Drug & supplement interaction

Corydalis Yanhusuo + Aspirin, Caffeine, Dihydrocodeine Bitartrate

Aspirin, Caffeine, Dihydrocodeine Bitartrate brand name: Synalgos DC.

Moderate Interaction
The bottom line Moderate

Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 4 drug categories that Corydalis Yanhusuo can interact with; the most serious is rated moderate. Theoretically, Corydalis yanhusuo might increase the sedative effects of CNS depressants.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Corydalis Yanhusuo and Aspirin, Caffeine, Dihydrocodeine Bitartrate

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Corydalis Yanhusuo interacts with whole categories of medication. Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 4 of those categories, so it can interact with Corydalis Yanhusuo in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 4

Why this applies to Aspirin, Caffeine, Dihydrocodeine Bitartrate

Aspirin, Caffeine, Dihydrocodeine Bitartrate falls under CNS DEPRESSANTS — the group Corydalis Yanhusuo interacts with.

Theoretically, Corydalis yanhusuo might increase the sedative effects of CNS depressants.
Corydalis yanhusuo contains berberine. Animal research suggests that berberine may have sedative effects. Theoretically, Corydalis yanhusuo might also have CNS depressants effects.
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 keep in mind: the dihydrocodeine in Synalgos DC is an opioid pain reliever, and opioids already tend to make people drowsy and slow the breathing a bit. Corydalis yanhusuo is thought to have its own calming, sedative-like effect on the brain. So if you stack the two together, you could feel more sleepy, foggy, dizzy, or short of breath than you would from the medicine alone. The caffeine in the combo doesn't really cancel that out.

I'll be straight with you: this concern is theoretical, based mostly on animal studies of the herb's compounds, not solid human data. Still, since added sedation can be risky with an opioid, it's worth a quick chat with your pharmacist or doctor before pairing them. Please don't change anything on your own.

References
  1. Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
  2. Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
  3. Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
  4. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 4

Aspirin, Caffeine, Dihydrocodeine Bitartrate also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP2D6.
Corydalis yanhusuo contains berberine. In vitro research and preliminary clinical evidence show that berberine can inhibit CYP2D6. Theoretically, Corydalis yanhusuo might also inhibit CYP2D6.
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 wrinkle with Synalgos DC: the dihydrocodeine part is a prodrug. Your liver uses an enzyme called CYP2D6 to convert it into the stronger painkiller that actually does the work. Corydalis (which contains berberine) may gently block that same enzyme. In theory, that means less of the dihydrocodeine gets switched on, so you could get weaker pain relief rather than more.

I want to be honest, though: this is a theoretical concern based on lab work, not solid human studies, so it may not amount to much in real life. The aspirin and caffeine pieces aren't really involved here. If you're leaning on this combo for pain and add Corydalis, just loop in your pharmacist or doctor first so they can keep an eye on how well it's working.

References
  1. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
  2. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  3. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 4

Aspirin, Caffeine, Dihydrocodeine Bitartrate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, Corydalis yanhusuo might increase serum levels of drugs metabolized by CYP3A4.
Corydalis yanhusuo contains berberine. In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, Corydalis yanhusuo might also inhibit 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 gist with Synalgos DC (aspirin, caffeine, and dihydrocodeine). The concern is the dihydrocodeine part, which your liver partly handles through an enzyme called CYP3A4. Corydalis contains compounds (like berberine) that may gently slow that enzyme down. If it does, a bit more of the medicine could hang around, which in theory could nudge up opioid effects like drowsiness, dizziness, constipation, or slowed breathing.

I'll be honest though: this is theoretical, based on lab work rather than real patient reports, so it may not amount to much. Still, since dihydrocodeine is an opioid, it's worth running past your pharmacist or doctor before combining the two. Please don't change anything on your own.

References
  1. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  2. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  3. Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
  4. Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

4 of 4

Aspirin, Caffeine, Dihydrocodeine Bitartrate also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, Corydalis yanhusuo might increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Corydalis yanhusuo contains berberine. In vitro and in vivo research suggest that berberine can inhibit platelet aggregation. Theoretically, Corydalis yanhusuo might also inhibit platelet aggregation.
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 combo product that matters here is the aspirin. Aspirin already thins the blood by keeping platelets from clumping together, which is part of how it works. Corydalis contains a compound called berberine, and in lab and animal studies that compound also seemed to slow platelet clumping. Put the two together and, in theory, you could get a little extra blood-thinning effect.

I want to be honest about the evidence here: this concern comes only from test tube and animal research, not real human cases, so it's more of a caution than a proven problem. Still, watch for things like easy bruising, nosebleeds, bleeding gums, or stomach upset. Before adding Corydalis, please check with your pharmacist or doctor first.

References
  1. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  2. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.

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

Corydalis Yanhusuo Also Interacts With Other Medications

Corydalis Yanhusuo has 1,159 moderate known drug interactions in our database — the Aspirin, Caffeine, Dihydrocodeine Bitartrate 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 Corydalis Yanhusuo

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

Everything else you take

See Every Supplement That Interacts With Aspirin, Caffeine, Dihydrocodeine Bitartrate

This page covers Corydalis Yanhusuo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.

Open the Aspirin, Caffeine, Dihydrocodeine Bitartrate interaction page

How much people look this up

Where Corydalis Yanhusuo and Aspirin, Caffeine, Dihydrocodeine Bitartrate 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 Corydalis Yanhusuo
Steady interest

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

29 days ago today
Medication Aspirin, Caffeine, Dihydrocodeine Bitartrate
Steady interest

#1,461 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 Corydalis Yanhusuo

What is Corydalis Yanhusuo?

  • Pain relief
  • Menstrual cramps
  • Headache
  • Stress and sleep support
  • Stomach and abdominal discomfort

Corydalis yanhusuo is a traditional Chinese herb used mainly for pain. Some early laboratory and animal research suggests its compounds may affect pain and the nervous system, but high-quality human studies are limited, so its true benefits and long-term safety are not well established. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Corydalis Yanhusuo monograph & all interactions
Keep checking

Other Drugs & Corydalis Yanhusuo

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

0Major
1,159Moderate
0Minor
1,670No known interaction
Moderate

1,159 interactions

Showing 60 of 1,159 moderate interactions — see all 1,159 on the Corydalis Yanhusuo page.

No interaction 1,670 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 Corydalis Yanhusuo and Aspirin, Caffeine, Dihydrocodeine Bitartrate Together: Common Questions

Can you take Corydalis Yanhusuo with Aspirin, Caffeine, Dihydrocodeine Bitartrate?
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 4 interactions listed for Corydalis Yanhusuo and Aspirin, Caffeine, Dihydrocodeine Bitartrate?
Aspirin, Caffeine, Dihydrocodeine Bitartrate belongs to more than one drug category, and Corydalis Yanhusuo 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 Corydalis Yanhusuo and Aspirin, Caffeine, Dihydrocodeine Bitartrate 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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