Sage + Acetaminophen, Caffeine, Codeine, Salicylamide
Acetaminophen, Caffeine, Codeine, Salicylamide brand names: Codalan No.1, Codalan No.2, Codalan No.3.
Acetaminophen, Caffeine, Codeine, Salicylamide falls into 4 drug categories that Sage can interact with; the most serious is rated moderate. Theoretically, taking sage might increase the sedative and adverse effects of CNS depressants.
Read the full interaction reportSage and Acetaminophen, Caffeine, Codeine, Salicylamide
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Sage interacts with whole categories of medication. Acetaminophen, Caffeine, Codeine, Salicylamide falls into 4 of those categories, so it can interact with Sage 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 Acetaminophen, Caffeine, Codeine, Salicylamide
Acetaminophen, Caffeine, Codeine, Salicylamide falls under CNS DEPRESSANTS — the group Sage interacts with.
Some constituents of sage have CNS depressant 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 product contains codeine, an opioid that can make you feel drowsy or relaxed. The concern here is fairly simple: some compounds in sage have shown mild calming, brain-slowing activity in lab studies. Stack that on top of codeine, and in theory you could feel a bit more sleepy, foggy, or lightheaded than usual.
I'll be honest with you, this is theoretical and only based on test-tube and animal research, so I wouldn't lose sleep over it. The pinch of sage in your cooking is not going to matter. Stronger sage extracts or the essential oil, taken regularly, are where I'd be more careful. If you notice extra grogginess, mention it to your pharmacist or doctor before changing anything.
- Perry NS, Bollen C, Perry EK, Ballard C. Salvia for dementia therapy: review of pharmacological activity and pilot tolerability clinical trial. Pharmacol Biochem Behav 2003;75:651-9.. PubMed
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 4Acetaminophen, Caffeine, Codeine, Salicylamide also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2D6. So far, this interaction has not been reported in humans.
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 product: the codeine part is a prodrug. Your body has to switch it on using an enzyme called CYP2D6 to turn it into morphine, which is what actually relieves pain. Lab studies suggest sage may block that same enzyme. If that happened in real life, you might get less pain relief from the codeine, not more, since less of it would be converted to its active form.
I'll be honest with you though, this is only seen in test-tube studies and has never been reported in people. Cooking with sage almost certainly won't matter; concentrated extracts are the bigger question mark. If you take sage supplements regularly, just mention it to your pharmacist or doctor so they can keep an eye on how well your medicine is working.
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Hellum BH, Nilsen OG. The in vitro inhibitory potential of trade herbal products on human CYP2D6-mediated metabolism and the influence of ethanol. Basic Clin Pharmacol Toxicol. 2007 Nov;101:350-8.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Acetaminophen, Caffeine, Codeine, Salicylamide also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP3A4. So far, this interaction has not been reported in humans.
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 combination pill includes codeine, and that's the piece worth a closer look. Lab studies hint that sage may slow down an enzyme called CYP3A4, one of the pathways your body uses to handle codeine. If that pathway is dampened, a bit more codeine could linger, which in theory might lead to more drowsiness, constipation, or slowed breathing. The same enzyme also helps clear caffeine, so you could feel slightly jittery longer too.
Here's the honest part: this is only seen in test tubes, not in real people, and everyday cooking with sage almost certainly won't matter. Concentrated sage extracts or the essential oil are a different story. If you use those regularly, just give your pharmacist or doctor a quick heads-up.
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.
CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES
4 of 4Acetaminophen, Caffeine, Codeine, Salicylamide also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.
Animal research suggests that drinking common sage (Salvia officinalis) tea increases the expression of CYP2E1. So far, this interaction has not been reported in humans.
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 includes acetaminophen (Tylenol), and one of the liver enzymes that processes acetaminophen is called CYP2E1. The lab and animal data we have suggests sage tea may slightly speed up this enzyme. In theory, that could shift how acetaminophen is broken down. The honest truth is this has only been seen in animal studies and has never actually been reported in people, so I wouldn't lose sleep over it.
