Drug & supplement interaction

Hops + Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital

Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital brand name: Cafergot PB.

Moderate Interaction
The bottom line Moderate

Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital 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 report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hops and Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital

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. Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital 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).

Moderate

CNS DEPRESSANTS

1 of 3

Why this applies to Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital

Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital falls under CNS DEPRESSANTS — the group Hops interacts with.

Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Some animal research shows that hops has sedative 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

This combo product (Cafergot PB) includes pentobarbital, a barbiturate that calms the nervous system. Hops is thought to have its own mild sedative, relaxing action. Putting the two together could, in theory, stack up that calming effect, so you might feel more drowsy, groggy, or lightheaded than usual, with slower reaction times. That matters if you drive or operate machinery.

I'll be honest with you: this concern is theoretical, mostly based on animal studies, not strong human proof. For most people the extra effect would be mild, but barbiturates are potent, so I wouldn't combine them casually. Please check with your pharmacist or doctor before adding hops, especially if you ever feel oversedated.

References
  1. 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
  2. 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.
  3. 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.
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 3

Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Hops extract does not seem to affect the metabolism of 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.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This combination pill (Cafergot PB) includes caffeine, which your body clears through a liver enzyme called CYP1A2. Hops do contain flavonoids that, in a test tube, can slow that enzyme down a little. On paper, that might make caffeine linger longer and add to jitteriness, a racing heartbeat, or trouble sleeping.

Here's the reassuring part: when researchers actually gave people a standardized hops extract for two weeks, caffeine levels didn't budge. So this concern stays in the lab and hasn't shown up in real people. I wouldn't lose sleep over it. Still, since this medicine also has ergotamine and a barbiturate, it's worth a quick check with your pharmacist before adding any sleep supplement.

References
  1. 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
  2. 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
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
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.
Severity Minor 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

This combo medicine (Cafergot PB) leans on the liver enzyme CYP3A4 to clear part of it, especially the ergotamine piece. The thinking here is that hops might nudge that enzyme to work a little faster, which could in theory lower drug levels and slightly soften the effect. None of these drugs are prodrugs, so faster clearance means less drug around, not more.

Honestly, I wouldn't lose sleep over this one. The evidence is just lab and animal data, and a human study showed only about an 8% drop in a similar drug, which isn't enough to matter. You're far more likely to notice that both hops and the pentobarbital in this product cause drowsiness, so they can stack up and leave you extra sleepy. If you use hops regularly, give your pharmacist a heads-up.

References
  1. 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
  2. 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.

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

Hops Also Interacts With Other Medications

Hops has 288 moderate, 576 minor known drug interactions in our database — the Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital 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 Hops

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

Everything else you take

See Every Supplement That Interacts With Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital

This page covers Hops only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital page lists 269 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), Beer (major), Ephedra (major) and Gamma-hydroxybutyrate (ghb) (major).

By severity: 13 major · 210 moderate · 46 minor.

From our pharmacist’s overview on the Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital page

“Cafergot PB combines ergotamine, caffeine, pentobarbital, and belladonna alkaloids to treat migraine, and the person taking it is often the same person reaching for kava to sleep or an herbal energy product afterward, which is exactly where the trouble sits. This list warrants genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital interaction page

One more smart check

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 Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital 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:

How much people look this up

Where Hops and Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital 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 Hops
Top 25%

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

29 days ago today
Medication Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital
Steady interest

#1,888 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 Hops

What is Hops?

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.

Read the full Hops monograph & all interactions
Keep checking

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.

0Major
288Moderate
576Minor
1,965No known interaction
Moderate

288 interactions

Showing 60 of 288 moderate interactions — see all 288 on the Hops page.

Minor

576 interactions

Showing 60 of 576 minor interactions — see all 576 on the Hops page.

No interaction 1,965 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.

Showing the 60 most looked-up of 1,965 medications checked with no known interaction — see the full Hops 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 Hops and Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital Together: Common Questions

Can you take Hops with Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital?
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 3 interactions listed for Hops and Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital?
Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital belongs to more than one drug category, and Hops 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 Hops and Bellafoline, Caffeine, Ergotamine Tartrate, Pentobarbital 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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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.