Oregon Grape + Acetaminophen, Caffeine, Codeine, Salicylamide
Acetaminophen, Caffeine, Codeine, Salicylamide brand names: Codalan No.1, Codalan No.2, Codalan No.3.
Acetaminophen, Caffeine, Codeine, Salicylamide falls into 3 drug categories that Oregon Grape can interact with; the most serious is rated moderate. Theoretically, Oregon grape might increase the sedative effects of CNS depressants.
Read the full interaction reportOregon Grape and Acetaminophen, Caffeine, Codeine, Salicylamide
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Oregon Grape interacts with whole categories of medication. Acetaminophen, Caffeine, Codeine, Salicylamide falls into 3 of those categories, so it can interact with Oregon Grape 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 Acetaminophen, Caffeine, Codeine, Salicylamide
Acetaminophen, Caffeine, Codeine, Salicylamide falls under CNS DEPRESSANTS — the group Oregon Grape interacts with.
Animal research suggests that berberine, a constituent of Oregon grape, can have sedative effects.
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 combo pill contains codeine, an opioid that already causes drowsiness on its own. The concern here is simple: berberine, a compound in Oregon grape, showed mild sedative effects in animal studies. If those effects carry over to people, stacking it on top of codeine could leave you feeling extra sleepy, foggy, or slow to react. That matters most if you drive or operate machinery.
Keep in mind this is only a theoretical concern based on lab and animal work, not human studies, so the real-world risk is likely small. Still, since codeine can also slow your breathing, it's worth a quick chat with your pharmacist before pairing the two, especially if you're already prone to feeling drowsy on this medication.
- Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
- Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
- Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
- Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 3Acetaminophen, Caffeine, Codeine, Salicylamide also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
In vitro research and preliminary clinical evidence suggest that berberine, a constituent of Oregon grape, can inhibit cytochrome P450 2D6 (CYP2D6).
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.
Here's the wrinkle with this combo: one of the ingredients, codeine, is a prodrug. Your body has to convert it into morphine using a liver enzyme called CYP2D6 before it can actually relieve pain. The berberine in Oregon grape may slow that same enzyme down. So instead of building codeine up, blocking CYP2D6 could mean less morphine is formed, which may leave you with weaker pain relief than you'd expect.
To be fair, this is mostly theoretical and based on lab work plus some early human data, so it isn't a guaranteed problem. The acetaminophen, caffeine, and salicylamide parts aren't really affected here. If you're leaning on this medicine for real pain, check with your pharmacist or doctor before adding Oregon grape.
- Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
- Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
- Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 3Acetaminophen, Caffeine, Codeine, Salicylamide also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research and preliminary clinical evidence suggest that berberine, a constituent of Oregon grape, moderately inhibits cytochrome P450 3A4 (CYP3A4).
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 pill is a mixed bag, so let me focus on the part that matters most. The berberine in Oregon grape may gently slow down a liver enzyme called CYP3A4. Caffeine in this product leans more on a different enzyme, and acetaminophen and salicylamide aren't a big concern here. The piece I'd watch is the codeine.
Codeine is a prodrug, meaning your body has to convert it before it works as a painkiller. With CYP3A4 partly blocked, more codeine can shift toward its stronger form, which could mean extra drowsiness, constipation, or slowed breathing. Keep in mind this is theoretical, based mostly on lab data, and food amounts likely matter less than concentrated supplements. Please check with your pharmacist or doctor before combining them.
- Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Guo, Y., Chen, Y., Tan, Z. R., Klaassen, C. D., and Zhou, H. H. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 2012;68(2):213-217. PubMed
- Hermann, R. and von, Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med 2012;78(13):1458-1477. 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.
Oregon Grape Also Interacts With Other Medications
Oregon Grape has 1,217 moderate known drug interactions in our database — the Acetaminophen, Caffeine, Codeine, Salicylamide one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Oregon Grape
We haven’t checked that one against Oregon Grape yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Oregon Grape. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Caffeine, Codeine, Salicylamide
This page covers Oregon Grape only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Caffeine, Codeine, Salicylamide page lists 303 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 Ephedra (major).
By severity: 15 major · 244 moderate · 44 minor.
Open the Acetaminophen, Caffeine, Codeine, Salicylamide interaction page
Taking Oregon Grape as Part of a Dietary Supplement Product? Check It for Interactions
We hold 740 real supplement products containing Oregon Grape, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Oregon Grape. Your product may carry other ingredients that interact with Acetaminophen, Caffeine, Codeine, Salicylamide too, on top of Oregon Grape — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Oregon Grape and Acetaminophen, Caffeine, Codeine, Salicylamide 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.
#285 of 1,452 supplements looked up here in the last 7 days
#1,333 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 Oregon Grape
What is Oregon Grape?
- Psoriasis (topical)
- Eczema and other skin conditions
- Digestive upset
- Mild skin infections
- General 'detox' or tonic use
Oregon grape is a shrub whose root contains berberine and related compounds. The strongest (though still modest) evidence is for topical creams that may slightly ease psoriasis; evidence for other uses is limited. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.
Other Drugs & Oregon Grape
Browse every other medication we’ve checked against Oregon Grape — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,217 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Trimipramine ›
- Amphetamine ›
- Buprenorphine ›
Showing 60 of 1,217 moderate interactions — see all 1,217 on the Oregon Grape page.
No interaction 1,612 drugs checked — show the list
We also checked Oregon Grape against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Rosuvastatin ›
- Escitalopram ›
- Acetaminophen ›
- Valacyclovir ›
- Docusate ›
- Hydroxyurea ›
- Sumatriptan ›
- Bupropion ›
- Amoxicillin ›
- Acyclovir ›
- Bendamustine ›
- Methotrexate ›
- Isotretinoin ›
- Azithromycin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Mitomycin ›
- Factor 7a ›
- Cefaclor ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Ezetimibe ›
- Levodopa ›
- Vancomycin ›
- Phenylephrine ›
- Dirithromycin ›
- Lenvatinib ›
- Procainamide ›
- Hethylphenidate Hcl ›
- Azelaic Acid ›
- Bentoquatam ›
- Amoxicillin, Clavulanate Potassium ›
- Hydroxychloroquine ›
- Triptorelin ›
- Dextrothyroxine ›
- Lomustine ›
- Succimer ›
- Tocainide ›
- Rocuronium ›
- Halothane ›
- Paracetamol ›
- Mitomycin C ›
- Pizotifen ›
- Gestodene ›
- Chenodiol ›
- Desflurane ›
- Niacin (prescription Drug) ›
- Famotidine ›
- Cabergoline ›
Showing the 60 most looked-up of 1,612 medications checked with no known interaction — see the full Oregon Grape 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
Acetaminophen, Caffeine, Codeine, Salicylamide Is Linked to Lower Levels of 2 Nutrients
Natural Medicines records Acetaminophen, Caffeine, Codeine, Salicylamide as a medicine that can lower these. This is not an interaction with Oregon Grape — 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 Acetaminophen, Caffeine, Codeine, Salicylamide 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 Oregon Grape and Acetaminophen, Caffeine, Codeine, Salicylamide Together: Common Questions
Can you take Oregon Grape with Acetaminophen, Caffeine, Codeine, Salicylamide?
Why are there 3 interactions listed for Oregon Grape and Acetaminophen, Caffeine, Codeine, Salicylamide?
How serious is the Oregon Grape and Acetaminophen, Caffeine, Codeine, Salicylamide interaction?
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.