Fo-ti + Aspirin, Butalbital, Caffeine, Codeine Phosphate
Aspirin, Butalbital, Caffeine, Codeine Phosphate brand name: Fiorinal w/ Codeine.
Aspirin, Butalbital, Caffeine, Codeine Phosphate falls into 4 drug categories that Fo-ti can interact with; the most serious is rated moderate. Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full interaction reportFo-ti and Aspirin, Butalbital, Caffeine, Codeine Phosphate
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Fo-ti interacts with whole categories of medication. Aspirin, Butalbital, Caffeine, Codeine Phosphate falls into 4 of those categories, so it can interact with Fo-ti in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 4Why this applies to Aspirin, Butalbital, Caffeine, Codeine Phosphate
Aspirin, Butalbital, Caffeine, Codeine Phosphate falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Fo-ti interacts with.
Animal research suggests that fo-ti might inhibit CYP2D6. Additionally, an in vitro study suggests that the degree of CYP2D6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
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.
Here's the wrinkle with Fiorinal with Codeine: the codeine part is a prodrug. Your body has to use an enzyme called CYP2D6 to turn codeine into morphine, which is what actually relieves pain. Lab and animal studies hint that Fo-ti (especially the raw root) might slow down CYP2D6. If that enzyme is blocked, less codeine gets converted to morphine, so you might get weaker pain relief than expected.
I want to be honest about the evidence here. This is only seen in test-tube and animal research, never confirmed in people, so it's more of a theoretical caution than a proven problem. Still, if you take this combo and notice your pain isn't well controlled, mention it to your pharmacist or doctor before changing anything.
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
2 of 4Aspirin, Butalbital, Caffeine, Codeine Phosphate also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.
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.
Here's the practical angle for this combo pill. Of its four ingredients, the caffeine is the one cleared mainly by an enzyme called CYP1A2. Lab studies hint that Fo-ti might slow that enzyme down, which could let caffeine linger longer in your system. In real life that might mean more jitteriness, a racing heart, trouble sleeping, or feeling wired, especially since this medication already contains added caffeine.
That said, this is only a theoretical concern based on test-tube and animal research, never confirmed in people, and the effect can even flip depending on how the Fo-ti is processed. So I wouldn't lose sleep over it (pun intended), but since Fo-ti has its own liver-safety questions, please run it by your pharmacist or doctor first.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Aspirin, Butalbital, Caffeine, Codeine Phosphate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction has not been reported in humans.
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.
Here's the gist with Fiorinal with Codeine. A few pieces of this combo pill, mainly the butalbital (a barbiturate) and to some degree the codeine, lean on a liver enzyme called CYP3A4 to get processed. In test-tube studies, fo-ti has shown it might slow that enzyme down. If that happened in your body, these ingredients could clear a little slower and build up, nudging up effects like drowsiness, dizziness, slowed breathing, or feeling foggy.
The reassuring part: this is only theoretical, based on lab work, and the animal data actually disagrees. It has never been reported in real people. Still, since this medicine already causes sedation and can be habit-forming, I'd run the fo-ti by your pharmacist or doctor before combining them rather than guessing.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
- Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
- Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
ANTICOAGULANT/ANTIPLATELET DRUGS
4 of 4Aspirin, Butalbital, Caffeine, Codeine Phosphate also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.
Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
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.
Of the four ingredients in Fiorinal with Codeine, the one that matters most for this interaction is the aspirin. Aspirin already thins the blood by making platelets less sticky. Fo-ti's concern here is not that it directly thins blood, but that it has been tied to rare cases of liver injury. Since your liver makes the proteins that help blood clot, a stressed liver plus aspirin could, in theory, raise your risk of bleeding or bruising more easily.
To be honest, this is based on a single anecdotal report involving warfarin, not aspirin, so the evidence is weak. Still, if you take this combo regularly, watch for unusual bruising, nosebleeds, dark stools, or signs of liver trouble like yellowing skin or belly pain. Please loop in your pharmacist or doctor before mixing the two.
