Terminalia + Hydrocodone, Ibuprofen
Hydrocodone, Ibuprofen brand name: Vicoprofen.
Hydrocodone, Ibuprofen falls into 4 drug categories that Terminalia can interact with; the most serious is rated moderate. Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2D6 substrates.
Read the full interaction reportTerminalia and Hydrocodone, Ibuprofen
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Terminalia interacts with whole categories of medication. Hydrocodone, Ibuprofen falls into 4 of those categories, so it can interact with Terminalia 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 Hydrocodone, Ibuprofen
Hydrocodone, Ibuprofen falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Terminalia interacts with.
In vitro research shows that Terminalia arjuna extract inhibits CYP2D6 enzymes and reduces CYP2D6 substrate metabolism.
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 Vicoprofen, which is hydrocodone paired with ibuprofen. The hydrocodone part is actually a prodrug that your liver enzyme CYP2D6 turns into hydromorphone, the form that does much of the pain relieving. Lab studies (test tube, not people) hint that Terminalia arjuna may slow that same CYP2D6 enzyme.
If that effect held true in the body, it could mean a bit less of the active painkiller being made, so your pain relief might feel weaker. The flip side is that more unchanged hydrocodone could linger, which is hard to predict. Honestly, this is theoretical and based only on lab work, so I wouldn't panic. Just mention the supplement to your pharmacist or doctor before combining them.
- Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. PubMed
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
2 of 4Hydrocodone, Ibuprofen also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
In vitro research shows that Terminalia arjuna extract inhibits CYP2C9 enzymes and reduces CYP2C9 substrate metabolism.
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.
Vicoprofen combines hydrocodone (an opioid) with ibuprofen (an anti-inflammatory). The ibuprofen half is partly broken down by a liver enzyme called CYP2C9. In lab dish studies only, Terminalia arjuna seems to slow that enzyme down. In theory, that could let ibuprofen build up a bit more than usual, which might nudge up its typical side effects like stomach upset, heartburn, or, with heavier or longer use, stomach irritation or kidney strain.
Here is the honest part: this is based on test-tube research, not real people, so the effect may be small or may not show up at all. Food amounts are different from concentrated capsules. Still, before pairing them, it is worth a quick chat with your pharmacist or doctor, especially if you have heart, stomach, or kidney concerns.
- Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Hydrocodone, Ibuprofen also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that Terminalia arjuna extract inhibits CYP3A4 enzymes and reduces CYP3A4 substrate metabolism.
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 gist with Vicoprofen, which pairs hydrocodone with ibuprofen. The hydrocodone part is handled in your liver partly by an enzyme called CYP3A4. Lab studies (in a test tube, not in people) suggest Terminalia arjuna may slow that enzyme down. In theory, that could let hydrocodone build up a bit more than usual, which might mean stronger effects like extra drowsiness, dizziness, nausea, constipation, or slowed breathing.
I want to be honest that this is only theoretical right now, based on early lab work, so I wouldn't lose sleep over it. Still, since both opioids and Terminalia can affect the heart, it's worth a quick chat with your pharmacist or doctor before combining them. Don't change your medication on your own.
- Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. PubMed
ANTICOAGULANT/ANTIPLATELET DRUGS
4 of 4Hydrocodone, Ibuprofen also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.
In vitro, Terminalia arjuna bark extract inhibits platelet aggregation, decreases platelet activation, and shows antithrombotic properties.
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 to know about Vicoprofen: it's a combo of hydrocodone (an opioid) and ibuprofen, which is an NSAID. The ibuprofen part is what matters here. Ibuprofen on its own can irritate the stomach lining and make it easier to bleed, especially in the gut.
Terminalia (arjuna) has shown, mostly in lab and test-tube studies, that it may make platelets a little less sticky, which can add to bleeding risk. Put those two together and you could theoretically be a bit more prone to bruising, nosebleeds, or stomach bleeding (think black or tarry stools, or stomach pain). This is theoretical and based on weak evidence, so don't panic. Still, it's worth running by your pharmacist or doctor before combining them, particularly if you already take other blood thinners.
- Malik N, Dhawan V, Bahl A, Kaul D. Inihbitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease. Platelets. 2009;20(3):183-1190.
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.
Terminalia Also Interacts With Other Medications
Terminalia has 932 moderate known drug interactions in our database — the Hydrocodone, Ibuprofen one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Terminalia
We haven’t checked that one against Terminalia yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Terminalia. Pick one to open its full report.
See Every Supplement That Interacts With Hydrocodone, Ibuprofen
This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrocodone, Ibuprofen page lists 379 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 Danshen (major).
By severity: 13 major · 324 moderate · 42 minor.
From our pharmacist’s overview on the Hydrocodone, Ibuprofen page
“Vicoprofen pairs hydrocodone, an opioid, with ibuprofen, an NSAID, which gives supplements two separate ways to cause trouble, and 13 of the 379 interactions on file are rated major, so this page deserves a careful read rather than a skim. The biggest patterns are bleeding and sedation: more than 200 of these ingredients can add to ibu…”
Reviewed by 2 · Jul 18, 2026
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 Hydrocodone, Ibuprofen 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:
Where Terminalia and Hydrocodone, Ibuprofen 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.
#319 of 1,452 supplements looked up here in the last 7 days
#1,981 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 Terminalia
What is 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.
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.
No drugs match “”.
932 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ketoprofen ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Meloxicam ›
- Nortriptyline ›
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.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Acetaminophen ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Bupropion ›
- Amoxicillin ›
- Acyclovir ›
- Lisinopril ›
- Bendamustine ›
- Doxycycline ›
- Methotrexate ›
- Lamotrigine ›
- Gabapentin ›
- Pregabalin ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Levetiracetam ›
- Spironolactone ›
- Factor 7a ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Minoxidil ›
- Mitomycin ›
- Levodopa ›
- Ezetimibe ›
- Phentermine, Topiramate ›
- Cefaclor ›
- Lenvatinib ›
- Phenylephrine ›
- Vancomycin ›
- Hethylphenidate Hcl ›
- Dirithromycin ›
- Bentoquatam ›
- Pentobarbitone ›
- Amoxicillin, Clavulanate Potassium ›
- Procainamide ›
- Hydroxychloroquine ›
- Digoxin ›
- Azelaic Acid ›
- Triptorelin ›
Showing the 60 most looked-up of 1,897 medications checked with no known interaction — see the full Terminalia 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
Hydrocodone, Ibuprofen Is Linked to Lower Levels of One Nutrient
Natural Medicines records Hydrocodone, Ibuprofen as a medicine that can lower these. This is not an interaction with Terminalia — 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 Hydrocodone, Ibuprofen 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 Terminalia and Hydrocodone, Ibuprofen Together: Common Questions
Can you take Terminalia with Hydrocodone, Ibuprofen?
Why are there 4 interactions listed for Terminalia and Hydrocodone, Ibuprofen?
How serious is the Terminalia and Hydrocodone, Ibuprofen interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Hydrocodone, Ibuprofen 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.