Rauwolscine + Acetaminophen, Butalbital, Caffeine, Codeine
Acetaminophen, Butalbital, Caffeine, Codeine brand names: Esgic with Codeine, Fioricet w/ Codeine.
Acetaminophen, Butalbital, Caffeine, Codeine falls into 3 drug categories that Rauwolscine can interact with; the most serious is rated moderate. Theoretically, taking rauwolscine with seizure threshold lowering drugs might increase the risk of adverse convulsant effects.
Read the full interaction reportRauwolscine and Acetaminophen, Butalbital, Caffeine, Codeine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Rauwolscine interacts with whole categories of medication. Acetaminophen, Butalbital, Caffeine, Codeine falls into 3 of those categories, so it can interact with Rauwolscine in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
SEIZURE THRESHOLD LOWERING DRUGS
1 of 3Why this applies to Acetaminophen, Butalbital, Caffeine, Codeine
Acetaminophen, Butalbital, Caffeine, Codeine falls under SEIZURE THRESHOLD LOWERING DRUGS — the group Rauwolscine interacts with.
In animal research, intraperitoneal rauwolscine lowered the seizure threshold level of the drug metrazol.
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 (Fioricet with Codeine) bundles together acetaminophen, butalbital, caffeine, and codeine for tension-type headaches. The piece that matters here is the stimulant side of things. Rauwolscine ramps up your body's natural stimulant chemical (norepinephrine), and in animal studies it made it a bit easier to trigger seizures. The caffeine in this medication can add to that jittery, over-stimulated effect, so stacking the two is the theoretical concern.
I want to be honest about the evidence: this comes only from lab and animal research, so it's a theoretical worry, not something proven in people. Still, if you have a history of seizures, or notice racing heart, anxiety, or shakiness, that's worth flagging. Please check with your pharmacist or doctor before pairing these.
- Aziz TA, Hussain SA, Mahwi TO, Ahmed ZA, Rahman HS, Rasedee A. The efficacy and safety of Ginkgo biloba extract as an adjuvant in type 2 diabetes mellitus patients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial.
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 3Acetaminophen, Butalbital, Caffeine, Codeine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
Rauwolscine is structurally related to yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
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 pill: the part that matters is the codeine. Codeine is a prodrug, meaning it's basically inactive until your body's CYP2D6 enzyme turns it into morphine, which is what actually relieves your pain. Rauwolscine is a cousin of yohimbine, and lab studies suggest yohimbine can block CYP2D6. If that blocking happens, less codeine gets converted to morphine, so you may simply get less pain relief from it.
Just as important, rauwolscine is a stimulant that pushes up heart rate and blood pressure, and the caffeine in this pill does the same, so stacking them could leave you jittery, anxious, or with a racing heart. This interaction is only theoretical right now, but if you take this regularly please run it by your pharmacist or doctor before mixing in rauwolscine.
- VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed
STIMULANT DRUGS
3 of 3Acetaminophen, Butalbital, Caffeine, Codeine also falls under STIMULANT DRUGS.
Rauwolscine has demonstrated stimulant effects in animal research.
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 your combination pill that matters here is the caffeine. Both caffeine and rauwolscine are stimulants, so stacking them can pile on the jittery effects: a faster or pounding heartbeat, higher blood pressure, restlessness, trouble sleeping, and feeling anxious or wired. Rauwolscine works by blocking alpha-2 receptors, which lets more of your body's natural 'go' signal (norepinephrine) loose, and that adds to what the caffeine is already doing.
Keep in mind this concern is mostly theoretical and comes from animal studies, so it isn't a strong, proven warning. Still, the butalbital and codeine in this product are sedating, so mixing an upper with downers is a confusing combination for your body. Please run this past your pharmacist or doctor before pairing them, especially if you have any heart concerns.
- Aziz TA, Hussain SA, Mahwi TO, Ahmed ZA, Rahman HS, Rasedee A. The efficacy and safety of Ginkgo biloba extract as an adjuvant in type 2 diabetes mellitus patients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial.
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.
Rauwolscine Also Interacts With Other Medications
Rauwolscine has 676 moderate known drug interactions in our database — the Acetaminophen, Butalbital, Caffeine, Codeine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Rauwolscine
We haven’t checked that one against Rauwolscine yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Rauwolscine. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Butalbital, Caffeine, Codeine
This page covers Rauwolscine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Butalbital, Caffeine, Codeine page lists 305 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 Ephedra (major).
By severity: 15 major · 245 moderate · 45 minor.
Open the Acetaminophen, Butalbital, Caffeine, Codeine interaction page
Taking Rauwolscine as Part of a Dietary Supplement Product? Check It for Interactions
We hold 196 real supplement products containing Rauwolscine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rauwolscine. Your product may carry other ingredients that interact with Acetaminophen, Butalbital, Caffeine, Codeine too, on top of Rauwolscine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Rauwolscine and Acetaminophen, Butalbital, Caffeine, Codeine 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.
