Schizonepeta + Acetaminophen, Butalbital, Caffeine, Codeine
Acetaminophen, Butalbital, Caffeine, Codeine brand names: Esgic with Codeine, Fioricet w/ Codeine.
Acetaminophen, Butalbital, Caffeine, Codeine falls into 4 drug categories that Schizonepeta can interact with; the most serious is rated moderate. Animal research suggests that schizonepetin, a monoterpene constituent of schizonepeta, inhibits cytochrome P450 (CYP) 2D6.
Read the full interaction reportSchizonepeta and Acetaminophen, Butalbital, Caffeine, Codeine
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Schizonepeta interacts with whole categories of medication. Acetaminophen, Butalbital, Caffeine, Codeine falls into 4 of those categories, so it can interact with Schizonepeta in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 4Why this applies to Acetaminophen, Butalbital, Caffeine, Codeine
Acetaminophen, Butalbital, Caffeine, Codeine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Schizonepeta interacts with.
Some substrates of CYP2D6 include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), haloperidol (Haldol), imipramine (Tofranil), metoprolol (Lopressor, Toprol XL), ondansetron (Zofran), paroxetine (Paxil), risperidone (Risperdal), tramadol (Ultram), venlafaxine (Effexor), and others.
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 codeine part is a prodrug. Your body uses an enzyme called CYP2D6 to turn codeine into morphine, which is what actually relieves your pain. Lab and animal studies hint that a compound in Schizonepeta may slow that same enzyme down. If that happens in people, you'd convert less codeine into morphine, so you might get less pain relief than expected rather than more.
I want to be honest that this is only theoretical right now, based on test-tube and animal work, not real patients, so I wouldn't lose sleep over it. Occasional herbal use likely matters little, but please check with your pharmacist or doctor before pairing them regularly.
- Bao B, Geng T, Cao Y, et al. Effects of schizonepetin on activity of mRNA expression of cytochrome P450 enzymes in rats. Int J Mol Sci. 2012;13(12):17006-18.
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
2 of 4Acetaminophen, Butalbital, Caffeine, Codeine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
Some substrates of CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
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 piece that interacts with Schizonepeta is the caffeine, which your liver clears using an enzyme called CYP1A2. Animal studies hint that a compound in Schizonepeta can slow that enzyme down. If that happens, caffeine could hang around longer, so you might feel more jittery, have a racing heart, trouble sleeping, or feel a bit wired.
Keep in mind this is very weak, theoretical evidence from lab and animal work, not from people, so a real problem is far from certain. The other ingredients (acetaminophen, butalbital, and codeine) aren't mainly cleared this way. Still, if you take Schizonepeta supplements regularly, it's worth a quick chat with your pharmacist or doctor before mixing the two.
- Bao B, Geng T, Cao Y, et al. Effects of schizonepetin on activity of mRNA expression of cytochrome P450 enzymes in rats. Int J Mol Sci. 2012;13(12):17006-18.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 4Acetaminophen, Butalbital, Caffeine, Codeine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Some substrates of CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others.
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 is a mixed bag when it comes to schizonepeta. Animal studies hint that schizonepeta may speed up an enzyme called CYP3A4. Your liver uses that enzyme to process the butalbital portion, so in theory you could clear it a bit faster and get less of the calming, headache-easing benefit you're after.
The codeine piece is a little different. Codeine is a prodrug that needs another enzyme (CYP2D6) to turn into morphine, so this particular interaction shouldn't change its pain relief much. Honestly, the evidence here is weak (only lab and animal data), so I wouldn't lose sleep over it. Still, since this medicine affects breathing and alertness, run it past your pharmacist or doctor before pairing the two.
- Bao B, Geng T, Cao Y, et al. Effects of schizonepetin on activity of mRNA expression of cytochrome P450 enzymes in rats. Int J Mol Sci. 2012;13(12):17006-18.
CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES
4 of 4Acetaminophen, Butalbital, Caffeine, Codeine also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.
Some substrates of CYP2E1 include acetaminophen, chlorzoxazone (Parafon Forte), ethanol, theophylline, and anesthetics such as enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), and methoxyflurane (Penthrane).
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 that matters for this combination pill: the acetaminophen part is partly handled by a liver enzyme called CYP2E1. In animal and test-tube studies, a compound in Schizonepeta appears to slow that enzyme down. In theory, that could let acetaminophen linger a bit longer or shift more of it down a pathway that's harder on the liver.
