Drug & supplement interaction

Tinospora Cordifolia + Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen brand name: Apadaz.

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

Benzhydrocodone, Acetaminophen falls into 2 drug categories that Tinospora Cordifolia can interact with; the most serious is rated moderate. Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2D6.

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

Tinospora Cordifolia and Benzhydrocodone, Acetaminophen

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

1 of 2

Why this applies to Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Tinospora Cordifolia interacts with.

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2D6.
In vitro research shows that Tinospora cordifolia extract inhibits CYP2D6 at high concentrations. However, this interaction 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 something worth knowing about Apadaz. The benzhydrocodone part is actually a prodrug, meaning your body has to convert it into hydrocodone (and then partly into hydromorphone via the CYP2D6 enzyme) to get the full pain-relieving punch. Lab studies hint that Tinospora cordifolia (Giloy) may block CYP2D6 at high concentrations.

If that blocking happened in people, it could slow that activation step and possibly leave you with less pain relief than expected. The honest truth, though, is that this is only test-tube data and hasn't been seen in real patients, so it's largely theoretical. Since Giloy has also been tied to liver injury and acetaminophen is processed by the liver, it's smart to run this combo past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. PubMed
Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 2

Benzhydrocodone, Acetaminophen also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP1A2.
In vitro research shows that Tinospora cordifolia extract inhibits CYP1A2 at high concentrations. However, this interaction 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

Let me put this one in perspective. Giloy (Tinospora cordifolia) has been shown in lab dish studies to slow down a liver enzyme called CYP1A2, but only at high concentrations, and this has not actually been seen in people. So we are really talking about a theoretical concern here, not something proven.

For Apadaz, the practical worry is small. Benzhydrocodone is a prodrug that gets converted to hydrocodone, and that activation along with the main breakdown depends on other enzymes (mostly CYP3A4 and CYP2D6), not CYP1A2. Still, since opioids carry real risks like heavy drowsiness, slowed breathing, and constipation, and Tinospora itself has been tied to liver injury (and you are also taking acetaminophen), it is smart to check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sahu R, Ahmed T, Sangana R, Punde R, Subudhi BB. Effect of Tinospora cordifolia aqua-alcoholic extract on pharmacokinetic of glibenclamide in rat: an herb-drug interaction study. J Pharm Biomed Anal. 2018;151:310-6. doi: 10.1016/j.jpba.2018.01.010. PubMed

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

Tinospora Cordifolia Also Interacts With Other Medications

Tinospora Cordifolia has 613 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.

Moderate 613 No known interaction 2,217 (incl. Benzhydrocodone, Acetaminophen)
Taking anything else?

Check Another of Your Medications Against Tinospora Cordifolia

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

Everything else you take

See Every Supplement That Interacts With Benzhydrocodone, Acetaminophen

This page covers Tinospora Cordifolia 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 Tinospora Cordifolia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 393 real supplement products containing Tinospora Cordifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tinospora Cordifolia. Your product may carry other ingredients that interact with Benzhydrocodone, Acetaminophen too, on top of Tinospora Cordifolia — 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 Tinospora Cordifolia 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 Tinospora Cordifolia
Top 25%

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

29 days ago today
Medication Benzhydrocodone, Acetaminophen
Top 25%

#435 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 Tinospora Cordifolia

What is Tinospora Cordifolia?

  • Immune support
  • Fever
  • Blood sugar support
  • General wellness and 'rejuvenation'
  • Allergic rhinitis
  • Inflammation

Tinospora cordifolia, known as Guduchi or Giloy in Ayurvedic medicine, is a climbing plant traditionally used to support immunity and treat fevers. Early laboratory and small human studies suggest possible immune and blood sugar effects, but high-quality evidence is limited, and there have been reports of liver injury. Talk with your pharmacist or doctor before using it.

Read the full Tinospora Cordifolia 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 — specifically pain severe enough to require an opioid analgesic and for which other treatments are inadequate. It is approved for use for no more than 14 days.

Apadaz is reserved for patients who have not been able to tolerate non-opioid pain relievers, or for whom those options have not provided adequate pain relief. It should not be used long-term unless pain remains severe and alternative treatments continue to be insufficient.

See full Benzhydrocodone and Acetaminophen drug information
Keep checking

Other Drugs & Tinospora Cordifolia

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

0Major
613Moderate
0Minor
2,216No known interaction
613 Moderate 2,216 No interaction
Moderate

613 interactions

Showing 60 of 613 moderate interactions — see all 613 on the Tinospora Cordifolia page.

No interaction 2,216 drugs checked — show the list

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

Showing the 60 most looked-up of 2,216 medications checked with no known interaction — see the full Tinospora Cordifolia list.

See the full Tinospora Cordifolia interactions page
See every supplement checked against Benzhydrocodone, Acetaminophen, 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
Tinospora Cordifolia monograph › Uses, safety, and every drug interaction in one place Benzhydrocodone, Acetaminophen supplement interactions › Every supplement checked against Benzhydrocodone, Acetaminophen, ranked by severity Benzhydrocodone and Acetaminophen 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 Tinospora Cordifolia and Benzhydrocodone, Acetaminophen Together: Common Questions

Can you take Tinospora Cordifolia 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 Tinospora Cordifolia and Benzhydrocodone, Acetaminophen?
Benzhydrocodone, Acetaminophen belongs to more than one drug category, and Tinospora Cordifolia 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 Tinospora Cordifolia 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

Still Have a Question About Benzhydrocodone, Acetaminophen and Tinospora Cordifolia?

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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.