- Jung KA, Min HJ, Yoo SS, et al. Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb. Gut Liver 2011;5(4):493-9. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Fo-ti Also Interacts With Other Medications
Fo-ti has 1,256 moderate known drug interactions in our database — the Aspirin, Butalbital, Caffeine, Codeine Phosphate one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Fo-ti
We haven’t checked that one against Fo-ti yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Fo-ti. Pick one to open its full report.
See Every Supplement That Interacts With Aspirin, Butalbital, Caffeine, Codeine Phosphate
This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Butalbital, Caffeine, Codeine Phosphate 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.
From our pharmacist’s overview on the Aspirin, Butalbital, Caffeine, Codeine Phosphate page
“Fiorinal with Codeine packs four active drugs into one capsule, and I would treat its supplement list with genuine wariness rather than a quick skim. The aspirin component is why roughly half of the 398 ingredients on file raise bleeding risk, while the codeine and butalbital explain a second large cluster that deepens sedation, someti…”
Reviewed by 2 · Jul 18, 2026
Open the Aspirin, Butalbital, Caffeine, Codeine Phosphate interaction page
Taking Fo-ti as Part of a Dietary Supplement Product? Check It for Interactions
We hold 976 real supplement products containing Fo-ti, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fo-ti. Your product may carry other ingredients that interact with Aspirin, Butalbital, Caffeine, Codeine Phosphate too, on top of Fo-ti — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Fo-ti and Aspirin, Butalbital, Caffeine, 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.
#208 of 1,452 supplements looked up here in the last 7 days
#1,728 of 2,830 medications looked up here in the last 7 days
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.
About Fo-ti
What is Fo-ti?
- Anti-aging and longevity
- Hair graying and hair loss
- General tonic for vitality
- Constipation
- High cholesterol
Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these benefits is limited, and processed Fo-ti has been linked to reports of liver injury, so caution and professional guidance are important.
Other Drugs & Fo-ti
Browse every other medication we’ve checked against Fo-ti — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,256 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Amoxicillin ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Fenofibrate ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Methyltestosterone ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Allopurinol ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
Showing 60 of 1,256 moderate interactions — see all 1,256 on the Fo-ti page.
No interaction 1,573 drugs checked — show the list
We also checked Fo-ti against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Escitalopram ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Lisinopril ›
- Acyclovir ›
- Pregabalin ›
- Lamotrigine ›
- Azithromycin ›
- Gabapentin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Cyclopentolate ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Roxithromycin ›
- Levetiracetam ›
- Pegunigalsidase Alfa-iwxj ›
- Ezetimibe ›
- Daptomycin ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Mitomycin ›
- Hexobarbitone ›
- Thyroid Hormone ›
- Phentermine, Topiramate ›
- Carbidopa, Levodopa ›
- Factor 7a ›
- Levodopa ›
- Minoxidil ›
- Hethylphenidate Hcl ›
- Cefaclor ›
- Azelaic Acid ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Vancomycin ›
- Dirithromycin ›
- Triptorelin ›
- Pizotifen ›
- Bentoquatam ›
- Pentobarbitone ›
- Ribavirin Aerosol ›
- Procainamide ›
- Dextrothyroxine ›
- Tocainide ›
- Rocuronium ›
- Telmisartan ›
- Mitomycin C ›
- Lomustine ›
- Lorazepam ›
- Digitoxin ›
- Salbutamol Sulfate ›
- Chenodiol ›
- Caspofungin ›
- Desflurane ›
Showing the 60 most looked-up of 1,573 medications checked with no known interaction — see the full Fo-ti list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Aspirin, Butalbital, Caffeine, Codeine Phosphate Is Linked to Lower Levels of 4 Nutrients
Natural Medicines records Aspirin, Butalbital, Caffeine, Codeine Phosphate as a medicine that can lower these. This is not an interaction with Fo-ti — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Aspirin, Butalbital, Caffeine, Codeine Phosphate nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Fo-ti and Aspirin, Butalbital, Caffeine, Codeine Phosphate Together: Common Questions
Can you take Fo-ti with Aspirin, Butalbital, Caffeine, Codeine Phosphate?
Why are there 4 interactions listed for Fo-ti and Aspirin, Butalbital, Caffeine, Codeine Phosphate?
How serious is the Fo-ti and Aspirin, Butalbital, Caffeine, Codeine Phosphate interaction?
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.