Schizonepeta + Tramadol, Acetaminophen
Tramadol, Acetaminophen brand name: Tramacet.
Tramadol, Acetaminophen 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 reportSchizonepeta and Tramadol, Acetaminophen
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. Tramadol, Acetaminophen 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).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 4Why this applies to Tramadol, Acetaminophen
Tramadol, Acetaminophen falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Schizonepeta interacts with.
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.
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 this combo product (Tramacet). The tramadol part actually needs your liver's CYP2D6 enzyme to turn it into its active, stronger pain-relieving form. So tramadol is a prodrug. Schizonepeta has shown in lab and animal studies that it may slow CYP2D6 down. If that happens in people, you could get less pain relief from the tramadol, since less of it gets converted to the active form.
The good news: this is only theoretical right now, based on animal and test-tube work, not human studies, so I wouldn't lose sleep over it. The acetaminophen part isn't really affected by this enzyme. Still, if you notice your pain isn't being controlled, give your pharmacist or doctor a quick call before changing anything.
- 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.
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
2 of 4Tramadol, Acetaminophen also falls under CYTOCHROME P450 1A2 (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.
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 honest picture with Tramacet (the tramadol plus acetaminophen combo) and Schizonepeta. The concern on file is that a compound in this herb may slow down a liver enzyme called CYP1A2 in lab and animal tests. If that slowing happened in people, drugs cleared by that enzyme could build up a bit and bring stronger effects.
For tramadol specifically, that could mean more drowsiness, dizziness, nausea, or constipation, and in higher amounts a real risk of breathing being slowed. That said, this is only theoretical, based on test-tube and animal data, and tramadol leans more on different enzymes anyway, so any real-world impact is uncertain. I wouldn't panic, but please run it by your pharmacist or doctor before combining them, especially since tramadol already affects alertness.
- 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.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Tramadol, Acetaminophen also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Some substrates of CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others.
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 thing worth knowing about Tramacet (which combines tramadol with acetaminophen). The tramadol part is actually a prodrug for pain relief, meaning your body has to convert it into its active form to do most of its work. Lab and animal studies hint that Schizonepeta may speed up an enzyme called CYP3A4. With tramadol, faster breakdown could shift it down a pathway that produces less of the active painkiller, so in theory you might get weaker pain control than expected.
I'll be honest, this is very thin evidence (animal and test-tube only), so I wouldn't lose sleep over it. Still, if your pain isn't being managed well or you're combining these regularly, it's worth a quick chat with your pharmacist or doctor before changing anything.
- 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.
CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES
4 of 4Tramadol, Acetaminophen also falls under CYTOCHROME P450 2E1 (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).
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 piece that matters for your Tramacet: it's a combo pill, and the acetaminophen half is partly handled by a liver enzyme called CYP2E1. In lab and animal studies, a compound in Schizonepeta appears to slow that enzyme down. The theory is that blocking CYP2E1 could let acetaminophen hang around a bit longer or shift how it's processed. The good news is this is only based on test-tube and animal work, not real people, so I wouldn't lose sleep over it.
Interestingly, slowing CYP2E1 may actually mean less of acetaminophen's harmful liver byproduct, so this isn't a clear danger signal. Still, since acetaminophen is hard on the liver in high doses, don't double up on it and skip alcohol. If you want to try Schizonepeta, just run it by your pharmacist or doctor first.
- 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.
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.
Schizonepeta Also Interacts With Other Medications
Schizonepeta has 796 moderate known drug interactions in our database — the Tramadol, Acetaminophen one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Schizonepeta
We haven’t checked that one against Schizonepeta yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Schizonepeta. Pick one to open its full report.
See Every Supplement That Interacts With Tramadol, Acetaminophen
This page covers Schizonepeta only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tramadol, Acetaminophen page lists 280 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 · 224 moderate · 44 minor.
From our pharmacist’s overview on the Tramadol, Acetaminophen page
“The combinations I worry about most with tramadol and acetaminophen (Tramacet) involve anything that deepens drowsiness or strains the liver. Tramadol is an opioid, so sedating supplements like kava, along with alcohol in any form, can slow breathing on top of adding sleepiness, which is why this list deserves genuine care rather than…”
Reviewed by 2 · Jul 18, 2026
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 Tramadol, Acetaminophen 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:
Where Schizonepeta and Tramadol, Acetaminophen 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.
#366 of 1,452 supplements looked up here in the last 7 days
#389 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 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.
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.
No drugs match “”.
796 interactions
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Oxybutynin ›
- Oxycodone ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Miconazole ›
- Morphine Sulfate ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Nortriptyline ›
- Propoxyphene ›
- Rifampin ›
- Testosterone Undecanoate ›
- Aripiprazole ›
- Bendamustine ›
- Caffeine (otc Drug) ›
- Ciclesonide ›
- Clonazepam ›
- Cyclobenzaprine ›
- Dapsone ›
- Desipramine ›
- Doxepin ›
- Duloxetine ›
- Erythromycin Ethylsuccinate ›
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.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Ibuprofen ›
- Sumatriptan ›
- Semaglutide ›
- Tirzepatide ›
- Bupropion ›
- Metformin ›
- Amoxicillin ›
- Acyclovir ›
- Lisinopril ›
- Doxycycline ›
- Methotrexate ›
- Lamotrigine ›
- Gabapentin ›
- Pregabalin ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Mannitol ›
- Roxithromycin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Valsartan ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Levetiracetam ›
- Spironolactone ›
- Factor 7a ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Mitomycin ›
- Minoxidil ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Lenvatinib ›
- Phenylephrine ›
- Vancomycin ›
- Hethylphenidate Hcl ›
- Phentermine, Topiramate ›
- Dirithromycin ›
- Bentoquatam ›
- Procainamide ›
- Amoxicillin, Clavulanate Potassium ›
- Tenecteplase ›
Showing the 60 most looked-up of 2,033 medications checked with no known interaction — see the full Schizonepeta 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
Tramadol, Acetaminophen Is Linked to Lower Levels of One Nutrient
Natural Medicines records Tramadol, Acetaminophen as a medicine that can lower these. This is not an interaction with Schizonepeta — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Tramadol, Acetaminophen nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Schizonepeta and Tramadol, Acetaminophen Together: Common Questions
Can you take Schizonepeta with Tramadol, Acetaminophen?
Why are there 4 interactions listed for Schizonepeta and Tramadol, Acetaminophen?
How serious is the Schizonepeta and Tramadol, Acetaminophen interaction?
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.