Clear Phlegm Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Clear Phlegm against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Clear Phlegm is a dietary supplement by Health Concerns with 9 active ingredients. Its ingredients are commonly taken for sore throat and cough, heartburn and stomach upset, mouth ulcers and digestive complaints.Based on those ingredients, 1,429 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Acorus, Licorice, Aurantium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Clear Phlegm by Health Concerns
Ask about any prescription or over-the-counter medication and we check it for interactions with Clear Phlegm by Health Concerns — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Clear Phlegm by Health Concerns
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Clear Phlegm contains 9 ingredients, most of which are traditional herbal components. The active ingredients include licorice (used in traditional medicine for inflammation and cough), bitter orange (also called aurantium), poria mushroom, bamboo shavings, calamus (acorus), and three others — pinellia, citrus, and agastache — whose monographs we don't hold complete data on.
The product also contains inactive ingredients like vegetable gum, silicon dioxide, stearic acid, and cellulose, which serve as fillers and binders to hold the tablet together.
Does it work?
Not established
The evidence we hold is limited. Licorice is rated possibly effective for canker sores and atopic dermatitis (eczema), but the other active ingredients lack established effectiveness ratings in our data.
For poria mushroom, bamboo, calamus, and bitter orange, the research is insufficient to rate them for any condition. We don't have effectiveness data on file for pinellia, citrus, or agastache.
How safe is it?
Well-documented data
Licorice is generally well tolerated in food amounts but can cause serious problems with high doses or long-term use — the active compound glycyrrhizin can affect potassium and blood pressure. The most common side effects are headache, nausea, and vomiting; contact dermatitis is possible if applied to skin.
Bitter orange may be unsafe at supplement doses; it can raise blood pressure and heart rate, especially with caffeine or other stimulants, and rare serious effects like heart attack, stroke, and seizure have been reported. Calamus is likely unsafe — it may cause cancer (it contains beta-asarone, a possible carcinogen the FDA has banned from food) and can cause nausea, vomiting, and intestinal paralysis.
Poria mushroom is generally well tolerated in traditional use but human safety data are limited. Bamboo supplements are not well studied; raw shoots can be toxic, though properly cooked ones are eaten widely.
We hold no safety data for pinellia, citrus, or agastache.
Meds to double-check
Major interaction found
If you take monoamine oxidase inhibitors (MAOIs) or midazolam, do not use this product without pharmacist approval — the risk is Major. Before starting, check with your pharmacist if you take warfarin or other blood thinners, digoxin or other heart medications, loop diuretics or other blood pressure drugs, antidiabetes medications, stimulant drugs, dextromethorphan, caffeine supplements, sedatives, anticholinergic or cholinergic drugs, antithyroid medications, or drugs metabolized by CYP2D6 or CYP3A4 (including many statins and immunosuppressants).
The interactions are Moderate or Minor, but they can affect how your medications work.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.
This is a traditional herbal blend aimed at respiratory support. Because it contains licorice, bitter orange, and calamus — all with serious medication interactions and safety concerns — you should check your prescriptions before using it.
If you take any heart medications, blood thinners, blood pressure drugs, stimulants, sedatives, antidiabetes drugs, or an MAOI, talk with your pharmacist first. Pregnant or breastfeeding women should avoid it.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 5 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 25, 2017.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Clear Phlegm, straight from the product label.
| Brand | Health Concerns |
|---|---|
| Net contents | 90 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Apr 25, 2017 |
| DSLD ID | 72785 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other |
| Intended target group(s) | Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Clear Phlegm by Health Concerns, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Proprietary Blend | 750 mg | -- |
| Licorice | 0 NP | -- |
| Aurantium | 0 NP | -- |
| Pinellia | 0 NP | -- |
| Citrus | 0 NP | -- |
| Poria sclerotium | 0 NP | -- |
| Bamboo shavings | 0 NP | -- |
| Arisaema | 0 NP | -- |
| Agastache | 0 NP | -- |
| Acorus | 0 NP | -- |
Other ingredients: Vegetable Gum, Silicon Dioxide, Stearic Acid, Cellulose
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
Suggested Use: Three tablets 3 times per day between meals.
Precautions
Notice: This product is not intended for use by pregnant women.
