Drug & supplement interaction

Strophanthus + Acetaminophen, Caffeine, Pyrilamine

Acetaminophen, Caffeine, Pyrilamine brand name: Midol Max Strength Menstrual.

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

Strophanthus has a moderate interaction with Acetaminophen, Caffeine, Pyrilamine. Theoretically, concomitant use of potassium-depleting diuretics and strophanthus can increase the risk of cardiac glycoside toxicity due to potassium depletion.

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

Strophanthus and Acetaminophen, Caffeine, Pyrilamine

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

Moderate

DIURETIC DRUGS

Why this applies to Acetaminophen, Caffeine, Pyrilamine

Acetaminophen, Caffeine, Pyrilamine falls under DIURETIC DRUGS — the group Strophanthus interacts with.

Theoretically, concomitant use of potassium-depleting diuretics and strophanthus can increase the risk of cardiac glycoside toxicity due to potassium depletion. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), 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

Here's the thing to understand about this one. The interaction on file is built around potassium-depleting diuretics, the water pills that flush potassium out of your body. When potassium runs low, heart compounds like the cardiac glycosides in Strophanthus become more toxic and can throw off your heart rhythm. But your Midol product (acetaminophen for pain, caffeine, and pyrilamine, an antihistamine) is not a diuretic in that sense. None of those three ingredients meaningfully drain your potassium, so the actual concern flagged here really doesn't apply to this combination.

That said, Strophanthus is genuinely powerful and not something to use casually. If you're taking it at all, please loop in your doctor or pharmacist so they can keep an eye on your heart and potassium directly.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

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

Strophanthus Also Interacts With Other Medications

Strophanthus has 3 major, 119 moderate known drug interactions in our database — the Acetaminophen, Caffeine, Pyrilamine one above is one of them. If you take anything else, check it against the full list below.

Major 3 Moderate 119 No known interaction 2,708 (incl. Acetaminophen, Caffeine, Pyrilamine)
Taking anything else?

Check Another of Your Medications Against Strophanthus

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Caffeine, Pyrilamine

This page covers Strophanthus only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Caffeine, Pyrilamine page lists 322 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: 16 major · 260 moderate · 46 minor.

Open the Acetaminophen, Caffeine, Pyrilamine interaction page

How much people look this up

Where Strophanthus and Acetaminophen, Caffeine, Pyrilamine 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 Strophanthus
Steady interest

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

29 days ago today
Medication Acetaminophen, Caffeine, Pyrilamine
Top half

#797 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 Strophanthus

What is Strophanthus?

  • Heart failure
  • Angina (chest pain)
  • Irregular heartbeat
  • Circulation support
  • Traditional African arrow poison (historical)

Strophanthus is a plant that contains powerful heart-affecting compounds called cardiac glycosides (the best known is ouabain/g-strophanthin). Because these substances can strongly affect heart rhythm and are toxic in the wrong amount, Strophanthus is not a casual supplement and should never be used without close medical supervision. Reliable modern evidence for its supplement use is limited.

Read the full Strophanthus monograph & all interactions
Keep checking

Other Drugs & Strophanthus

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

3Major
119Moderate
0Minor
2,707No known interaction
3 Major 119 Moderate 2,707 No interaction
Major

3 interactions

Moderate

119 interactions

Showing 60 of 119 moderate interactions — see all 119 on the Strophanthus page.

No interaction 2,707 drugs checked — show the list

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

Showing the 60 most looked-up of 2,707 medications checked with no known interaction — see the full Strophanthus list.

See the full Strophanthus interactions page
See every supplement checked against Acetaminophen, Caffeine, Pyrilamine, 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
Strophanthus monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Caffeine, Pyrilamine supplement interactions › Every supplement checked against Acetaminophen, Caffeine, Pyrilamine, 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 Strophanthus and Acetaminophen, Caffeine, Pyrilamine Together: Common Questions

Can you take Strophanthus with Acetaminophen, Caffeine, Pyrilamine?
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 Strophanthus and Acetaminophen, Caffeine, Pyrilamine 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, Caffeine, Pyrilamine and Strophanthus?

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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.