Phellodendron + Aspirin, Caffeine, Phenacetin, Propoxyphene
Aspirin, Caffeine, Phenacetin, Propoxyphene brand name: Margesic Comp. 65.
Aspirin, Caffeine, Phenacetin, Propoxyphene falls into 4 drug categories that Phellodendron can interact with; the most serious is rated moderate. Theoretically, phellodendron might increase the sedative effects of CNS depressants.
Read the full interaction reportPhellodendron and Aspirin, Caffeine, Phenacetin, Propoxyphene
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Phellodendron interacts with whole categories of medication. Aspirin, Caffeine, Phenacetin, Propoxyphene falls into 4 of those categories, so it can interact with Phellodendron 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, Phenacetin, Propoxyphene
Aspirin, Caffeine, Phenacetin, Propoxyphene falls under CNS DEPRESSANTS — the group Phellodendron interacts with.
Phellodendron contains berberine. Animal research suggests that berberine may have sedative effects. Theoretically, phellodendron might also have CNS depressants 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 combination product contains propoxyphene, an opioid pain reliever that can make you feel drowsy or relaxed, plus aspirin and caffeine. The concern here is fairly simple: phellodendron contains berberine, and in animal studies berberine has shown mild sedative effects. So in theory, pairing it with the propoxyphene part could add to that sleepy, slowed-down feeling, leading to more drowsiness, dizziness, or trouble concentrating.
I want to be honest about the strength of this: it is theoretical, based on lab and animal work, not solid human studies. For most people this won't be a big deal, but if you notice extra grogginess, take it easy with driving and check in with your pharmacist or doctor before combining them.
- 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, Phenacetin, Propoxyphene also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
Phellodendron contains berberine. In vitro research and preliminary clinical evidence show that berberine can inhibit CYP2D6. Theoretically, phellodendron might also inhibit 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.
In this combination pill, the ingredient that matters most for this interaction is propoxyphene, an opioid pain reliever that the body partly handles through a liver enzyme called CYP2D6. Phellodendron contains berberine, which lab and early human studies suggest can slow that same enzyme down. In theory, that could let propoxyphene build up a bit, which might bump up its effects: more drowsiness, dizziness, nausea, constipation, or feeling foggy.
I want to be honest that this is a theoretical concern based on how these compounds behave, not something proven in real patients. The aspirin and caffeine pieces aren't the main players here. Still, because propoxyphene is a sedating opioid, I'd run this past your pharmacist or doctor before combining them rather than guessing.
- 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, Phenacetin, Propoxyphene also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Phellodendron contains berberine. In vitro research and preliminary clinical research show that berberine moderately inhibits CYP3A4. Theoretically, phellodendron might also inhibit 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 packs several ingredients, but the one that matters most here is propoxyphene, an opioid pain reliever that your liver processes using an enzyme called CYP3A4. Phellodendron contains berberine, which lab and early human studies suggest can mildly slow that same enzyme down. In theory, that could let propoxyphene linger a bit longer in your body, nudging up its effects, things like extra drowsiness, dizziness, nausea, or constipation.
I want to be honest with you though: this is a theoretical concern based on how the chemistry works, not on real cases. Concentrated supplement doses are more likely to matter than a sip of herbal tea. Since this product is fairly potent, please check with your pharmacist or doctor before pairing it with phellodendron.
- 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, Phenacetin, Propoxyphene also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.
Phellodendron contains berberine. In vitro and in vivo research suggest that berberine can inhibit platelet aggregation. Theoretically, phellodendron might also 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.
This combination product includes aspirin, which is the part that matters here. Aspirin already thins the blood by blocking platelets from clumping together. Phellodendron contains berberine, and early lab and animal research hints that it may also slow platelet activity. Put the two together and, in theory, you could be a little more prone to bruising, nosebleeds, bleeding gums, or stomach upset from the aspirin.
I want to be honest with you: this is a theoretical concern based only on test-tube and animal studies, not real-world human cases, so the actual risk is likely small. Still, since both nudge in the same direction, it is worth a quick chat with your pharmacist or doctor before pairing them, especially if you already bruise easily or take other blood thinners.
- 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.
