Drug & supplement interaction

Turmeric + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium

Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium brand name: Hista-Derfule.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium falls into 3 drug categories that Turmeric can interact with; the most serious is rated moderate. Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Turmeric and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium

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

Why Are There 3 Interactions?

Turmeric interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium falls into 3 of those categories, so it can interact with Turmeric in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

HEPATOTOXIC DRUGS

1 of 3

Why this applies to Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium

Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium falls under HEPATOTOXIC DRUGS — the group Turmeric interacts with.

Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
There is concern that turmeric might cause hepatotoxicity, especially when highly bioavailable formulations are used in high doses.
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

This combination product contains acetaminophen, which is the piece that matters here. Acetaminophen is processed by your liver, and in high doses or with heavy alcohol use it can stress the liver. Turmeric is mostly gentle, but there have been a handful of reports linking concentrated, high-dose turmeric supplements (especially the highly absorbable formulas) to liver irritation.

So the worry is simply about two things that lean on your liver at the same time. I want to be honest: this is theoretical and based on scattered case reports, not strong proof. The turmeric in your food won't be an issue. If you take turmeric capsules regularly and use this medicine often, just check with your pharmacist or doctor first, and watch for yellowing skin, dark urine, or belly pain.

References
  1. Lombardi N, Crescioli G, Maggini V, et al. Acute liver injury following turmeric use in Tuscany: an analysis of the Italian Phytovigilance database and systematic review of case reports. Br J Clin Pharmacol. 2020. PubMed
  2. Sohal A, Alhankawi D, Sandhu S, Chintanaboina J. Turmeric-induced hepatotoxicity: Report of 2 cases. Int Med Case Rep J 2021;14:849-852. PubMed
  3. 109288 Halegoua-DeMarzio D, Navarro V, Ahmad J, et al. Liver injury associated with turmeric-A growing problem: Ten cases from the drug-induced liver injury network [DILIN]. Am J Med. 2022:S0002-9343(22)00740-9. PubMed
  4. Arzallus T, Izagirre A, Castiella A, Torrente S, Garmendia M, Zapata EM. Drug induced autoimmune hepatitis after turmeric intake. Gastroenterol Hepatol 2023. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
In vitro and animal research show that turmeric and its constituents curcumin and curcuminoids inhibit CYP3A4. Also, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking turmeric and cancer medications that are CYP3A4 substrates, including everolimus, ruxolitinib, ibrutinib, and palbociclib, and bortezomib. In another case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels after consuming turmeric powder at a dose of 15 or more spoonfuls daily for ten days prior. It was thought that turmeric increased levels of tacrolimus due to CYP3A4 inhibition.
Conversely, other in vitro research suggests that turmeric induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. An animal model suggests that induction of CYP3A4 occurs after daily curcumin use for 1 week. However, the induction of CYP3A4 by turmeric 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

This combination product blends a few medicines, and the opium (an opioid) and chlorpheniramine (a sedating antihistamine) are the ones partly handled by a liver enzyme called CYP3A4. The concern with turmeric is that, in lab and animal studies, its curcumin can block that enzyme. If it slows the breakdown of these ingredients, levels could creep up, which might mean extra drowsiness, dizziness, constipation, slowed breathing from the opioid, or a dry mouth from the antihistamine.

Here's the honest part: this is mostly test-tube and animal evidence, and turmeric you sprinkle on food is very unlikely to cause trouble. Concentrated curcumin capsules taken daily are a different story. If you're using those, run it by your pharmacist or doctor before mixing the two.

References
  1. Appiah-Opong, R., Commandeur, J. N., Vugt-Lussenburg, B., and Vermeulen, N. P. Inhibition of human recombinant cytochrome P450s by curcumin and curcumin decomposition products. Toxicology 6-3-2007;235(1-2):83-91. PubMed
  2. Hou, X. L., Takahashi, K., Kinoshita, N., Qiu, F., Tanaka, K., Komatsu, K., Takahashi, K., and Azuma, J. Possible inhibitory mechanism of Curcuma drugs on CYP3A4 in 1alpha,25 dihydroxyvitamin D3 treated Caco-2 cells. Int.J Pharm 6-7-2007;337(1-2):169-177.
  3. Valentine, S. P., Le Nedelec, M. J., Menzies, A. R., Scandlyn, M. J., Goodin, M. G., and Rosengren, R. J. Curcumin modulates drug metabolizing enzymes in the female Swiss Webster mouse. Life Sci. 4-11-2006;78(20):2391-2398. PubMed
  4. Nayeri A, Wu S, Adams E, et al. Acute Calcineurin Inhibitor Nephrotoxicity Secondary to Turmeric Intake: A Case Report. Transplant Proc. 2017;49(1):198-200. PubMed
  5. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  6. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
  7. Dibaei M, Hosseini A, Lavasani H, Kiani-Dehkordi B, Rouini M. Assessment of metabolic interaction between curcumin and tramadol using the isolated perfused rat liver. Heliyon 2024;10(15):e35070. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

