Sage + Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride
Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride brand name: Hycofenix.
Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride falls into 3 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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Sage interacts with whole categories of medication. Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride falls into 3 of those categories, so it can interact with Sage in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CNS DEPRESSANTS
1 of 3Why this applies to Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride
Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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.
The piece of this combo medicine that matters here is the hydrocodone, the opioid cough and pain ingredient. It already slows down your brain and can leave you drowsy, foggy, or short of breath. Some of sage's natural compounds appear to have a mild calming, sedative-like effect of their own, so on paper they could add to that drowsiness and make you feel extra sleepy, dizzy, or slowed down.
I'll be honest though: this is a theoretical concern based only on lab and animal studies, not real patient cases. A little sage in your cooking is very unlikely to cause trouble. Concentrated sage extracts or the essential oil are where I'd be more cautious. If you take those, check with your pharmacist or doctor first, and don't drive until you know how the combo affects you.
- 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 3Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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 what to know about Hycofenix, which combines guaifenesin, hydrocodone, and pseudoephedrine. The piece that matters here is the hydrocodone, an opioid cough suppressant and pain reliever. Your body uses an enzyme called CYP2D6 to convert hydrocodone into its more active form. Lab studies hint that sage extracts may slow this enzyme down a bit, which in theory could shift how much active drug you make.
This is purely test-tube evidence, and it has never been reported in real people, so I wouldn't lose sleep over it. A sprinkle of sage in cooking is no concern at all. If you're using strong sage capsules or oil and notice extra drowsiness, dizziness, or constipation, just check in with your pharmacist or doctor.
- 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 3Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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.
Hycofenix is a combination cough and cold medicine, and the part to keep an eye on here is the hydrocodone. Hydrocodone is partly broken down by a liver enzyme called CYP3A4. In test-tube studies, water-based sage extracts seemed to slow that enzyme down. If that were to happen in the body, hydrocodone could build up a bit, which might mean more drowsiness, dizziness, constipation, nausea, or in larger amounts, slowed breathing.
I want to be honest about the strength of this, though: it's only seen in lab dishes, never reported in real people. Sprinkling sage on food almost certainly won't matter. Concentrated sage extracts or the essential oil are where I'd be more cautious. If you take Hycofenix regularly, just run your sage supplement by your pharmacist or doctor first.
- 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.
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 1,296 moderate known drug interactions in our database — the Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride
This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride page lists 241 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), Ephedra (major) and Gamma-hydroxybutyrate (ghb) (major).
By severity: 13 major · 190 moderate · 38 minor.
From our pharmacist’s overview on the Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride page
“Hycofenix combines guaifenesin with hydrocodone, an opioid, and pseudoephedrine, a decongestant, so supplements can collide with it from two directions at once. That is why this list of 241 ingredients deserves real caution, starting with the 13 rated major.”
Reviewed by 2 · Jul 18, 2026
Open the Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride 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.
#214 of 1,452 supplements looked up here in the last 7 days
#227 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 “”.
1,296 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 1,296 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.
- Levothyroxine ›
- Methylphenidate ›
- Rosuvastatin ›
- Aspirin ›
- Levothyroxine, Liothyronine ›
- Isotretinoin ›
- Docusate ›
- Sumatriptan ›
- Amoxicillin ›
- Valacyclovir ›
- Hydroxyurea ›
- Bupropion ›
- Methotrexate ›
- Azithromycin ›
- Acyclovir ›
- Methylene Blue ›
- Bendamustine ›
- Ciprofloxacin ›
- Amoxicillin, Clavulanate Potassium ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Acetylsalicylic Acid ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aspirin, Butalbital ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Ezetimibe ›
- Cephalexin ›
- Levodopa ›
- Daunorubicin, Cytarabine ›
- Carbidopa, Levodopa ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Sodium Bicarbonate (otc Drug) ›
- Cytomegalovirus Immune Globulin ›
- Cyclopentolate ›
- Efgartigimod Alfa-fcab ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Thyroid Hormone ›
- Measles, Mumps, Rubella Virus Live ›
- Aminolevulinic Acid Hydrochloride ›
- Alginic Acid, Aluminum Hydroxide ›
- Vestronidase Alfa-vjbk ›
- Glycerol Phenylbutyrate ›
- Psyllium , Senna (otc Drug) ›
- Neomycin, Polymyxin B, Gramicidin ›
- Lonapegsomatropin-tcgd ›
- Tubocurarine ›
- Human Papillomavirus Vaccine ›
- Levothyroxine Sodium ›
- Magnesium Hydroxide (otc Drug) ›
- Sulfadiazine, Trimethoprim ›
- Daxibotulinumtoxina-lanm ›
- Delafloxacin (oral) ›
- Peginterferon Alfa-2a, Ribavirin ›
- Imipenem, Cilastatin, Relebactam ›
- Docusate Sodium, Sennosides (otc Drug) ›
- Alpha-1 Proteinase Inhibitor ›
- Articaine, Epinephrine ›
- Aluminum Acetate, Benzethonium Chloride ›
- Diphenhydramine, Menthol, Aloe Vera ›
- Collagenase Clostridium Histolyticum-aaes ›
Showing the 60 most looked-up of 1,533 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 Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride Together: Common Questions
Can you take Sage with Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride?
Why are there 3 interactions listed for Sage and Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride?
How serious is the Sage and Guaifenesin, Hydrocodone Bitartrate, Pseudoephedrine Hydrochloride interaction?
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