Brand IP Statement(s)
Chinese traditional formulas
Combining modern research and ancient wisdom
FDA Statement of Identity
Wen Dan Tang Herbal Supplement
Formula
Pinyin: Ban Xia, Chen Pi, Fu Ling, Zhi Shi, Zhu Ru, Tian Nan Xing, Huo Xiang, Shi Chang Pu, Gan Cao.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Clear Phlegm by Health Concerns label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Clear Phlegm by Health Concerns
These are the 9 active ingredients this product is made of. Select any to open its full monograph.
Serving size3 Tablet(s) Dosage formTablet Or Pill Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Proprietary Blend
- › Licorice
- › Aurantium
- › Pinellia
- › Citrus
- › Poria sclerotium
- › Bamboo shavings
- › Arisaema
- › Agastache
- › Acorus
Other (inactive) ingredients: Vegetable Gum, Silicon Dioxide, Stearic Acid, Cellulose. These complete the product’s ingredient list but are not active constituents.
Clear Phlegm by Health Concerns Drug Interactions
HelloPharmacist Interaction Report
Clear Phlegm by Health Concerns contains multiple ingredients with documented interactions with medications.
The most serious concern is bitter orange (aurantium), which carries Major-severity interactions with monoamine oxidase inhibitors (MAOIs — used for depression and certain other conditions) and with midazolam, a sedative. Taking bitter orange with MAOIs could trigger a dangerous spike in blood pressure (hypertensive crisis); with midazolam, it may raise drug levels and increase sedation and side effects.
Read the full breakdown — every affected drug type, severity by severity
Bitter orange also has Moderate interactions with QT interval-prolonging drugs (certain heart rhythm medications), CYP3A4-metabolized drugs (a large group including some statins, immunosuppressants, and others), antidiabetes medications, stimulant drugs, dextromethorphan (a cough suppressant), and caffeine — potentially worsening blood pressure, heart rate, or blood sugar control. Licorice carries Moderate interactions with digoxin (a heart medication), blood thinners like warfarin, loop diuretics (water pills), the cancer drug cisplatin, paclitaxel, several CYP-metabolized drugs, and midazolam, mostly affecting how your liver processes them or increasing the risk of potassium loss and heart problems.
Calamus (acorus) has Moderate interactions with sedatives, blood pressure medications, CYP2D6 and CYP3A4-metabolized drugs, anticholinergic and cholinergic medications, and MAOIs, plus a Minor interaction with H2-blockers (heartburn drugs). Poria mushroom carries Moderate interactions with sedatives, anticholinergic drugs, and cholinergic medications.
Bamboo shavings interact with antithyroid drugs. We could not check pinellia, citrus, arisaema, or agastache — no interaction data is on file for them.
Altogether, these interactions span 1,411 individual medications. Run your exact prescriptions through the interaction checker on this page before starting Clear Phlegm.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Clear Phlegm?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Clear Phlegm interact with 1,429 drugs. Click any drug to see the details.
5 of the 9 ingredients in Clear Phlegm interact with drugs. Each result below shows which ingredient is responsible. Acorus Licorice Aurantium Poria sclerotium Bamboo shavings
AmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis
How Amphetamine interacts with Clear Phlegm — through 2 ingredients. Tap an ingredient for the detail:
AurantiumStimulant Drugs, Monoamine Oxidase Inhibitors (maois) +1 Major
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Aurantium + Amphetamine interactionAcorusMonoamine Oxidase Inhibitors (maois), Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Read the full Acorus + Amphetamine interactionIsocarboxazidMarplan
How Isocarboxazid interacts with Clear Phlegm — through 2 ingredients. Tap an ingredient for the detail:
AurantiumMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Aurantium + Isocarboxazid interactionAcorusMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Read the full Acorus + Isocarboxazid interactionMidazolamNayzilam, Seizalam, Versed
How Midazolam interacts with Clear Phlegm — through 4 ingredients. Tap an ingredient for the detail:
AurantiumCytochrome P450 3a4 (cyp3a4) Substrates, Midazolam (versed) Major
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Aurantium + Midazolam interactionLicoriceCytochrome P450 3a4 (cyp3a4) Substrates, Midazolam (versed) Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Midazolam interactionAcorusCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Read the full Acorus + Midazolam interactionPoria SclerotiumCns Depressants Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Midazolam interactionMoclobemideManerix, Moclobemide
How Moclobemide interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
AurantiumMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Aurantium + Moclobemide interactionLicoriceCytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
Read the full Licorice + Moclobemide interactionAcorusMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Read the full Acorus + Moclobemide interactionOzanimod HydrochlorideZeposia
How Ozanimod Hydrochloride interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
AurantiumQt Interval-prolonging Drugs, Monoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, bitter orange might have an additive effect when combined with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
Read the full Aurantium + Ozanimod Hydrochloride interactionAcorusMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Read the full Acorus + Ozanimod Hydrochloride interactionLicoriceCytochrome P450 2c8 (cyp2c8) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase levels of drugs metabolized by CYP2C8.
