Drug & supplement interaction

Saffron + Acetaminophen, Butalbital, Caffeine, Codeine

Acetaminophen, Butalbital, Caffeine, Codeine brand names: Esgic with Codeine, Fioricet w/ Codeine.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Butalbital, Caffeine, Codeine falls into 2 drug categories that Saffron can interact with; the most serious is rated moderate. Theoretically, concomitant use of saffron and CNS depressants might have additive sedative effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Saffron and Acetaminophen, Butalbital, Caffeine, Codeine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Saffron interacts with whole categories of medication. Acetaminophen, Butalbital, Caffeine, Codeine falls into 2 of those categories, so it can interact with Saffron in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 2

Why this applies to Acetaminophen, Butalbital, Caffeine, Codeine

Acetaminophen, Butalbital, Caffeine, Codeine falls under CNS DEPRESSANTS — the group Saffron interacts with.

Theoretically, concomitant use of saffron and CNS depressants might have additive sedative effects.
Clinical research shows that taking saffron extract 60 mg orally daily for 26 weeks can cause drowsiness and sedation. Animal research suggests that adding saffron to hexobarbital further increases sleeping and slows motor activity.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This combination pill already has two ingredients that can make you sleepy: butalbital (a barbiturate) and codeine (an opioid). Saffron, especially in concentrated supplement doses, has been linked in some studies to drowsiness and a calming, sedative effect. So the concern here is simple addition. Stacking saffron on top of a medicine that already slows the brain could leave you more groggy, dizzy, or foggy than usual, and in theory could deepen slowed breathing.

Keep in mind this is a theoretical caution based on how these things work, not strong human proof, and the saffron you sprinkle in food is unlikely to matter. Concentrated supplements are the real question. Before pairing them, check with your pharmacist or doctor.

References
  1. Safarinejad MR, Shafiei N, Safarinejad S. A prospective double-blind randomized placebo-controlled study of the effect of saffron (Crocus sativus Linn.) on semen parameters and seminal plasma antioxidant capacity in infertile men with idiopathic oligoasth
  2. Zhang, Y., Shoyama, Y., Sugiura, M., and Saito, H. Effects of Crocus sativus L. on the ethanol-induced impairment of passive avoidance performances in mice. Biol.Pharm Bull. 1994;17(2):217-221. PubMed
Moderate

CAFFEINE

2 of 2

Acetaminophen, Butalbital, Caffeine, Codeine also falls under CAFFEINE.

Theoretically, saffron might inhibit the metabolism of caffeine.
A small clinical study suggests that taking saffron powder 300 mg in 150 mL water daily for 5 days and then taking caffeine 200 mg seems to reduce caffeine metabolite levels in the saliva and urine in males, but not females. Theoretically, this may be due to the inhibition of cytochrome P450 1A2 by saffron.
Severity Moderate Likelihood Possible Evidence B

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This combination pill includes caffeine, and that is the piece saffron may touch. A small study found that saffron seemed to slow down how the body clears caffeine, likely by blocking an enzyme called CYP1A2. If caffeine hangs around longer, you might notice more jitteriness, a racing heart, trouble sleeping, or feeling on edge, especially since you may already be getting caffeine from coffee or tea.

I want to keep this in perspective. The evidence is early and somewhat theoretical, the effect was modest, and it showed up in men but not women. Saffron sprinkled in food is very unlikely to matter; concentrated supplement doses are the bigger question. Saffron does not change the codeine, butalbital, or acetaminophen parts here. If you take a saffron supplement, just give your pharmacist a heads-up.

References
  1. Begas E, Bounitsi M, Kilindris T, et al. Effects of short-term saffron (Crocus sativus L.) intake on the in vivo activities of xenobiotic metabolizing enzymes in healthy volunteers. Food Chem Toxicol. 2019;130:32-43. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • 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.
Evidence the quality of the studies behind the rating (graded A–D)
  • 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.

Keep it in perspective

Saffron Also Interacts With Other Medications

Saffron has 520 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.

Taking anything else?

Check Another of Your Medications Against Saffron

Covers the 2,830 medications we’ve checked against Saffron. Pick one to open its full report.

From our Q&A

Questions About Saffron or Acetaminophen, Butalbital, Caffeine, Codeine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Saffron or Acetaminophen, Butalbital, Caffeine, Codeine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Butalbital, Caffeine, Codeine

This page covers Saffron 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

One more smart check

Taking Saffron as Part of a Dietary Supplement Product? Check It for Interactions

We hold 418 real supplement products containing Saffron, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Saffron. Your product may carry other ingredients that interact with Acetaminophen, Butalbital, Caffeine, Codeine too, on top of Saffron — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Saffron 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.

Supplement Saffron
Top 25%

#236 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Acetaminophen, Butalbital, Caffeine, Codeine
Top half

#911 of 2,830 medications looked up here in the last 7 days

29 days ago today

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.

Supplement

About Saffron

What is Saffron?

Saffron
  • Depression and low mood
  • Anxiety
  • PMS symptoms
  • Memory and cognition
  • Eye health (age-related macular degeneration)

Saffron is a costly spice that has shown promise in early studies for mild-to-moderate depression and some mood and PMS symptoms, but most research uses small trials, so results are not definitive. It is generally well tolerated in food and small supplement amounts, but high doses can be harmful and it should be avoided in pregnancy. Talk to your pharmacist or doctor before using saffron supplements.

Read the full Saffron monograph & all interactions
Keep checking

Other Drugs & Saffron

Browse every other medication we’ve checked against Saffron — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
520Moderate
0Minor
2,309No known interaction
Moderate

520 interactions

Showing 60 of 520 moderate interactions — see all 520 on the Saffron page.

No interaction 2,309 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

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Pharmacist Counseling Corner

Taking Saffron and Acetaminophen, Butalbital, Caffeine, Codeine Together: Common Questions

Can you take Saffron with Acetaminophen, Butalbital, Caffeine, Codeine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Saffron and Acetaminophen, Butalbital, Caffeine, Codeine?
Acetaminophen, Butalbital, Caffeine, Codeine belongs to more than one drug category, and Saffron interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Saffron and Acetaminophen, Butalbital, Caffeine, Codeine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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.