A couple of practical points. Normal cooking amounts of sage are very unlikely to matter at all. Concentrated sage extracts or essential oil are a different story and deserve more caution. Since CYP2E1 also plays a role in how acetaminophen affects the liver, I'd keep this on your radar if you use higher doses of sage. When in doubt, run it by your pharmacist or doctor first.
- Lima, C. F., Fernandes-Ferreira, M., and Pereira-Wilson, C. Drinking of Salvia officinalis tea increases CCl(4)-induced hepatotoxicity in mice. Food Chem.Toxicol. 2007;45(3):456-464.
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.
Sage Also Interacts With Other Medications
Sage has 1,295 moderate known drug interactions in our database — the Acetaminophen, Caffeine, Codeine, Salicylamide one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Sage
We haven’t checked that one against Sage yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Sage. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Caffeine, Codeine, Salicylamide
This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Caffeine, Codeine, Salicylamide page lists 303 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 · 244 moderate · 44 minor.
Open the Acetaminophen, Caffeine, Codeine, Salicylamide interaction page
Taking Sage as Part of a Dietary Supplement Product? Check It for Interactions
We hold 718 real supplement products containing Sage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sage. Your product may carry other ingredients that interact with Acetaminophen, Caffeine, Codeine, Salicylamide too, on top of Sage — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Sage and Acetaminophen, Caffeine, Codeine, Salicylamide 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.
#260 of 1,452 supplements looked up here in the last 7 days
#1,356 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 Sage
What is Sage?
- Sore throat and mouth irritation
- Digestive upset
- Excessive sweating
- Memory and thinking
- Menopause symptoms (hot flashes)
- General antioxidant support
Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.
Other Drugs & Sage
Browse every other medication we’ve checked against Sage — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,295 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Glycopyrrolate ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Insulin (human) ›
- Ipratropium ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
Showing 60 of 1,295 moderate interactions — see all 1,295 on the Sage page.
No interaction 1,534 drugs checked — show the list
We also checked Sage against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Valacyclovir ›
- Docusate ›
- Hydroxyurea ›
- Sumatriptan ›
- Acyclovir ›
- Bupropion ›
- Amoxicillin ›
- Bendamustine ›
- Methotrexate ›
- Isotretinoin ›
- Azithromycin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Mitomycin ›
- Cefaclor ›
- Factor 7a ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Ezetimibe ›
- Levodopa ›
- Vancomycin ›
- Phenylephrine ›
- Dirithromycin ›
- Lenvatinib ›
- Hethylphenidate Hcl ›
- Azelaic Acid ›
- Bentoquatam ›
- Tenecteplase ›
- Amoxicillin, Clavulanate Potassium ›
- Hydroxychloroquine ›
- Dextrothyroxine ›
- Triptorelin ›
- Lomustine ›
- Acetylsalicylic Acid ›
- Succimer ›
- Tocainide ›
- Rocuronium ›
- Halothane ›
- Mitomycin C ›
- Pizotifen ›
- Gestodene ›
- Chenodiol ›
- Niacin (prescription Drug) ›
- Desflurane ›
- Cabergoline ›
- Famotidine ›
Showing the 60 most looked-up of 1,534 medications checked with no known interaction — see the full Sage 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, Caffeine, Codeine, Salicylamide Is Linked to Lower Levels of 2 Nutrients
Natural Medicines records Acetaminophen, Caffeine, Codeine, Salicylamide as a medicine that can lower these. This is not an interaction with Sage — 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, Caffeine, Codeine, Salicylamide 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 Sage and Acetaminophen, Caffeine, Codeine, Salicylamide Together: Common Questions
Can you take Sage with Acetaminophen, Caffeine, Codeine, Salicylamide?
Why are there 4 interactions listed for Sage and Acetaminophen, Caffeine, Codeine, Salicylamide?
How serious is the Sage and Acetaminophen, Caffeine, Codeine, Salicylamide interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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