Drug & supplement interaction

Spearmint + Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen brand name: Apadaz.

Moderate Interaction
The bottom line Moderate

Benzhydrocodone, Acetaminophen falls into 2 drug categories that Spearmint can interact with; the most serious is rated moderate. Theoretically, spearmint might alter the sedative effects of CNS depressants.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Spearmint and Benzhydrocodone, Acetaminophen

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Spearmint interacts with whole categories of medication. Benzhydrocodone, Acetaminophen falls into 2 of those categories, so it can interact with Spearmint in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 2

Why this applies to Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen falls under CNS DEPRESSANTS — the group Spearmint interacts with.

Theoretically, spearmint might alter the sedative effects of CNS depressants.
Animal research suggests that (-)-carvone, a major constituent of spearmint, has sedative effects. However, in humans, chewing spearmint-flavored gum induced arousal effects.
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 honest picture: this concern is mostly theoretical. Apadaz (benzhydrocodone with acetaminophen) is a strong opioid pain reliever that can already make you drowsy, slow your breathing, and leave you feeling foggy or unsteady. Spearmint contains a compound called carvone that calmed animals in lab studies, so the worry is that it could add to that sleepy, sedating effect. Interestingly, in people, chewing spearmint gum actually seemed to perk them up, so the science points in opposite directions.

Bottom line, a cup of spearmint tea or a little flavoring is very unlikely to matter here. Concentrated spearmint supplements are less studied, so I'd run those by your pharmacist or doctor first, and watch for extra drowsiness if you do combine them.

References
  1. de Sousa, D. P., Farias Nobrega, F. F., and de Almeida, R. N. Influence of the chirality of (R)-(-)- and (S)-(+)-carvone in the central nervous system: a comparative study. Chirality 5-5-2007;19(4):264-268.
  2. Masumoto, Y., Morinushi, T., Kawasaki, H., Ogura, T., and Takigawa, M. Effects of three principal constituents in chewing gum on electroencephalographic activity. Psychiatry Clin.Neurosci. 1999;53(1):17-23. PubMed
  3. Goncalves, J. C., Oliveira, Fde S., Benedito, R. B., de Sousa, D. P., de Almeida, R. N., and de Araujo, D. A. Antinociceptive activity of (-)-carvone: evidence of association with decreased peripheral nerve excitability. Biol Pharm Bull. 2008;31(5):1017- PubMed
Moderate

HEPATOTOXIC DRUGS

2 of 2

Benzhydrocodone, Acetaminophen also falls under HEPATOTOXIC DRUGS.

Theoretically, high doses of spearmint might increase the risk of liver damage when taken with hepatotoxic drugs.
Animal research suggests that drinking spearmint tea for 30 days can increase markers of liver damage, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and cause liver degeneration and necrosis, in a dose-dependent manner. 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 connection to know about with Apadaz (benzhydrocodone and acetaminophen). The acetaminophen part of this combo is processed by your liver, and at high doses it's one of the more common causes of liver strain. The thinking is that concentrated spearmint supplements, taken in large amounts, might add a little extra stress to the liver too, so stacking them could theoretically nudge your risk up.

I want to be honest about how soft this evidence is. It comes from animal studies using heavy spearmint doses, and nothing like this has been seen in people. A cup of spearmint tea or mint in your food is not the concern. The bigger thing with Apadaz is never going over the daily acetaminophen limit and avoiding alcohol. If you're using spearmint capsules regularly, just mention it to your pharmacist or doctor.

References
  1. Akdogan M, Ozguner M, Aydin G, Gokalp O. Investigation of biochemical and histopathological effects of Mentha piperita Labiatae and Mentha spicata Labiatae on liver tissue in rats. Hum Exp Toxicol 2004;23:21-8.

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

Spearmint Also Interacts With Other Medications

Spearmint has 578 moderate known drug interactions in our database — the Benzhydrocodone, Acetaminophen 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 Spearmint

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

Everything else you take

See Every Supplement That Interacts With Benzhydrocodone, Acetaminophen

This page covers Spearmint only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Benzhydrocodone, Acetaminophen page lists 299 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: 14 major · 239 moderate · 46 minor.

Open the Benzhydrocodone, Acetaminophen interaction page

One more smart check

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

We hold 408 real supplement products containing Spearmint, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Spearmint. Your product may carry other ingredients that interact with Benzhydrocodone, Acetaminophen too, on top of Spearmint — 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 Spearmint and Benzhydrocodone, 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.

Supplement Spearmint
Top 25%

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

29 days ago today
Medication Benzhydrocodone, Acetaminophen
Steady interest

#2,186 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 Spearmint

What is Spearmint?

Spearmint
  • Digestive upset and indigestion
  • Nausea
  • Hormonal acne and unwanted hair (PCOS-related)
  • Memory and focus
  • Mild stress and anxiety
  • Joint discomfort

Spearmint is a common culinary mint that is generally safe in food and tea amounts. Early research suggests possible benefits for digestion, mild hormone-related issues (such as excess facial hair in women), and memory, but the evidence is still limited. Talk to your pharmacist or doctor before using concentrated supplements, especially if you are pregnant or have a health condition.

Read the full Spearmint monograph & all interactions
Medication

About Benzhydrocodone and Acetaminophen

What Is Benzhydrocodone and Acetaminophen Used For?

Brand name: Apadaz

Apadaz is indicated for the short-term management of acute pain — up to 14 days — that is severe enough to require an opioid and for which non-opioid treatments have not worked or are not expected to work. It combines benzhydrocodone (a prodrug that converts to the opioid hydrocodone) with acetaminophen.

Because of serious risks including addiction, abuse, and misuse, Apadaz is reserved for patients who have not tolerated or have not gotten adequate relief from alternative pain treatments. It should not be used for an extended period of time unless the pain remains severe enough to require an opioid and alternatives remain inadequate.

See full Benzhydrocodone and Acetaminophen drug information
Keep checking

Other Drugs & Spearmint

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

0Major
578Moderate
0Minor
2,251No known interaction
Moderate

578 interactions

Showing 60 of 578 moderate interactions — see all 578 on the Spearmint page.

No interaction 2,251 drugs checked — show the 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

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Pharmacist Counseling Corner

Taking Spearmint and Benzhydrocodone, Acetaminophen Together: Common Questions

Can you take Spearmint with Benzhydrocodone, Acetaminophen?
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 2 interactions listed for Spearmint and Benzhydrocodone, Acetaminophen?
Benzhydrocodone, Acetaminophen belongs to more than one drug category, and Spearmint 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 Spearmint and Benzhydrocodone, Acetaminophen 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

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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.