Drug & supplement interaction

Ceylon Leadwort + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide

Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide brand name: Ascriptin Codeine #2.

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

Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide falls into 2 drug categories that Ceylon Leadwort can interact with; the most serious is rated moderate. Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 2D6 (CYP2D6) in vitro.

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

Ceylon Leadwort and Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide

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

Why Are There 2 Interactions?

Ceylon Leadwort interacts with whole categories of medication. Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide falls into 2 of those categories, so it can interact with Ceylon Leadwort 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 2D6 (CYP2D6) SUBSTRATES

1 of 2

Why this applies to Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide

Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Ceylon Leadwort interacts with.

Plumbagin, a constituent of Ceylon leadwort, has been shown to inhibit cytochrome P450 2D6 (CYP2D6) in vitro. So far, this interaction has not been reported in humans. Theoretically, Ceylon leadwort might increase the levels of drugs metabolized by CYP2D6. Some drugs metabolized by CYP2D6 include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), fluoxetine (Prozac), ondansetron (Zofran), tramadol (Ultram), and others.
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

This combination product contains codeine, and that's the piece I want to focus on. Codeine is a prodrug, meaning it doesn't do much until your body converts it into morphine using a liver enzyme called CYP2D6. Ceylon Leadwort contains plumbagin, which in lab tests has slowed that same enzyme down.

If that effect held true in people, it could mean less codeine gets turned into morphine, so you'd get weaker pain relief from this product. The good news: this is only theoretical right now, based on test-tube studies and never shown in humans, so I wouldn't lose sleep over it. Still, before pairing this supplement with your medicine, it's worth a quick chat with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Chen A, Zhou X, Tang S, Liu M, Wang X. Evaluation of the inhibition potential of plumbagin against cytochrome P450 using LC-MS/MS and cocktail approach. Sci Rep. 2016 Jun 22;6:28482. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

There is some concern that Ceylon leadwort might potentiate the effects of anticoagulant and antiplatelet drugs and possibly increase the risk of bleeding. Ceylon leadwort root extract has been shown to decrease platelet adhesion and prolong bleeding in animals. However, this effect has not yet been demonstrated in humans. Until more is known, use cautiously in patients taking anticoagulant or antiplatelet drugs. Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
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

The piece of this combination product that matters here is the aspirin. Aspirin already thins the blood by making platelets less sticky, which is part of why it can cause bruising, stomach upset, or bleeding. In animal studies, Ceylon Leadwort root also reduced platelet stickiness and made bleeding last longer, so stacking the two could, in theory, nudge your bleeding risk a bit higher.

I want to be honest about the evidence though: this effect has only been seen in lab and animal research, not in people, so it's more of a caution than a proven problem. Still, watch for things like easy bruising, nosebleeds, bleeding gums, or dark stools, and check with your pharmacist or doctor before adding this supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Vijayakumar R, Senthilvelan M, Ravindran R, Devi RS. Plumbago zeylanica action on blood coagulation profile with and without blood volume reduction. Vascul Pharmacol. 2006 Aug;45(2):86-90. 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

Ceylon Leadwort Also Interacts With Other Medications

Ceylon Leadwort has 1,096 moderate known drug interactions in our database — the Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide one above is among them. If you take anything else, check it against the full list below.

Moderate 1,096 No known interaction 1,734 (incl. Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide)
Taking anything else?

Check Another of Your Medications Against Ceylon Leadwort

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

Everything else you take

See Every Supplement That Interacts With Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide

This page covers Ceylon Leadwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide page lists 339 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: 11 major · 286 moderate · 42 minor.

From our pharmacist’s overview on the Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide page

“A person taking Ascriptin Codeine #2 for pain is getting aspirin, codeine, and two antacids in a single tablet, and the 339 supplement interactions on file deserve real attention before adding anything alongside it. Most of the list splits two ways.”

Reviewed by 2 · Jul 18, 2026

Open the Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interaction page

One more smart check

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

We hold 96 real supplement products containing Ceylon Leadwort, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ceylon Leadwort. Your product may carry other ingredients that interact with Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide too, on top of Ceylon Leadwort — 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 Ceylon Leadwort and Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide 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 Ceylon Leadwort
Top half

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

29 days ago today
Medication Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide
Top 5%

#77 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 Ceylon Leadwort

What is Ceylon Leadwort?

  • Digestive complaints and poor appetite
  • Skin conditions and wounds (applied to the skin)
  • Joint pain and swelling
  • Traditional 'metabolism-boosting' tonics
  • Antimicrobial folk remedy

Ceylon Leadwort (Plumbago zeylanica) is a plant long used in Ayurvedic and other traditional medicine systems, mainly for digestion, skin problems, and pain. Solid human studies are lacking, and the plant contains plumbagin, a compound that can irritate skin and tissues and may be unsafe in larger amounts. Talk to a pharmacist or doctor before using it, and avoid it in pregnancy.

Read the full Ceylon Leadwort monograph & all interactions
Keep checking

Other Drugs & Ceylon Leadwort

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

0Major
1,096Moderate
0Minor
1,733No known interaction
1,096 Moderate 1,733 No interaction
Moderate

1,096 interactions

Showing 60 of 1,096 moderate interactions — see all 1,096 on the Ceylon Leadwort page.

No interaction 1,733 drugs checked — show the list

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

Showing the 60 most looked-up of 1,733 medications checked with no known interaction — see the full Ceylon Leadwort list.

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

Can you take Ceylon Leadwort with Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide?
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 Ceylon Leadwort and Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide?
Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide belongs to more than one drug category, and Ceylon Leadwort 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 Ceylon Leadwort and Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide 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.