Kratom + Belladonna, Caffeine, Ergotamine, Pentobarbital
Belladonna, Caffeine, Ergotamine, Pentobarbital brand name: Micomp PB.
Belladonna, Caffeine, Ergotamine, Pentobarbital falls into 3 drug categories that Kratom can interact with; the most serious is rated moderate. Theoretically, concomitant use might increase the risk for adverse CNS depressant effects.
Read the full interaction reportKratom and Belladonna, Caffeine, Ergotamine, Pentobarbital
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Kratom interacts with whole categories of medication. Belladonna, Caffeine, Ergotamine, Pentobarbital falls into 3 of those categories, so it can interact with Kratom 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 Belladonna, Caffeine, Ergotamine, Pentobarbital
Belladonna, Caffeine, Ergotamine, Pentobarbital falls under CNS DEPRESSANTS — the group Kratom interacts with.
Kratom contains mitragynine, a mu-receptor agonist that may cause respiratory depression. Although results from animal research suggest that mitragynine causes less respiratory depression than the CNS depressant codeine, fatalities have been reported for patients who ingested a combination of kratom and O-desmethyltramadol, another mu-receptor agonist. Additionally, observational research suggests that adverse effects such as drowsiness and coma are more likely to occur in individuals taking kratom in combination with agents such as opioids and sedatives. Theoretically, ingesting kratom along with other CNS depressants can increase the risk of adverse effects, including drowsiness, coma, and/or severe or fatal respiratory depression.
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 combination pill I want to focus on is the pentobarbital, which is a barbiturate sedative. It slows down your central nervous system to calm you and help with sleep. Kratom acts on the same opioid receptors in the brain and can add its own calming, opioid-like effects on top.
When you put a sedative and kratom together, those slowing effects can stack up. That could mean more drowsiness, foggy thinking, slow or shallow breathing, and in serious cases, dangerously low breathing. To be honest, this concern is theoretical, based mostly on how these substances behave rather than strong human studies, but barbiturates are potent, so I take it seriously. Please talk with your pharmacist or doctor before pairing these.
- Backstrom BG, Classon G, Lowenhielm P, Thelander G. [Krypton--new, deadly Internet drug. Since October 2009 have nine young persons died in Sweden]. Lakartidningen 2010;107(50):3196-3197.
- Kronstrand R, Roman M, Thelander G, Eriksson A. Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton. J Anal Toxicol 2011;35(4):242-247. PubMed
- Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
- Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
2 of 3Belladonna, Caffeine, Ergotamine, Pentobarbital also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro research suggests that kratom extract inhibits the activity of CYP1A2. In one case report, a 63-year-old male presented with possible serotonin syndrome after taking an unknown dose of kratom for up to 3 months along with serotonergic prescription medications bupropion, buspirone, desvenlafaxine, trazodone, and ziprasidone. It was hypothesized that kratom inhibited CYP1A2-mediaed metabolism of ziprasidone which consequently increased systemic exposure to serotonin.
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 combination product (Micomp PB) is a mix of belladonna, caffeine, ergotamine, and a barbiturate (pentobarbital), often used for migraine-type headaches. The piece that matters here is the caffeine, which your liver clears mainly through an enzyme called CYP1A2. Lab studies suggest kratom may slow that enzyme down. In theory, that could let caffeine build up a bit, so you might feel jittery, restless, have a racing heart, or trouble sleeping.
I want to be honest that this is theoretical, based on test-tube data, not solid human studies, so the real-world risk may be small. The bigger concern is that both kratom and the barbiturate in this medicine are sedating, and kratom carries its own serious risks. Please check with your pharmacist or doctor before mixing them.
