Medication interaction hub

What Supplements Interact with Acetaminophen, Dextromethorphan?

Acetaminophen, Dextromethorphan brand name: Tylenol Cough Ex Strength. Every interaction below applies to the brands too.

236 Interactions 8 Major 185 Moderate 43 Minor
Curated & coded by · Clinical Pharmacist · Updated September 22, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Acetaminophen, Dextromethorphan? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Acetaminophen, Dextromethorphan against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

Alcohol tops my worry list for Acetaminophen with Dextromethorphan (Tylenol Cough Ex Strength). Beer and wine both carry major ratings, since acetaminophen already asks a lot of the liver and regular drinking compounds that strain. Eight of the 236 supplements and herbs listed here are rated major, and I read that as a genuine warning, not fine print. Lithium is another serious one, able to stack with dextromethorphan's serotonin effects, and many entries speed up or slow down the liver enzymes that clear both drugs.

The remaining 185 moderate and 43 minor entries mostly work those same enzyme angles more gently, nudging drug levels up or down, while a smaller group, activated charcoal among them, can block absorption of anything taken by mouth, so keep those well separated from your dose. Almost everyone will recognize something they use on this list, which is why the severity ratings matter more than the sheer count.

— , Clinical Pharmacist · July 18, 2026

Major 8 Moderate 185 Minor 43 No known interaction 1,216

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Most Viewed Ingredient Interactions

Acetaminophen, Dextromethorphan: Top Interactions at a Glance

The Acetaminophen, Dextromethorphan supplement & herbal interactions people checked most in the last 24 hours, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 236 interacting ingredients — plus 1,216 more checked with no known interaction. See the complete ranked list.

Start here

The Most-Checked Acetaminophen, Dextromethorphan Combinations Today

The Acetaminophen, Dextromethorphan + supplement pages people viewed most in the last 24 hours (resets at midnight). Open any card for the full report.

Moderate Likelihood Possible Bitter Orange + Acetaminophen, Dextromethorphani

Bitter orange might increase levels of drugs metabolized by CYP3A4.

Read the full interaction Moderate Likelihood Possible Acetyl-l-carnitine + Acetaminophen, Dextromethorphani

Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders, wh...

Read the full interaction Major Likelihood Probable Lithium + Acetaminophen, Dextromethorphani

Theoretically, taking lithium supplements with serotonergic drugs might both mask and increase the risk of serotonin syndrome.

Read the full interaction Moderate Likelihood Possible Bog Labrador Tea + Acetaminophen, Dextromethorphani

In vitro research shows that aqueous and ethanolic extracts of Bog Labrador tea leaves can increase the concentration of cytochrome P450 3A4 (CYP3A4) enzymes.

Read the full interaction Moderate Likelihood Possible English Ivy + Acetaminophen, Dextromethorphani

Theoretically, English ivy might increase the levels of drugs metabolized by CYP2D6.

Read the full interaction Moderate Likelihood Possible Fermented Wheat Germ Extract + Acetaminophen, Dextromethorphani

Theoretically, concomitant use of fermented wheat germ extract with serotonergic medications may increase the risk of serotonergic adverse effects.

Read the full interaction
The complete list

Every Supplement Checked Against Acetaminophen, Dextromethorphan

All 1,452 ingredients in our database, ranked by severity — 236 with a Acetaminophen, Dextromethorphan interaction on file and 1,216 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Acetaminophen, Dextromethorphan?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Bitter Orange with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Bitter orange might increase levels of drugs metabolized by CYP3A4.

Full Bitter Orange + Acetaminophen, Dextromethorphan answer

Can you take Acetyl-l-carnitine with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, acetyl-L-carnitine might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstr...

Full Acetyl-l-carnitine + Acetaminophen, Dextromethorphan answer

Can you take Lithium with Acetaminophen, Dextromethorphan?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Theoretically, taking lithium supplements with serotonergic drugs might both mask and increase the risk of serotonin syndrome.

Full Lithium + Acetaminophen, Dextromethorphan answer

Can you take Bog Labrador Tea with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research shows that aqueous and ethanolic extracts of Bog Labrador tea leaves can increase the concentration of cytochrome P450 3A4...

Full Bog Labrador Tea + Acetaminophen, Dextromethorphan answer

Can you take English Ivy with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, English ivy might increase the levels of drugs metabolized by CYP2D6.

Full English Ivy + Acetaminophen, Dextromethorphan answer

Can you take Ashwagandha with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Full Ashwagandha + Acetaminophen, Dextromethorphan answer

Can you take Astaxanthin with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, astaxanthin may decrease levels of drugs metabolized by CYP3A4.

Full Astaxanthin + Acetaminophen, Dextromethorphan answer

Can you take Bacopa with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.

Full Bacopa + Acetaminophen, Dextromethorphan answer

Can you take Baikal Skullcap with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Baikal skullcap may increase levels of drugs metabolized by CYP1A2 enzymes.

Full Baikal Skullcap + Acetaminophen, Dextromethorphan answer

Can you take Beet with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, beet might increase the levels of CYP3A4 substrates.

Full Beet + Acetaminophen, Dextromethorphan answer

Can you take Berberine with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, berberine might increase serum levels of drugs metabolized by CYP2D6.

Full Berberine + Acetaminophen, Dextromethorphan answer

Can you take Beta-methylphenethylamine (bmpea) with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, BMPEA might increase the levels and clinical effects of CYP2D6 substrates.

