Drug & supplement interaction

Acerola + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide

Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide brand name: Ascriptin Codeine #2.

Minor Interaction
The bottom line Minor

Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide falls into 2 drug categories that Acerola can interact with; the most serious is rated minor. Theoretically, acerola might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Acerola and Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide

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

Why Are There 2 Interactions?

Acerola interacts with whole categories of medication. Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide falls into 2 of those categories, so it can interact with Acerola in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

ASPIRIN

1 of 2

Why this applies to Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide

Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide falls under ASPIRIN — the group Acerola interacts with.

Theoretically, acerola might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Acerola contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion. The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and aspirin is unlikely.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the idea behind this one. Acerola is loaded with vitamin C, and the theory goes that vitamin C can make your urine more acidic, which could slow how fast your kidneys flush out the aspirin (salicylate) part of this combo product. In theory, that might let aspirin levels creep up a bit, bringing things like stomach upset, ringing in the ears, or easier bruising.

In real life, though, this is very unlikely to matter. Studies show even fairly large vitamin C doses don't really change urine acidity or aspirin clearance, and the codeine and antacid pieces aren't involved here at all. Food amounts of acerola are no worry, and concentrated supplements are still low-risk. If you take this product regularly, it's always smart to run your supplement list past your pharmacist.

References
  1. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  2. Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
  3. Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
Minor

ALUMINUM

2 of 2
Theoretically, concomitant use of acerola with aluminum salts might increase the amount of aluminum absorbed.
Acerola contains vitamin C. It is thought that vitamin C chelates aluminum, keeping it in solution and available for absorption. In people with normal renal function, urinary excretion of aluminum likely increases, making aluminum retention and toxicity unlikely. However, patients with renal failure who take aluminum-containing compounds, such as phosphate binders, should avoid acerola in doses that provide more vitamin C than the recommended dietary allowances.
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

The piece to focus on here is the aluminum hydroxide in this combination product. Acerola is loaded with vitamin C, and vitamin C can grab onto aluminum and help keep it dissolved, which may let a little more aluminum get absorbed from your gut. This is a theoretical concern based on how the chemistry works, not something seen as a real problem in most people.

If your kidneys work normally, your body simply pees out the extra aluminum, so retention and toxicity are very unlikely. The exception is folks with kidney failure who rely on aluminum-containing products as phosphate binders. For them, large vitamin C doses (more than the daily recommended amount) are best avoided. Food amounts of acerola are not a worry. If you have kidney issues, check with your pharmacist before adding a concentrated acerola supplement.

References
  1. Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
  2. Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
  3. Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. 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

Acerola Also Interacts With Other Medications

Acerola has 39 moderate, 88 minor known drug interactions in our database — the Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Acerola

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

Everything else you take

See Every Supplement That Interacts With Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide

This page covers Acerola only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide page lists 339 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 Danshen (major).

By severity: 11 major · 286 moderate · 42 minor.

From our pharmacist’s overview on the Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide page

“A person taking Ascriptin Codeine #2 for pain is getting aspirin, codeine, and two antacids in a single tablet, and the 339 supplement interactions on file deserve real attention before adding anything alongside it. Most of the list splits two ways.”

Reviewed by 2 · Jul 18, 2026

Open the Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interaction page

One more smart check

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

We hold 2,642 real supplement products containing Acerola, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Acerola. Your product may carry other ingredients that interact with Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide too, on top of Acerola — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Acerola and Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide 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 Acerola
Top 10%

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

29 days ago today
Medication Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide
Top 5%

#74 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 Acerola

What is Acerola?

Acerola
  • Vitamin C source
  • Immune support
  • Antioxidant support
  • General wellness
  • Skin health

Acerola is a small tropical fruit prized for its very high natural vitamin C content, and it is mostly used as a food-based source of vitamin C and antioxidants. While vitamin C itself has well-known roles in the body, strong human studies showing that acerola specifically treats or prevents disease are limited. It is generally considered safe in food amounts, but check with your pharmacist or doctor before using concentrated supplements.

Read the full Acerola monograph & all interactions
Keep checking

Other Drugs & Acerola

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

0Major
39Moderate
88Minor
2,702No known interaction
Moderate

39 interactions

Minor

88 interactions

Showing 60 of 88 minor interactions — see all 88 on the Acerola page.

No interaction 2,702 drugs checked — show the list
Sources

Sources & How We Checked

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

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

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

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

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Acerola and Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide Together: Common Questions

Can you take Acerola with Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Acerola and Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide?
Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide belongs to more than one drug category, and Acerola 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 Acerola and Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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.