- Kong WM, Chik Z, Ramachandra M, et al. Evaluation of the effects of Mitragyna speciosa alkaloid extract on cytochrome P450 enzymes using a high throughput assay. Molecules. 2011;16(9):7344-7356. PubMed
- Eudaley ST, Brooks SP, Hamilton LA. Case Report: Possible Serotonin Syndrome in a Patient Taking Kratom and Multiple Serotonergic Agents. J Pharm Pract 2022. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 3Belladonna, Caffeine, Ergotamine, Pentobarbital also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that kratom extract inhibits CYP3A4 enzyme activity. A pharmacokinetic study in adults shows that taking kratom tea 2 grams modestly increases the plasma concentration time-curve (AUC) and maximum concentration (Cmax) of CYP3A4 probe midazolam by 40-50% and its CYP3A4-mediated metabolites 18-27%. However, a lack of change in the half-life of midazolam and a simulation of the kratom-midazolam interaction suggest that kratom inhibits CYP3A4 enzymes in the small intestine but not the liver. Additionally, there is one case report of a 27-year-old male who died from neuroleptic malignant-like symptoms after concomitant use of kratom and quetiapine, a CYP3A4 substrate. Although it did not appear that the patient had consumed large quantities of quetiapine, postmortem plasma levels were in the lethal range, indicating possible inhibition of CYP3A4 by kratom. In another case report, a 63-year-old male presented with possible serotonin syndrome after taking an unknown dose of kratom for up to 3 months along with serotonergic prescription medications bupropion, buspirone, desvenlafaxine, trazodone, and ziprasidone. It is hypothesized that CYP3A4 inhibition by kratom reduced metabolism of desvenlafaxine, trazodone, and ziprasidone and consequently increased systemic exposure to serotonin.
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 combination product contains ergotamine, the ingredient I worry about most here. Ergotamine is cleared by an enzyme called CYP3A4, and lab studies suggest kratom can slow that enzyme down, mostly in your gut. If ergotamine isn't broken down as quickly, more of it can build up in your body. With ergotamine, higher levels can mean serious problems like cold, numb, or tingling hands and feet, leg cramping, or reduced blood flow to the fingers and toes (a condition called ergotism).
To be fair, this is a theoretical concern based mostly on lab work, not strong human studies on this exact mix. Kratom carries its own real risks too. Please don't stop or start anything on your own. Run this past your pharmacist or doctor first.
- Kong WM, Chik Z, Ramachandra M, et al. Evaluation of the effects of Mitragyna speciosa alkaloid extract on cytochrome P450 enzymes using a high throughput assay. Molecules. 2011;16(9):7344-7356. PubMed
- Hughes RL. Fatal combination of mitragynine and quetiapine - a case report with discussion of a potential herb-drug interaction. Forensic Sci Med Pathol. 2019 Mar;15(1):110-113. PubMed
- Eudaley ST, Brooks SP, Hamilton LA. Case Report: Possible Serotonin Syndrome in a Patient Taking Kratom and Multiple Serotonergic Agents. J Pharm Pract 2022. PubMed
- Tanna RS, Nguyen JT, Hadi DL, et al. Clinical Assessment of the Drug Interaction Potential of the Psychotropic Natural Product Kratom. Clin Pharmacol Ther 2023;113(6):1315-1325. 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.
Kratom Also Interacts With Other Medications
Kratom has 982 moderate, 12 minor known drug interactions in our database — the Belladonna, Caffeine, Ergotamine, Pentobarbital one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Kratom
We haven’t checked that one against Kratom yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Kratom. Pick one to open its full report.
Questions About Kratom or Belladonna, Caffeine, Ergotamine, Pentobarbital
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Kratom or Belladonna, Caffeine, Ergotamine, Pentobarbital, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Belladonna, Caffeine, Ergotamine, Pentobarbital
This page covers Kratom only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Belladonna, Caffeine, Ergotamine, Pentobarbital page lists 290 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: 15 major · 227 moderate · 48 minor.
From our pharmacist’s overview on the Belladonna, Caffeine, Ergotamine, Pentobarbital page
“People who take Micomp PB for migraines are often the same people reaching for an herbal sleep aid or a caffeinated energy product during a rough stretch, and with four drugs in one tablet (belladonna, caffeine, ergotamine, pentobarbital) nearly everything clashes with something. The 290 supplement ingredients on file here earn genuine…”
Reviewed by 2 · Jul 18, 2026
Open the Belladonna, Caffeine, Ergotamine, Pentobarbital interaction page
Taking Kratom as Part of a Dietary Supplement Product? Check It for Interactions
We hold 8 real supplement products containing Kratom, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Kratom. Your product may carry other ingredients that interact with Belladonna, Caffeine, Ergotamine, Pentobarbital too, on top of Kratom — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Kratom and Belladonna, Caffeine, Ergotamine, 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.