Read the full Licorice + Ozanimod Hydrochloride interactionPhenelzine SulfateNardil
How Phenelzine Sulfate interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
AurantiumMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Aurantium + Phenelzine Sulfate interactionPoria SclerotiumCns Depressants Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Phenelzine Sulfate interactionAcorusCns Depressants, Monoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Read the full Acorus + Phenelzine Sulfate interactionRasagilineAzilect
How Rasagiline interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
AurantiumMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Aurantium + Rasagiline interactionAcorusMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Read the full Acorus + Rasagiline interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Rasagiline interactionSafinamide MesylateXadago
How Safinamide Mesylate interacts with Clear Phlegm — through 2 ingredients. Tap an ingredient for the detail:
AurantiumMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Aurantium + Safinamide Mesylate interactionAcorusMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Read the full Acorus + Safinamide Mesylate interactionSelegilineCarbex, Eldepryl, Emsam, Zelapar
How Selegiline interacts with Clear Phlegm — through 2 ingredients. Tap an ingredient for the detail:
AurantiumMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Aurantium + Selegiline interactionAcorusMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Read the full Acorus + Selegiline interactionTranylcypromineParnate
How Tranylcypromine interacts with Clear Phlegm — through 2 ingredients. Tap an ingredient for the detail:
AurantiumMonoamine Oxidase Inhibitors (maois) Major
Interaction Summary
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Read the full Aurantium + Tranylcypromine interactionAcorusMonoamine Oxidase Inhibitors (maois) Moderate
Interaction Summary
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Read the full Acorus + Tranylcypromine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Ado-trastuzumab Emtansine interactionAurantiumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Aurantium + Ado-trastuzumab Emtansine interactionAcorusCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Ado-trastuzumab Emtansine interactionAbemaciclibVerzenio
How Abemaciclib interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
AurantiumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Aurantium + Abemaciclib interactionAcorusCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Abemaciclib interactionLicoriceCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Abiraterone interactionAcorusCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Abiraterone interactionAurantiumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Aurantium + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
AurantiumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Aurantium + Abiraterone Acetate interactionAcorusCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Abiraterone Acetate interactionLicoriceCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Clear Phlegm — through 1 ingredient. Tap an ingredient for the detail:
LicoriceCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 2c19 (cyp2c19) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.
Read the full Licorice + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Acalabrutinib interactionAurantiumCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Aurantium + Acalabrutinib interactionAcorusCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Clear Phlegm — through 1 ingredient. Tap an ingredient for the detail:
AurantiumAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Aurantium + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Clear Phlegm — through 2 ingredients. Tap an ingredient for the detail:
LicoriceAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, licorice might reduce the effects of antihypertensive drugs.
Read the full Licorice + Acebutolol interactionAcorusAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, taking calamus with other antihypertensive medications might increase the risk of hypotension.
