Fo-ti + Aspirin, Caffeine, Orphenadrine
Aspirin, Caffeine, Orphenadrine brand names: Norgesic Forte, Invagesic, Invagesic Forte, Orphengesic, Norgesic, and others.
Aspirin, Caffeine, Orphenadrine falls into 4 drug categories that Fo-ti can interact with; the most serious is rated moderate. Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.
Read the full interaction reportFo-ti and Aspirin, Caffeine, Orphenadrine
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, Caffeine, Orphenadrine 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 1A2 (CYP1A2) SUBSTRATES
1 of 4Why this applies to Aspirin, Caffeine, Orphenadrine
Aspirin, Caffeine, Orphenadrine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Fo-ti interacts with.
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.
In this combination product, the part to watch is the caffeine, which your body clears mainly through an enzyme called CYP1A2. Lab studies hint that Fo-ti might slow that enzyme down, especially the raw root. If that happened in real life, caffeine could linger longer and you might feel more jittery, anxious, fast-hearted, or have trouble sleeping. Confusingly, one animal study showed the opposite (an alcohol-based extract sped the enzyme up), so the direction isn't settled.
The important thing: this is only test-tube and animal data, never confirmed in people, so I wouldn't be alarmed. Aspirin and orphenadrine aren't really affected by this pathway. Just check with your pharmacist or doctor before pairing them.
- 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
2 of 4Aspirin, Caffeine, Orphenadrine 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.
In your combination pill, the muscle relaxer orphenadrine is the part handled by a liver enzyme called CYP3A4. Lab studies hint that Fo-ti might slow that enzyme down. If that happened, orphenadrine could build up a bit, which might mean more of its usual side effects like drowsiness, dry mouth, blurry vision, dizziness, or a faster heartbeat. The aspirin and caffeine pieces aren't really driven by this enzyme, so they're less of a concern here.
I want to be honest about how thin this evidence is. It comes only from test-tube and animal work, the studies even disagree, and it has never actually been reported in people. So I wouldn't lose sleep over it. Still, since Fo-ti has also been linked to liver problems, please run it past 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
ANTICOAGULANT/ANTIPLATELET DRUGS
3 of 4Aspirin, Caffeine, Orphenadrine 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.
The piece of this combo pill that matters here is the aspirin, which thins the blood a bit by making platelets less sticky. Fo-ti's concern isn't that it directly changes how aspirin works. The worry is that fo-ti has been tied to rare cases of liver injury, and your liver makes the proteins your body needs to form clots. If fo-ti harms the liver, your blood may clot less easily, and stacking that on top of aspirin could raise your bleeding risk (think easy bruising, nosebleeds, or stomach bleeding from the aspirin itself).
This is based on scattered case reports, not strong proof, so I don't want to alarm you. Still, please check with your pharmacist or doctor before combining them, especially if you notice yellowing skin, dark urine, or unusual bruising.
- 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
CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES
4 of 4Aspirin, Caffeine, Orphenadrine also falls under CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES.
Animal research suggests that fo-ti might inhibit CYP2B6. One in vitro study suggests that the degree of CYP2B6 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.
This combo product pairs aspirin and caffeine with orphenadrine, a muscle relaxant. The piece that matters here is orphenadrine, which is partly broken down by a liver enzyme called CYP2B6. In lab and animal studies, Fo-ti (especially the raw, less-processed root) appears to slow that enzyme down. If that happened in people, orphenadrine could build up a bit and you might notice more of its usual effects, like drowsiness, dizziness, dry mouth, blurred vision, or a faster heartbeat.
I want to be honest though: this is theoretical. It has only been seen in test tubes and animals, never confirmed in humans, so I wouldn't lose sleep over it. Still, since Fo-ti has its own liver-safety concerns, it's worth a quick chat with your pharmacist or doctor before combining the two.
- 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
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, Caffeine, Orphenadrine 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, Caffeine, Orphenadrine
This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Caffeine, Orphenadrine page lists 350 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: 14 major · 289 moderate · 47 minor.
From our pharmacist’s overview on the Aspirin, Caffeine, Orphenadrine page
“Aspirin, caffeine, and orphenadrine (the Norgesic and Orphengesic brands) come with a supplement list that deserves real vigilance, with 14 of its 350 entries rated major. Over 200 of those ingredients can add to aspirin's effect on platelets and raise bleeding risk, another 44 stack stimulant effects on top of the caffeine, and grapef…”
Reviewed by 2 · Jul 18, 2026
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, Caffeine, Orphenadrine 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, Caffeine, Orphenadrine 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.
#187 of 1,452 supplements looked up here in the last 7 days
#85 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 ›
- Sumatriptan ›
- Valacyclovir ›
- Hydroxyurea ›
- Lisinopril ›
- Pregabalin ›
- Azithromycin ›
- Levothyroxine, Liothyronine ›
- Lamotrigine ›
- Acyclovir ›
- Gabapentin ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Cyclopentolate ›
- Ezetimibe ›
- Carbidopa, Levodopa ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Roxithromycin ›
- Levetiracetam ›
- Thyroid Hormone ›
- Levodopa ›
- Mitomycin ›
- Alginic Acid, Aluminum Hydroxide ›
- Levothyroxine Sodium ›
- Atenolol ›
- Dexmethylphenidate ›
- Minoxidil ›
- Phentermine, Topiramate ›
- Cefaclor ›
- Daptomycin ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Amobarbital, Ephedrine Sulfate ›
- Pegunigalsidase Alfa-iwxj ›
- Hydroxychloroquine ›
- Flutemetamol F-18 ›
- Avatrombopag Maleate ›
- Factor 7a ›
- Hexobarbitone ›
- Articaine, Epinephrine ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Bentoquatam ›
- Peginterferon Alfa-2a, Ribavirin ›
- Atropine Methyl Nitrate, Digestive Enzymes ›
- Olmesartan Medoxomil ›
- Pizotifen ›
- Alendronate Sodium, Cholecalciferol ›
- Telmisartan ›
- Alglucosidase Alpha ›
- Charcoal (otc Drug) ›
- Phenylephrine ›
- Salbutamol Sulfate ›
- Colistin, Neomycin, Hydrocortisone ›
- Carbinoxamine Maleate ›
- Aminolevulinic Acid Hydrochloride ›
- Famotidine ›
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, Caffeine, Orphenadrine Is Linked to Lower Levels of 4 Nutrients
Natural Medicines records Aspirin, Caffeine, Orphenadrine 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, Caffeine, Orphenadrine 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, Caffeine, Orphenadrine Together: Common Questions
Can you take Fo-ti with Aspirin, Caffeine, Orphenadrine?
Why are there 4 interactions listed for Fo-ti and Aspirin, Caffeine, Orphenadrine?
How serious is the Fo-ti and Aspirin, Caffeine, Orphenadrine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Aspirin, Caffeine, Orphenadrine and Fo-ti?
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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.