Sage + Chlorpheniramine Polistirex, Codeine Polistirex
Chlorpheniramine Polistirex, Codeine Polistirex brand name: Tuzistra XR.
Chlorpheniramine Polistirex, Codeine Polistirex 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 Chlorpheniramine Polistirex, Codeine Polistirex
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 Polistirex, Codeine Polistirex 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 Chlorpheniramine Polistirex, Codeine Polistirex
Chlorpheniramine Polistirex, Codeine Polistirex 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.
Tuzistra XR combines codeine (an opioid) with chlorpheniramine (a sedating antihistamine), so it already tends to make people drowsy and slow their breathing a bit. The concern here is simple: some compounds in sage may have their own mild calming, sedative-type activity. Stacked on top of this medicine, that could add to the sleepiness, dizziness, foggy thinking, or slowed breathing you might already feel.
I want to be honest that this is a theoretical concern based only on lab and animal data, not real-world reports. A little sage in your cooking is very unlikely to matter. Concentrated sage extracts or the essential oil are where I'd be more cautious. Before pairing them, just check with your pharmacist or doctor.
- 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 2D6 (CYP2D6) SUBSTRATES
2 of 4Chlorpheniramine Polistirex, Codeine Polistirex also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2D6. 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.
Here's the wrinkle with Tuzistra XR: the codeine part is actually a prodrug. Your body has to use an enzyme called CYP2D6 to turn codeine into morphine, which is what gives the cough and pain relief. Lab tests suggest sage may slow that same enzyme down. If that happened in real life, you might convert less codeine into morphine, so you could get weaker cough control rather than more.
The chlorpheniramine side could theoretically build up a bit, possibly adding to drowsiness or dry mouth. Honestly though, this is only seen in test tubes, never reported in people, so food amounts of sage are very unlikely to matter. If you use concentrated sage extracts regularly, just mention it to your pharmacist.
- 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 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.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Chlorpheniramine Polistirex, Codeine Polistirex 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.
Here's the gist for Tuzistra XR, which pairs codeine with the antihistamine chlorpheniramine. Lab studies hint that sage may block an enzyme called CYP3A4, one of the liver pathways that helps process these medicines. If that enzyme slows down, levels could creep up a bit, which in theory might mean more drowsiness, dizziness, constipation, or slower breathing.
I want to keep this in perspective though. This is only test-tube evidence and has never actually been reported in people, so it's more of a maybe than a real-world worry. A little sage in your cooking is very unlikely to matter. Concentrated sage extracts or the essential oil are where I'd be more cautious. Since this combo already makes you sleepy, it's worth a quick chat with your pharmacist before adding sage supplements.
- 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
4 of 4Chlorpheniramine Polistirex, Codeine Polistirex 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.
Tuzistra XR combines codeine (a cough suppressant) with chlorpheniramine, an antihistamine that has anticholinergic activity, meaning it dries you out and calms an overactive cough and runny nose. Sage may work in the opposite direction. Lab studies suggest some sage compounds can raise levels of acetylcholine, the very chemical that chlorpheniramine tries to block. In theory, that could slightly blunt the drying, calming effect of the chlorpheniramine portion.
Honestly, this is a theoretical concern based only on test-tube and animal data, not real patient reports. A little sage on your dinner is very unlikely to matter. Concentrated sage extracts or essential oil are a bigger question mark, so it's worth a quick chat with your pharmacist before combining them.
- 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
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 Chlorpheniramine Polistirex, Codeine Polistirex 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 Chlorpheniramine Polistirex, Codeine Polistirex
This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Chlorpheniramine Polistirex, Codeine Polistirex page lists 259 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 Grapefruit (major).
By severity: 12 major · 205 moderate · 42 minor.
Open the Chlorpheniramine Polistirex, Codeine Polistirex 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 Chlorpheniramine Polistirex, Codeine Polistirex 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 Chlorpheniramine Polistirex, Codeine Polistirex 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.
#246 of 1,452 supplements looked up here in the last 7 days
#968 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 ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Amoxicillin ›
- Isotretinoin ›
- Methotrexate ›
- Bupropion ›
- Bendamustine ›
- Acyclovir ›
- Azithromycin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Ciprofloxacin ›
- Amoxicillin, Clavulanate Potassium ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Ezetimibe ›
- Acetylsalicylic Acid ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Pizotifen ›
- Daptomycin ›
- Pegunigalsidase Alfa-iwxj ›
- Mitomycin ›
- Levodopa ›
- Hexobarbitone ›
- Flutemetamol F-18 ›
- Magnesium Hydroxide (otc Drug) ›
- Bentoquatam ›
- Cefaclor ›
- Factor 7a ›
- Azelaic Acid ›
- Alglucosidase Alpha ›
- Hethylphenidate Hcl ›
- Salbutamol Sulfate ›
- Lenvatinib ›
- Tocainide ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Ribavirin Aerosol ›
- Casanthranol, Docusate ›
- Rocuronium ›
- Vancomycin ›
- Triptorelin ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Tenecteplase ›
- Dirithromycin ›
- Ropinirole ›
- Choline Magnesium Trisalicylate ›
- Birth Control Pills ›
- Ferric Derisomaltose ›
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
Taking Sage and Chlorpheniramine Polistirex, Codeine Polistirex Together: Common Questions
Can you take Sage with Chlorpheniramine Polistirex, Codeine Polistirex?
Why are there 4 interactions listed for Sage and Chlorpheniramine Polistirex, Codeine Polistirex?
How serious is the Sage and Chlorpheniramine Polistirex, Codeine Polistirex interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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