Drug & supplement interaction

1,3-dmba + Acetaminophen, Butalbital, Caffeine, Codeine

Acetaminophen, Butalbital, Caffeine, Codeine brand names: Esgic with Codeine, Fioricet w/ Codeine.

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

Acetaminophen, Butalbital, Caffeine, Codeine falls into 2 drug categories that 1,3-dmba can interact with; the most serious is rated moderate. Theoretically, combining 1,3-DMBA with other stimulant drugs might increase the risk of cardiovascular toxicity.

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

1,3-dmba and Acetaminophen, Butalbital, Caffeine, Codeine

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

Why Are There 2 Interactions?

1,3-dmba interacts with whole categories of medication. Acetaminophen, Butalbital, Caffeine, Codeine falls into 2 of those categories, so it can interact with 1,3-dmba in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

STIMULANT DRUGS

1 of 2

Why this applies to Acetaminophen, Butalbital, Caffeine, Codeine

Acetaminophen, Butalbital, Caffeine, Codeine falls under STIMULANT DRUGS — the group 1,3-dmba interacts with.

Theoretically, combining 1,3-DMBA with other stimulant drugs might increase the risk of cardiovascular toxicity.
Animal research shows that 1,3-DMBA has stimulant effects, such as increasing blood pressure and heart rate.
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 is the piece worth focusing on with this combo pill. Your medicine (Esgic or Fioricet with Codeine) contains caffeine, which is itself a stimulant. 1,3-DMBA is a powerful, unapproved stimulant similar to the banned ingredient DMAA. Stacking two stimulants together can push your heart rate and blood pressure higher than either would alone. That is the real concern here, not how your liver breaks the drug down.

So you might notice a racing or pounding heart, jitteriness, anxiety, or feeling wired. The evidence is mostly animal and lab based, so think of this as a sensible caution rather than a proven danger. Still, given the known heart and stroke risks of 1,3-DMBA, I would steer clear of it. Please check with your pharmacist or doctor before mixing them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. SWANSON EE, CHEN KK. Comparison of pressor action of alicyclic derivatives of aliphatic amines. J Pharmacol Exp Ther. 1948 Aug;93(4):423-9.
Minor

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 2

Acetaminophen, Butalbital, Caffeine, Codeine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, 1,3-DMBA might modestly increase the levels of CYP2D6 substrates.
In vitro research shows that 1,3-DMBA weakly inhibits CYP2D6 enzymes.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the wrinkle with this combo product: the codeine part is a prodrug. Your body uses an enzyme called CYP2D6 to turn codeine into morphine, which is what actually relieves pain. Lab studies suggest 1,3-DMBA may weakly block that same enzyme. If it does, less codeine gets converted, so you might get less pain relief than expected from the codeine portion.

Honestly, the bigger concern here isn't the enzyme. 1,3-DMBA is a risky, FDA-flagged stimulant that can spike your heart rate and blood pressure, while butalbital and codeine are sedating. Mixing an upper with downers is hard on your body. This enzyme effect is only theoretical (lab-based), but I'd avoid 1,3-DMBA entirely and talk with your pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Liu Y, Santillo MF. Cytochrome P450 2D6 and 3A4 enzyme inhibition by amine stimulants in dietary supplements. Drug Test Anal. 2016;8(3-4):307-10. PubMed

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

1,3-dmba Also Interacts With Other Medications

1,3-dmba has 171 moderate, 149 minor known drug interactions in our database — the Acetaminophen, Butalbital, Caffeine, Codeine one above is among them. If you take anything else, check it against the full list below.

Moderate 171 Minor 149 No known interaction 2,510 (incl. Acetaminophen, Butalbital, Caffeine, Codeine)
Taking anything else?

Check Another of Your Medications Against 1,3-dmba

Covers the 2,830 medications we’ve checked against 1,3-dmba. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Butalbital, Caffeine, Codeine

This page covers 1,3-dmba only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Butalbital, Caffeine, Codeine page lists 305 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), Asarabacca (major), Beer (major) and Ephedra (major).

By severity: 15 major · 245 moderate · 45 minor.

Open the Acetaminophen, Butalbital, Caffeine, Codeine interaction page

How much people look this up

Where 1,3-dmba and Acetaminophen, Butalbital, Caffeine, Codeine 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 1,3-dmba
Steady interest

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

29 days ago today
Medication Acetaminophen, Butalbital, Caffeine, Codeine
Top 5%

#100 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 1,3-dmba

What is 1,3-dmba?

  • Athletic and workout performance
  • Energy and stimulation
  • Weight loss and fat burning
  • Appetite suppression
  • Focus and concentration

1,3-DMBA is a synthetic stimulant chemically similar to the banned stimulant DMAA, and it is not a proven or safe dietary ingredient. The U.S. FDA considers supplements containing it adulterated, and it is banned in sports. Because of serious heart and stroke risks, it is best to avoid products that contain it.

Read the full 1,3-dmba monograph & all interactions
Keep checking

Other Drugs & 1,3-dmba

Browse every other medication we’ve checked against 1,3-dmba — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
171Moderate
149Minor
2,509No known interaction
171 Moderate 149 Minor 2,509 No interaction
Moderate

171 interactions

Showing 60 of 171 moderate interactions — see all 171 on the 1,3-dmba page.

Minor

149 interactions

Showing 60 of 149 minor interactions — see all 149 on the 1,3-dmba page.

No interaction 2,509 drugs checked — show the list

We also checked 1,3-dmba against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,509 medications checked with no known interaction — see the full 1,3-dmba list.

See the full 1,3-dmba interactions page
See every supplement checked against Acetaminophen, Butalbital, Caffeine, Codeine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
1,3-dmba monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Butalbital, Caffeine, Codeine supplement interactions › Every supplement checked against Acetaminophen, Butalbital, Caffeine, Codeine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking 1,3-dmba and Acetaminophen, Butalbital, Caffeine, Codeine Together: Common Questions

Can you take 1,3-dmba with Acetaminophen, Butalbital, Caffeine, Codeine?
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 1,3-dmba and Acetaminophen, Butalbital, Caffeine, Codeine?
Acetaminophen, Butalbital, Caffeine, Codeine belongs to more than one drug category, and 1,3-dmba 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 1,3-dmba and Acetaminophen, Butalbital, Caffeine, Codeine 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.