Drug & supplement interaction

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

Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide brand name: Ascriptin Codeine #3.

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

Aspirin, Aluminum Hydroxide, 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 Aspirin, Aluminum Hydroxide, 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. Aspirin, Aluminum Hydroxide, 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 Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide

Aspirin, Aluminum Hydroxide, 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

The piece to focus on here is the codeine in this combination product. Codeine is a prodrug, meaning your body has to convert it into morphine (the part that actually relieves pain) using a liver enzyme called CYP2D6. In lab tests, the plumbagin in Ceylon Leadwort appears to block that very enzyme. If it did the same in people, less codeine would turn into morphine, so you might get weaker pain relief than expected.

The good news: this is only test-tube evidence and hasn't been seen in real patients, so I wouldn't lose sleep over it. The aspirin, aluminum hydroxide, and magnesium hydroxide parts aren't really affected. Still, before adding this herb, run it by 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

Aspirin, Aluminum Hydroxide, 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 is already a blood thinner that keeps your platelets from clumping together. Ceylon Leadwort may do something similar, since its root extract slowed platelet stickiness and lengthened bleeding time in animal studies. Stacked on top of aspirin, the theory is that you could bruise or bleed a little more easily, see longer bleeding from small cuts, or rarely notice stomach upset or bleeding.

I want to be honest about the strength of this: it is based only on lab and animal work, not on people, so it is a soft caution rather than a red alert. Still, since you are already on aspirin, it is worth running Ceylon Leadwort by your pharmacist or doctor before starting it.

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 Aspirin, Aluminum Hydroxide, 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. Aspirin, Aluminum Hydroxide, 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 Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide

This page covers Ceylon Leadwort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide page lists 293 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: 8 major · 246 moderate · 39 minor.

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

“Bleeding dominates the supplement list for Ascriptin Codeine #3, which pairs aspirin and codeine with two antacid ingredients. Of 293 interactions on file, 8 are rated major, and this combination pill earns real caution.”

Reviewed by 2 · Jul 18, 2026

Open the Aspirin, Aluminum Hydroxide, 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 Aspirin, Aluminum Hydroxide, 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 Aspirin, Aluminum Hydroxide, 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

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

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

#83 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 Aspirin, Aluminum Hydroxide, 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 Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide supplement interactions › Every supplement checked against Aspirin, Aluminum Hydroxide, 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 Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide Together: Common Questions

Can you take Ceylon Leadwort with Aspirin, Aluminum Hydroxide, 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 Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide?
Aspirin, Aluminum Hydroxide, 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 Aspirin, Aluminum Hydroxide, 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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