Panax Ginseng + Acetaminophen, Butalbital, Caffeine
Acetaminophen, Butalbital, Caffeine brand names: Tecnal, Esgic Plus, Fiogesic, Triad, Repan, and others.
Acetaminophen, Butalbital, Caffeine falls into 3 drug categories that Panax Ginseng can interact with; the most serious is rated moderate. Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full interaction reportPanax Ginseng and Acetaminophen, Butalbital, Caffeine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Panax Ginseng interacts with whole categories of medication. Acetaminophen, Butalbital, Caffeine falls into 3 of those categories, so it can interact with Panax Ginseng in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
1 of 3Why this applies to Acetaminophen, Butalbital, Caffeine
Acetaminophen, Butalbital, Caffeine falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Panax Ginseng interacts with.
Panax ginseng may affect the clearance of drugs metabolized by CYP3A4. One such drug is imatinib. Inhibition of CYP3A4 was believed to be responsible for a case of imatinib-induced hepatotoxicity. In contrast, Panax ginseng has been shown to increase the clearance of midazolam, another drug metabolized by CYP3A4. Clinical research shows that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng. Until more is known, use Panax ginseng cautiously in combination with CYP3A4 substrates.
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 with this combo headache pill: the butalbital piece (a barbiturate) is partly handled by the same liver enzyme, CYP3A4, that ginseng can nudge. The tricky part is that ginseng has gone both ways in studies. In one case it appeared to slow this enzyme, while in another it sped up the clearance of a similar drug (midazolam). So we honestly can't promise which direction it would push butalbital.
If ginseng slowed things down, you might feel more drowsy, lightheaded, or foggy. If it sped things up, the medicine might not calm your headache as well. This is mostly theoretical, so don't panic, but please run it by your pharmacist or doctor before pairing them, especially since butalbital can already make you sleepy.
- Malati CY, Robertson SM, Hunt JD, Chairez C, Alfaro RM, Kovacs JA, Penzak SR. Influence of Panax ginseng on cytochrome P450 (CYP)3A and P-glycoprotein (P-gp) activity in healthy participants. J Clin Pharmacol 2012;52(6):932-9.
- Bilgi N, Bell K, Ananthakrishnan AN, Atallah E. Imatinib and Panax ginseng: a potential interaction resulting in liver toxicity. Ann Pharmacother 2010;44(5):926-8.
- Kim Y, Jo JJ, Cho P, et al. Characterization of red ginseng-drug interaction by CYP3A activity increased in high dose administration in mice. Biopharm Drug Dispos. 2020;41(7):295-306. PubMed
STIMULANT DRUGS
2 of 3Acetaminophen, Butalbital, Caffeine also falls under STIMULANT DRUGS.
Panax ginseng has been shown to have stimulant 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 keep in mind: the medicine you're asking about already contains caffeine, which is a stimulant. Panax ginseng has mild stimulant-like effects of its own, so pairing the two could, in theory, add up. The piece this interaction is really pointing at is the caffeine, not the acetaminophen or butalbital (which is actually a sedative).
If both push in the same direction, you might notice more jitteriness, a racing or pounding heart, trouble sleeping, or feeling wired and anxious. To be fair, this is a theoretical concern based on how each acts, not strong study data, so for most people it's a minor issue. Still, if you take ginseng regularly or notice these effects, check in with your pharmacist or doctor before changing anything.
- Scaglione F, Cattaneo G, Alessandria M, Cogo R. Efficacy and safety of the standardized Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold. Drugs Exp Clin Res 1996;22:65-72.
- Gonzalez-Seijo JC, Ramos YM, Lastra I. Manic episode and ginseng: Report of a possible case. J Clin Psychopharmacol 1995;15:447-8.
CAFFEINE
3 of 3Acetaminophen, Butalbital, Caffeine also falls under CAFFEINE.
Panax ginseng has been shown to have stimulant effects. Theoretically, caffeine might have an additive effect on the stimulant effects of Panax ginseng.
Interaction 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..
Here's the thing to know about your headache medicine: the part we're focused on is the caffeine in this combo. Panax ginseng has mild stimulant-like effects of its own, so pairing it with the caffeine in Tecnal or Esgic can stack up. You might feel more jittery, notice a racing or pounding heart, have trouble falling asleep, or feel anxious or restless.
This is mostly a theoretical, additive concern, and the evidence behind it is on the weaker side, so it's not something to panic about. Interestingly, the butalbital in this product is a sedative, so effects can be a bit of a tug-of-war. If you take ginseng regularly and notice you feel wired, just mention it to your pharmacist or doctor before changing anything.
