German Chamomile + Aspirin, Caffeine, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate brand name: Synalgos DC.
Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 4 drug categories that German Chamomile can interact with; the most serious is rated moderate. Theoretically, German chamomile might have additive effects when used with CNS depressants.
Read the full interaction reportGerman Chamomile and Aspirin, Caffeine, Dihydrocodeine Bitartrate
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
German Chamomile interacts with whole categories of medication. Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 4 of those categories, so it can interact with German Chamomile in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CNS DEPRESSANTS
1 of 4Why this applies to Aspirin, Caffeine, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate falls under CNS DEPRESSANTS — the group German Chamomile interacts with.
German chamomile has mild sedative effects. Theoretically, concomitant use with drugs with sedative properties can cause additive effects and side effects.
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 takeaway with Synalgos DC. The dihydrocodeine in this combo is an opioid, and opioids already tend to make people drowsy, foggy, or lightheaded. German chamomile has a mild calming, sedative quality of its own. Put the two together and those effects could potentially stack, leaving you sleepier or more sluggish than you'd expect.
To be fair, this concern is mostly theoretical and comes from lab and animal work, not real patient cases. A cup of chamomile tea now and then is unlikely to cause trouble, while stronger concentrated extracts are more of a question mark. Still, if you notice extra drowsiness, take it easy with driving, and check in with your pharmacist or doctor before pairing them regularly.
- Viola H, Wasowski C, Levi de Stein M, et al. Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Med 1995;61:213-6.
- Avallone R, Zanoli P, Puia G, et al. Pharmacological profile of apigenin, a flavonoid isolated from Matricaria chamomilla. Biochem Pharmacol 2000;59:1387-94. PubMed
- Loggia RD, Traversa U, Scarcia V, et al. Depressive effects of Chamomilla recutita (L.) Rausch, tubular flowers, on central nervous system in mice. Pharmacol Res Commun 1982;14(2):153-162. PubMed
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 4Aspirin, Caffeine, Dihydrocodeine Bitartrate also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
In vitro evidence shows that German chamomile might inhibit CYP2D6. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2D6 in patients taking German chamomile.
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 this combo: the dihydrocodeine in Synalgos-DC is a prodrug. Your body uses an enzyme called CYP2D6 to turn it into its stronger active painkiller (dihydromorphine). German chamomile has been shown in lab studies to slow down that same CYP2D6 enzyme. So in theory, if chamomile blocks the conversion, you might get less pain relief from the dihydrocodeine, not more.
The good news is that this is only based on test-tube research and hasn't actually been seen in real people, so I wouldn't lose sleep over a cup of chamomile tea. The aspirin and caffeine parts aren't really affected here. If you rely on this medicine for pain and want to drink chamomile regularly, just run it by your pharmacist or doctor first.
- Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Aspirin, Caffeine, Dihydrocodeine Bitartrate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.
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 Synalgos DC (aspirin, caffeine, and dihydrocodeine). German chamomile has shown in lab dishes that it can slow down an enzyme called CYP3A4, which helps your body process many medicines. The dihydrocodeine piece is partly handled by this pathway, so in theory, if chamomile slows it down, a bit more drug could hang around. That might mean stronger opioid effects like extra drowsiness, dizziness, constipation, or slowed breathing in higher amounts.
That said, this is only a theoretical concern. It has been seen in test tubes, not in real people, and a cup of chamomile tea is very unlikely to cause trouble. Concentrated supplement doses are more of a question mark. If you use chamomile regularly, just mention it to your pharmacist or doctor so they can keep an eye on things.
- 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
- Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
4 of 4Aspirin, Caffeine, Dihydrocodeine Bitartrate also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro and animal research shows that German chamomile might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP1A2 in patients taking German chamomile.
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 (Synalgos DC), the piece that matters for chamomile is the caffeine. Caffeine is cleared by an enzyme called CYP1A2, and lab and animal studies hint that German chamomile might slow that enzyme down a little. If that happened, caffeine could hang around longer, so you might feel a bit more jittery, have trouble sleeping, a faster heartbeat, or a touch of stomach upset.
Honestly, this is a minor, theoretical concern. It has never actually been reported in people, and a casual cup of chamomile tea is very unlikely to cause problems. The aspirin and dihydrocodeine parts aren't really affected by this pathway. If you use concentrated chamomile supplements regularly, just mention it to your pharmacist or doctor.
- Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
- Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. 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.
German Chamomile Also Interacts With Other Medications
German Chamomile has 924 moderate, 35 minor 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.
Check Another of Your Medications Against German Chamomile
We haven’t checked that one against German Chamomile yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against German Chamomile. Pick one to open its full report.