Read the full Acorus + Acebutolol interactionAcepromazineAtravet
How Acepromazine interacts with Clear Phlegm — through 2 ingredients. Tap an ingredient for the detail:
AcorusCns Depressants, Anticholinergic Drugs Moderate
Interaction Summary
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Read the full Acorus + Acepromazine interactionPoria SclerotiumCns Depressants, Anticholinergic Drugs Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Acepromazine interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Acetaminophen, Aspirin, Caffeine interactionAurantiumStimulant Drugs, Caffeine +1 Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Aurantium + Acetaminophen, Aspirin, Caffeine interactionAcorusCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Clear Phlegm — through 2 ingredients. Tap an ingredient for the detail:
AurantiumStimulant Drugs Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Aurantium + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Acetaminophen, Butalbital, Caffeine interactionAurantiumStimulant Drugs, Caffeine +1 Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Aurantium + Acetaminophen, Butalbital, Caffeine interactionAcorusCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Clear Phlegm — through 4 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Acetaminophen, Butalbital, Caffeine, Codeine interactionAurantiumStimulant Drugs, Caffeine +2 Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Aurantium + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcorusCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Acetaminophen, Butalbital, Caffeine, Codeine interactionPoria SclerotiumCns Depressants Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Clear Phlegm — through 4 ingredients. Tap an ingredient for the detail:
Poria SclerotiumCns Depressants Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Acetaminophen, Butalbital, Codeine interactionAcorusCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP2D6 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Acetaminophen, Butalbital, Codeine interactionAurantiumCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Aurantium + Acetaminophen, Butalbital, Codeine interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Clear Phlegm — through 4 ingredients. Tap an ingredient for the detail:
AcorusCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Read the full Acorus + Acetaminophen, Butalbital, Codeine Phosphate interactionPoria SclerotiumCns Depressants Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Acetaminophen, Butalbital, Codeine Phosphate interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Acetaminophen, Butalbital, Codeine Phosphate interactionAurantiumCytochrome P450 2d6 (cyp2d6) Substrates Minor
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Aurantium + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Clear Phlegm — through 4 ingredients. Tap an ingredient for the detail:
Poria SclerotiumCns Depressants, Anticholinergic Drugs Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcorusCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP2D6 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionLicoriceCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAurantiumCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Aurantium + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Clear Phlegm — through 4 ingredients. Tap an ingredient for the detail:
AurantiumCaffeine, Stimulant Drugs +2 Moderate
Interaction Summary
Bitter orange might increase blood pressure and heart rate when taken with caffeine.
Read the full Aurantium + Acetaminophen, Caffeine, Codeine interactionLicoriceCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Acetaminophen, Caffeine, Codeine interactionAcorusCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Read the full Acorus + Acetaminophen, Caffeine, Codeine interactionPoria SclerotiumCns Depressants Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Clear Phlegm — through 4 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAurantiumCytochrome P450 2d6 (cyp2d6) Substrates, Stimulant Drugs +2 Moderate
Interaction Summary
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
Read the full Aurantium + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcorusCytochrome P450 2d6 (cyp2d6) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP2D6 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Acetaminophen, Caffeine, Codeine, Salicylamide interactionPoria SclerotiumCns Depressants Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Clear Phlegm — through 4 ingredients. Tap an ingredient for the detail:
Poria SclerotiumCns Depressants Moderate
Interaction Summary
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Read the full Poria Sclerotium + Acetaminophen, Caffeine, Dihydrocodeine interactionAcorusCns Depressants, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Read the full Acorus + Acetaminophen, Caffeine, Dihydrocodeine interactionLicoriceCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Licorice + Acetaminophen, Caffeine, Dihydrocodeine interactionAurantiumStimulant Drugs, Caffeine +2 Moderate
Interaction Summary
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Read the full Aurantium + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Clear Phlegm — through 3 ingredients. Tap an ingredient for the detail:
LicoriceCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
Read the full Licorice + Acetaminophen, Caffeine, Isometheptene interactionAurantiumCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Drugs +1 Moderate
Interaction Summary
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Read the full Aurantium + Acetaminophen, Caffeine, Isometheptene interactionAcorusCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
Read the full Acorus + Acetaminophen, Caffeine, Isometheptene interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Clear Phlegm with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Acorus
Anticholinergic Drugs
Theoretically, concurrent use of anticholinergic drugs and calamus might decrease the effectiveness of the anticholinergic drug.
In vitro evidence shows that calamus can inhibit acetylcholinesterase (AChE).
Antihypertensive Drugs
Theoretically, taking calamus with other antihypertensive medications might increase the risk of hypotension.
Animal research shows that calamus decreases the rate and strength of the heartbeat, which might lower blood pressure. use with caution.
Cholinergic Drugs
Theoretically, concurrent use of cholinergic drugs and calamus might have an additive effect and increase the risk of cholinergic effects.
In vitro evidence shows that calamus can inhibit acetylcholinesterase (AChE).
Cns Depressants
Theoretically, concurrent use of CNS depressants and calamus might have an additive effect and increase the risk of sedative effects.
