Drug & supplement interaction

Tree Turmeric + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine

Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine brand name: Conar-A.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine falls into 3 drug categories that Tree Turmeric can interact with; the most serious is rated moderate. Theoretically, tree turmeric might increase the levels and clinical effects of drugs metabolized by CYP2D6.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Tree Turmeric and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Tree Turmeric interacts with whole categories of medication. Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine falls into 3 of those categories, so it can interact with Tree Turmeric in 3 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 3

Why this applies to Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine

Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Tree Turmeric interacts with.

Theoretically, tree turmeric might increase the levels and clinical effects of drugs metabolized by CYP2D6.
In vitro research and preliminary clinical evidence suggest that berberine, a constituent of tree turmeric, can inhibit CYP2D6.
Severity Moderate Likelihood Possible Evidence B

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

This is one of those combo cold-and-cough products, and only one piece of it really matters here: the dextromethorphan (the cough suppressant). Dextromethorphan is cleared by a liver enzyme called CYP2D6. The berberine in tree turmeric can gently slow that enzyme down, so in theory the dextromethorphan could hang around longer and build up a bit. That might mean more of its usual effects, like drowsiness, dizziness, or feeling foggy. The acetaminophen, guaifenesin, and phenylephrine aren't really driven by CYP2D6, so they're not the concern.

Keep in mind this is mostly theoretical, based on lab work and some early human data, so it's not a strong, well-proven interaction. For a short cold course it's usually minor, but if you take berberine regularly, it's worth a quick chat with your pharmacist or doctor.

References
  1. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
  2. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  3. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, tree turmeric might increase the levels and clinical effects of drugs that are substrates of CYP3A4.
In vitro research and preliminary clinical evidence suggest that berberine, a constituent of tree turmeric, moderately inhibits CYP3A4.
Severity Moderate Likelihood Probable Evidence A

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This is a combination cold and cough product, and the piece that matters here is the dextromethorphan (the cough suppressant). Berberine, the active compound in tree turmeric, can mildly slow down CYP3A4, one of the liver enzymes that helps break down dextromethorphan. If that clearing slows, a bit more dextromethorphan can hang around, which may mean more drowsiness, dizziness, or a foggy, lightheaded feeling.

The acetaminophen, guaifenesin, and phenylephrine aren't strongly affected through this pathway. Honestly, for occasional cold-and-cough use this is usually a minor concern, and the evidence is mostly theoretical and lab-based. Still, if you take tree turmeric regularly or feel unusually sleepy, check with your pharmacist or doctor before combining them.

References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  4. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
Moderate

DEXTROMETHORPHAN (Robitussin DM, others)

3 of 3
Theoretically, tree turmeric might increase levels of dextromethorphan and potentially increase the risk of adverse effects including drowsiness, confusion, and irritability.
Preliminary clinical research suggests that berberine, a constituent of tree turmeric, can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan.
Severity Moderate Likelihood Possible Evidence B

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 piece to watch in your Conar-A combo: the dextromethorphan (the cough suppressant). Your body clears it using a liver enzyme called CYP2D6, and the berberine in tree turmeric can slow that enzyme down. When the cleanup slows, dextromethorphan can build up a bit more than usual, which may make side effects like drowsiness, dizziness, confusion, or feeling irritable or jittery more noticeable.

This is mostly theoretical and based on early, lower-quality research, so it's not a guaranteed problem, especially with a cold remedy you take for just a few days. The acetaminophen, guaifenesin, and phenylephrine pieces aren't the concern here. Still, if you plan to use a concentrated berberine supplement alongside this, check with your pharmacist or doctor first.

References
  1. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. 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

Tree Turmeric Also Interacts With Other Medications

Tree Turmeric has 2 major, 1,157 moderate known drug interactions in our database — the Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine 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 Tree Turmeric

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine

This page covers Tree Turmeric only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine page lists 261 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: 12 major · 206 moderate · 43 minor.

From our pharmacist’s overview on the Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine page

“Picture the week someone takes Conar-A (acetaminophen, dextromethorphan, guaifenesin, phenylephrine): a miserable cold, coffee to push through, maybe wine at night or an herbal remedy on top. Those habits are exactly where this list turns serious.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interaction page

One more smart check

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

We hold 51 real supplement products containing Tree Turmeric, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tree Turmeric. Your product may carry other ingredients that interact with Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine too, on top of Tree Turmeric — 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 Tree Turmeric and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine 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 Tree Turmeric
Top half

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

29 days ago today
Medication Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine
Top 10%

#262 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 Tree Turmeric

What is Tree Turmeric?

  • Blood sugar support
  • High cholesterol
  • Digestive complaints
  • Skin and eye conditions
  • Antimicrobial uses
  • Liver support

Tree turmeric (Berberis aristata) is a shrub used in traditional Indian (Ayurvedic) medicine, valued mainly for its berberine content. Early research suggests possible benefits for blood sugar and cholesterol, but high-quality human evidence is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Tree Turmeric monograph & all interactions
Keep checking

Other Drugs & Tree Turmeric

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

2Major
1,157Moderate
0Minor
1,670No known interaction
Major

2 interactions

Moderate

1,157 interactions

Showing 60 of 1,157 moderate interactions — see all 1,157 on the Tree Turmeric page.

No interaction 1,670 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 Tree Turmeric and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine Together: Common Questions

Can you take Tree Turmeric with Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine?
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 3 interactions listed for Tree Turmeric and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine?
Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine belongs to more than one drug category, and Tree Turmeric 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 Tree Turmeric and Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine 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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