Drug & supplement interaction

Aconite + Aspirin, Butalbital, Caffeine, Codeine Phosphate

Aspirin, Butalbital, Caffeine, Codeine Phosphate brand name: Fiorinal w/ Codeine.

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

Aspirin, Butalbital, Caffeine, Codeine Phosphate falls into 2 drug categories that Aconite can interact with; the most serious is rated moderate. Theoretically, combining aconite with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.

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

Aconite and Aspirin, Butalbital, Caffeine, Codeine Phosphate

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

Why Are There 2 Interactions?

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Aspirin, Butalbital, Caffeine, Codeine Phosphate

Aspirin, Butalbital, Caffeine, Codeine Phosphate falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Aconite interacts with.

Theoretically, combining aconite with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Higenamine, a constituent of aconite, is thought to have antiplatelet and antithrombotic effects. In an animal model of thrombosis, higenamine inhibited platelet aggregation and reduced the size of thrombus formation.
Severity Moderate Likelihood Possible Evidence D

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

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

Here's the piece that matters in this combo: the aspirin part of Fiorinal with Codeine already thins your blood by making platelets less sticky. Aconite contains a compound called higenamine that, at least in lab and animal studies, seems to do something similar. Stack the two and, in theory, you could see easier bruising, nosebleeds, bleeding gums, or stomach bleeding that's slower to stop.

I want to be honest about the evidence here. This is based only on test-tube and animal research, so it's more of a theoretical concern than a proven one. That said, aconite is genuinely toxic on its own and I'd steer clear of it regardless. Please check with your pharmacist or doctor before mixing anything with this medication.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Zhao D, Wang J, Cui Y, Wu X. Pharmacological effects of Chinese herb aconite (fuzi) on cardiovascular system. J Tradit Chin Med. 2012 Sep;32(3):308-13. PubMed
Moderate

STIMULANT DRUGS

2 of 2

Aspirin, Butalbital, Caffeine, Codeine Phosphate also falls under STIMULANT DRUGS.

Theoretically, combining aconite with other stimulant drugs might alter the effects of the stimulant drug or increase the risk of cardiovascular toxicity.
Aconite and its constituents have stimulant effects due to agonist activity at beta-2-adrenoreceptors. In cardiac muscle, aconite appears to have a positive inotropic effect and increases heart rate and blood pressure. However, some constituents of aconite can reduce heart rate and blood pressure.
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

Let's focus on the caffeine inside your Fiorinal with Codeine, since that's the stimulant piece here. Aconite can act on your heart and blood vessels, and on paper it may push heart rate and blood pressure in unpredictable directions. Pair that with the caffeine in this combo and you could, in theory, feel more jittery, notice a racing or pounding heartbeat, or see your blood pressure climb. The bigger worry is added strain on the heart.

Keep in mind this concern comes only from lab and animal research, so it's theoretical, not proven in people. The far more pressing issue is that aconite itself is genuinely poisonous and should be avoided. Please talk with your pharmacist or doctor before using any product containing it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Yeih DF, Chiang FT, Huang SKS. Successful treatment of aconitine induced life threatening ventricular tachyarrhythmia with amiodarone. Heart 2000;84:E8. PubMed
  2. Lin CC, Chan TY, Deng JF. Clinical features and management of herb-induced aconitine poisoning. Ann Emerg Med 2004;43:574-9. PubMed
  3. Telang, B. V. and Ng'ang'a, J. N. Involvement of Central adrenergic mechanisms in the induction of cardiac arrhythmias by aconitine nitrate administered intraventricularly. Indian J Physiol Pharmacol. 1975;19(1):1-10.
  4. Kimura, I., Takada, M., and Nojima, H. Aconitine induces bradycardia through a transmission pathway including the anterior hypothalamus in conscious mice. Biol.Pharm Bull. 1997;20(8):856-860. PubMed
  5. Zhao D, Wang J, Cui Y, Wu X. Pharmacological effects of Chinese herb aconite (fuzi) on cardiovascular system. J Tradit Chin Med. 2012 Sep;32(3):308-13. 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

Aconite Also Interacts With Other Medications

Aconite has 277 moderate known drug interactions in our database — the Aspirin, Butalbital, Caffeine, Codeine Phosphate one above is among them. If you take anything else, check it against the full list below.