#296 of 1,452 supplements looked up here in the last 7 days
#310 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 Kratom
What is Kratom?
- Pain relief
- Opioid withdrawal symptoms
- Anxiety and stress
- Low energy or fatigue
- Mood enhancement
Kratom is a Southeast Asian plant whose leaves act on the brain's opioid receptors and can produce both stimulant-like and opioid-like effects. It is not approved or proven safe by health regulators, carries real risks of dependence and serious harm, and its legal status varies widely. Talk to a pharmacist or doctor before considering it.
Other Drugs & Kratom
Browse every other medication we’ve checked against Kratom — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
982 interactions
- Diltiazem ›
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- Dextromethorphan ›
- Doxorubicin ›
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- Miconazole ›
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- Nitrazepam ›
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- Everolimus ›
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- Propoxyphene ›
- Rifampin ›
- Selegiline ›
Showing 60 of 982 moderate interactions — see all 982 on the Kratom page.
12 interactions
No interaction 1,835 drugs checked — show the list
We also checked Kratom against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Ivermectin ›
- Aspirin ›
- Rosuvastatin ›
- Docusate ›
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- Ibuprofen ›
- Hydroxyurea ›
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- Metformin ›
- Amoxicillin ›
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- Methotrexate ›
- Isotretinoin ›
- Acyclovir ›
- Doxycycline ›
- Azithromycin ›
- Levothyroxine, Liothyronine ›
- Candesartan Cilexetil ›
- Cyclopentolate ›
- Cephalexin ›
- Amoxicillin, Clavulanate Potassium ›
- Mannitol ›
- Ezetimibe ›
- Levothyroxine Sodium ›
- Pegunigalsidase Alfa-iwxj ›
- Spironolactone ›
- Thyroid Hormone ›
- Daptomycin ›
- Carbidopa, Levodopa ›
- Valsartan ›
- Mitomycin ›
- Acetylsalicylic Acid ›
- Hexobarbitone ›
- Levodopa ›
- Factor 7a ›
- Cefaclor ›
- Minoxidil ›
- Hethylphenidate Hcl ›
- Bentoquatam ›
- Azelaic Acid ›
- Lenvatinib ›
- Pizotifen ›
- Hydroxychloroquine ›
- Diclofenac Sodium ›
- Rocuronium ›
- Ribavirin Aerosol ›
- Salbutamol Sulfate ›
- Alglucosidase Alpha ›
- Procainamide ›
- Flutemetamol F-18 ›
- Insulin Degludec, Liraglutide ›
- Vancomycin ›
- Insulin Human, Sodium Chloride ›
- Digoxin ›
- Canagliflozin, Metformin ›
- Hydrochlorothiazide, Lisinopril ›
- Sacubitril, Valsartan ›
Showing the 60 most looked-up of 1,835 medications checked with no known interaction — see the full Kratom 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
Belladonna, Caffeine, Ergotamine, Pentobarbital Is Linked to Lower Levels of 2 Nutrients
Natural Medicines records Belladonna, Caffeine, Ergotamine, Pentobarbital as a medicine that can lower these. This is not an interaction with Kratom — 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 Belladonna, Caffeine, Ergotamine, Pentobarbital 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 Kratom and Belladonna, Caffeine, Ergotamine, Pentobarbital Together: Common Questions
Can you take Kratom with Belladonna, Caffeine, Ergotamine, Pentobarbital?
Why are there 3 interactions listed for Kratom and Belladonna, Caffeine, Ergotamine, Pentobarbital?
How serious is the Kratom and Belladonna, Caffeine, Ergotamine, Pentobarbital interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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