- Scaglione F, Cattaneo G, Alessandria M, Cogo R. Efficacy and safety of the standardized Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold. Drugs Exp Clin Res 1996;22:65-72.
- Gonzalez-Seijo JC, Ramos YM, Lastra I. Manic episode and ginseng: Report of a possible case. J Clin Psychopharmacol 1995;15:447-8.
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.
Panax Ginseng Also Interacts With Other Medications
Panax Ginseng has 1,129 moderate known drug interactions in our database — the Acetaminophen, Butalbital, Caffeine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Panax Ginseng
We haven’t checked that one against Panax Ginseng yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Panax Ginseng. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Butalbital, Caffeine
This page covers Panax Ginseng 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
Taking Panax Ginseng as Part of a Dietary Supplement Product? Check It for Interactions
We hold 517 real supplement products containing Panax Ginseng, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Panax Ginseng. Your product may carry other ingredients that interact with Acetaminophen, Butalbital, Caffeine too, on top of Panax Ginseng — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Panax Ginseng 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.
#232 of 1,452 supplements looked up here in the last 7 days
#26 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 Panax Ginseng
What is Panax Ginseng?
- Boosting energy and fighting fatigue
- Improving mental focus and memory
- Coping with stress (adaptogen)
- Erectile dysfunction
- Supporting immune health
- Blood sugar support
Panax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and mostly preliminary. It is generally well tolerated for short-term use in healthy adults, but it can cause side effects like trouble sleeping and may not be safe during pregnancy or breastfeeding. Always check with your pharmacist or doctor before starting it, especially if you have a medical condition or take other medicines.
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.
Other Drugs & Panax Ginseng
Browse every other medication we’ve checked against Panax Ginseng — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,129 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Phentermine ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Methylphenidate ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Phenylpropanolamine ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Nicotine ›
- Oxybutynin ›
- Oxycodone ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Phenylephrine ›
- Procainamide ›
- Pseudoephedrine ›
- Trimipramine ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Diethylpropion ›
- Everolimus ›
Showing 60 of 1,129 moderate interactions — see all 1,129 on the Panax Ginseng page.
No interaction 1,700 drugs checked — show the list
We also checked Panax Ginseng against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Ivermectin ›
- Acetaminophen ›
- Rosuvastatin ›
- Escitalopram ›
- Isotretinoin ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Levothyroxine, Liothyronine ›
- Methotrexate ›
- Amoxicillin ›
- Lisinopril ›
- Bupropion ›
- Pregabalin ›
- Doxycycline ›
- Bendamustine ›
- Gabapentin ›
- Lamotrigine ›
- Acyclovir ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Ezetimibe ›
- Cephalexin ›
- Cyclopentolate ›
- Levetiracetam ›
- Atenolol, Chlorthalidone ›
- Avatrombopag Maleate ›
- Levodopa ›
- Thyroid Hormone ›
- Sacubitril, Valsartan ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Mannitol ›
- Carbidopa, Levodopa ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Enalapril Maleate ›
- Valsartan ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Spironolactone ›
- Alginic Acid, Aluminum Hydroxide ›
- Mitomycin ›
- Roxithromycin ›
- Atenolol ›
- Daunorubicin, Cytarabine ›
- Charcoal (otc Drug) ›
- Levothyroxine Sodium ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Irbesartan, Hydrochlorothiazide ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Magnesium Hydroxide (otc Drug) ›
- Atropine Methyl Nitrate, Digestive Enzymes ›
- Aminolevulinic Acid Hydrochloride ›
- Bupivacaine, Meloxicam ›
- Peginterferon Alfa-2a, Ribavirin ›
- Minoxidil ›
- Articaine, Epinephrine ›
- Alpha-1 Proteinase Inhibitor ›
Showing the 60 most looked-up of 1,700 medications checked with no known interaction — see the full Panax Ginseng 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, Butalbital, Caffeine Is Linked to Lower Levels of 2 Nutrients
Natural Medicines records Acetaminophen, Butalbital, Caffeine as a medicine that can lower these. This is not an interaction with Panax Ginseng — 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, Butalbital, Caffeine 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 Panax Ginseng and Acetaminophen, Butalbital, Caffeine Together: Common Questions
Can you take Panax Ginseng with Acetaminophen, Butalbital, Caffeine?
Why are there 3 interactions listed for Panax Ginseng and Acetaminophen, Butalbital, Caffeine?
How serious is the Panax Ginseng and Acetaminophen, Butalbital, Caffeine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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