Drug & supplement interaction

Chokeberry + Acetaminophen, Aspirin, Caffeine

Acetaminophen, Aspirin, Caffeine brand names: Excedrin Migraine, Excedrin, Excedrin Extra Strength.

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

Acetaminophen, Aspirin, Caffeine falls into 2 drug categories that Chokeberry can interact with; the most serious is rated moderate. Theoretically, chokeberry might increase levels of drugs metabolized by CYP3A4.

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

Chokeberry and Acetaminophen, Aspirin, Caffeine

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

Why Are There 2 Interactions?

Chokeberry interacts with whole categories of medication. Acetaminophen, Aspirin, Caffeine falls into 2 of those categories, so it can interact with Chokeberry 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 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Acetaminophen, Aspirin, Caffeine

Acetaminophen, Aspirin, Caffeine falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Chokeberry interacts with.

Theoretically, chokeberry might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that chokeberry inhibits CYP3A4. In humans, there is one case report of a drug interaction with trabectedin, a CYP3A4 substrate, which is hypothesized to have been caused by chokeberry inhibition of CYP3A4.
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 version: this concern is mostly theoretical. Lab dish studies suggest chokeberry may slow down a liver enzyme called CYP3A4, and slowing that enzyme could let certain drugs build up a bit. But of the three ingredients in Excedrin, only caffeine leans on this pathway at all, and even caffeine is mostly handled by a different enzyme (CYP1A2). The acetaminophen and aspirin aren't really CYP3A4 stories.

So for this combo, any effect is likely small and unproven. At most, you might feel caffeine linger a little (jittery, hard to sleep, racing heart). Food amounts of chokeberry shouldn't matter; concentrated supplements are the bigger question mark. If you take Excedrin often, just run it by your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Bräunlich M, Christensen H, Johannesen S, Slimestad R, Wangensteen H, Malterud KE, Barsett H. In vitro inhibition of cytochrome P450 3A4 by Aronia melanocarpa constituents. Planta Med. 2013 Jan;79(2):137-41. PubMed
  2. Strippoli S, Lorusso V, Albano A, Guida M. Herbal-drug interaction induced rhabdomyolysis in a liposarcoma patient receiving trabectedin. BMC Complement Altern Med. 2013 Jul 30;13:199. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Acetaminophen, Aspirin, Caffeine also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, chokeberry might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Clinical and in vitro research suggests that chokeberry extract can temporarily inhibit platelet aggregation and decrease clot formation.
Severity Moderate Likelihood Possible Evidence B

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 combo product to watch here is the aspirin. Even at the low doses found in products like Excedrin, aspirin already makes your platelets less sticky, which is part of how it relieves pain but also why it can promote bruising and bleeding. Chokeberry's polyphenols appear to do something similar, gently slowing platelet clumping. Stacking the two could, in theory, add up and raise your bleeding risk a bit.

Honestly, the evidence here is still early and mostly based on small studies and lab work, so I don't want to alarm you. A little chokeberry jam or juice is unlikely to matter. Concentrated supplements are where I'd be more cautious, especially if you notice easy bruising, nosebleeds, or stomach upset. Check with your pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sikora J, Broncel M, Markowicz M, Chalubinski M, Wojdan K, Mikiciuk-Olasik E. Short-term supplementation with Aronia melanocarpa extract improves platelet aggregation, clotting, and fibrinolysis in patients with metabolic syndrome. Eur J Nutr. 2012 Aug;51 PubMed
  2. Ryszawa N, Kawczynska-Drózdz A, Pryjma J, Czesnikiewicz-Guzik M, Adamek-Guzik T, Naruszewicz M, Korbut R, Guzik TJ. Effects of novel plant antioxidants on platelet superoxide production and aggregation in atherosclerosis. J Physiol Pharmacol. 2006 Dec;57(

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

Chokeberry Also Interacts With Other Medications

Chokeberry has 810 moderate known drug interactions in our database — the Acetaminophen, Aspirin, Caffeine one above is among them. If you take anything else, check it against the full list below.

Moderate 810 No known interaction 2,020 (incl. Acetaminophen, Aspirin, Caffeine)
Taking anything else?

Check Another of Your Medications Against Chokeberry

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Aspirin, Caffeine

This page covers Chokeberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Aspirin, Caffeine page lists 371 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Ephedra (major).

By severity: 13 major · 312 moderate · 46 minor.

From our pharmacist’s overview on the Acetaminophen, Aspirin, Caffeine page

“Excedrin (acetaminophen, aspirin, and caffeine) packs three drugs into one tablet, which multiplies the ways supplements can collide with it, so treat this list with real care. Most entries involve the aspirin: hundreds of herbs add to its blood-thinning effect and raise bleeding risk, and even beer or wine earns a major rating for sto…”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Aspirin, Caffeine interaction page

One more smart check

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

We hold 493 real supplement products containing Chokeberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Chokeberry. Your product may carry other ingredients that interact with Acetaminophen, Aspirin, Caffeine too, on top of Chokeberry — 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 Chokeberry and Acetaminophen, Aspirin, Caffeine 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 Chokeberry
Top half

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

29 days ago today
Medication Acetaminophen, Aspirin, Caffeine
Top 25%

#389 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 Chokeberry

What is Chokeberry?

Chokeberry
  • Antioxidant support
  • Heart and blood vessel health
  • Blood pressure support
  • Blood sugar support
  • Common cold symptoms
  • Anti-inflammatory support

Chokeberry (aronia) is a dark berry rich in antioxidants called polyphenols, and it's widely eaten as juice, jam, and supplements. Early research hints it may support heart health, blood pressure, and blood sugar, but the evidence is still limited and far from proven. It's generally well tolerated as a food, but talk to your pharmacist or doctor before using concentrated supplements.

Read the full Chokeberry monograph & all interactions
Keep checking

Other Drugs & Chokeberry

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

0Major
810Moderate
0Minor
2,019No known interaction
810 Moderate 2,019 No interaction
Moderate

810 interactions

Showing 60 of 810 moderate interactions — see all 810 on the Chokeberry page.

No interaction 2,019 drugs checked — show the list

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

Showing the 60 most looked-up of 2,019 medications checked with no known interaction — see the full Chokeberry list.

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

Can you take Chokeberry with Acetaminophen, Aspirin, Caffeine?
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 Chokeberry and Acetaminophen, Aspirin, Caffeine?
Acetaminophen, Aspirin, Caffeine belongs to more than one drug category, and Chokeberry 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 Chokeberry and Acetaminophen, Aspirin, Caffeine 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 Acetaminophen, Aspirin, Caffeine and Chokeberry?

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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.