Drug & supplement interaction

Baikal Skullcap + Acetaminophen, Butalbital, Codeine Phosphate

Acetaminophen, Butalbital, Codeine Phosphate brand name: Phrenilin #3.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Butalbital, Codeine Phosphate falls into 2 drug categories that Baikal Skullcap can interact with; the most serious is rated moderate. Theoretically, Baikal skullcap may increase levels of drugs metabolized by CYP1A2 enzymes.

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

Baikal Skullcap and Acetaminophen, Butalbital, Codeine Phosphate

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Acetaminophen, Butalbital, Codeine Phosphate

Acetaminophen, Butalbital, Codeine Phosphate falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Baikal Skullcap interacts with.

Theoretically, Baikal skullcap may increase levels of drugs metabolized by CYP1A2 enzymes.
In vitro evidence suggests that constituents of Baikal skullcap inhibit the activity of CYP1A2. This effect has not been reported 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 honest scoop on combining Baikal skullcap with this combo pill (acetaminophen, butalbital, and codeine). The concern on file is that lab studies show skullcap may slow down a liver enzyme called CYP1A2. In theory, slowing that enzyme could let certain drugs build up a bit more in your system.

But here's the key thing: the main parts of this medication aren't mainly handled by CYP1A2, so this particular pairing is more of a theoretical flag than a proven problem. It has only been seen in test tubes, never reported in actual people. If you do notice extra drowsiness, dizziness, or feeling foggy, that's worth mentioning. Always check with your pharmacist or doctor before adding skullcap.

References
  1. Kim, B. R., Kim, D. H., Park, R., Kwon, K. B., Ryu, D. G., Kim, Y. C., Kim, N. Y., Jeong, S., Kang, B. K., and Kim, K. S. Effect of an extract of the root of Scutellaria baicalensis and its flavonoids on aflatoxin B1 oxidizing cytochrome P450 enzymes. Pl PubMed
  2. Li, T., Li, N., Guo, Q., Ji, H., Zhao, D., Xie, S., Li, X., Qiu, Z., Han, D., Chen, X., and You, Q. Inhibitory effects of wogonin on catalytic activity of cytochrome P450 enzyme in human liver microsomes. Eur J Drug Metab Pharmacokinet. 6-29-2011; PubMed
Minor

CNS DEPRESSANTS

2 of 2

Acetaminophen, Butalbital, Codeine Phosphate also falls under CNS DEPRESSANTS.

Theoretically, Baikal skullcap might cause additive therapeutic and adverse effects when used concomitantly with drugs with sedative properties.
In vitro and animal research suggests that Baikal skullcap binds to GABA-A receptors and causes sedation. Theoretically, Baikal skullcap might cause additive therapeutic and adverse effects when used concomitantly with drugs with sedative properties. Preliminary clinical research has not identified clinically relevant sedation after use of Baikal skullcap; however, a thorough evaluation of safety outcomes has not been conducted.
Severity Minor Likelihood Unlikely Evidence D

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

This combination pill already pulls your nervous system in a calming direction. The butalbital (a barbiturate) and the codeine both work as sedatives, and codeine is also a pain reliever that can make you drowsy. Baikal skullcap has been studied in lab and animal work and seems to gently nudge the same calming brain receptors (GABA), so on paper the two could add together.

In practice, this is rated minor and unlikely, and it rests only on test-tube and animal data, not solid human studies. Still, if you took both, you might notice extra sleepiness, dizziness, slowed thinking, or feeling unsteady. I wouldn't lose sleep over it, but check with your pharmacist or doctor before pairing them, especially if you drive or already feel groggy on this medicine.

References
  1. Hui KM, Wang XH, Xue H. Interaction of flavones from the roots of Scutellaria baicalensis with the benzodiazepine site. Planta Med 2000;66:91-3.
  2. Liao JF, Wang HH, Chen MC, et al. Benzodiazepine binding site-interactive flavones from Scutellaria baicalensis root. Planta Med 1998;64:571-2.
  3. Chang, H. H., Yi, P. L., Cheng, C. H., Lu, C. Y., Hsiao, Y. T., Tsai, Y. F., Li, C. L., and Chang, F. C. Biphasic effects of baicalin, an active constituent of Scutellaria baicalensis Georgi, in the spontaneous sleep-wake regulation. J Ethnopharmacol. 5- 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

Baikal Skullcap Also Interacts With Other Medications

Baikal Skullcap has 593 moderate, 352 minor known drug interactions in our database — the Acetaminophen, Butalbital, Codeine Phosphate 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 Baikal Skullcap

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Butalbital, Codeine Phosphate

This page covers Baikal Skullcap only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Butalbital, Codeine Phosphate page lists 240 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 Gamma-hydroxybutyrate (ghb) (major).

Open the Acetaminophen, Butalbital, Codeine Phosphate interaction page

One more smart check

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

We hold 737 real supplement products containing Baikal Skullcap, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Baikal Skullcap. Your product may carry other ingredients that interact with Acetaminophen, Butalbital, Codeine Phosphate too, on top of Baikal Skullcap — 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 Baikal Skullcap and Acetaminophen, Butalbital, 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 Baikal Skullcap
Top 25%

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

29 days ago today
Medication Acetaminophen, Butalbital, Codeine Phosphate
Steady interest

#1,523 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 Baikal Skullcap

What is Baikal Skullcap?

Baikal Skullcap
  • Inflammation
  • Allergies
  • Anxiety and sleep
  • Immune support
  • Respiratory infections

Baikal skullcap is a traditional Chinese herb (Huang Qin) used for inflammation, allergies, and infections, with active compounds like baicalin and baicalein studied mostly in the lab. Human evidence remains limited, so it should not replace proven treatments. Talk to your pharmacist or doctor before using it, and avoid it in pregnancy and breastfeeding.

Read the full Baikal Skullcap monograph & all interactions
Keep checking

Other Drugs & Baikal Skullcap

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

0Major
593Moderate
352Minor
1,884No known interaction
Moderate

593 interactions

Showing 60 of 593 moderate interactions — see all 593 on the Baikal Skullcap page.

Minor

352 interactions

Showing 60 of 352 minor interactions — see all 352 on the Baikal Skullcap page.

No interaction 1,884 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 Baikal Skullcap and Acetaminophen, Butalbital, Codeine Phosphate Together: Common Questions

Can you take Baikal Skullcap with Acetaminophen, Butalbital, 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 Baikal Skullcap and Acetaminophen, Butalbital, Codeine Phosphate?
Acetaminophen, Butalbital, Codeine Phosphate belongs to more than one drug category, and Baikal Skullcap 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 Baikal Skullcap and Acetaminophen, Butalbital, 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

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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.