Hops + Acetaminophen, Caffeine, Codeine
Acetaminophen, Caffeine, Codeine brand names: Gesic C8, Gesic C15, Lenoltec 2, Gesic C30, Lenoltec 3, and others.
Acetaminophen, Caffeine, Codeine falls into 3 drug categories that Hops can interact with; the most serious is rated moderate. Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full interaction reportHops and Acetaminophen, Caffeine, Codeine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Hops interacts with whole categories of medication. Acetaminophen, Caffeine, Codeine falls into 3 of those categories, so it can interact with Hops in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CNS DEPRESSANTS
1 of 3Why this applies to Acetaminophen, Caffeine, Codeine
Acetaminophen, Caffeine, Codeine falls under CNS DEPRESSANTS — the group Hops interacts with.
Some animal research shows that hops has sedative 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 simple version. This combo pill already contains codeine, which can make you feel sleepy or foggy on its own. Hops are mainly used to help with sleep and mild anxiety, so the worry is that the two together could pile on more drowsiness. That means feeling extra tired, slowed down, dizzy, or having trouble concentrating, especially if you're also driving or doing anything that needs you sharp.
I want to be honest about the strength of this concern, though. It's theoretical, based mostly on animal studies, not strong human proof. The caffeine in the pill may even offset a little of the sleepiness. Still, since codeine is a real sedative, it's worth a quick chat with your pharmacist or doctor before pairing them.
- Schiller, H., Forster, A., Vonhoff, C., Hegger, M., Biller, A., and Winterhoff, H. Sedating effects of Humulus lupulus L. extracts. Phytomedicine. 2006;13(8):535-541. PubMed
- Lee KM, Jung JS, Song DK, and et al. Effects of Humulus lupulus extract on the central nervous system in mice. Planta Med 1993;59(Suppl):A691.
- Assessment report on Humulus lupulus L., flos. European Medicines Agency, 2014. Available at: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-humulus-lupulus-l-flos_en.pdf. Accessed September 29, 2021.
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
2 of 3Acetaminophen, Caffeine, Codeine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro research suggests that flavonoid constituents of hops inhibit CYP1A2 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, does not affect levels of caffeine, a CYP1A2 probe substrate.
Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..
Good news here: this is a very minor, mostly theoretical concern. The piece of this combo pill that overlaps with hops is the caffeine, which your body clears using an enzyme called CYP1A2. In a test tube, certain hops flavonoids seemed to slow that enzyme down, which could in theory let caffeine linger a bit longer and add to jitteriness or trouble sleeping. But when researchers actually gave people a standardized hops extract for two weeks, caffeine levels didn't budge.
So in real life, taking hops with this product is unlikely to cause a problem. One thing worth keeping in mind separately: both hops and the codeine in this pill can make you drowsy, so you may feel sleepier than usual. If you have questions, your pharmacist is happy to look it over with you.
- Henderson MC, Miranda CL, Stevens JF, et al. In vitro inhibition of human P450 enzymes by prenylated flavonoids from hops, Humulus lupulus. Xenobiotica 2000;30:235-51.. PubMed
- van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. 2020;68(18):5212-5220. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 3Acetaminophen, Caffeine, Codeine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Animal research suggests that specific constituents of hops, called lupulones, can induce hepatic CYP3A4 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients with normal metabolism shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, decreases the concentration of alprazolam, a CYP3A4 probe substrate, by 7.6%. This reduction is unlikely to be clinically relevant.
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 situation with this combo pill. The codeine part is actually a prodrug, meaning your body has to convert it into morphine before it relieves pain. That conversion mostly runs through a different enzyme (CYP2D6), not the CYP3A4 pathway this interaction is about. So the theoretical worry that hops might slightly speed up CYP3A4 isn't likely to do much to how well your codeine works.
And honestly, the evidence here is thin. It comes from lab and animal studies, and a human study showed only about an 8% change in a CYP3A4 test drug, which is too small to matter. I wouldn't lose sleep over it. Just keep in mind both hops and codeine can make you drowsy, so the bigger real-world issue is feeling extra sleepy. If you have questions, check with your pharmacist.
- Mannering, G. J., Shoeman, J. A., and Deloria, L. B. Identification of the antibiotic hops component, colupulone, as an inducer of hepatic cytochrome P-4503A in the mouse. Drug Metab Dispos 1992;20(2):142-147. DOI
- van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. 2020;68(18):5212-5220. 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.
Hops Also Interacts With Other Medications
Hops has 288 moderate, 574 minor known drug interactions in our database — the Acetaminophen, Caffeine, Codeine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Hops
We haven’t checked that one against Hops yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Hops. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Caffeine, Codeine
This page covers Hops only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Caffeine, Codeine page lists 303 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 Ephedra (major).
By severity: 15 major · 244 moderate · 44 minor.
Taking Hops as Part of a Dietary Supplement Product? Check It for Interactions
We hold 1,325 real supplement products containing Hops, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hops. Your product may carry other ingredients that interact with Acetaminophen, Caffeine, Codeine too, on top of Hops — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Hops and Acetaminophen, Caffeine, Codeine 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.
#156 of 1,452 supplements looked up here in the last 7 days
#66 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 Hops
What is Hops?
- Sleep problems and insomnia
- Anxiety and restlessness
- Menopausal symptoms
- Mild digestive complaints
- Flavoring in beer and food
Hops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They are generally well tolerated when used short-term, though they may cause drowsiness, and should be avoided during pregnancy and breastfeeding because their safety is unknown.
