Drug & supplement interaction

Tyramine + Acetaminophen, Butalbital, Caffeine

Acetaminophen, Butalbital, Caffeine brand names: Tecnal, Esgic Plus, Fiogesic, Triad, Repan, and others.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Tyramine has a minor interaction with Acetaminophen, Butalbital, Caffeine. Theoretically, taking tyramine with stimulant drugs might increase the risk of adverse cardiovascular effects.

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

Tyramine and Acetaminophen, Butalbital, Caffeine

Here is the interaction we found between these two, with the evidence behind it.

Minor

STIMULANT DRUGS

Why this applies to Acetaminophen, Butalbital, Caffeine

Acetaminophen, Butalbital, Caffeine falls under STIMULANT DRUGS — the group Tyramine interacts with.

Theoretically, taking tyramine with stimulant drugs might increase the risk of adverse cardiovascular effects.
Tyramine is thought to have stimulant effects.
Severity Minor 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

Here's the gist for your headache medicine: the only piece that really matters in this combination is the caffeine, which is a mild stimulant. Tyramine (the natural compound in aged cheese, cured meats, and fermented foods) can also nudge your body to release norepinephrine, a chemical that raises blood pressure and heart rate. So in theory, pairing a lot of tyramine with the caffeine in your pills could add a little extra stimulation, maybe a faster heartbeat, jitteriness, or a small bump in blood pressure.

Honestly, this is rated minor and is only a theory based on how these things work, not on real patient reports. Normal food amounts of tyramine are unlikely to cause trouble here. If you've been told to follow a low-tyramine diet for another reason, or you feel your heart racing, check with your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Pawar RS, Grundel E. Overview of regulation of dietary supplements in the USA and issues of adulteration with phenethylamines (PEAs). Drug Test Anal 2017;9:500-517. PubMed
  2. National Institutes of Health. Dietary Supplement Label Database. http://www.dsld.nlm.nih.gov/dsld/rptQSearch.jsp?item=tyramine&db=adsld. Accessed October 23, 2019.

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

Tyramine Also Interacts With Other Medications

Tyramine has 181 major, 1 moderate, 170 minor known drug interactions in our database — the Acetaminophen, Butalbital, Caffeine one above is one of them. If you take anything else, check it against the full list below.

Major 181 Moderate 1 Minor 170 No known interaction 2,478 (incl. Acetaminophen, Butalbital, Caffeine)
Taking anything else?

Check Another of Your Medications Against Tyramine

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

From our Q&A

Questions About Tyramine or Acetaminophen, Butalbital, Caffeine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Tyramine or Acetaminophen, Butalbital, Caffeine, 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

This page covers Tyramine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Butalbital, Caffeine page lists 252 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Ephedra (major) and Grapefruit (major).

By severity: 11 major · 197 moderate · 44 minor.

From our pharmacist’s overview on the Acetaminophen, Butalbital, Caffeine page

“Alcohol is the interaction I would flag first for anyone taking acetaminophen, butalbital, and caffeine (Esgic, Fiogesic, and others). Drinking raises the risk of liver injury from the acetaminophen component, and 38 of the 252 supplement ingredients on file carry that same liver concern.”

Reviewed by 2 · Jul 18, 2026

Open the Acetaminophen, Butalbital, Caffeine interaction page

One more smart check

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

We hold 20 real supplement products containing Tyramine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Tyramine. Your product may carry other ingredients that interact with Acetaminophen, Butalbital, Caffeine too, on top of Tyramine — 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 Tyramine and Acetaminophen, Butalbital, Caffeine 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 Tyramine
Steady interest

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

29 days ago today
Medication Acetaminophen, Butalbital, Caffeine
Top 5%

#54 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 Tyramine

What is Tyramine?

  • Studied for effects on blood pressure
  • Discussed in relation to migraine and headache triggers
  • Of interest in food and diet science
  • Subject of research on the nervous system

Tyramine is a natural compound formed when certain proteins break down, and it is found in aged cheeses, cured meats, fermented foods, and some other items. It is not a typical health supplement and is best known for the problems it can cause—such as dangerous spikes in blood pressure—in people taking certain medications or in those who are sensitive to it. If you have been told to follow a low-tyramine diet, talk with your pharmacist or doctor before making changes.

Read the full Tyramine monograph & all interactions
Medication

About Acetaminophen, Butalbital, and Caffeine

What Is Acetaminophen, Butalbital, and Caffeine Used For?

Brand names: Tecnal, Esgic Plus, Fiogesic, Triad, Repan, Esgic, Fioricet

This combination product — available as capsules, tablets, and oral solution under various names including Fioricet — is used to relieve the symptoms of tension headaches (also called muscle contraction headaches).

All supported products, including Fioricet capsules and the oral solution, share this same indication. Because butalbital can be habit-forming, extended or repeated use is not recommended, and these products are not established as safe or effective for treating headaches that come back frequently over time.

See full Acetaminophen, Butalbital, and Caffeine drug information
Keep checking

Other Drugs & Tyramine

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

181Major
1Moderate
170Minor
2,477No known interaction
181 Major 1 Moderate 170 Minor 2,477 No interaction
Major

181 interactions

Showing 60 of 181 major interactions — see all 181 on the Tyramine page.

Moderate

1 interaction

Minor

170 interactions

Showing 60 of 170 minor interactions — see all 170 on the Tyramine page.

No interaction 2,477 drugs checked — show the list

We also checked Tyramine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,477 medications checked with no known interaction — see the full Tyramine list.

See the full Tyramine interactions page
See every supplement checked against Acetaminophen, Butalbital, Caffeine, ranked by severity
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

Keep exploring
Tyramine monograph › Uses, safety, and every drug interaction in one place Acetaminophen, Butalbital, Caffeine supplement interactions › Every supplement checked against Acetaminophen, Butalbital, Caffeine, ranked by severity Acetaminophen, Butalbital, and Caffeine drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Tyramine and Acetaminophen, Butalbital, Caffeine Together: Common Questions

Can you take Tyramine with Acetaminophen, Butalbital, Caffeine?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Tyramine and Acetaminophen, Butalbital, Caffeine interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Acetaminophen, Butalbital, Caffeine and Tyramine?

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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.