Drug & supplement interaction

Atractylodes + Aspirin, Caffeine, Codeine Phosphate

Aspirin, Caffeine, Codeine Phosphate brand name: Anacin w/ Codeine.

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

Aspirin, Caffeine, Codeine Phosphate falls into 3 drug categories that Atractylodes can interact with; the most serious is rated moderate. Theoretically, atractylodes might increase the risk of bleeding when used concomitantly with anticoagulant and antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Atractylodes and Aspirin, Caffeine, Codeine Phosphate

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Atractylodes interacts with whole categories of medication. Aspirin, Caffeine, Codeine Phosphate falls into 3 of those categories, so it can interact with Atractylodes in 3 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 3

Why this applies to Aspirin, Caffeine, Codeine Phosphate

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

Theoretically, atractylodes might increase the risk of bleeding when used concomitantly with anticoagulant and antiplatelet drugs.
Laboratory research suggests that atractylenolides II and III, constituents of atractylodes, reduce platelet activation. So far, this has not been shown in humans.
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 about this combo: your medication already contains aspirin, which thins the blood and makes platelets less sticky. Atractylodes may do a little of the same. In lab dishes, two of its compounds (atractylenolides II and III) lowered platelet activity, so stacking it on top of aspirin could, in theory, nudge your bleeding risk up a bit.

I want to be honest, though: this has only been seen in test tubes and animals, never proven in people. So it's a gentle caution, not a red alert. Just keep an eye out for things like easy bruising, nosebleeds, bleeding gums, or stomach upset from the aspirin. Before adding atractylodes, run it by your pharmacist or doctor, especially if you take it daily.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chen Y, Yang W, Guo L, Wu X, Zhang T, Liu J, Zhang J. Atractylodes lactone compounds inhibit platelet activation. Platelets. 2017 Mar;28(2):194-202. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 3

Aspirin, Caffeine, Codeine Phosphate also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, atractylodes might decrease the levels of CYP1A2 substrates.
In animals, atractylodes administered at high doses has been shown to induce CYP1A2 activity. This effect has not been shown in humans.
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

In this combo pill, the part that interacts is the caffeine. Caffeine is cleared by a liver enzyme called CYP1A2, and in animal studies (using high doses) atractylodes seemed to speed that enzyme up. If that happened in people, your body might break down caffeine a little faster, so you could feel less of its usual pick-me-up effect. The aspirin and codeine pieces aren't really affected by this particular interaction.

Honestly, this is a very minor, theoretical concern. It has only been seen in lab and animal research, never confirmed in humans, so I wouldn't lose sleep over it. Still, it's always smart to mention any new supplement to your pharmacist or doctor before adding it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Muhamad N, Plengsuriyakarn T, Na-Bangchang K. Atractylodes lancea for cholangiocarcinoma: Modulatory effects on CYP1A2 and CYP3A1 and pharmacokinetics in rats and biodistribution in mice. PLoS One 2022;17(11):e0277614. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Aspirin, Caffeine, Codeine Phosphate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, atractylodes might increase the levels of CYP3A4 substrates.
In animals, atractylodes administered at high doses has been shown to inhibit CYP3A1 activity, which is a homolog to the human CYP3A4 enzyme. This effect has not been shown in humans.
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 with this combo pill (aspirin, caffeine, and codeine). The codeine portion is the piece tied to the CYP3A4 idea you're reading about. Codeine is partly handled by an enzyme called CYP3A4, and in animal lab studies, high doses of atractylodes seemed to slow that enzyme down a bit. If that happened in people, codeine could hang around a little longer, which in theory might nudge up its usual effects like drowsiness, constipation, or feeling lightheaded.

That said, this is very weak, theoretical evidence. It has only been seen in test tubes and animals, not in humans, and it's rated a minor concern. I wouldn't lose sleep over it, but since codeine is a narcotic, it's worth a quick mention to your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Muhamad N, Plengsuriyakarn T, Na-Bangchang K. Atractylodes lancea for cholangiocarcinoma: Modulatory effects on CYP1A2 and CYP3A1 and pharmacokinetics in rats and biodistribution in mice. PLoS One 2022;17(11):e0277614. 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

Atractylodes Also Interacts With Other Medications

Atractylodes has 126 moderate, 674 minor known drug interactions in our database — the Aspirin, Caffeine, Codeine Phosphate one above is among them. If you take anything else, check it against the full list below.

Moderate 126 Minor 674 No known interaction 2,030 (incl. Aspirin, Caffeine, Codeine Phosphate)
Taking anything else?

Check Another of Your Medications Against Atractylodes

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

Everything else you take

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

This page covers Atractylodes only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, 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, Caffeine, Codeine Phosphate page

“Anacin with Codeine combines aspirin, caffeine, and codeine, and each of the three picks up its own supplement problems, so this is a list worth real caution. Just over half of the 398 ingredients here, 202 of them, can add to aspirin's blood-thinning action and raise bleeding risk.”

Reviewed by 2 · Jul 18, 2026

Open the Aspirin, Caffeine, Codeine Phosphate interaction page

One more smart check

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

We hold 691 real supplement products containing Atractylodes, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Atractylodes. Your product may carry other ingredients that interact with Aspirin, Caffeine, Codeine Phosphate too, on top of Atractylodes — 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 Atractylodes and Aspirin, 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 Atractylodes
Top 25%

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

29 days ago today
Medication Aspirin, Caffeine, Codeine Phosphate
Top half

#1,405 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 Atractylodes

What is Atractylodes?

Atractylodes
  • Digestive upset and poor appetite
  • Bloating and fluid retention
  • General fatigue or 'weakness'
  • Diarrhea
  • Support within traditional formulas

Atractylodes is a root used for centuries in traditional Chinese, Japanese, and Thai medicine, mostly for digestive complaints and fatigue, often as part of multi-herb formulas. Modern research is still early and mostly from lab and animal studies, so its true benefits in people are not well proven. If you want to try it, talk with a pharmacist or doctor first, and avoid it during pregnancy and breastfeeding.

Read the full Atractylodes monograph & all interactions
Keep checking

Other Drugs & Atractylodes

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

0Major
126Moderate
674Minor
2,029No known interaction
126 Moderate 674 Minor 2,029 No interaction
Moderate

126 interactions

Showing 60 of 126 moderate interactions — see all 126 on the Atractylodes page.

Minor

674 interactions

Showing 60 of 674 minor interactions — see all 674 on the Atractylodes page.

No interaction 2,029 drugs checked — show the list

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

Showing the 60 most looked-up of 2,029 medications checked with no known interaction — see the full Atractylodes list.

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

Can you take Atractylodes with Aspirin, 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 3 interactions listed for Atractylodes and Aspirin, Caffeine, Codeine Phosphate?
Aspirin, Caffeine, Codeine Phosphate belongs to more than one drug category, and Atractylodes 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 Atractylodes and Aspirin, 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, Caffeine, Codeine Phosphate and Atractylodes?

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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.