Other Drugs & Hops
Browse every other medication we’ve checked against Hops — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
288 interactions
- Diphenhydramine ›
- Estradiol ›
- Flurazepam ›
- Triazolam ›
- Zopiclone ›
- Fentanyl ›
- Oxycodone ›
- Phenytoin ›
- Temazepam ›
- Carbamazepine ›
- Morphine Sulfate ›
- Nitrazepam ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Lofepramine ›
- Meprobamate ›
- Oxymorphone ›
- Propoxyphene ›
- Topiramate ›
- Aripiprazole ›
- Cetirizine ›
- Clobazam ›
- Clonazepam ›
- Clorazepate ›
- Desipramine ›
- Doxepin ›
- Hydromorphone ›
- Levetiracetam ›
- Metoclopramide ›
- Midazolam ›
- Phenobarbital ›
- Tramadol ›
- Valproic Acid ›
- Zolpidem ›
- Acetazolamide ›
- Alprazolam ›
- Aripiprazole Lauroxil ›
- Buprenorphine Hydrochloride ›
- Butabarbital Sodium ›
- Chlorpromazine ›
- Dexmedetomidine ›
- Esterified Estrogens ›
- Estropipate ›
- Gabapentin ›
- Hexobarbital ›
- Hydrocodone ›
- Hydrocodone Bitartrate ›
- Lithium Carbonate (prescription Drug) ›
- Loxapine ›
- Magnesium Sulfate (prescription Drug) ›
- Meperidine ›
- Oxcarbazepine ›
- Oxycodone Hydrochloride ›
- Pregabalin ›
- Tasimelteon ›
- Zaleplon ›
- Zonisamide ›
- Acepromazine ›
- Alfentanil ›
Showing 60 of 288 moderate interactions — see all 288 on the Hops page.
574 interactions
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Colchicine ›
- Oxybutynin ›
- Prednisolone ›
- Tacrolimus ›
- Budesonide ›
- Clindamycin ›
- Dextromethorphan ›
- Doxorubicin ›
- Fluticasone ›
- Miconazole ›
- Acetaminophen ›
- Everolimus ›
- Ivabradine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Nortriptyline ›
- Rifampin ›
- Testosterone Undecanoate ›
- Bendamustine ›
- Caffeine (otc Drug) ›
- Ciclesonide ›
- Cyclobenzaprine ›
- Dapsone ›
- Erythromycin Ethylsuccinate ›
- Erythromycin Stearate ›
- Etoposide ›
- Fluticasone Propionate ›
- Hydroxyzine ›
- Itraconazole ›
- Modafinil ›
- Nicardipine ›
- Omeprazole ›
- Pantoprazole ›
- Progesterone (prescription Drug) ›
- Riluzole ›
- Warfarin Sodium ›
- Abiraterone Acetate ›
- Almotriptan ›
- Ambrisentan ›
- Amiodarone ›
- Aprepitant ›
- Asenapine ›
- Beclomethasone ›
- Beclomethasone Dipropionate ›
Showing 60 of 574 minor interactions — see all 574 on the Hops page.
No interaction 1,967 drugs checked — show the list
We also checked Hops against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Aspirin ›
- Rosuvastatin ›
- Metoprolol ›
- Escitalopram ›
- Methamphetamine ›
- Tirzepatide ›
- Isotretinoin ›
- Ibuprofen ›
- Docusate ›
- Sumatriptan ›
- Valacyclovir ›
- Hydroxyurea ›
- Semaglutide ›
- Metformin ›
- Lisdexamfetamine ›
- Amphetamine ›
- Methotrexate ›
- Lisinopril ›
- Amoxicillin ›
- Bupropion ›
- Levothyroxine, Liothyronine ›
- Fluoxetine ›
- Doxycycline ›
- Azithromycin ›
- Acyclovir ›
- Dextroamphetamine ›
- Duloxetine ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Bisoprolol ›
- Acetylsalicylic Acid ›
- Cephalexin ›
- Cyclopentolate ›
- Insulin Degludec, Liraglutide ›
- Ezetimibe ›
- Thyroid Hormone ›
- Mannitol ›
- Roxithromycin ›
- Levodopa ›
- Carbidopa, Levodopa ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Spironolactone ›
- Alginic Acid, Aluminum Hydroxide ›
- Mitomycin ›
- Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Valsartan ›
- Sacubitril, Valsartan ›
- Magnesium Hydroxide (otc Drug) ›
- Venlafaxine ›
- Levothyroxine Sodium ›
- Atenolol, Chlorthalidone ›
- Atenolol ›
- Bupivacaine, Meloxicam ›
- Canagliflozin, Metformin ›
Showing the 60 most looked-up of 1,967 medications checked with no known interaction — see the full Hops 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
Acetaminophen, Caffeine, Codeine Is Linked to Lower Levels of 2 Nutrients
Natural Medicines records Acetaminophen, Caffeine, Codeine as a medicine that can lower these. This is not an interaction with Hops — 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 Acetaminophen, Caffeine, Codeine 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 Hops and Acetaminophen, Caffeine, Codeine Together: Common Questions
Can you take Hops with Acetaminophen, Caffeine, Codeine?
Why are there 3 interactions listed for Hops and Acetaminophen, Caffeine, Codeine?
How serious is the Hops and Acetaminophen, Caffeine, Codeine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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