Moderate 277 No known interaction 2,553 (incl. Aspirin, Butalbital, Caffeine, Codeine Phosphate)
Taking anything else?

Check Another of Your Medications Against Aconite

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

Everything else you take

See Every Supplement That Interacts With Aspirin, Butalbital, Caffeine, Codeine Phosphate

This page covers Aconite only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Butalbital, Caffeine, Codeine Phosphate page lists 398 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: 17 major · 334 moderate · 47 minor.

From our pharmacist’s overview on the Aspirin, Butalbital, Caffeine, Codeine Phosphate page

“Fiorinal with Codeine packs four active drugs into one capsule, and I would treat its supplement list with genuine wariness rather than a quick skim. The aspirin component is why roughly half of the 398 ingredients on file raise bleeding risk, while the codeine and butalbital explain a second large cluster that deepens sedation, someti…”

Reviewed by 2 · Jul 18, 2026

Open the Aspirin, Butalbital, Caffeine, Codeine Phosphate interaction page

One more smart check

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

We hold 56 real supplement products containing Aconite, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Aconite. Your product may carry other ingredients that interact with Aspirin, Butalbital, Caffeine, Codeine Phosphate too, on top of Aconite — 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 Aconite and Aspirin, Butalbital, Caffeine, Codeine Phosphate 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 Aconite
Top half

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

29 days ago today
Medication Aspirin, Butalbital, Caffeine, Codeine Phosphate
Steady interest

#1,912 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 Aconite

What is Aconite?

Aconite
  • Pain and nerve pain
  • Fever and cold or flu symptoms
  • Anxiety and restlessness (homeopathic use)
  • Inflammation and joint pain
  • Heart-related complaints (traditional use)

Aconite is a highly poisonous plant, and even small amounts of the raw or improperly processed root can cause severe, life-threatening reactions. There is no good scientific evidence that it safely treats any condition, and the only forms generally considered acceptable are extremely diluted homeopathic preparations. We strongly recommend avoiding raw or unprocessed aconite entirely and talking to a pharmacist or doctor before using any product containing it.

Read the full Aconite monograph & all interactions
Keep checking

Other Drugs & Aconite

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

0Major
277Moderate
0Minor
2,552No known interaction
277 Moderate 2,552 No interaction
Moderate

277 interactions

Showing 60 of 277 moderate interactions — see all 277 on the Aconite page.

No interaction 2,552 drugs checked — show the list

We also checked Aconite against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,552 medications checked with no known interaction — see the full Aconite list.

See the full Aconite interactions page
See every supplement checked against Aspirin, Butalbital, Caffeine, Codeine Phosphate, 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
Aconite monograph › Uses, safety, and every drug interaction in one place Aspirin, Butalbital, Caffeine, Codeine Phosphate supplement interactions › Every supplement checked against Aspirin, Butalbital, Caffeine, Codeine Phosphate, 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 Aconite and Aspirin, Butalbital, Caffeine, Codeine Phosphate Together: Common Questions

Can you take Aconite with Aspirin, Butalbital, Caffeine, Codeine Phosphate?
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 Aconite and Aspirin, Butalbital, Caffeine, Codeine Phosphate?
Aspirin, Butalbital, Caffeine, Codeine Phosphate belongs to more than one drug category, and Aconite 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 Aconite and Aspirin, Butalbital, Caffeine, Codeine Phosphate 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

Still Have a Question About Aspirin, Butalbital, Caffeine, Codeine Phosphate and Aconite?

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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.