Oregon Grape + Aspirin, Caffeine, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate brand name: Synalgos DC.
Aspirin, Caffeine, Dihydrocodeine Bitartrate 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, Dihydrocodeine Bitartrate
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, Dihydrocodeine Bitartrate 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, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.
Synalgos DC combines aspirin, caffeine, and dihydrocodeine. The dihydrocodeine piece is an opioid, so it can already make you feel drowsy, foggy, or relaxed. The concern here is that Oregon grape contains berberine, which in animal studies showed some calming, sedative-type effects. Stacked on top of an opioid, that could in theory add to the sleepiness.
I want to be honest with you though: this is based only on lab and animal research, not on real people taking these together, so I wouldn't lose sleep over it. Just be a little cautious if you notice extra drowsiness or feel less alert, especially before driving. It's always worth a quick chat with your pharmacist or doctor before pairing the two.
- 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, Dihydrocodeine Bitartrate 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. The dihydrocodeine part of Synalgos-DC is a prodrug, meaning your body has to convert it (using the CYP2D6 enzyme) into its stronger, more active pain-relieving form. Berberine from Oregon grape may gently block that same CYP2D6 enzyme. So instead of building up the drug, this interaction could actually leave you with less active painkiller, meaning your headache or pain relief may not feel as strong as expected.
The good news is this is mostly theoretical, based on lab work and some early human data, so it's not a sure thing. Aspirin and caffeine aren't really affected here. If you take Oregon grape regularly and feel your pain medicine isn't working, mention it to your pharmacist or doctor before changing anything.
- 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, Dihydrocodeine Bitartrate 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.
Here's the gist with this combo pill (Synalgos DC). The berberine in Oregon grape may gently slow down a liver enzyme called CYP3A4, which helps process several medicines. The caffeine portion is partly cleared this way, so in theory it could linger a bit longer and leave you feeling jittery, restless, or wide awake at bedtime.
The dihydrocodeine piece is worth a word too. It's a prodrug that your body converts (mainly through a different enzyme, CYP2D6) into its stronger active form, so the CYP3A4 effect here is less clear-cut for pain relief. Honestly, this whole concern is theoretical, based on lab work rather than real patient reports, so I wouldn't lose sleep over it. Still, please run it by your pharmacist or doctor before pairing 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
ANTICOAGULANT/ANTIPLATELET DRUGS
4 of 4Aspirin, Caffeine, Dihydrocodeine Bitartrate 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 of this combo product that matters here is the aspirin. Aspirin already thins your blood by stopping platelets from clumping together. Oregon grape contains berberine, which lab and animal studies suggest may also slow platelets down a bit. Stack the two, and in theory you could nudge your bleeding risk a little higher than aspirin alone.
In real life this means watching for things like easy bruising, nosebleeds, bleeding gums, or stomach upset. To be honest, the evidence here is weak, coming only from test tube and animal work, so I wouldn't lose sleep over it. Still, since you're already on a blood thinner, it's worth a quick chat with your pharmacist or doctor before adding Oregon grape, especially in concentrated supplement form.
- 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, Dihydrocodeine Bitartrate 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, Dihydrocodeine Bitartrate
This page covers Oregon Grape 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
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, Dihydrocodeine Bitartrate 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, 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.
#278 of 1,452 supplements looked up here in the last 7 days
#1,534 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 ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Bupropion ›
- Amoxicillin ›
- Acyclovir ›
- Bendamustine ›
- Methotrexate ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Factor 7a ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Mitomycin ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Lenvatinib ›
- Phenylephrine ›
- Vancomycin ›
- Hethylphenidate Hcl ›
- Bentoquatam ›
- Dirithromycin ›
- Procainamide ›
- Hydroxychloroquine ›
- Amoxicillin, Clavulanate Potassium ›
- Azelaic Acid ›
- Dextrothyroxine ›
- Triptorelin ›
- Lomustine ›
- Tocainide ›
- Pizotifen ›
- Rocuronium ›
- Succimer ›
- Mitomycin C ›
- Paracetamol ›
- Halothane ›
- Gestodene ›
- Chenodiol ›
- Desflurane ›
- Niacin (prescription Drug) ›
- Metronidazole ›
- Caspofungin ›
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, Dihydrocodeine Bitartrate Is Linked to Lower Levels of 4 Nutrients
Natural Medicines records Aspirin, Caffeine, Dihydrocodeine Bitartrate 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, Dihydrocodeine Bitartrate 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, Dihydrocodeine Bitartrate Together: Common Questions
Can you take Oregon Grape with Aspirin, Caffeine, Dihydrocodeine Bitartrate?
Why are there 4 interactions listed for Oregon Grape and Aspirin, Caffeine, Dihydrocodeine Bitartrate?
How serious is the Oregon Grape and Aspirin, Caffeine, Dihydrocodeine Bitartrate 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.