3 of 3

Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2. However, research is conflicting.
In vitro and animal research show that the turmeric constituent, curcumin, inhibits CYP1A2. However, other in vitro research suggests that curcumin does not significantly affect CYP1A2.
Severity Minor 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

This combo product (a cold and cough mix with acetaminophen, the antihistamine chlorpheniramine, a decongestant, and a small amount of opium) contains a couple of ingredients that the liver enzyme CYP1A2 helps break down. In lab and animal studies, the curcumin in turmeric may slow that enzyme a little, which could let levels of these ingredients run higher than usual.

Honestly though, the evidence here is weak and mixed, so I wouldn't lose sleep over it. The sprinkle of turmeric on your dinner is a non-issue. If higher levels did happen, you might notice more drowsiness, dry mouth, or constipation. If you take concentrated turmeric capsules along with this medicine, just run it by your pharmacist or doctor first.

References
  1. Thapliyal R, Deshpande SS, Maru GB. Mechanism(s) of turmeric-mediated protective effects against benzo(a)pyrene-derived DNA adducts. Cancer Lett 2002;175:79-88. PubMed
  2. Appiah-Opong, R., Commandeur, J. N., Vugt-Lussenburg, B., and Vermeulen, N. P. Inhibition of human recombinant cytochrome P450s by curcumin and curcumin decomposition products. Toxicology 6-3-2007;235(1-2):83-91. PubMed
  3. Price, R. J., Scott, M. P., Giddings, A. M., Walters, D. G., Stierum, R. H., Meredith, C., and Lake, B. G. Effect of butylated hydroxytoluene, curcumin, propyl gallate and thiabendazole on cytochrome P450 forms in cultured human hepatocytes. Xenobiotica 2 PubMed
  4. Oetari, S., Sudibyo, M., Commandeur, J. N., Samhoedi, R., and Vermeulen, N. P. Effects of curcumin on cytochrome P450 and glutathione S-transferase activities in rat liver. Biochem Pharmacol 1-12-1996;51(1):39-45. 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

Turmeric Also Interacts With Other Medications

Turmeric has 1,057 moderate, 76 minor known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium 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 Turmeric

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

From our Q&A

Questions About Turmeric or Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Turmeric or Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium, 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 Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium

This page covers Turmeric only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium page lists 332 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 Ephedra (major).

By severity: 18 major · 267 moderate · 47 minor.

From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium page

“Hista-Derfule is really four medicines at once: acetaminophen, the antihistamine chlorpheniramine, the decongestant phenylpropanolamine, and opium. That mix is why I read its 332 supplement interactions with genuine care, starting with the 18 rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interaction page

One more smart check

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

We hold 1,368 real supplement products containing Turmeric, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Turmeric. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium too, on top of 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 Turmeric and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium 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 Turmeric
Top 5%

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

29 days ago today
Medication Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium
Top 5%

#33 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 Turmeric

What is Turmeric?

Turmeric
  • Joint pain and arthritis
  • Inflammation
  • Digestive upset
  • Antioxidant support
  • Skin conditions

Turmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising, but quality is mixed and curcumin is poorly absorbed on its own. For most people, dietary amounts are safe, but talk to your pharmacist or doctor before taking concentrated supplements, especially if you are pregnant, nursing, or have a medical condition.

Read the full Turmeric monograph & all interactions
Keep checking

Other Drugs & Turmeric

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

0Major
1,057Moderate
76Minor
1,696No known interaction
Moderate

1,057 interactions

Showing 60 of 1,057 moderate interactions — see all 1,057 on the Turmeric page.

Minor

76 interactions

Showing 60 of 76 minor interactions — see all 76 on the Turmeric page.

No interaction 1,696 drugs checked — show the list

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

Showing the 60 most looked-up of 1,696 medications checked with no known interaction — see the full Turmeric 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

Keep exploring
Pharmacist Counseling Corner

Taking Turmeric and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium Together: Common Questions

Can you take Turmeric with Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium?
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 Turmeric and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium?
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium belongs to more than one drug category, and 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 Turmeric and Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium 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, Chlorpheniramine, Phenylpropanolamine, Opium and Turmeric?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.