Full Beta-methylphenethylamine (bmpea) + Acetaminophen, Dextromethorphan answer

Can you take Bilberry with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.

Full Bilberry + Acetaminophen, Dextromethorphan answer

Can you take Bishop's Weed with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Bergapten, a constituent of bishop's weed, has been shown to inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

Full Bishop's Weed + Acetaminophen, Dextromethorphan answer

Can you take Black Cohosh with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.

Full Black Cohosh + Acetaminophen, Dextromethorphan answer

Can you take Black Hoof Mushroom with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, black hoof mushroom might increase the levels and clinical effects of CYP1A2 substrates.

Full Black Hoof Mushroom + Acetaminophen, Dextromethorphan answer

Can you take Black Pepper with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, black pepper might increase levels of drugs metabolized by CYP2D6.

Full Black Pepper + Acetaminophen, Dextromethorphan answer

Can you take Black Seed with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, combining serotonergic drugs with black seed might increase the risk of serotonergic side effects, including serotonin syndro...

Full Black Seed + Acetaminophen, Dextromethorphan answer

Can you take Boldo with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking boldo with hepatotoxic drugs might increase the risk of hepatic injury and disease.

Full Boldo + Acetaminophen, Dextromethorphan answer

Can you take Boswellia Serrata with Acetaminophen, Dextromethorphan?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.

Full Boswellia Serrata + Acetaminophen, Dextromethorphan answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Acetaminophen, Dextromethorphan is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Acetaminophen, Dextromethorphan, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Acetaminophen, Dextromethorphan sits in 13 interaction categories. Open any one to see what the group means:

Cytochrome P450 3A4 (Cyp3A4) Substrates 121 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

121 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Cytochrome P450 1A2 (Cyp1A2) Substrates 79 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

79 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Cytochrome P450 2D6 (Cyp2D6) Substrates 60 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

60 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Hepatotoxic Drugs 38 ingredients

Medications with known liver considerations. Supplements that can stress the liver add to the load.

38 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Cytochrome P450 2E1 (Cyp2E1) Substrates 24 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

24 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Serotonergic Drugs 20 ingredients

Medications that raise serotonin activity. Combining them with serotonin-active supplements can, in rare cases, push serotonin too high.

20 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Glucuronidated Drugs 12 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

12 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Dextromethorphan (Robitussin Dm, Others) 9 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

9 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Acetaminophen (Tylenol, Others) 8 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

8 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Nephrotoxic Drugs 6 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

6 of the supplement ingredients on this page reach Acetaminophen, Dextromethorphan through this category.

Cytochrome P450 1A2 (Cyp1A2) Substrates 1 ingredient

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

1 of the supplement ingredient on this page reaches Acetaminophen, Dextromethorphan through this category.

Serotonergic Drugs 1 ingredient

Medications that raise serotonin activity. Combining them with serotonin-active supplements can, in rare cases, push serotonin too high.

1 of the supplement ingredient on this page reaches Acetaminophen, Dextromethorphan through this category.

Related: does Acetaminophen, Dextromethorphan deplete any nutrients?

Acetaminophen, Dextromethorphan has 1 reported nutrient association in the research literature — see the Acetaminophen, Dextromethorphan nutrient depletion report.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Acetaminophen, Dextromethorphan

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Acetaminophen, Dextromethorphan.

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Pharmacist Counseling Corner

Acetaminophen, Dextromethorphan & Supplements: Common Questions

What supplements interact with Acetaminophen, Dextromethorphan?
Our database currently documents 236 ingredients with a known Acetaminophen, Dextromethorphan interaction (8 major, 185 moderate, 43 minor). The practical move: scan the major group first, then look up the exact supplements you take rather than reading all 236. The highest-ranked right now: Grapefruit, Siberian Cocklebur, Activated Charcoal.
Which Acetaminophen, Dextromethorphan supplement interactions are the most serious?
The 8 major-rated combinations — led by Grapefruit, Siberian Cocklebur, Activated Charcoal, Beer and Lithium — deserve real caution: these are the ones generally best avoided, or used only with your prescriber watching. If you take any of them today, don't panic and don't stop anything abruptly — call your pharmacist first. Jump to the ranked list.
Can I take vitamins or supplements while on Acetaminophen, Dextromethorphan?
Plenty of supplements coexist fine with Acetaminophen, Dextromethorphan; a shorter list does not. Rather than memorizing it, check the specific ingredients on your labels — the ranked list above covers every one we've checked, and multi-ingredient products can be checked label-by-label with our scanner. Try the label scanner or the interaction checker.
Do brands like Tylenol Cough Ex Strength have the same supplement interactions as Acetaminophen, Dextromethorphan?
Yes — Tylenol Cough Ex Strength all contain Acetaminophen, Dextromethorphan, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
Does Acetaminophen, Dextromethorphan deplete any vitamins or nutrients?
It might — Acetaminophen, Dextromethorphan has 1 reported nutrient-depletion association in the research literature, which is a different question from interactions: instead of a supplement changing the drug, the drug may lower a nutrient over time. See the Acetaminophen, Dextromethorphan nutrient depletion report for the specifics and what to discuss with your pharmacist.
What about Acetaminophen, Dextromethorphan and my other medications?
This page covers Acetaminophen, Dextromethorphan against supplements and herbal ingredients. Checking Acetaminophen, Dextromethorphan against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker.

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

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 22, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.