Animal research shows that calamus is a CNS depressant and increases gamma-aminobutyric acid levels.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, taking calamus with drugs metabolized by CYP2D6 might increase drug levels and potentially increase the risk of adverse effects.
In vitro research shows that calamus extract inhibits CYP2D6 enzyme.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, taking calamus with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.
In vitro research shows that calamus extract inhibits CYP3A4 enzyme.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, calamus might potentiate the effects and adverse effects of MAOIs.
Some reports suggest that calamus increases the effects of MAOIs.
Antacids
Theoretically, taking calamus might reduce the effectiveness of antacids.
Some research suggests that calamus lowers gastric pH.
H2-Blockers
Theoretically, taking calamus might reduce the effectiveness of H2-blockers.
Some research suggests that calamus lowers gastric pH.
Proton Pump Inhibitors (Ppis)
Theoretically, taking calamus might reduce the effectiveness of PPIs.
Some research suggests that calamus lowers gastric pH.
Licorice
Antihypertensive Drugs
Theoretically, licorice might reduce the effects of antihypertensive drugs.
In human research, licorice increases blood pressure in a dose-dependent manner.
Cisplatin (Platinol-Aq)
Theoretically, licorice might reduce the effects of cisplatin.
In animal research, licorice diminished the therapeutic efficacy of cisplatin.
Corticosteroids
Theoretically, concomitant use of licorice and corticosteroids might increase the side effects of corticosteroids.
Case reports suggest that concomitant use of licorice and oral corticosteroids, such as hydrocortisone, can potentiate the duration of activity and increase blood levels of corticosteroids. Additionally, in one case report, a patient with neurogenic orthostatic hypertension stabilized on fludrocortisone 0.1 mg twice daily developed pseudohyperaldosteronism after recent consumption of large amounts of black licorice.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2B6.
In vitro research shows that licorice extract and glabridin, a licorice constituent, inhibit CYP2B6 isoenzymes. Licorice extract from the species G. uralensis seems to inhibit CYP2B6 isoenzymes to a greater degree than G. glabra extract in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2B6; however, these interactions have not yet been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C19.
In vitro, licorice extracts from the species G. glabra and G. uralensis inhibit CYP2C19 isoenzymes in vitro. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C19; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, licorice might increase levels of drugs metabolized by CYP2C8.
In vitro, licorice extract from the species G. glabra and G. uralensis inhibits CYP2C8 isoenzymes. Theoretically, these species of licorice might increase levels of drugs metabolized by CYP2C8; however, this interaction has not yet been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP2C9.
There is conflicting evidence about the effect of licorice on CYP2C9 enzyme activity. In vitro research shows that extracts from the licorice species G. glabra and G. uralensis moderately inhibit CYP2C9 isoenzymes. However, evidence from an animal model shows that licorice extract from the species G. uralensis can induce hepatic CYP2C9 activity. Until more is known, licorice should be used cautiously in people taking CYP2C9 substrates.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, licorice might increase or decrease levels of drugs metabolized by CYP3A4.
Pharmacokinetic research shows that the licorice constituent glycyrrhizin, taken in a dosage of 150 mg orally twice daily for 14 days, modestly decreases the area under the concentration-time curve of midazolam by about 20%. Midazolam is a substrate of CYP3A4, suggesting that glycyrrhizin modestly induces CYP3A4 activity. Animal research also shows that licorice extract from the species G. uralensis induces CYP3A4 activity. However, licorice extract from G. glabra species appear to inhibit CYP3A4-induced metabolism of testosterone in vitro. It is thought that the G. glabra inhibits CYP3A4 due to its constituent glabridin, which is a moderate CYP3A4 inhibitor in vitro and not present in other licorice species. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates.
Digoxin (Lanoxin)
Theoretically, concomitant use of licorice with digoxin might increase the risk of cardiac toxicity.
Overuse or misuse of licorice with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.
Diuretic Drugs
Theoretically, concomitant use of licorice with diuretic drugs might increase the risk of hypokalemia.
Overuse of licorice might compound diuretic-induced potassium loss. In one case report, a 72-year-old male with a past medical history of hypertension, type 2 diabetes, hyperlipidemia, arrhythmia, stroke, and hepatic dysfunction was hospitalized with severe hypokalemia and uncontrolled hypertension due to pseudohyperaldosteronism. This was thought to be provoked by concomitant daily consumption of a product containing 225 mg of glycyrrhizin, a constituent of licorice, and hydrochlorothiazide 12.5 mg for 1 month.