#387 of 1,452 supplements looked up here in the last 7 days
#807 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 Rauwolscine
What is Rauwolscine?
- Fat loss and weight management
- Bodybuilding and physique support
- Energy and stimulant effects
- Athletic performance
- Libido support
Rauwolscine (alpha-yohimbine) is a stimulant alkaloid closely related to yohimbine that is marketed mainly in fat-burning and pre-workout supplements. Human evidence for its benefits is very limited, and it can raise heart rate and blood pressure and cause anxiety, so it should be used with caution and is not recommended for people with heart conditions, anxiety, or during pregnancy or breastfeeding.
Other Drugs & Rauwolscine
Browse every other medication we’ve checked against Rauwolscine — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
676 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Phentermine ›
- Diphenhydramine ›
- Aspirin ›
- Methylphenidate ›
- Naproxen ›
- Doxycycline ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Amoxicillin ›
- Verapamil ›
- Phenylpropanolamine ›
- Quinidine ›
- Cyclosporine ›
- Bupropion ›
- Chloroquine ›
- Ciprofloxacin ›
- Fentanyl ›
- Nicotine ›
- Oxycodone ›
- Penicillin V Potassium ›
- Phenytoin ›
- Tacrolimus ›
- Amphotericin B ›
- Ampicillin ›
- Carbamazepine ›
- Ceftazidime ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Formoterol ›
- Indomethacin ›
- Morphine Sulfate ›
- Penicillin G Potassium ›
- Phenylephrine ›
- Pseudoephedrine ›
- Acyclovir ›
- Amphetamine ›
- Baclofen ›
- Buprenorphine ›
- Cephalexin ›
- Dicloxacillin Sodium ›
- Diethylpropion ›
- Dimenhydrinate ›
- Famotidine ›
- Ketoprofen ›
- Lofepramine ›
- Methotrexate ›
- Nortriptyline ›
- Ofloxacin ›
- Oxymorphone ›
- Propoxyphene ›
- Sotalol ›
- Aripiprazole ›
Showing 60 of 676 moderate interactions — see all 676 on the Rauwolscine page.
No interaction 2,153 drugs checked — show the list
We also checked Rauwolscine against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Testosterone ›
- Losartan Potassium ›
- Ivermectin ›
- Rosuvastatin ›
- Acetaminophen ›
- Escitalopram ›
- Tadalafil ›
- Abemaciclib ›
- Atorvastatin ›
- Docusate ›
- Hydroxyurea ›
- Tirzepatide ›
- Semaglutide ›
- Sumatriptan ›
- Prednisone ›
- Metformin ›
- Lisinopril ›
- Bendamustine ›
- Pregabalin ›
- Lamotrigine ›
- Azithromycin ›
- Gabapentin ›
- Isotretinoin ›
- Clonazepam ›
- Methylene Blue ›
- Omeprazole ›
- Letrozole ›
- Buspirone ›
- Levothyroxine, Liothyronine ›
- Diazepam ›
- Dapsone ›
- Candesartan Cilexetil ›
- Cyclopentolate ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Roxithromycin ›
- Mannitol ›
- Atorvastatin Calcium ›
- Levetiracetam ›
- Pegunigalsidase Alfa-iwxj ›
- Finasteride ›
- Ezetimibe ›
- Estrogen ›
- Daptomycin ›
- Levothyroxine Sodium ›
- Mitomycin ›
- Valsartan ›
- Spironolactone ›
- Hexobarbitone ›
- Thyroid Hormone ›
- Phentermine, Topiramate ›
- Factor 7a ›
- Alprazolam ›
- Bromocriptine ›
- Dutasteride ›
- Finasteride, Tadalafil ›
- Minoxidil ›
- Lenvatinib ›
- Macitentan ›
- Azelaic Acid ›
Showing the 60 most looked-up of 2,153 medications checked with no known interaction — see the full Rauwolscine 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, Codeine Is Linked to Lower Levels of 2 Nutrients
Natural Medicines records Acetaminophen, Butalbital, Caffeine, Codeine as a medicine that can lower these. This is not an interaction with Rauwolscine — 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, Codeine 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 Rauwolscine and Acetaminophen, Butalbital, Caffeine, Codeine Together: Common Questions
Can you take Rauwolscine with Acetaminophen, Butalbital, Caffeine, Codeine?
Why are there 3 interactions listed for Rauwolscine and Acetaminophen, Butalbital, Caffeine, Codeine?
How serious is the Rauwolscine and Acetaminophen, Butalbital, Caffeine, Codeine 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.