Drug & supplement interaction

Terminalia + Chlorzoxazone

Chlorzoxazone brand names: Parafon Forte DSC, Paraflex.

Moderate Interaction
Medically reviewed by · Updated July 2023
The bottom line Moderate

Terminalia has a moderate interaction with Chlorzoxazone. Theoretically, use of Terminalia chebula may increase the risk of adverse effects from chlorzoxazone.

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

Terminalia and Chlorzoxazone

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

Moderate

CHLORZOXAZONE (Parafon Forte, Paraflex)

Theoretically, use of Terminalia chebula may increase the risk of adverse effects from chlorzoxazone.
Animal research shows that enteral administration of Terminalia chebula for 15 days prior to administration of chlorzoxazone increases blood levels of chlorzoxazone and decreases chlorzoxazone clearance. It is speculated that Terminalia chebula reduces the metabolism of chlorzoxazone by inhibiting cytochrome P450 2E1.
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: your body clears chlorzoxazone, a muscle relaxer, using a liver enzyme called CYP2E1. Animal research suggests that a type of Terminalia (Terminalia chebula) may slow that enzyme down. If clearance drops, more of the drug can linger in your bloodstream than usual. That could mean stronger or longer-lasting effects, like extra drowsiness, dizziness, lightheadedness, or an upset stomach.

I want to be honest with you, though: this is based only on lab and animal studies, not on people, so it's more of a theoretical concern than a proven problem. Everyday food amounts likely aren't an issue, but concentrated supplements are harder to predict. Before pairing the two, it's worth a quick chat with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.

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

Terminalia Also Interacts With Other Medications

Terminalia has 932 moderate known drug interactions in our database — the Chlorzoxazone one above is one of them. If you take anything else, check it against the full list below.

Moderate 932 No known interaction 1,898 (incl. Chlorzoxazone)
Taking anything else?

Check Another of Your Medications Against Terminalia

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

From our Q&A

Questions About Terminalia or Chlorzoxazone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Terminalia or Chlorzoxazone, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Chlorzoxazone

This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Chlorzoxazone page lists 26 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Procaine (major), Coffee Charcoal (moderate), Diosmin (moderate) and European Mandrake (moderate).

By severity: 2 major · 15 moderate · 9 minor.

From our pharmacist’s overview on the Chlorzoxazone page

“Chlorzoxazone (Parafon Forte DSC, Paraflex) is a muscle relaxant for painful spasms, and its supplement list is one I want readers genuinely careful with. Twenty-six ingredients are on file, two rated major, led by activated charcoal, which can soak up the drug in the gut and cut what your body actually receives.”

Reviewed by 2 · Jul 18, 2026

Open the Chlorzoxazone interaction page

One more smart check

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

We hold 306 real supplement products containing Terminalia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Terminalia. Your product may carry other ingredients that interact with Chlorzoxazone too, on top of Terminalia — 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 Terminalia and Chlorzoxazone 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 Terminalia
Top 25%

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

29 days ago today
Medication Chlorzoxazone
Top half

#1,212 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 Terminalia

What is Terminalia?

Terminalia
  • Heart health and circulation
  • Digestive problems (constipation, diarrhea)
  • Cholesterol support
  • Antioxidant and anti-inflammatory support
  • Immune support

Terminalia is a group of traditional Ayurvedic tree species (most notably Terminalia arjuna) used for heart, digestive, and general wellness purposes. Some small studies suggest possible benefits for heart and cholesterol health, but the evidence is limited and not strong enough to recommend it as a treatment. Talk to your pharmacist or doctor before using it, especially if you have a heart condition.

Read the full Terminalia monograph & all interactions
Medication

About Chlorzoxazone

What Is Chlorzoxazone Used For?

Brand names: Parafon Forte DSC, Paraflex

Chlorzoxazone tablets are used to relieve discomfort caused by acute, painful musculoskeletal conditions — things like muscle spasms and the pain that comes with them. It is meant to be used alongside rest, physical therapy, and other treatments, not as a stand-alone cure.

It is not intended for long-term muscle problems; it's most useful during a short-term flare of muscle pain and stiffness.

See full Chlorzoxazone drug information
Keep checking

Other Drugs & Terminalia

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

0Major
932Moderate
0Minor
1,897No known interaction
932 Moderate 1,897 No interaction
Moderate

932 interactions

Showing 60 of 932 moderate interactions — see all 932 on the Terminalia page.

No interaction 1,897 drugs checked — show the list

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

Showing the 60 most looked-up of 1,897 medications checked with no known interaction — see the full Terminalia list.

See the full Terminalia interactions page
See every supplement checked against Chlorzoxazone, 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
Terminalia monograph › Uses, safety, and every drug interaction in one place Chlorzoxazone supplement interactions › Every supplement checked against Chlorzoxazone, ranked by severity Chlorzoxazone drug information › The full plain-English guide to this medication 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 Terminalia and Chlorzoxazone Together: Common Questions

Can you take Terminalia with Chlorzoxazone?
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 Terminalia and Chlorzoxazone 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 Chlorzoxazone and Terminalia?

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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.