Drug & supplement interaction

Methoxylated Flavones + Aspirin, Caffeine, Dihydrocodeine Bitartrate

Aspirin, Caffeine, Dihydrocodeine Bitartrate brand name: Synalgos DC.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 3 drug categories that Methoxylated Flavones can interact with; the most serious is rated moderate. Some in vitro evidence suggests that methoxylated flavones might induce CYP1A2, possibly by increasing gene transcription.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Methoxylated Flavones and Aspirin, Caffeine, Dihydrocodeine Bitartrate

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Methoxylated Flavones interacts with whole categories of medication. Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 3 of those categories, so it can interact with Methoxylated Flavones in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 3

Why this applies to Aspirin, Caffeine, Dihydrocodeine Bitartrate

Aspirin, Caffeine, Dihydrocodeine Bitartrate falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Methoxylated Flavones interacts with.

Some in vitro evidence suggests that methoxylated flavones might induce CYP1A2, possibly by increasing gene transcription. However, other in vitro research has not shown this effect. So far this interaction has not been reported in humans. Theoretically, concurrent use of methoxylated flavones and drugs metabolized by CYP1A2 might increase drug metabolism, decrease serum levels, and reduce effectiveness.
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

Here's the piece of your Synalgos DC combo that matters for this interaction: the caffeine. Caffeine is cleared by an enzyme called CYP1A2, and lab studies hint that methoxylated flavones from citrus peel might speed that enzyme up. If that happened, your body could clear caffeine a little faster, so you might notice less of caffeine's kick (it's added here to help the pain reliever work and to ease certain headaches).

Honestly, though, this is theoretical. It comes from test-tube research, the results conflict, and it has never been reported in real people. The aspirin and dihydrocodeine parts aren't the concern here. Small culinary amounts of citrus are very unlikely to matter; concentrated supplements are the bigger unknown. If you take this regularly, just run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Middleton E, Kandaswami C, Theoharides TC. The effects of plant flavonoids on mammalian cells: implications for inflammation, heart disease, and cancer. Pharmacol Rev 2000;52:673-751. DOI
  2. Li Y, Ning J, Wang Y, et al. Drug interaction study of flavonoids toward CYP3A4 and their quantitative structure activity relationship (QSAR) analysis for predicting potential effects. Toxicol Lett. 2018 Sep 15;294:27-36. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Aspirin, Caffeine, Dihydrocodeine Bitartrate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

In vitro evidence suggests that methoxylated flavones might inhibit cytochrome P450 3A4 (CYP3A4). This effect seems to be structure-dependent, and does not occur with all methoxylated flavones. So far this interaction has not been reported in humans. Theoretically, concurrent use of certain methoxylated flavones with drugs metabolized by CYP3A4 might result in increased drug levels and an increased risk for adverse effects.
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

This combo pill (Synalgos DC) pairs aspirin and caffeine with dihydrocodeine, an opioid pain reliever. The piece worth knowing about is the dihydrocodeine, which is partly handled by the liver's CYP3A4 system. Some methoxylated flavones from citrus peel may slow that enzyme down in lab tests, so in theory the opioid could clear a little slower and build up.

If that happened, you might feel more of the typical opioid effects: extra drowsiness, dizziness, constipation, or slowed breathing. But here's the honest part this has only been seen in test tubes and animals, not in real people, and not every flavone does it. Eating citrus is no worry. Before adding a concentrated supplement, just run it by your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Li Y, Ning J, Wang Y, et al. Drug interaction study of flavonoids toward CYP3A4 and their quantitative structure activity relationship (QSAR) analysis for predicting potential effects. Toxicol Lett. 2018 Sep 15;294:27-36. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

3 of 3

Aspirin, Caffeine, Dihydrocodeine Bitartrate also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

In vitro evidence suggests that some methoxylated flavones have antiplatelet effects. Theoretically, methoxylated flavones might additive effects when used with anticoagulant or antiplatelet drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), 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

The piece of this combo that matters here is the aspirin. Aspirin works by making your platelets less sticky, which is how it thins the blood. In lab studies, methoxylated flavones (the citrus-peel compounds like nobiletin) also seem to slow platelets down a little. Stacking the two could, in theory, add up and make you bruise or bleed a bit more easily, like longer bleeding from a small cut, nosebleeds, or stomach upset.

