Drug & supplement interaction

Shiitake Mushroom + Dextromethorphan, Pseudoephedrine

Dextromethorphan, Pseudoephedrine brand name: Sudafed Cold/Flu.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Shiitake Mushroom has a moderate interaction with Dextromethorphan, Pseudoephedrine. Theoretically, shiitake mushroom might decrease levels of drugs metabolized by CYP2D6.

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

Shiitake Mushroom and Dextromethorphan, Pseudoephedrine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Dextromethorphan, Pseudoephedrine

Dextromethorphan, Pseudoephedrine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Shiitake Mushroom interacts with.

Theoretically, shiitake mushroom might decrease levels of drugs metabolized by CYP2D6.
In vitro studies suggest that the shiitake mushroom extract AHCC might induce the CYP2D6 enzyme. This effect 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

Here's the gist for your Sudafed Cold/Flu, which combines dextromethorphan (the cough suppressant) and pseudoephedrine (the decongestant). The dextromethorphan part is handled by a liver enzyme called CYP2D6. Lab studies hint that a concentrated shiitake extract (AHCC) might speed that enzyme up, which could clear dextromethorphan a little faster and make it work slightly less well for calming a cough. The pseudoephedrine side isn't really affected.

Honestly, this is very theoretical. It's only been seen in test-tube studies, never in actual people, and simply eating shiitake as food in a meal is not a concern. If you take concentrated shiitake capsules regularly, just mention it to your pharmacist so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mach, C. M., Fugii, H., Wakame, K., and Smith, J. Evaluation of active hexose correlated compound hepatic metabolism and potential for drug interactions with chemotherapy agents. J Soc Integr.Oncol. 2008;6(3):105-109.
  2. Smith, J. A., Hunter, R. J., Fujii, H., Wakame, K., and Wolf, J. Defining Synergistic Activity ofthe Combination of Active Hexose Correlated Compound (AHCC) with Liposomal Doxorubicin (Doxil). Presented at the 18th International Congress on Nutrition and

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

Shiitake Mushroom Also Interacts With Other Medications

Shiitake Mushroom has 311 moderate known drug interactions in our database — the Dextromethorphan, Pseudoephedrine one above is one of them. If you take anything else, check it against the full list below.

Moderate 311 No known interaction 2,519 (incl. Dextromethorphan, Pseudoephedrine)
Taking anything else?

Check Another of Your Medications Against Shiitake Mushroom

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

Everything else you take

See Every Supplement That Interacts With Dextromethorphan, Pseudoephedrine

This page covers Shiitake Mushroom only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dextromethorphan, Pseudoephedrine page lists 198 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 8 major · 149 moderate · 41 minor.

Open the Dextromethorphan, Pseudoephedrine interaction page

One more smart check

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

We hold 1,613 real supplement products containing Shiitake Mushroom, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Shiitake Mushroom. Your product may carry other ingredients that interact with Dextromethorphan, Pseudoephedrine too, on top of Shiitake Mushroom — 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 Shiitake Mushroom and Dextromethorphan, Pseudoephedrine 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 Shiitake Mushroom
Top 25%

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

29 days ago today
Medication Dextromethorphan, Pseudoephedrine
Steady interest

#2,691 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 Shiitake Mushroom

What is Shiitake Mushroom?

  • Immune support
  • General wellness and nutrition
  • Cholesterol and heart health
  • Adjunct in cancer care (lentinan, AHCC)
  • Antioxidant support

Shiitake is a popular edible mushroom that is nutritious and safe to eat as food for most people. Some of its extracts (like lentinan and AHCC) have been studied as immune support, mainly alongside cancer treatment, but evidence for most supplement uses is limited. Talk with your pharmacist or doctor before using concentrated shiitake supplements.

Read the full Shiitake Mushroom monograph & all interactions
Keep checking

Other Drugs & Shiitake Mushroom

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

0Major
311Moderate
0Minor
2,518No known interaction
311 Moderate 2,518 No interaction
Moderate

311 interactions

Showing 60 of 311 moderate interactions — see all 311 on the Shiitake Mushroom page.

No interaction 2,518 drugs checked — show the list

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

Showing the 60 most looked-up of 2,518 medications checked with no known interaction — see the full Shiitake Mushroom list.

See the full Shiitake Mushroom interactions page
See every supplement checked against Dextromethorphan, Pseudoephedrine, ranked by severity
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
Shiitake Mushroom monograph › Uses, safety, and every drug interaction in one place Dextromethorphan, Pseudoephedrine supplement interactions › Every supplement checked against Dextromethorphan, Pseudoephedrine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Shiitake Mushroom and Dextromethorphan, Pseudoephedrine Together: Common Questions

Can you take Shiitake Mushroom with Dextromethorphan, Pseudoephedrine?
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.
How serious is the Shiitake Mushroom and Dextromethorphan, Pseudoephedrine 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 Dextromethorphan, Pseudoephedrine and Shiitake Mushroom?

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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.