Phellodendron Also Interacts With Other Medications
Phellodendron has 1,159 moderate known drug interactions in our database — the Aspirin, Caffeine, Phenacetin, Propoxyphene one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Phellodendron
We haven’t checked that one against Phellodendron yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Phellodendron. Pick one to open its full report.
See Every Supplement That Interacts With Aspirin, Caffeine, Phenacetin, Propoxyphene
This page covers Phellodendron only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Caffeine, Phenacetin, Propoxyphene page lists 414 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 · 350 moderate · 47 minor.
From our pharmacist’s overview on the Aspirin, Caffeine, Phenacetin, Propoxyphene page
“Margesic Comp. 65 packs four drugs into one tablet, aspirin, caffeine, phenacetin, and the sedating opioid propoxyphene, which is why 414 supplement ingredients appear on this page and why I would slow down before adding any of them.”
Reviewed by 2 · Jul 18, 2026
Open the Aspirin, Caffeine, Phenacetin, Propoxyphene interaction page
Taking Phellodendron as Part of a Dietary Supplement Product? Check It for Interactions
We hold 393 real supplement products containing Phellodendron, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Phellodendron. Your product may carry other ingredients that interact with Aspirin, Caffeine, Phenacetin, Propoxyphene too, on top of Phellodendron — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Phellodendron and Aspirin, Caffeine, Phenacetin, Propoxyphene 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.
#268 of 1,452 supplements looked up here in the last 7 days
#2,649 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 Phellodendron
What is Phellodendron?
- Digestive complaints and diarrhea
- Inflammation and joint discomfort
- Stress and weight management (in combination products)
- Skin conditions (topical, traditional)
- Antimicrobial support
Phellodendron is a traditional Chinese medicine bark (Huang Bai) that contains berberine and other plant compounds with antimicrobial and anti-inflammatory activity in lab studies. Human evidence for most uses is limited, and it is often sold in combination with other herbs, making its individual effects hard to judge. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.
Other Drugs & Phellodendron
Browse every other medication we’ve checked against Phellodendron — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,159 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Guaifenesin ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Trimipramine ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
Showing 60 of 1,159 moderate interactions — see all 1,159 on the Phellodendron page.
No interaction 1,670 drugs checked — show the list
We also checked Phellodendron against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Acetaminophen ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Amoxicillin ›
- Isotretinoin ›
- Methotrexate ›
- Bupropion ›
- Bendamustine ›
- Doxycycline ›
- Acyclovir ›
- Azithromycin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Ciprofloxacin ›
- Amoxicillin, Clavulanate Potassium ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Ezetimibe ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Pizotifen ›
- Daptomycin ›
- Pegunigalsidase Alfa-iwxj ›
- Mitomycin ›
- Levodopa ›
- Hexobarbitone ›
- Flutemetamol F-18 ›
- Magnesium Hydroxide (otc Drug) ›
- Bentoquatam ›
- Cefaclor ›
- Factor 7a ›
- Azelaic Acid ›
- Hethylphenidate Hcl ›
- Alglucosidase Alpha ›
- Salbutamol Sulfate ›
- Lenvatinib ›
- Tocainide ›
- Phenylephrine ›
- Hydroxychloroquine ›
- Ribavirin Aerosol ›
- Acetaminophen, Brompheniramine, Phenylpropanolamine ›
- Casanthranol, Docusate ›
- Rocuronium ›
- Vancomycin ›
- Digoxin ›
- Procainamide ›
- Triptorelin ›
- Paracetamol ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Dirithromycin ›
Showing the 60 most looked-up of 1,670 medications checked with no known interaction — see the full Phellodendron 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, Phenacetin, Propoxyphene Is Linked to Lower Levels of 4 Nutrients
Natural Medicines records Aspirin, Caffeine, Phenacetin, Propoxyphene as a medicine that can lower these. This is not an interaction with Phellodendron — 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, Phenacetin, Propoxyphene 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 Phellodendron and Aspirin, Caffeine, Phenacetin, Propoxyphene Together: Common Questions
Can you take Phellodendron with Aspirin, Caffeine, Phenacetin, Propoxyphene?
Why are there 4 interactions listed for Phellodendron and Aspirin, Caffeine, Phenacetin, Propoxyphene?
How serious is the Phellodendron and Aspirin, Caffeine, Phenacetin, Propoxyphene 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.