Drug & supplement interaction

Madder + Acetaminophen, Butalbital, Caffeine

Acetaminophen, Butalbital, Caffeine brand names: Tecnal, Esgic Plus, Fiogesic, Triad, Repan, and others.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Madder and Acetaminophen, Butalbital, Caffeine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Madder and Acetaminophen, Butalbital, Caffeine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Acetaminophen, Butalbital, Caffeine and Madder in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Madder at all — not against Acetaminophen, Butalbital, Caffeine, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Madder safety at a glance

Madder overall Avoid Some madder compounds have shown genotoxic and possible cancer-causing effects, so it is best avoided as a supplement.
Pregnancy Unsafe When used orally because it may be a potential menstrual stimulant and a genotoxin. Read the full pregnancy detail
Breastfeeding Unsafe When used orally because it is a potential genotoxin. It also can cause red-colored breast milk. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Acetaminophen, Butalbital, Caffeine and Madder? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Madder and Acetaminophen, Butalbital, Caffeine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Sweating Additional detail

    Madder

    “There is currently a limited amount of information available about the adverse effects of madder. Orally, madder can cause red colored urine, saliva, and perspiration (2). There is some concern that madder can stain contact lenses. Advise patients to be cautious.

    Topically, contact dermatitis has been reported while handling madder.”

    Madder · Natural Medicines adverse-effect record, reported in dermatitis.

    3 sources cited
    1. 2. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
    2. 6002. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
    3. 20044. Castelain M, Ducombs G. Contact dermatitis from madder. Contact Dermatitis 1988;19(3):228-229. PubMed

    Acetaminophen, Butalbital, Caffeine

    Listed in the ADVERSE REACTIONS section of the FDA label for Acetaminophen, Butalbital, Caffeine. Read the label on DailyMed ›

  • A skin rash Additional detail

    Madder

    “A case of contact dermatitis has been reported in a woman who handled madder while working in the garden.”

    Madder · Natural Medicines adverse-effect record, reported in dermatitis.

    1 source cited
    1. 20044. Castelain M, Ducombs G. Contact dermatitis from madder. Contact Dermatitis 1988;19(3):228-229. PubMed

    Acetaminophen, Butalbital, Caffeine

    Listed in the ADVERSE REACTIONS section of the FDA label for Acetaminophen, Butalbital, Caffeine. Read the label on DailyMed ›

Effects for Acetaminophen, Butalbital, Caffeine come from the ADVERSE REACTIONS section of its FDA label; effects for Madder come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Madder in Pregnancy & Breastfeeding

Pregnancy Unsafe

When used orally because it may be a potential menstrual stimulant and a genotoxin.

Lactation Unsafe

When used orally because it is a potential genotoxin. It also can cause red-colored breast milk.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Butalbital, Caffeine

This page covers Madder only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Butalbital, Caffeine page lists 252 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Ephedra (major) and Grapefruit (major).

By severity: 11 major · 197 moderate · 44 minor.

From our pharmacist’s overview on the Acetaminophen, Butalbital, Caffeine page

“Alcohol is the interaction I would flag first for anyone taking acetaminophen, butalbital, and caffeine (Esgic, Fiogesic, and others). Drinking raises the risk of liver injury from the acetaminophen component, and 38 of the 252 supplement ingredients on file carry that same liver concern.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Butalbital, Caffeine interaction page

One more smart check

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

We hold 9 real supplement products containing Madder, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Madder. Even though Madder itself has no known interaction with Acetaminophen, Butalbital, Caffeine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Madder and Acetaminophen, Butalbital, Caffeine 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 Madder
Top half

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

29 days ago today
Medication Acetaminophen, Butalbital, Caffeine
Top half

#1,145 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Madder reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Madder and Acetaminophen, Butalbital, Caffeine records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Madder

What is Madder?

  • Kidney and bladder stones
  • Urinary tract complaints
  • Menstrual problems
  • Natural red dye for fabric
  • Traditional digestive remedy

Madder is a plant whose root has long been used as a red dye and in traditional medicine, mostly for kidney and urinary problems. There is very little reliable human evidence that it works, and some of its compounds have raised concerns about possible cancer-causing effects, so it is generally not recommended for use as a supplement. Talk to your pharmacist or doctor before considering it.

Rubia tinctorum · Rubiaceae · Root · Dried root, powder, capsules, tea, extracts, and natural dye

An interaction check asks whether these two react with each other — it does not ask whether Madder is a good idea for someone in your situation. Here is what our Madder record says about it on its own.

Madder: dosing

There is no established safe or effective dose of madder for any health condition. In general, we do not recommend taking madder root internally. Its safer, well-established use is as a fabric dye rather than as a supplement.

From our Madder monograph — the full record covers uses, side effects and every documented interaction.

Read the full Madder monograph & all interactions
Medication

About Acetaminophen, Butalbital, and Caffeine

What Is Acetaminophen, Butalbital, and Caffeine Used For?

Brand names: Tecnal, Esgic Plus, Fiogesic, Triad, Repan, Esgic, Fioricet

This combination product — available as capsules, tablets, and oral solution under various names including Fioricet — is used to relieve the symptoms of tension headaches (also called muscle contraction headaches).

All supported products, including Fioricet capsules and the oral solution, share this same indication. Because butalbital can be habit-forming, extended or repeated use is not recommended, and these products are not established as safe or effective for treating headaches that come back frequently over time.

See full Acetaminophen, Butalbital, and Caffeine drug information
Keep checking

Other Drugs & Madder

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

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Madder References

The 4 references that drive our Madder monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
  4. Castelain M, Ducombs G. Contact dermatitis from madder. Contact Dermatitis 1988;19(3):228-229. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Madder and Acetaminophen, Butalbital, Caffeine Together: Common Questions

Is it safe to take Madder with Acetaminophen, Butalbital, Caffeine?
We do not list a known interaction between Madder and Acetaminophen, Butalbital, Caffeine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Madder and Acetaminophen, Butalbital, Caffeine have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Acetaminophen, Butalbital, Caffeine interact with any supplements?
Yes. Acetaminophen, Butalbital, Caffeine has documented interactions with 252 supplements in our database — Madder is not one of them. The Acetaminophen, Butalbital, Caffeine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Acetaminophen, Butalbital, Caffeine and Madder?

Our pharmacists answer your medication & supplement questions — free.

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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.