Oregon Grape + Aspirin, Caffeine, Codeine Phosphate
Aspirin, Caffeine, Codeine Phosphate brand name: Anacin w/ Codeine.
Aspirin, Caffeine, Codeine Phosphate falls into 4 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 Aspirin, Caffeine, Codeine Phosphate
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Oregon Grape interacts with whole categories of medication. Aspirin, Caffeine, Codeine Phosphate falls into 4 of those categories, so it can interact with Oregon Grape in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CNS DEPRESSANTS
1 of 4Why this applies to Aspirin, Caffeine, Codeine Phosphate
Aspirin, Caffeine, Codeine Phosphate 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.
Here's the thing to know about this combo: your medication contains codeine, which is a sedating opioid pain reliever. Oregon grape contains berberine, and in animal studies berberine showed some calming, sedative effects of its own. So the concern is simply additive sleepiness. Stacking the two could make you feel drowsier, foggier, or more lightheaded than the codeine alone, and in larger amounts opioids can slow your breathing.
That said, this is a theoretical interaction based only on lab and animal research, not human studies, so I wouldn't lose sleep over it. Still, since codeine already causes drowsiness, it's worth a quick chat with your pharmacist or doctor before pairing them, especially if you drive or take other sedating meds.
- 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 4Aspirin, Caffeine, Codeine Phosphate 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 product: the codeine part is what matters. Codeine is a prodrug, meaning your body has to convert it into morphine using an enzyme called CYP2D6 before it can ease your pain. Berberine, a compound in Oregon grape, may gently block that same enzyme. So instead of building codeine up, blocking CYP2D6 actually means less codeine gets turned into morphine, which can leave you with weaker pain relief.
Keep in mind this is mostly theoretical, based on lab work and limited human data, so it may not be a big deal for everyone. The aspirin and caffeine pieces aren't really affected. Still, if your pain isn't well controlled, check with your pharmacist or doctor before mixing the two.
- 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 4Aspirin, Caffeine, Codeine Phosphate 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 combo pill has three pieces, and the one to watch here is the codeine. Oregon grape contains berberine, which in lab studies appears to mildly slow down the CYP3A4 enzyme. One of codeine's breakdown paths runs through that same enzyme, so in theory codeine could hang around a little longer and feel a bit stronger. That might mean more drowsiness, constipation, nausea, or lightheadedness than you'd expect.
Honestly, this is a theoretical concern based mostly on test-tube work, not real-world reports, so I wouldn't panic. Still, since codeine already makes some people sleepy, it's worth mentioning to your pharmacist or doctor before pairing them, especially if you take Oregon grape as a concentrated supplement rather than a dab of cream.
- 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
ANTICOAGULANT/ANTIPLATELET DRUGS
4 of 4Aspirin, Caffeine, Codeine Phosphate also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.
In vitro and in vivo research suggests that berberine, a constituent of Oregon grape, can inhibit platelet aggregation.
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 to focus on here is the aspirin in this combination product. Aspirin is already a blood thinner that keeps your platelets from clumping together. Oregon grape contains berberine, and lab and animal studies hint that it may also make platelets a little less sticky. Put the two together and, in theory, you could nudge your bleeding risk up a bit. That might show up as easier bruising, a nosebleed that won't quit, or a cut that takes longer to stop.
I want to be honest about the strength of this: it's based on test-tube and animal work, not solid human studies, so it's a possibility rather than a proven problem. Still, before adding an Oregon grape supplement, check with your pharmacist or doctor first, especially if you take this regularly.
- Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
- Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.
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 Aspirin, Caffeine, Codeine Phosphate 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 Aspirin, Caffeine, Codeine Phosphate
This page covers Oregon Grape only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, 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, Caffeine, Codeine Phosphate page
“Anacin with Codeine combines aspirin, caffeine, and codeine, and each of the three picks up its own supplement problems, so this is a list worth real caution. Just over half of the 398 ingredients here, 202 of them, can add to aspirin's blood-thinning action and raise bleeding risk.”
Reviewed by 2 · Jul 18, 2026
Open the Aspirin, Caffeine, Codeine Phosphate 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 Aspirin, Caffeine, Codeine Phosphate 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 Aspirin, 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.
#285 of 1,452 supplements looked up here in the last 7 days
#1,480 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
Aspirin, Caffeine, Codeine Phosphate Is Linked to Lower Levels of 4 Nutrients
Natural Medicines records Aspirin, Caffeine, Codeine Phosphate 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 Aspirin, Caffeine, Codeine Phosphate 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 Aspirin, Caffeine, Codeine Phosphate Together: Common Questions
Can you take Oregon Grape with Aspirin, Caffeine, Codeine Phosphate?
Why are there 4 interactions listed for Oregon Grape and Aspirin, Caffeine, Codeine Phosphate?
How serious is the Oregon Grape and Aspirin, Caffeine, Codeine Phosphate 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.