Panax Notoginseng + Aspirin, Caffeine, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate brand name: Synalgos DC.
Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 3 drug categories that Panax Notoginseng can interact with; the most serious is rated moderate. Theoretically, taking Panax notoginseng might reduce the levels and clinical effects of CYP1A2 substrates.
Read the full interaction reportPanax Notoginseng and Aspirin, Caffeine, Dihydrocodeine Bitartrate
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Panax Notoginseng interacts with whole categories of medication. Aspirin, Caffeine, Dihydrocodeine Bitartrate falls into 3 of those categories, so it can interact with Panax Notoginseng in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 3Why this applies to Aspirin, Caffeine, Dihydrocodeine Bitartrate
Aspirin, Caffeine, Dihydrocodeine Bitartrate falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Panax Notoginseng interacts with.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction was attributed to the ability of Panax notoginseng to increase the activity of CYP1A2.
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 piece this interaction touches on. The caffeine inside your Synalgos DC is cleared by a liver enzyme called CYP1A2. Lab and animal work hints that Panax notoginseng may speed up that enzyme, which could lower caffeine levels a bit. In plain terms, you might just notice less of caffeine's usual lift, like feeling a touch less alert. Keep in mind this is theoretical and based only on animal studies, so it may not show up in real life at all.
The aspirin and dihydrocodeine parts of this combo aren't really driven by CYP1A2, so I wouldn't expect their pain relief to change much here. Still, before adding this herb, it's worth a quick chat with your pharmacist or doctor.
- Liu R, Qin M, Hang P, Liu Y, Zhang Z, Liu G. Effects of Panax notoginseng saponins on the activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in rats in vivo. Phytother Res. 2012 Aug;26(8):1113-8.
ASPIRIN
2 of 3Animal research shows that taking Panax notoginseng extract with aspirin increases blood levels of salicylic acid by approximately 50% and blood levels of Panax notoginseng by 75% to 196%. This effect may be due to increased absorption of both products.
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.
Your medicine combines aspirin, caffeine, and dihydrocodeine. The interaction we have on file is about the aspirin part. Animal studies suggest that pairing Panax notoginseng with aspirin may bump up blood levels of both, with aspirin (salicylic acid) rising around 50%. More aspirin floating around could mean more stomach upset, heartburn, or a higher chance of bleeding and easy bruising. Since this herb is itself used to affect bleeding and clotting, the two together could add up.
I want to be honest though: this is theoretical, based mostly on lab and animal work, so it's a caution rather than a sure thing. If you'd like to use both, please run it by your pharmacist or doctor first, especially before any surgery or dental work.
- Tian Z, Pang H, Du S, Lu Y, Zhang L, Wu H, Guo S, Wang M, Zhang Q. Effect of Panax notoginseng saponins on the pharmacokinetics of aspirin in rats. J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jan 1;1040:136-143. PubMed
- Tian Z, Pang H, Zhang Q, et al. Effect of aspirin on the pharmacokinetics and absorption of panax notoginsengsaponins. J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Jan 2;1074-75.
CAFFEINE
3 of 3Aspirin, Caffeine, Dihydrocodeine Bitartrate also falls under CAFFEINE.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction is attributed to the ability of Panax notoginseng to increase the activity of cytochrome P450 1A2 (CYP1A2) enzymes.
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 piece that matters for Synalgos DC: it contains caffeine, and this product (Panax notoginseng) may speed up the liver enzyme called CYP1A2 that breaks caffeine down. If that happens, your body could clear the caffeine a bit faster, so you might notice less of caffeine's usual kick (the part that's meant to boost the pain relief and keep you a touch more alert). The aspirin and dihydrocodeine portions aren't the focus of this particular interaction.
Honestly, I wouldn't lose sleep over this one. The evidence comes only from animal research, so it's theoretical for people, and the caffeine in this combo is a small piece of the puzzle anyway. Still, it's worth a quick chat with your pharmacist before adding the herb.
- Liu R, Qin M, Hang P, Liu Y, Zhang Z, Liu G. Effects of Panax notoginseng saponins on the activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in rats in vivo. Phytother Res. 2012 Aug;26(8):1113-8.
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 Notoginseng Also Interacts With Other Medications
Panax Notoginseng has 206 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 Panax Notoginseng
We haven’t checked that one against Panax Notoginseng yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Panax Notoginseng. Pick one to open its full report.
See Every Supplement That Interacts With Aspirin, Caffeine, Dihydrocodeine Bitartrate
This page covers Panax Notoginseng 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 Panax Notoginseng as Part of a Dietary Supplement Product? Check It for Interactions
We hold 55 real supplement products containing Panax Notoginseng, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Panax Notoginseng. Your product may carry other ingredients that interact with Aspirin, Caffeine, Dihydrocodeine Bitartrate too, on top of Panax Notoginseng — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Panax Notoginseng 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.
