Drug & supplement interaction

Turpentine Oil + Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen brand name: Apadaz.

Minor Interaction
The bottom line Minor

Turpentine Oil has a minor interaction with Benzhydrocodone, Acetaminophen. There is some concern that turpentine oil can inhibit CYP1A2 enzyme activity by up to 90% via induction of inflammation and subsequent downregulation of CYP activity.

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

Turpentine Oil and Benzhydrocodone, Acetaminophen

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

Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Benzhydrocodone, Acetaminophen

Benzhydrocodone, Acetaminophen falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Turpentine Oil interacts with.

There is some concern that turpentine oil can inhibit CYP1A2 enzyme activity by up to 90% via induction of inflammation and subsequent downregulation of CYP activity. However, animal research suggests that turpentine oil does not affect the metabolism of phenacetin, a CYP1A2 substrate, despite inducing inflammation.
Some medications metabolized by CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, tizanidine (Zanaflex), zileuton (Zyflo), zolmitriptan (Zomig), and others.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the honest scoop on mixing turpentine oil with Apadaz (benzhydrocodone and acetaminophen). The theory is that turpentine oil might slow down a liver enzyme called CYP1A2. But this particular pain medicine doesn't really lean on CYP1A2 to do its job, so the connection here is pretty loose to begin with.

On top of that, the evidence is very thin. It comes from lab and animal studies, and one of those animal studies actually showed turpentine oil didn't change how a CYP1A2 drug was processed. So I wouldn't lose sleep over this pairing. A small amount in a topical muscle rub is especially unlikely to matter. Still, opioids deserve respect, so check with your pharmacist or doctor before combining anything new.

References
  1. Prasad VG, Vivek Ch, Anand Kumar P, Ravi Kumar P, Rao GS. Turpentine oil induced inflammation decreases absorption and increases distribution of phenacetin without altering its elimination process in rats. Eur J Drug Metab Pharmacokinet 2015;40(1):23-8. 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

Turpentine Oil Also Interacts With Other Medications

Turpentine Oil has 198 moderate, 177 minor known drug interactions in our database — the Benzhydrocodone, Acetaminophen one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Turpentine Oil

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

Everything else you take

See Every Supplement That Interacts With Benzhydrocodone, Acetaminophen

This page covers Turpentine Oil 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

How much people look this up

Where Turpentine Oil 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 Turpentine Oil
Top half

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

29 days ago today
Medication Benzhydrocodone, Acetaminophen
Top 25%

#515 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 Turpentine Oil

What is Turpentine Oil?

Turpentine Oil
  • Muscle and joint aches (topical)
  • Cough and congestion (chest rubs)
  • Minor skin conditions
  • Antiseptic
  • Toothache (traditional)

Turpentine oil is a strong-smelling pine resin product used mostly in tiny amounts in topical rubs for muscle aches and congestion. It can be dangerous and even deadly if swallowed, and reliable evidence for health benefits is very limited. Never drink turpentine oil, and only use diluted, purified products on the skin with care.

Read the full Turpentine Oil 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 & Turpentine Oil

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

0Major
198Moderate
177Minor
2,454No known interaction
Moderate

198 interactions

Showing 60 of 198 moderate interactions — see all 198 on the Turpentine Oil page.

Minor

177 interactions

Showing 60 of 177 minor interactions — see all 177 on the Turpentine Oil page.

No interaction 2,454 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

Keep exploring
Pharmacist Counseling Corner

Taking Turpentine Oil and Benzhydrocodone, Acetaminophen Together: Common Questions

Can you take Turpentine Oil with Benzhydrocodone, Acetaminophen?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Turpentine Oil and Benzhydrocodone, Acetaminophen interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Benzhydrocodone, Acetaminophen and Turpentine Oil?

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.