Drug & supplement interaction

Aspen + 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

Aspen has a moderate interaction with Aspirin, Butalbital, Caffeine, Codeine Phosphate. Aspen contains salicin, a plant salicylate.

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

Aspen and Aspirin, Butalbital, Caffeine, Codeine Phosphate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ASPIRIN

Aspen contains salicin, a plant salicylate. Theoretically, aspen might have an additive effect with other salicylate-containing drugs, such as aspirin.
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 thing to know: this combination product (Fiorinal with Codeine) already contains aspirin, which is a salicylate. Aspen bark holds a natural cousin called salicin that your body turns into salicylic acid, the same family of compound. So taking both at once could stack salicylates on top of each other. On paper, that extra load might raise your chance of aspirin-type side effects like stomach upset, heartburn, or stomach bleeding, and at higher amounts ringing in the ears.

I'll be honest, this concern is theoretical and based on how the chemistry lines up, not on strong human studies. Still, since you're already getting a real dose of aspirin in this medicine, I'd run any aspen product by your pharmacist or doctor first, especially if you're aspirin-sensitive or take it daily.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Goodman LS, Gilman A. The Pharmacological Basis of Therapeutics. 5th ed. New York, NY: Macmillan Publ. Co., Inc., 1975.

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

Aspen Also Interacts With Other Medications

Aspen has 38 moderate known drug interactions in our database — the Aspirin, Butalbital, Caffeine, Codeine Phosphate one above is one of them. If you take anything else, check it against the full list below.

Moderate 38 No known interaction 2,792 (incl. Aspirin, Butalbital, Caffeine, Codeine Phosphate)
Taking anything else?

Check Another of Your Medications Against Aspen

Covers the 2,830 medications we’ve checked against Aspen. 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 Aspen 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 Aspen as Part of a Dietary Supplement Product? Check It for Interactions

We hold 8 real supplement products containing Aspen, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Aspen. Your product may carry other ingredients that interact with Aspirin, Butalbital, Caffeine, Codeine Phosphate too, on top of Aspen — 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 Aspen 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 Aspen
Top half

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

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

#1,766 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 Aspen

What is Aspen?

Aspen
  • Joint and muscle pain
  • Arthritis-related discomfort
  • Urinary tract symptoms and prostate issues
  • Mild fever and inflammation
  • Nerve pain (sciatica, neuropathic pain)

Aspen bark and leaf contain salicin, a natural compound related to aspirin, which is why it is traditionally used for pain, fever, and inflammation. Solid human studies are lacking, and because it acts like aspirin it carries similar risks. Talk to your pharmacist or doctor before using it, especially if you are sensitive to aspirin.

Read the full Aspen monograph & all interactions
Keep checking

Other Drugs & Aspen

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

0Major
38Moderate
0Minor
2,791No known interaction
38 Moderate 2,791 No interaction
Moderate

38 interactions

No interaction 2,791 drugs checked — show the list

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

Showing the 60 most looked-up of 2,791 medications checked with no known interaction — see the full Aspen list.

See the full Aspen 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
Aspen 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 Aspen and Aspirin, Butalbital, Caffeine, Codeine Phosphate Together: Common Questions

Can you take Aspen 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.
How serious is the Aspen 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 Aspen?

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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.