Estrogens
Theoretically, licorice might increase or decrease the effects of estrogen therapy.
Theoretically, licorice might interfere with estrogen therapy due to estrogenic and anti-estrogenic effects.
Loop Diuretics
Theoretically, loop diuretics might increase the mineralocorticoid effects of licorice.
Theoretically, loop diuretics might enhance the mineralocorticoid effects of licorice by inhibiting the enzyme that converts cortisol to cortisone; however, bumetanide (Bumex) does not appear to have this effect.
Midazolam (Versed)
Theoretically, licorice might decrease levels of midazolam.
In humans, the licorice constituent glycyrrhizin appears to moderately induce the metabolism of midazolam. This is likely due to induction of cytochrome P450 3A4 by licorice. Until more is known, licorice should be used cautiously in people taking midazolam.
P-Glycoprotein Substrates
Theoretically, licorice might decrease the absorption of P-glycoprotein substrates.
In vitro research shows that licorice can increase P-glycoprotein activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, licorice might decrease plasma levels and clinical effects of paclitaxel.
Multiple doses of licorice taken concomitantly with paclitaxel might reduce the effectiveness of paclitaxel. Animal research shows that licorice 3 grams/kg given orally for 14 days before intravenous administration of paclitaxel decreases the exposure to paclitaxel and increases its clearance. Theoretically, this occurs because licorice induces cytochrome P450 3A4 enzymes, which metabolize paclitaxel. Notably, a single dose of licorice did not affect exposure or clearance of paclitaxel.
Warfarin (Coumadin)
Theoretically, licorice might decrease plasma levels and clinical effects of warfarin.
Licorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by licorice. Advise patients taking warfarin to avoid taking licorice.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, licorice might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that licorice induces CYP1A2 enzymes.
Methotrexate (Trexall, Others)
Theoretically, licorice might increase levels of methotrexate.
Animal research suggests that intravenous administration of glycyrrhizin, a licorice constituent, and high-dose methotrexate may delay methotrexate excretion and increase systemic exposure, leading to transient elevations in liver enzymes and total bilirubin. This interaction has not yet been reported in humans.
Aurantium
Midazolam (Versed)
Bitter orange might increase blood levels of midazolam.
One small clinical study shows that bitter orange juice can increase midazolam levels, likely through inhibition of cytochrome P450 3A4 (CYP3A4). Theoretically, bitter orange might increase the risk of midazolam-related adverse effects.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, taking MAOIs with synephrine-containing bitter orange preparations might increase the hypertensive effects of synephrine, potentially leading to hypertensive crisis.
Bitter orange contains tyramine, octopamine, and synephrine, which are MAO substrates.
Antidiabetes Drugs
Theoretically, bitter orange might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Some clinical research shows that drinking a tea containing bitter orange and Indian snakeroot reduces fasting and postprandial glucose levels in patients with type 2 diabetes who are using antidiabetes drugs. However, it is unclear if these effects are due to bitter orange, Indian snakeroot, or the combination. An animal study also shows that p-synephrine in combination with gliclazide , a sulfonylurea, causes an additional 20% to 44% decrease in glucose levels when compared with gliclazide alone.
Caffeine
Bitter orange might increase blood pressure and heart rate when taken with caffeine.
Small clinical studies show that taking bitter orange in combination with caffeine can increase blood pressure and heart rate in otherwise healthy normotensive adults. Theoretically, this might increase the risk of serious cardiovascular adverse effects.
Colchicine
Bitter orange might affect colchicine levels.
Colchicine is a substrate of P-glycoprotein and cytochrome P450 3A4 (CYP3A4). Bitter orange has been reported to inhibit CYP3A4 and increase levels of CYP3A4 substrates. However, one small clinical study in healthy adults shows that drinking bitter orange juice 240 mL twice daily for 4 days and taking a single dose of colchicine 0.6 mg on the 4th day decreases colchicine peak serum levels by 24%, time to peak serum level by 1 hour, and overall exposure to colchicine by 20%. The clinical significance of this finding is unclear.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Bitter orange might increase levels of drugs metabolized by CYP3A4.