I want to be honest about the strength of this, though. We only have lab and animal data, no real human studies, so this is more of a 'maybe' than a proven problem. The bigger, well-known caution with any acetaminophen product is simply not stacking too much acetaminophen and going easy on alcohol. If you'd like to use Schizonepeta, run it by your pharmacist or doctor first so they can check your full medication list.
- Bao B, Geng T, Cao Y, et al. Effects of schizonepetin on activity of mRNA expression of cytochrome P450 enzymes in rats. Int J Mol Sci. 2012;13(12):17006-18.
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.
Schizonepeta Also Interacts With Other Medications
Schizonepeta has 796 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 Schizonepeta
We haven’t checked that one against Schizonepeta yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Schizonepeta. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Butalbital, Caffeine, Codeine
This page covers Schizonepeta 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 Schizonepeta as Part of a Dietary Supplement Product? Check It for Interactions
We hold 285 real supplement products containing Schizonepeta, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Schizonepeta. Your product may carry other ingredients that interact with Acetaminophen, Butalbital, Caffeine, Codeine too, on top of Schizonepeta — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Schizonepeta 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.
#359 of 1,452 supplements looked up here in the last 7 days
#901 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 Schizonepeta
What is Schizonepeta?
- Common cold and early-stage fever
- Itchy skin rashes and hives
- Sore throat
- Headache
- Measles and other skin eruptions (traditional use)
Schizonepeta is a mint-family herb long used in traditional Chinese medicine, usually as part of combination formulas for colds, fevers, and itchy skin conditions. Modern human evidence is very limited, so its benefits are not well proven. Talk to a pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.
Other Drugs & Schizonepeta
Browse every other medication we’ve checked against Schizonepeta — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
796 interactions
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Oxybutynin ›
- Oxycodone ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Miconazole ›
- Morphine Sulfate ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Lofepramine ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Nortriptyline ›
- Propoxyphene ›
- Rifampin ›
- Testosterone Undecanoate ›
- Aripiprazole ›
- Bendamustine ›
- Caffeine (otc Drug) ›
- Ciclesonide ›
- Clonazepam ›
- Cyclobenzaprine ›
- Dapsone ›
- Desipramine ›
- Doxepin ›
- Duloxetine ›
- Erythromycin Ethylsuccinate ›
Showing 60 of 796 moderate interactions — see all 796 on the Schizonepeta page.
No interaction 2,033 drugs checked — show the list
We also checked Schizonepeta against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Aspirin ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Valacyclovir ›
- Docusate ›
- Hydroxyurea ›
- Ibuprofen ›
- Semaglutide ›
- Sumatriptan ›
- Tirzepatide ›
- Bupropion ›
- Metformin ›
- Acyclovir ›
- Amoxicillin ›
- Lisinopril ›
- Doxycycline ›
- Lamotrigine ›
- Methotrexate ›
- Gabapentin ›
- Pregabalin ›
- Isotretinoin ›
- Azithromycin ›
- Methylene Blue ›
- Ciprofloxacin ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Daptomycin ›
- Hexobarbitone ›
- Dexmethylphenidate ›
- Valsartan ›
- Levothyroxine Sodium ›
- Levetiracetam ›
- Mitomycin ›
- Minoxidil ›
- Cefaclor ›
- Factor 7a ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Ezetimibe ›
- Levodopa ›
- Vancomycin ›
- Phenylephrine ›
- Spironolactone ›
- Dirithromycin ›
- Procainamide ›
- Lenvatinib ›
- Hethylphenidate Hcl ›
- Azelaic Acid ›
- Phentermine, Topiramate ›
- Bentoquatam ›
- Tenecteplase ›
Showing the 60 most looked-up of 2,033 medications checked with no known interaction — see the full Schizonepeta 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 Schizonepeta — 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 Schizonepeta and Acetaminophen, Butalbital, Caffeine, Codeine Together: Common Questions
Can you take Schizonepeta with Acetaminophen, Butalbital, Caffeine, Codeine?
Why are there 4 interactions listed for Schizonepeta and Acetaminophen, Butalbital, Caffeine, Codeine?
How serious is the Schizonepeta and Acetaminophen, Butalbital, Caffeine, Codeine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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