#483 of 1,452 supplements looked up here in the last 7 days
#2,171 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 Notoginseng
What is Panax Notoginseng?
- Bleeding and bruising
- Heart and circulation health
- High blood pressure
- Chest pain (angina)
- Inflammation and swelling
Panax notoginseng (sanqi or tienchi ginseng) is a traditional Chinese herb most often used to help with bleeding, bruising, and circulation. Human evidence for these uses is limited and mostly early, so it should not replace proven treatments. Talk to a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.
Other Drugs & Panax Notoginseng
Browse every other medication we’ve checked against Panax Notoginseng — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
206 interactions
- Theophylline ›
- Aspirin ›
- Naproxen ›
- Estradiol ›
- Propranolol ›
- Verapamil ›
- Acetaminophen ›
- Diazepam ›
- Lofepramine ›
- Nortriptyline ›
- Bendamustine ›
- Caffeine (otc Drug) ›
- Cyclobenzaprine ›
- Desipramine ›
- Riluzole ›
- Warfarin Sodium ›
- Asenapine ›
- Caffeine (prescription Drug) ›
- Clomipramine ›
- Clozapine ›
- Flutamide ›
- Imipramine ›
- Propafenone ›
- Ropinirole ›
- Tasimelteon ›
- Tizanidine ›
- Zileuton ›
- Acetylsalicylic Acid ›
- Agomelatine ›
- Amitriptyline ›
- Anagrelide ›
- Bendamustine Hydrochloride ›
- Chlordiazepoxide ›
- Clopidogrel ›
- Enasidenib ›
- Estrogen ›
- Ethinyl Estradiol ›
- Etonogestrel ›
- Fenfluamine ›
- Fezolinetant ›
- Fluvoxamine ›
- Grepafloxacin ›
- Haloperidol ›
- Levobupivacaine ›
- Mexiletine ›
- Mirtazapine ›
- Naproxen Sodium ›
- Oestrogen ›
- Olanzapine ›
- Ondansetron ›
- Paracetamol ›
- Pentazocine ›
- Perampanel ›
- Pirfenidone ›
- Pomalidomide ›
- Propranolol Hydrochloride ›
- Ramelteon ›
- Rasagiline ›
- Ropivacaine ›
- Tacrine ›
Showing 60 of 206 moderate interactions — see all 206 on the Panax Notoginseng page.
No interaction 2,623 drugs checked — show the list
We also checked Panax Notoginseng against these medications and found no known interaction in our sources. Open any page to confirm.
- Apixaban ›
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Sertraline ›
- Testosterone ›
- Losartan Potassium ›
- Ivermectin ›
- Metoprolol ›
- Rivaroxaban ›
- Rosuvastatin ›
- Escitalopram ›
- Abemaciclib ›
- Tadalafil ›
- Atorvastatin ›
- Docusate ›
- Ibuprofen ›
- Valacyclovir ›
- Tirzepatide ›
- Methamphetamine ›
- Hydroxyurea ›
- Semaglutide ›
- Sumatriptan ›
- Prednisone ›
- Lisdexamfetamine ›
- Metformin ›
- Lisinopril ›
- Amoxicillin ›
- Bupropion ›
- Methotrexate ›
- Acyclovir ›
- Doxycycline ›
- Fluoxetine ›
- Amphetamine ›
- Lamotrigine ›
- Pregabalin ›
- Azithromycin ›
- Isotretinoin ›
- Gabapentin ›
- Dextroamphetamine ›
- Amlodipine Besylate ›
- Methylene Blue ›
- Clonazepam ›
- Omeprazole ›
- Quetiapine ›
- Letrozole ›
- Duloxetine ›
- Buspirone ›
- Citalopram ›
- Ciprofloxacin ›
- Bisoprolol ›
- Levothyroxine, Liothyronine ›
- Candesartan Cilexetil ›
- Dapsone ›
- Cephalexin ›
- Cyclopentolate ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Mannitol ›
- Roxithromycin ›
- Atorvastatin Calcium ›
Showing the 60 most looked-up of 2,623 medications checked with no known interaction — see the full Panax Notoginseng 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 Panax Notoginseng — 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 Panax Notoginseng and Aspirin, Caffeine, Dihydrocodeine Bitartrate Together: Common Questions
Can you take Panax Notoginseng with Aspirin, Caffeine, Dihydrocodeine Bitartrate?
Why are there 3 interactions listed for Panax Notoginseng and Aspirin, Caffeine, Dihydrocodeine Bitartrate?
How serious is the Panax Notoginseng 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.