White Pepper - Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine Interaction Details

There are multiple interactions reported between these two agents.

Interaction Details

Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine is classified as belonging to the following category: Cytochrome P450 2D6 (Cyp2D6) Substrates

In vitro evidence suggests that some constituents of white pepper inhibit cytochrome P450 2D6 (CYP2D6). Theoretically, concomitant use may affect drugs metabolized by CYP2D6.
Some drugs metabolized by CYP2D6 include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), haloperidol (Haldol), imipramine (Tofranil), metoprolol (Lopressor, Toprol XL), ondansetron (Zofran), paroxetine (Paxil), risperidone (Risperdal), tramadol (Ultram), venlafaxine (Effexor), and others.

Interaction Rating

Moderate

Likelihood of Occurrence

Possible

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

References

Subehan, Usia, T., Kadota, S., and Tezuka, Y. Mechanism-based inhibition of human liver microsomal cytochrome P450 2D6 (CYP2D6) by alkamides of Piper nigrum. Planta Med 2006;72(6):527-532.

Interaction Details

Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

In vitro evidence suggests that piperine, a constituent of white pepper, inhibits cytochrome P450 3A4 (CYP3A4). Theoretically, concomitant use with white pepper might increase the effects and side effects of drugs metabolized by CYP3A4.
Some drugs metabolized by CYP3A4 include some calcium channel blockers (diltiazem, nicardipine, verapamil), chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), glucocorticoids, cisapride (Propulsid), alfentanil (Alfenta), fentanyl (Sublimaze), losartan (Cozaar), fluoxetine (Prozac), midazolam (Versed), omeprazole (Prilosec), ondansetron (Zofran), propranolol (Inderal), fexofenadine (Allegra), and numerous others.

Interaction Rating

Moderate

Likelihood of Occurrence

Possible

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

White Pepper - More Interactions

White Pepper interacts with 951 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.

Major	The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur.
Moderate	Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur.
Minor	Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction.
Unknown	No interactions have been reported or no interaction data is currently available.