Rooibos + 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 Rooibos can interact with; the most serious is rated moderate. Theoretically, taking rooibos with CYP1A2 substrates may increase the effects of CYP1A2 substrates.
Read the full interaction reportRooibos and Acetaminophen, Butalbital, Caffeine, Codeine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Rooibos interacts with whole categories of medication. Acetaminophen, Butalbital, Caffeine, Codeine falls into 3 of those categories, so it can interact with Rooibos 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 Acetaminophen, Butalbital, Caffeine, Codeine
Acetaminophen, Butalbital, Caffeine, Codeine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Rooibos interacts with.
In vitro research shows that the methanol extract of rooibos leaves and stems inhibits CYP1A2 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 piece of this combo pill that actually matters for rooibos: the caffeine. Caffeine is cleared by a liver enzyme called CYP1A2, and very early lab work hints that rooibos may slow that enzyme down a little. In theory, that could let caffeine linger longer, so you might notice more jitteriness, a racing heart, trouble sleeping, or feeling wired.
I want to be honest about the strength of this, though. It comes only from test-tube studies, not from real people drinking rooibos tea, so a normal cup or two is very unlikely to cause a problem. Concentrated rooibos extracts are the bigger unknown. If you take this medication regularly and want to use rooibos for health reasons, just run it by your pharmacist or doctor first.
- Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 3Acetaminophen, Butalbital, Caffeine, Codeine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
In vitro research shows that the methanol extract of rooibos leaves and stems 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. Of the four ingredients in Fioricet with Codeine, the one that matters here is codeine. Codeine is a prodrug, meaning your body has to convert it into morphine using a liver enzyme called CYP2D6 before you feel any real pain relief. Lab studies suggest rooibos may gently slow that same enzyme down.
If rooibos blocks CYP2D6, less codeine turns into morphine, so you might get weaker pain control rather than more. That said, this is only based on test-tube research, not people, so the real-world effect is uncertain and probably small with everyday tea. Sipping rooibos is unlikely to cause trouble, but check with your pharmacist before using concentrated extracts.
- Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 3Acetaminophen, Butalbital, Caffeine, Codeine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that the methanol extract of rooibos leaves and stems strongly inhibits CYP3A4 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.
This combination pill is a busy mix: codeine (a pain reliever), butalbital (a relaxing barbiturate), caffeine, and acetaminophen. The piece worth talking about here is what rooibos might do to enzymes in your liver called CYP3A4, which help process some of these ingredients. In lab dishes, concentrated rooibos extract slowed that enzyme down. In theory, slowing it could let parts of the medicine linger a bit longer, nudging up effects like drowsiness, dizziness, lightheadedness, or constipation.
Here's the reassuring part: this is based only on test-tube research, not real people, and a normal cup or two of rooibos tea is very unlikely to cause trouble. Concentrated rooibos supplements are the bigger question mark. If you take those regularly, just check with your pharmacist or doctor first.
- Fantoukh OI, Dale OR, Parveen A, et al. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea (Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. J Agric Food Chem. 2019;67(17):4967-4975.
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.
Rooibos Also Interacts With Other Medications
Rooibos has 878 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 Rooibos
We haven’t checked that one against Rooibos yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Rooibos. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Butalbital, Caffeine, Codeine
This page covers Rooibos 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 Rooibos as Part of a Dietary Supplement Product? Check It for Interactions
We hold 142 real supplement products containing Rooibos, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rooibos. Your product may carry other ingredients that interact with Acetaminophen, Butalbital, Caffeine, Codeine too, on top of Rooibos — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Rooibos 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.
#580 of 1,452 supplements looked up here in the last 7 days
#988 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 Rooibos
What is Rooibos?
- Caffeine-free beverage
- Antioxidant support
- Heart health
- Blood sugar support
- Digestive upset
- General wellness
Rooibos is a caffeine-free herbal tea from South Africa that is rich in antioxidants and generally considered safe as a beverage. While lab and early studies suggest possible benefits for heart health, blood sugar, and inflammation, strong human evidence is lacking for most medical uses. Enjoy it as a tea, but talk to your pharmacist or doctor before using concentrated extracts for health reasons.
Other Drugs & Rooibos
Browse every other medication we’ve checked against Rooibos — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
878 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Meloxicam ›
- Nortriptyline ›
- Propoxyphene ›
- Rifampin ›
- Testosterone Undecanoate ›
- Aripiprazole ›
- Bendamustine ›
Showing 60 of 878 moderate interactions — see all 878 on the Rooibos page.
No interaction 1,951 drugs checked — show the list
We also checked Rooibos against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Semaglutide ›
- Tirzepatide ›
- Bupropion ›
- Metformin ›
- Amoxicillin ›
- Acyclovir ›
- Doxycycline ›
- Methotrexate ›
- Lamotrigine ›
- Gabapentin ›
- Pregabalin ›
- Azithromycin ›
- Isotretinoin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Mannitol ›
- Roxithromycin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Levetiracetam ›
- Spironolactone ›
- Factor 7a ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Mitomycin ›
- Minoxidil ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Lenvatinib ›
- Phenylephrine ›
- Vancomycin ›
- Hethylphenidate Hcl ›
- Phentermine, Topiramate ›
- Dirithromycin ›
- Bentoquatam ›
- Procainamide ›
- Amoxicillin, Clavulanate Potassium ›
- Tenecteplase ›
- Hydroxychloroquine ›
- Digoxin ›
- Azelaic Acid ›
Showing the 60 most looked-up of 1,951 medications checked with no known interaction — see the full Rooibos 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 Rooibos — 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 Rooibos and Acetaminophen, Butalbital, Caffeine, Codeine Together: Common Questions
Can you take Rooibos with Acetaminophen, Butalbital, Caffeine, Codeine?
Why are there 3 interactions listed for Rooibos and Acetaminophen, Butalbital, Caffeine, Codeine?
How serious is the Rooibos and Acetaminophen, Butalbital, Caffeine, Codeine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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