Drug & supplement interaction

Ipriflavone + Aspirin, Butalbital, Caffeine, Codeine Phosphate

Aspirin, Butalbital, Caffeine, Codeine Phosphate brand name: Fiorinal w/ Codeine.

Moderate Interaction
The bottom line Moderate

Ipriflavone has a moderate interaction with Aspirin, Butalbital, Caffeine, Codeine Phosphate. Ipriflavone is thought to competitively inhibit cytochrome P450 1A2 (CYP1A2).

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ipriflavone and Aspirin, Butalbital, Caffeine, Codeine Phosphate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Aspirin, Butalbital, Caffeine, Codeine Phosphate

Aspirin, Butalbital, Caffeine, Codeine Phosphate falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Ipriflavone interacts with.

Ipriflavone is thought to competitively inhibit cytochrome P450 1A2 (CYP1A2). Theoretically, concurrent use of ipriflavone and drugs metabolized by these enzymes might result in decreased drug elimination, increased serum levels, and potential toxicity. Some drugs metabolized by CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), Pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline (Slo-bid, Theo-Dur, others), zileuton (Zyflo), Zolmitriptan (Zomig), and others.
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

In this combination pill (Fiorinal with Codeine), the part most affected by ipriflavone is the caffeine. Caffeine is cleared by an enzyme called CYP1A2, and ipriflavone may slow that enzyme down. The catch is that this is only a theoretical concern based on lab studies, not real-world cases, so the effect is uncertain.

If it did happen, caffeine could linger longer than usual, leaving you feeling jittery, restless, fast-hearted, or having trouble sleeping. The aspirin, butalbital, and codeine pieces are handled by other pathways and aren't really driven by CYP1A2. None of this is cause for alarm, but if you take ipriflavone regularly, mention it to your pharmacist or doctor so they can keep an eye on things.

References
  1. Monostory K, Vereczkey L, Levai F, et al. Ipriflavone as an inhibitor of human cytochrome P450 enzymes. Br J Pharmacol 1998;123:605-10. 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

Ipriflavone Also Interacts With Other Medications

Ipriflavone has 390 moderate known drug interactions in our database — the Aspirin, Butalbital, Caffeine, Codeine Phosphate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Ipriflavone

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

Everything else you take

See Every Supplement That Interacts With Aspirin, Butalbital, Caffeine, Codeine Phosphate

This page covers Ipriflavone 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

One more smart check

Taking Ipriflavone as Part of a Dietary Supplement Product? Check It for Interactions

We hold 204 real supplement products containing Ipriflavone, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ipriflavone. Your product may carry other ingredients that interact with Aspirin, Butalbital, Caffeine, Codeine Phosphate too, on top of Ipriflavone — 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 Ipriflavone 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.

Supplement Ipriflavone
Top half

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

29 days ago today
Medication Aspirin, Butalbital, Caffeine, Codeine Phosphate
Top 5%

#136 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 Ipriflavone

What is Ipriflavone?

Ipriflavone
  • Bone density and osteoporosis
  • Postmenopausal bone loss
  • Athletic performance
  • Tinnitus related to bone disorders

Ipriflavone is a synthetic isoflavone studied mainly for bone health and osteoporosis, but high-quality research has not shown that it reliably prevents fractures or builds strong bone. Because it can lower white blood cell counts in some people and its long-term safety is not well established, talk with your pharmacist or doctor before using it.

Read the full Ipriflavone monograph & all interactions
Keep checking

Other Drugs & Ipriflavone

Browse every other medication we’ve checked against Ipriflavone — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
390Moderate
0Minor
2,439No known interaction
Moderate

390 interactions

Showing 60 of 390 moderate interactions — see all 390 on the Ipriflavone page.

No interaction 2,439 drugs checked — show the 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 Ipriflavone and Aspirin, Butalbital, Caffeine, Codeine Phosphate Together: Common Questions

Can you take Ipriflavone with Aspirin, Butalbital, Caffeine, Codeine Phosphate?
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.
How serious is the Ipriflavone and Aspirin, Butalbital, Caffeine, Codeine Phosphate 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

Still Have a Question About Aspirin, Butalbital, Caffeine, Codeine Phosphate and Ipriflavone?

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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.