Small clinical studies suggest that single or multiple doses of freshly squeezed bitter orange juice 200-240 mL can inhibit CYP3A4 metabolism of drugs, causing increased drug levels and potentially increasing the risk of adverse effects. However, the extent of the effect of bitter orange on CYP3A4-mediated drug interactions is unknown. Some evidence suggests that bitter orange selectively inhibits intestinal CYP3A4, but not hepatic CYP3A4. Its effect on P-glycoprotein, which strongly overlaps with CYP3A4 interactions, is unclear. One small clinical study shows that drinking 8 ounces of freshly squeezed bitter orange juice has no effect on cyclosporine, which seems to be more dependent on hepatic CYP3A4 and P-glycoprotein than intestinal CYP3A4.
Dextromethorphan (Robitussin Dm, Others)
Bitter orange might increase blood levels of dextromethorphan.
One small clinical study shows that bitter orange juice increases dextromethorphan levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for dextromethorphan-related adverse effects.
Felodipine (Plendil)
Bitter orange might increase blood levels of felodipine.
One small clinical study shows that bitter orange juice increases felodipine levels, likely through cytochrome P450 3A4 (CYP3A4) inhibition. Theoretically, bitter orange might increase the risk for felodipine-related adverse effects.
Indinavir (Crixivan)
Bitter orange might increase blood levels of indinavir.
One small clinical study shows that bitter orange juice slightly increases indinavir levels, but this effect is likely to be clinically insignificant. Bitter orange selectively inhibits intestinal cytochrome P450 3A4 (CYP3A4); however, the metabolism of indinavir seems to be more dependent on hepatic CYP3A4. The effect of bitter orange on other protease inhibitors has not been studied.
Qt Interval-Prolonging Drugs
Theoretically, bitter orange might have an additive effect when combined with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
One case report suggests that taking bitter orange in combination with other stimulants such as caffeine might prolong the QT interval in some patients.
Sildenafil (Viagra)
Bitter orange juice might increase blood levels of sildenafil.
A small clinical study in healthy adult males shows that drinking freshly squeezed bitter orange juice 250 mL daily for 3 days and taking a single dose of sildenafil 50 mg on the 3rd day increases the peak plasma concentration of sildenafil by 18% and the overall exposure to sildenafil by 44%. Theoretically, this may be due to inhibition of cytochrome P450 3A4 by bitter orange.
Stimulant Drugs
Theoretically, bitter orange might increase the risk of hypertension and adverse cardiovascular effects when taken with stimulant drugs.
Bitter orange appears to have stimulant effects.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, bitter orange might increase levels of drug metabolized by CYP2D6.
In vitro research shows that octopamine, a constituent of bitter orange, weakly inhibits CYP2D6 enzymes. This effect has not been reported in humans.
Poria sclerotium
Anticholinergic Drugs
Theoretically, poria mushroom might decrease the clinical effects of anticholinergic drugs.
In animal research, poria mushroom essential oil reduces acetylcholinesterase activity. This interaction has not been shown in humans.
Cholinergic Drugs
Theoretically, poria mushroom might have additive effects when used with cholinergic drugs.
In animal research, poria mushroom essential oil reduces acetylcholinesterase activity. This interaction has not been shown in humans.
Cns Depressants
Theoretically, taking poria mushroom extract may enhance the therapeutic and adverse effects of sedatives.
Animal research shows that poria mushroom extract has sedative properties. This interaction has not been shown in humans.
Bamboo shavings
Antithyroid Drugs
Theoretically, long-term bamboo use might increase the effects and adverse effects of antithyroid drugs, possibly leading to hypothyroidism.
Animal research suggests that long-term consumption of bamboo shoot can decrease thyroid peroxidase activity, as well as levels of thyroxine (T4) and triiodothyronine (T3). This effect has not yet been reported in humans.
Brand information
Manufacturer and brand details for Clear Phlegm, from the product label.
Health Concerns
See all Health Concerns products- Name
- Health Concerns
- Street Address
- 8001 Capwell Drive
- City
- Oakland
- State
- CA
- ZipCode
- 94621
- Phone Number
- (800) 233-9355
- Web Address
- www.healthconcerns.com/pro
Clear Phlegm by Health Concerns: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Clear Phlegm’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Licorice
Interacts with 1,040 drugsLicorice root is a traditional remedy used for sore throats, coughs, and digestive complaints, but solid human evidence is limited for most uses. Regular licorice contains glycyrrhizin, whic...