See Every Supplement That Interacts With Aspirin, Caffeine, Dihydrocodeine Bitartrate
This page covers German Chamomile 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
Taking German Chamomile as Part of a Dietary Supplement Product? Check It for Interactions
We hold 782 real supplement products containing German Chamomile, each one broken down to its full ingredient list — and combination products often carry several ingredients besides German Chamomile. Your product may carry other ingredients that interact with Aspirin, Caffeine, Dihydrocodeine Bitartrate too, on top of German Chamomile — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where German Chamomile 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.
#248 of 1,452 supplements looked up here in the last 7 days
#1,540 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 German Chamomile
What is German Chamomile?
- Anxiety and stress
- Sleep and relaxation
- Digestive upset
- Skin irritation and inflammation
- Mouth sores and gum irritation
German chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin or digestive issues, but the evidence is limited and most uses are based on tradition rather than strong proof. It is generally well tolerated, but people allergic to ragweed or related plants and those who are pregnant should be cautious.
Other Drugs & German Chamomile
Browse every other medication we’ve checked against German Chamomile — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
924 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Trimipramine ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Meloxicam ›
- Meprobamate ›
- Nortriptyline ›
- Oxymorphone ›
- Propoxyphene ›
- Rifampin ›
Showing 60 of 924 moderate interactions — see all 924 on the German Chamomile page.
35 interactions
- Theophylline ›
- Acetaminophen ›
- Bendamustine ›
- Riluzole ›
- Asenapine ›
- Ropinirole ›
- Tizanidine ›
- Anagrelide ›
- Bendamustine Hydrochloride ›
- Fezolinetant ›
- Grepafloxacin ›
- Paracetamol ›
- Pirfenidone ›
- Rasagiline ›
- Ropivacaine ›
- Tacrine ›
- Triclabendazole ›
- Acetaminophen, Butalbital ›
- Acetaminophen, Pseudoephedrine ›
- Guaifenesin, Theophylline ›
- Acetaminophen, Chlorzoxazone ›
- Acetaminophen, Pamabrom, Pyrilamine ›
- Acetaminophen, Phenyltoloxamine ›
- Ephedrine, Hydroxyzine, Theophylline ›
- Acetaminophen, Aspirin ›
- Acetaminophen, Brompheniramine, Phenylpropanolamine ›
- Acetaminophen, Dexbrompheniramine, Pseudoephedrine ›
- Acetaminophen, Doxylamine, Pseudoephedrine ›
- Acetaminophen, Methocarbamol ›
- Acetaminophen, Orphenadrine ›
- Acetaminophen, Phenylpropanolamine ›
- Acetaminophen, Phenylpropanolamine, Phenyltoloxamine ›
- Acetaminophen, Phenyltoloxamine, Salicylamide ›
- Acetaminophen, Pseudoephedrine, Triprolidine ›
- Ephedrine Sulfate, Hydroxyzine, Theophylline ›
No interaction 1,870 drugs checked — show the list
We also checked German Chamomile against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Semaglutide ›
- Tirzepatide ›
- Bupropion ›
- Metformin ›
- Amoxicillin ›
- Acyclovir ›
- Lisinopril ›
- Doxycycline ›
- Methotrexate ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Mannitol ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Spironolactone ›
- Factor 7a ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Minoxidil ›
- Mitomycin ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Lenvatinib ›
- Phenylephrine ›
- Vancomycin ›
- Hethylphenidate Hcl ›
- Dirithromycin ›
- Bentoquatam ›
- Procainamide ›
- Tenecteplase ›
- Amoxicillin, Clavulanate Potassium ›
- Hydroxychloroquine ›
- Digoxin ›
- Azelaic Acid ›
- Dextrothyroxine ›
- Triptorelin ›
- Lomustine ›
- Acetylsalicylic Acid ›
- Hydrochlorothiazide ›
Showing the 60 most looked-up of 1,870 medications checked with no known interaction — see the full German Chamomile 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, Dihydrocodeine Bitartrate Is Linked to Lower Levels of 4 Nutrients
Natural Medicines records Aspirin, Caffeine, Dihydrocodeine Bitartrate as a medicine that can lower these. This is not an interaction with German Chamomile — 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, Dihydrocodeine Bitartrate 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 German Chamomile and Aspirin, Caffeine, Dihydrocodeine Bitartrate Together: Common Questions
Can you take German Chamomile with Aspirin, Caffeine, Dihydrocodeine Bitartrate?
Why are there 4 interactions listed for German Chamomile and Aspirin, Caffeine, Dihydrocodeine Bitartrate?
How serious is the German Chamomile and Aspirin, Caffeine, Dihydrocodeine Bitartrate interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Aspirin, Caffeine, Dihydrocodeine Bitartrate and German Chamomile?
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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.