I want to be honest about the strength of this: it is theoretical, based only on test-tube work, not real people. A bit of citrus in your diet is very unlikely to cause trouble. Concentrated supplement doses are the bigger question mark. Before adding a flavone supplement, check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Robbins RC. Effect of methoxylated flavones on erythrocyte aggregation and sedimentation in blood of normal subjects: Evidence of a dietary role for flavonoids. Internat J Vit Nutr Res 1973;43:494-503.
  2. Robbins RC. In vitro effects of penta-, hexa-, and hepta-methoxylated flavones on aggregation of cells in blood from hospitalized patients. J Clin Pharmacol 1973;13:271-5. 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

Methoxylated Flavones Also Interacts With Other Medications

Methoxylated Flavones has 891 moderate known drug interactions in our database — the Aspirin, Caffeine, Dihydrocodeine Bitartrate one above is among them. If you take anything else, check it against the full list below.

Moderate 891 No known interaction 1,939 (incl. Aspirin, Caffeine, Dihydrocodeine Bitartrate)
Taking anything else?

Check Another of Your Medications Against Methoxylated Flavones

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

Everything else you take

See Every Supplement That Interacts With Aspirin, Caffeine, Dihydrocodeine Bitartrate

This page covers Methoxylated Flavones only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.

Open the Aspirin, Caffeine, Dihydrocodeine Bitartrate interaction page

How much people look this up

Where Methoxylated Flavones and Aspirin, Caffeine, Dihydrocodeine Bitartrate 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 Methoxylated Flavones
Steady interest

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

29 days ago today
Medication Aspirin, Caffeine, Dihydrocodeine Bitartrate
Top half

#806 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 Methoxylated Flavones

What is Methoxylated Flavones?

  • Antioxidant support
  • Circulation and blood vessel health
  • Anti-inflammatory support
  • Skin and aging support
  • General 'metabolism' or wellness blends

Methoxylated flavones (often called polymethoxyflavones) are a group of plant compounds, found mainly in citrus peel, that include substances like nobiletin and tangeretin. Lab and animal studies suggest possible antioxidant and anti-inflammatory effects, but solid human research is very limited, so their real-world benefits are unproven. Talk with a pharmacist or doctor before using them, especially if you take medicines or are pregnant or breastfeeding.

Read the full Methoxylated Flavones monograph & all interactions
Keep checking

Other Drugs & Methoxylated Flavones

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

0Major
891Moderate
0Minor
1,938No known interaction
891 Moderate 1,938 No interaction
Moderate

891 interactions

Showing 60 of 891 moderate interactions — see all 891 on the Methoxylated Flavones page.

No interaction 1,938 drugs checked — show the list

We also checked Methoxylated Flavones against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,938 medications checked with no known interaction — see the full Methoxylated Flavones list.

See the full Methoxylated Flavones interactions page
See every supplement checked against Aspirin, Caffeine, Dihydrocodeine Bitartrate, ranked by severity
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

Keep exploring
Methoxylated Flavones monograph › Uses, safety, and every drug interaction in one place Aspirin, Caffeine, Dihydrocodeine Bitartrate supplement interactions › Every supplement checked against Aspirin, Caffeine, Dihydrocodeine Bitartrate, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Methoxylated Flavones and Aspirin, Caffeine, Dihydrocodeine Bitartrate Together: Common Questions

Can you take Methoxylated Flavones with Aspirin, Caffeine, Dihydrocodeine Bitartrate?
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 Methoxylated Flavones and Aspirin, Caffeine, Dihydrocodeine Bitartrate?
Aspirin, Caffeine, Dihydrocodeine Bitartrate belongs to more than one drug category, and Methoxylated Flavones 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 Methoxylated Flavones and Aspirin, Caffeine, Dihydrocodeine Bitartrate 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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