Read the full Licorice monograph → Herb & supplement monographBitter Orange
Interacts with 957 drugsBitter orange is a citrus fruit whose extracts contain synephrine, a mild stimulant often added to weight-loss and energy supplements. Evidence that it works for weight loss or performance i...
Read the full Bitter Orange monograph → Herb & supplement monographPoria Mushroom
Interacts with 417 drugsPoria mushroom (Fu Ling) is a fungus long used in Traditional Chinese Medicine, mainly as a mild diuretic and digestive and calming aid. Modern scientific evidence in humans is very limited,...
Read the full Poria Mushroom monograph → Herb & supplement monographBamboo
Interacts with 5 drugsBamboo is a giant grass whose shoots are eaten as food and whose leaves and silica-rich extracts are sold as supplements, often for hair, skin, nail, and bone support. Solid human evidence f...
Read the full Bamboo monograph → Herb & supplement monographCalamus
Interacts with 1,117 drugsCalamus is a swamp plant with a long history in Ayurvedic and traditional Chinese medicine, mostly for digestive and nervous-system complaints. However, it contains beta-asarone, a compound...
Read the full Calamus monograph →Sources & How We Checked
Clear Phlegm's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 159 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Licorice 92 references
- Farese RV Jr, Biglieri EG, Shackleton CH, et al. Licorice-induced hypermineralocorticoidism. N Engl J Med 1991;325:1223-7. PubMed
- Sigurjonsdottir HA, Ragnarsson J, Franzson L, Sigurdsson G. Is blood pressure commonly raised by moderate consumption of liquorice? J Hum Hypertens 1995;9:345-8.
- Armanini D, Lewicka S, Pratesi C, et al. Further studies on the mechanism of the mineralocorticoid action of licorice in humans. J Endocrinol Invest 1996;19:624-9. PubMed
- Zhang YD, Lorenzo B, Reidenberg MM. Inhibition of 11 beta hydroxysteroid dehydrogenase obtained from guinea pig kidney by furosemide, naringenin and some other compounds. J Steroid Biochem Mol Biol 1994;49:81-5.
- Strandberg TE, Jarvenpaa AL, Vanhanen H, McKeigue PM. Birth outcome in relation to licorice consumption during pregnancy. Am J Epidemiol 2001;153:1085-8. PubMed
- Sigurjonsdottir HA, Franzson L, Manhem K, et al. Liquorice-induced rise in blood pressure: a linear dose-response relationship. J Hum Hypertens 2001;15:549-52. PubMed
- Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause 2002;9:145-50. PubMed
- Kent UM, Aviram M, Rosenblat M, Hollenberg PF. The licorice root derived isoflavan glabridin inhibits the activities of human cytochrome P450S 3A4, 2B6, and 2C9. Drug Metab Dispos 2002;30:709-15.. PubMed
- Yoshida S, Takayama Y. Licorice-induced hypokalemia as a treatable cause of dropped head syndrome. Clin Neurol Neurosurg 2003;105:286-7.. PubMed
- Strandberg TE, Andersson S, Jarvenpaa AL, et al. Preterm birth and licorice consumption during pregnancy. Am J Epidemiol 2002;156:803-5.. PubMed
- Hussain RM. The sweet cake that reaches parts other cakes can't! Postgrad Med J 2003;79:115-6.. PubMed
- Morris DJ, Davis E, Latif SA. Licorice, tobacco chewing, and hypertension. N Engl J Med 1990;322:849-50. PubMed
- Quinkler M, Stewart PM. Hypertension and the cortisol-cortisone shuttle. J Clin Endocrinol Metab 2003;88:2384-92. PubMed
- Westman EC, Guthrie GP. Licorice, tobacco chewing, and hypertension. N Engl J Med 1990;322:850. PubMed
- Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77. PubMed
- Yasue H, Itoh T, Mizuno Y, Harada E. Severe hypokalemia, rhabdomyolysis, muscle paralysis, and respiratory impairment in a hypertensive patient taking herbal medicines containing licorice. Intern Med 2007;46:575-8. PubMed
- Brayley J, Jones J. Life-threatening hypokalemia associated with excessive licorice ingestion (letter). Am J Psychiatry 1994;151:617-8. PubMed
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