Drug & supplement interaction

Schizonepeta + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine

Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine brand name: Multi Symptom Cold Relief.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine falls into 4 drug categories that Schizonepeta can interact with; the most serious is rated moderate. Animal research suggests that schizonepetin, a monoterpene constituent of schizonepeta, inhibits cytochrome P450 (CYP) 2D6.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Schizonepeta and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Schizonepeta interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine falls into 4 of those categories, so it can interact with Schizonepeta 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 Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine

Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Schizonepeta interacts with.

Animal research suggests that schizonepetin, a monoterpene constituent of schizonepeta, inhibits cytochrome P450 (CYP) 2D6. Theoretically, schizonepeta might increase the effects and side effects of CYP2D6 substrates.
Some substrates of CYP2D6 include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), haloperidol (Haldol), imipramine (Tofranil), metoprolol (Lopressor, Toprol XL), ondansetron (Zofran), paroxetine (Paxil), risperidone (Risperdal), tramadol (Ultram), venlafaxine (Effexor), and others.
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 product has one ingredient that matters most here: dextromethorphan, the cough suppressant. Your body relies on an enzyme called CYP2D6 to break it down. Lab and animal studies hint that a compound in Schizonepeta may slow that enzyme. If it does, dextromethorphan could build up a bit, which might mean more drowsiness, dizziness, or feeling foggy. In rare cases, very high dextromethorphan levels can cause restlessness or confusion.

That said, this is theoretical and based only on lab and animal data, so I would not lose sleep over it. The other ingredients (acetaminophen, chlorpheniramine, phenylpropanolamine) are less affected. If you take Schizonepeta regularly, just check in with your pharmacist before combining them.

References
  1. Bao B, Geng T, Cao Y, et al. Effects of schizonepetin on activity of mRNA expression of cytochrome P450 enzymes in rats. Int J Mol Sci. 2012;13(12):17006-18.
Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 4

Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Animal research suggests that schizonepetin, a monoterpene constituent of schizonepeta, inhibits cytochrome P450 (CYP) 1A2. Theoretically, schizonepeta might increase the effects and side effects of CYP1A2 substrates.
Some substrates of CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
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 combination cold product packs four ingredients into one dose, so let's keep this in perspective. The concern on file is that Schizonepeta may slow down a liver enzyme called CYP1A2. In theory, that could let certain medicines linger a bit longer than usual. Of the ingredients here, none lean heavily on CYP1A2 for clearance, so the practical impact is likely small.

Still, if levels did creep up, you might notice more of the usual effects from this product, like drowsiness or dry mouth from the chlorpheniramine, or feeling jittery from the decongestant. Importantly, this warning comes only from lab and animal research, not human studies, so it's theoretical. Casual culinary or tea amounts are unlikely to matter much, but concentrated supplements are less certain. Check with your pharmacist before pairing them.

References
  1. Bao B, Geng T, Cao Y, et al. Effects of schizonepetin on activity of mRNA expression of cytochrome P450 enzymes in rats. Int J Mol Sci. 2012;13(12):17006-18.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 4

Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Animal research suggests that schizonepetin, a monoterpene constituent of schizonepeta, induces cytochrome P450 (CYP) 3A4. Theoretically, schizonepeta might decrease the effects of CYP3A4 substrates.
Some substrates of CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others.
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 with this multi-symptom cold product. Schizonepeta has shown, in animal and test-tube studies only, that it may speed up an enzyme in your liver called CYP3A4. That same enzyme helps break down the dextromethorphan (the cough suppressant) in your cold medicine. If the herb revs up that enzyme, your body could clear the cough portion a little faster, which might make it work less well for calming a cough.

I want to be straight with you though: this is very weak, theoretical evidence, and we don't have human studies showing it actually matters. The acetaminophen, chlorpheniramine, and phenylpropanolamine pieces aren't really driven by this pathway. I wouldn't lose sleep over it, but check with your pharmacist before combining them.

References
  1. Bao B, Geng T, Cao Y, et al. Effects of schizonepetin on activity of mRNA expression of cytochrome P450 enzymes in rats. Int J Mol Sci. 2012;13(12):17006-18.
Moderate

CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES

4 of 4

Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.

Animal research suggests that schizonepetin, a monoterpene constituent of schizonepeta, inhibits cytochrome P450 (CYP) 2E1. Theoretically, schizonepeta might increase the effects and side effects of CYP2E1 substrates.
Some substrates of CYP2E1 include acetaminophen, chlorzoxazone (Parafon Forte), ethanol, theophylline, and anesthetics such as enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), and methoxyflurane (Penthrane).
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

The piece of this combo cold product that matters here is the acetaminophen (the pain and fever reducer, also known as Tylenol). One enzyme called CYP2E1 helps process acetaminophen, and lab and animal studies hint that a compound in Schizonepeta may slow that enzyme down. In theory, that could let a bit more acetaminophen linger in the body. Since acetaminophen is hard on the liver in high amounts, the concern is mostly about not overdoing the total dose.

The honest truth is that this is very weak evidence, based only on test-tube and animal work, so I would not lose sleep over an occasional cold remedy. Still, it is smart to avoid extra acetaminophen from other products and skip alcohol. Check with your pharmacist if you plan to use Schizonepeta regularly.

References
  1. Bao B, Geng T, Cao Y, et al. Effects of schizonepetin on activity of mRNA expression of cytochrome P450 enzymes in rats. Int J Mol Sci. 2012;13(12):17006-18.

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

Schizonepeta Also Interacts With Other Medications

Schizonepeta has 796 moderate known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine 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 Schizonepeta

Covers the 2,830 medications we’ve checked against Schizonepeta. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine

This page covers Schizonepeta only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine page lists 300 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Ephedra (major) and Grapefruit (major).

By severity: 14 major · 241 moderate · 45 minor.

Open the Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interaction page

One more smart check

Taking Schizonepeta as Part of a Dietary Supplement Product? Check It for Interactions

We hold 285 real supplement products containing Schizonepeta, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Schizonepeta. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine too, on top of Schizonepeta — 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 Schizonepeta and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine 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 Schizonepeta
Top half

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

29 days ago today
Medication Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine
Top 5%

#42 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 Schizonepeta

What is Schizonepeta?

  • Common cold and early-stage fever
  • Itchy skin rashes and hives
  • Sore throat
  • Headache
  • Measles and other skin eruptions (traditional use)

Schizonepeta is a mint-family herb long used in traditional Chinese medicine, usually as part of combination formulas for colds, fevers, and itchy skin conditions. Modern human evidence is very limited, so its benefits are not well proven. Talk to a pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Schizonepeta monograph & all interactions
Keep checking

Other Drugs & Schizonepeta

Browse every other medication we’ve checked against Schizonepeta — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
796Moderate
0Minor
2,033No known interaction
Moderate

796 interactions

Showing 60 of 796 moderate interactions — see all 796 on the Schizonepeta page.

No interaction 2,033 drugs checked — show the list

We also checked Schizonepeta against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,033 medications checked with no known interaction — see the full Schizonepeta 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 Schizonepeta and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine Together: Common Questions

Can you take Schizonepeta with Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine?
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 Schizonepeta and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine?
Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine belongs to more than one drug category, and Schizonepeta 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 Schizonepeta and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine 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 Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine and Schizonepeta?

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.