine Maleate, Dextromethorphan Hydrobromide 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 Chlorpheniramine Maleate, Dextromethorphan Hydrobromide 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.