Drug & supplement interaction

Anise + Acetaminophen, Butalbital, Caffeine

Acetaminophen, Butalbital, Caffeine brand names: Tecnal, Esgic Plus, Fiogesic, Triad, Repan, and others.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Butalbital, Caffeine falls into 2 drug categories that Anise can interact with; the most serious is rated moderate. Theoretically, anise oil might decrease the efficacy of caffeine.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Anise and Acetaminophen, Butalbital, Caffeine

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

Why Are There 2 Interactions?

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

Moderate

CAFFEINE

1 of 2

Why this applies to Acetaminophen, Butalbital, Caffeine

Acetaminophen, Butalbital, Caffeine falls under CAFFEINE — the group Anise interacts with.

Theoretically, anise oil might decrease the efficacy of caffeine.
Animal research shows that taking anise oil with caffeine decreases the bioavailability of caffeine. Whether this interaction will occur in humans is unclear.
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 short version: this combo pill for tension headaches contains caffeine, and some animal studies hint that anise oil might lower how much caffeine your body actually absorbs. If that held true in people, the caffeine portion could work a little less, so you might notice slightly less of its usual perk, like reduced alertness or its mild boost to the pain relievers. The acetaminophen and butalbital parts aren't really part of this concern.

Honestly, I wouldn't lose sleep over this one. The evidence is lab-and-animal only, and nobody knows if it happens in humans. A cup of anise tea is very different from concentrated anise oil. If you're using strong anise supplements regularly, just mention it to your pharmacist or doctor.

References
  1. Samojlik I, Petkovic S, Stilinovic N, et al. Pharmacokinetic herb-drug interaction between essential oil of aniseed (Pimpinella anisum L., Apiaceae) and acetaminophen and caffeine: A potential risk for clinical practice. Phytother Res 2016;30:253-9.
Minor

ACETAMINOPHEN (Tylenol, others)

2 of 2
Theoretically, anise oil might decrease the levels and clinical effects of acetaminophen.
Animal research shows that taking anise oil with acetaminophen decreases peak plasma levels of acetaminophen but does not reduce overall bioavailability. Whether this interaction will occur in humans is unclear.
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 gist for your headache medicine (the Tecnal/Esgic-type combo): the only piece that anise has any link to is the acetaminophen part, not the butalbital or caffeine. In animal studies, concentrated anise oil seemed to lower the peak blood level of acetaminophen, basically slowing how fast it shows up, without reducing the total amount your body absorbs. So in theory it might take a little longer to feel the pain-relieving kick.

Honestly, this is very weak evidence (lab and animal only), rated minor, and nobody has shown it actually happens in people. A bit of anise in cooking or a cup of anise tea is unlikely to matter at all. If you regularly use strong anise essential oil, just mention it to your pharmacist or doctor to be safe.

References
  1. Samojlik I, Petkovic S, Stilinovic N, et al. Pharmacokinetic herb-drug interaction between essential oil of aniseed (Pimpinella anisum L., Apiaceae) and acetaminophen and caffeine: A potential risk for clinical practice. Phytother Res 2016;30:253-9.

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

Anise Also Interacts With Other Medications

Anise has 192 moderate, 52 minor known drug interactions in our database — the Acetaminophen, Butalbital, Caffeine 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 Anise

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Butalbital, Caffeine

This page covers Anise only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Butalbital, Caffeine page lists 252 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Ephedra (major) and Grapefruit (major).

By severity: 11 major · 197 moderate · 44 minor.

From our pharmacist’s overview on the Acetaminophen, Butalbital, Caffeine page

“Alcohol is the interaction I would flag first for anyone taking acetaminophen, butalbital, and caffeine (Esgic, Fiogesic, and others). Drinking raises the risk of liver injury from the acetaminophen component, and 38 of the 252 supplement ingredients on file carry that same liver concern.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Butalbital, Caffeine interaction page

One more smart check

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

We hold 465 real supplement products containing Anise, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Anise. Your product may carry other ingredients that interact with Acetaminophen, Butalbital, Caffeine too, on top of Anise — 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 Anise and Acetaminophen, Butalbital, Caffeine 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 Anise
Top 25%

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

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

#69 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 Anise

What is Anise?

Anise
  • Digestive upset and bloating
  • Cough and respiratory complaints
  • Sore throat
  • Menstrual discomfort
  • Flavoring agent

Anise is a fragrant, licorice-flavored seed used for centuries to ease digestion and soothe coughs. Most of its health claims are based on tradition and small or laboratory studies rather than strong human research, so evidence is limited. It is generally safe as a food and tea for most adults, but the concentrated essential oil should be used carefully and avoided in pregnancy.

Read the full Anise monograph & all interactions
Medication

About Acetaminophen, Butalbital, and Caffeine

What Is Acetaminophen, Butalbital, and Caffeine Used For?

Brand names: Tecnal, Esgic Plus, Fiogesic, Triad, Repan, Esgic, Fioricet

This combination product — available as capsules, tablets, and oral solution under various names including Fioricet — is used to relieve the symptoms of tension headaches (also called muscle contraction headaches).

All supported products, including Fioricet capsules and the oral solution, share this same indication. Because butalbital can be habit-forming, extended or repeated use is not recommended, and these products are not established as safe or effective for treating headaches that come back frequently over time.

See full Acetaminophen, Butalbital, and Caffeine drug information
Keep checking

Other Drugs & Anise

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

0Major
192Moderate
52Minor
2,585No known interaction
Moderate

192 interactions

Showing 60 of 192 moderate interactions — see all 192 on the Anise page.

Minor

52 interactions

No interaction 2,585 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

Keep exploring
Pharmacist Counseling Corner

Taking Anise and Acetaminophen, Butalbital, Caffeine Together: Common Questions

Can you take Anise with Acetaminophen, Butalbital, Caffeine?
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 Anise and Acetaminophen, Butalbital, Caffeine?
Acetaminophen, Butalbital, Caffeine belongs to more than one drug category, and Anise 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 Anise and Acetaminophen, Butalbital, Caffeine 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 Acetaminophen, Butalbital, Caffeine and Anise?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.