Drug & supplement interaction

Tyramine + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine

Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine brand names: Tylenol Cold Ex Strength, Children's Tylenol Cold Plus Cough.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Tyramine has a minor interaction with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine. Theoretically, taking tyramine with stimulant drugs might increase the risk of adverse cardiovascular effects.

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

Tyramine and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine

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

Minor

STIMULANT DRUGS

Why this applies to Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine

Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine falls under STIMULANT DRUGS — the group Tyramine interacts with.

Theoretically, taking tyramine with stimulant drugs might increase the risk of adverse cardiovascular effects.
Tyramine is thought to have stimulant effects.
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

The ingredient to focus on here is the pseudoephedrine in this cold combo. Pseudoephedrine is a decongestant that already nudges up your blood pressure and heart rate. Tyramine (from aged cheeses, cured meats, and fermented foods) can do a little of the same by triggering the release of norepinephrine. So in theory, stacking the two could add up to a slightly higher chance of a faster heart rate, jitteriness, or a bump in blood pressure.

That said, this is a theoretical concern based on how the two work, not strong real-world evidence, and it is rated minor. For most people eating normal amounts of food, it is unlikely to cause trouble. If you have high blood pressure or heart issues, check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Pawar RS, Grundel E. Overview of regulation of dietary supplements in the USA and issues of adulteration with phenethylamines (PEAs). Drug Test Anal 2017;9:500-517. PubMed
  2. National Institutes of Health. Dietary Supplement Label Database. http://www.dsld.nlm.nih.gov/dsld/rptQSearch.jsp?item=tyramine&db=adsld. Accessed October 23, 2019.

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

Tyramine Also Interacts With Other Medications

Tyramine has 181 major, 1 moderate, 170 minor known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine one above is one of them. If you take anything else, check it against the full list below.

Major 181 Moderate 1 Minor 170 No known interaction 2,478 (incl. Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine)
Taking anything else?

Check Another of Your Medications Against Tyramine

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

From our Q&A

Questions About Tyramine or Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine

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

This page covers Tyramine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page lists 301 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: 14 major · 242 moderate · 45 minor.

From our pharmacist’s overview on the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine page

“Because Tylenol Cold Extra Strength packs four drugs into one dose (acetaminophen, chlorpheniramine, dextromethorphan, and pseudoephedrine), its supplement list runs to 301 ingredients, and 14 carry a major rating, so I'd approach this one with real care. The biggest hazards mirror the drugs themselves.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction page

One more smart check

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

We hold 20 real supplement products containing Tyramine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tyramine. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine too, on top of Tyramine — 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 Tyramine and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine 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 Tyramine
Steady interest

#1,171 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine
Top 25%

#533 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 Tyramine

What is Tyramine?

  • Studied for effects on blood pressure
  • Discussed in relation to migraine and headache triggers
  • Of interest in food and diet science
  • Subject of research on the nervous system

Tyramine is a natural compound formed when certain proteins break down, and it is found in aged cheeses, cured meats, fermented foods, and some other items. It is not a typical health supplement and is best known for the problems it can cause—such as dangerous spikes in blood pressure—in people taking certain medications or in those who are sensitive to it. If you have been told to follow a low-tyramine diet, talk with your pharmacist or doctor before making changes.

Read the full Tyramine monograph & all interactions
Keep checking

Other Drugs & Tyramine

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

181Major
1Moderate
170Minor
2,477No known interaction
181 Major 1 Moderate 170 Minor 2,477 No interaction
Major

181 interactions

Showing 60 of 181 major interactions — see all 181 on the Tyramine page.

Moderate

1 interaction

Minor

170 interactions

Showing 60 of 170 minor interactions — see all 170 on the Tyramine page.

No interaction 2,477 drugs checked — show the list

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

Showing the 60 most looked-up of 2,477 medications checked with no known interaction — see the full Tyramine list.

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

Can you take Tyramine with Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine?
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 Tyramine and Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine 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 Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine and Tyramine?

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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.