Drug & supplement interaction

Wild Lettuce + Hydrocodone/Chlorpheniramine

Hydrocodone/Chlorpheniramine brand name: Tussionex.

Moderate Interaction
The bottom line Moderate

Hydrocodone/Chlorpheniramine falls into 2 drug categories that Wild Lettuce can interact with; the most serious is rated moderate. Theoretically, concomitant use with drugs with sedative effects might cause additive therapeutic effects and adverse effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Wild Lettuce and Hydrocodone/Chlorpheniramine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Wild Lettuce interacts with whole categories of medication. Hydrocodone/Chlorpheniramine falls into 2 of those categories, so it can interact with Wild Lettuce in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 2

Why this applies to Hydrocodone/Chlorpheniramine

Hydrocodone/Chlorpheniramine falls under CNS DEPRESSANTS — the group Wild Lettuce interacts with.

Theoretically, concomitant use with drugs with sedative effects might cause additive therapeutic effects and adverse effects.
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

Tussionex already packs two ingredients that calm the nervous system: hydrocodone, an opioid that eases coughing, and chlorpheniramine, an antihistamine that makes most people drowsy. Wild lettuce is traditionally used as a mild sedative, so the worry here is simple addition. Stacking a calming herb on top of an already sedating cough syrup could leave you more drowsy, foggy, dizzy, or unsteady than expected, and in theory could deepen the slowed, shallow breathing opioids can cause.

To be fair, this is a theoretical concern based on how these ingredients work, not strong human studies, and wild lettuce's calming effect is fairly weak. Still, I'd play it safe. Don't drive until you know how the combo affects you, and check with your pharmacist or doctor before pairing them.

References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Moderate

ANTICHOLINERGIC DRUGS

2 of 2

Hydrocodone/Chlorpheniramine also falls under ANTICHOLINERGIC DRUGS.

Studies report varying evidence on whether or not wild lettuce contains hyoscyamine, an anticholinergic drug. If it does, it appears to be in very low amounts. Nevertheless, there have been case reports of individuals consuming large amounts of wild lettuce experiencing anticholinergic-related side effects, such as constipation, dry mouth, dizziness, and sweating. Therefore, if you are already taking a drug with anticholinergic effects, you should be cautious about combining it with wild lettuce as the risk of side effects may be increased.
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

Here's the thing to keep in mind with Tussionex (hydrocodone with chlorpheniramine). The chlorpheniramine part is an antihistamine that already has anticholinergic effects, meaning it can dry you out and slow things down. Wild lettuce might add a little anticholinergic activity of its own, though honestly the evidence for that is shaky and any amount in the plant appears very low.

Stacking the two could nudge up side effects like dry mouth, constipation, blurry vision, dizziness, and drowsiness. The bigger concern is that wild lettuce is also calming, so layering it on top of an opioid like hydrocodone could leave you more sedated than you'd expect. This isn't a hard danger for most people, but I'd run it past your pharmacist or doctor before combining them.

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

Wild Lettuce Also Interacts With Other Medications

Wild Lettuce has 392 moderate known drug interactions in our database — the Hydrocodone/Chlorpheniramine 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 Wild Lettuce

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

From our Q&A

Questions About Wild Lettuce or Hydrocodone/Chlorpheniramine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Wild Lettuce or Hydrocodone/Chlorpheniramine, 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 Hydrocodone/Chlorpheniramine

This page covers Wild Lettuce only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrocodone/Chlorpheniramine page lists 258 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), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 12 major · 204 moderate · 42 minor.

From our pharmacist’s overview on the Hydrocodone/Chlorpheniramine page

“Tussionex (hydrocodone with chlorpheniramine) pairs an opioid with a sedating antihistamine, so anything that deepens drowsiness or slows breathing is a genuine hazard, and 78 of the 258 supplements on file do exactly that. Alcohol in any form tops that group, and kava carries a major rating for the same reason.”

Reviewed by 2 · Jul 18, 2026

Open the Hydrocodone/Chlorpheniramine interaction page

One more smart check

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

We hold 99 real supplement products containing Wild Lettuce, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Wild Lettuce. Your product may carry other ingredients that interact with Hydrocodone/Chlorpheniramine too, on top of Wild Lettuce — 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 Wild Lettuce and Hydrocodone/Chlorpheniramine 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 Wild Lettuce
Steady interest

#1,173 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Hydrocodone/Chlorpheniramine
Steady interest

#1,687 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 Wild Lettuce

What is Wild Lettuce?

Wild Lettuce
  • Insomnia and trouble sleeping
  • Anxiety and restlessness
  • Pain relief
  • Cough and respiratory symptoms
  • Muscle spasms

Wild lettuce is a traditional herb used mainly for sleep, anxiety, and pain, but solid human research supporting these uses is very limited. Because its safety is not well studied, it should be used cautiously, avoided in pregnancy and breastfeeding, and discussed with your pharmacist or doctor first.

Read the full Wild Lettuce monograph & all interactions
Keep checking

Other Drugs & Wild Lettuce

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

0Major
392Moderate
0Minor
2,437No known interaction
Moderate

392 interactions

Showing 60 of 392 moderate interactions — see all 392 on the Wild Lettuce page.

No interaction 2,437 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 Wild Lettuce and Hydrocodone/Chlorpheniramine Together: Common Questions

Can you take Wild Lettuce with Hydrocodone/Chlorpheniramine?
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 2 interactions listed for Wild Lettuce and Hydrocodone/Chlorpheniramine?
Hydrocodone/Chlorpheniramine belongs to more than one drug category, and Wild Lettuce 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 Wild Lettuce and Hydrocodone/Chlorpheniramine 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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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.