Medication interaction hub

What Supplements Interact with Acetaminophen, Butalbital, Caffeine?

Acetaminophen, Butalbital, Caffeine brand names: Tecnal, Esgic Plus, Fiogesic, Triad, Repan, and others. Every interaction below applies to the brands too.

252 Interactions 11 Major 197 Moderate 44 Minor
Curated & coded by · Clinical Pharmacist · Updated September 22, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Acetaminophen, Butalbital, Caffeine? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Acetaminophen, Butalbital, Caffeine against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

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. Eleven entries are rated major, which puts this list in territory that calls for real vigilance rather than a quick glance. The largest group, 121 ingredients, affects a liver enzyme called CYP3A4 that helps process this drug; grapefruit can push levels up, St. John's wort can drive them down, and both are rated major.

Every dose also contains caffeine, so coffee, tea, cocoa, and the 44 stimulant entries stack onto it, adding jitteriness, a racing heart, or higher blood pressure. The 197 moderate and 44 minor entries mostly echo these same themes at lower intensity. Activated charcoal is a different problem entirely; it can soak up the medication in your gut, so keep the two well separated.

— , Clinical Pharmacist · July 18, 2026

Major 11 Moderate 197 Minor 44 No known interaction 1,200

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Most Viewed Ingredient Interactions

Acetaminophen, Butalbital, Caffeine: Top Interactions at a Glance

The Acetaminophen, Butalbital, Caffeine supplement & herbal interactions people checked most in the last 24 hours, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 252 interacting ingredients — plus 1,200 more checked with no known interaction. See the complete ranked list.

Start here

The Most-Checked Acetaminophen, Butalbital, Caffeine Combinations Today

The Acetaminophen, Butalbital, Caffeine + supplement pages people viewed most in the last 24 hours (resets at midnight). Open any card for the full report.

Minor Likelihood Possible Vitamin D + Acetaminophen, Butalbital, Caffeinei

Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.

Read the full interaction Minor Likelihood Probable Vitamin C + Acetaminophen, Butalbital, Caffeinei

High-dose vitamin C might slightly prolong the clearance of acetaminophen.

Read the full interaction Moderate Likelihood Possible Ashwagandha + Acetaminophen, Butalbital, Caffeinei

Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Read the full interaction Minor Likelihood Possible Glucosamine + Acetaminophen, Butalbital, Caffeinei

Acetaminophen might interfere with the activity of glucosamine sulfate by interacting with the sulfate portion.

Read the full interaction Moderate Likelihood Possible Black Pepper + Acetaminophen, Butalbital, Caffeinei

Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.

Read the full interaction Minor Likelihood Possible Aloe + Acetaminophen, Butalbital, Caffeinei

Theoretically, aloe might decrease the levels and clinical effects of CYP1A2 substrates.

Read the full interaction
The complete list

Every Supplement Checked Against Acetaminophen, Butalbital, Caffeine

All 1,452 ingredients in our database, ranked by severity — 252 with a Acetaminophen, Butalbital, Caffeine interaction on file and 1,200 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Acetaminophen, Butalbital, Caffeine?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Vitamin D with Acetaminophen, Butalbital, Caffeine?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.

Full Vitamin D + Acetaminophen, Butalbital, Caffeine answer

Can you take Vitamin C with Acetaminophen, Butalbital, Caffeine?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. High-dose vitamin C might slightly prolong the clearance of acetaminophen.

Full Vitamin C + Acetaminophen, Butalbital, Caffeine answer

Can you take Ashwagandha with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, taking ashwagandha with hepatotoxic drugs might increase the risk of liver damage.

Full Ashwagandha + Acetaminophen, Butalbital, Caffeine answer

Can you take Glucosamine with Acetaminophen, Butalbital, Caffeine?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Acetaminophen might interfere with the activity of glucosamine sulfate by interacting with the sulfate portion.

Full Glucosamine + Acetaminophen, Butalbital, Caffeine answer

Can you take Black Pepper with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, black pepper might increase levels of drugs metabolized by CYP3A4.

Full Black Pepper + Acetaminophen, Butalbital, Caffeine answer

Can you take St. John's Wort with Acetaminophen, Butalbital, Caffeine?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. St.

Full St. John's Wort + Acetaminophen, Butalbital, Caffeine answer

Can you take Wine with Acetaminophen, Butalbital, Caffeine?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.

Full Wine + Acetaminophen, Butalbital, Caffeine answer

Can you take Asarabacca with Acetaminophen, Butalbital, Caffeine?

Major Use real caution — this is a major-rated interaction, generally best avoided or used only under close supervision. Asarabacca, a herbaceous plant, is often contaminated with aristolochic acid, a compound known for its nephrotoxic effects.

Full Asarabacca + Acetaminophen, Butalbital, Caffeine answer

Can you take Black Tea with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use might increase stimulant adverse effects.

Full Black Tea + Acetaminophen, Butalbital, Caffeine answer

Can you take Brussels Sprout with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. A cabbage and Brussels sprout-containing diet seems to boost elimination through glucuronide conjugation.

Full Brussels Sprout + Acetaminophen, Butalbital, Caffeine answer

Can you take Cabbage with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.

Full Cabbage + Acetaminophen, Butalbital, Caffeine answer

Can you take Caffeine with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use might increase stimulant adverse effects.

Full Caffeine + Acetaminophen, Butalbital, Caffeine answer

Can you take Cannabidiol (cbd) with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Cannabidiol may increase levels of drugs metabolized by CYP1A2.

Full Cannabidiol (cbd) + Acetaminophen, Butalbital, Caffeine answer

Can you take Cocoa with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use might increase stimulant adverse effects.

Full Cocoa + Acetaminophen, Butalbital, Caffeine answer

Can you take Coffee with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use might increase stimulant adverse effects.

Full Coffee + Acetaminophen, Butalbital, Caffeine answer

Can you take Coffee Charcoal with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Coffee charcoal can reduce the absorption of orally administered drugs and should be separated from oral drug administration by at least two...

Full Coffee Charcoal + Acetaminophen, Butalbital, Caffeine answer

Can you take Cola Nut with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concomitant use might increase stimulant adverse effects.

Full Cola Nut + Acetaminophen, Butalbital, Caffeine answer

Can you take Echinacea with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Echinacea can increase plasma levels of caffeine by inhibiting its metabolism.

Full Echinacea + Acetaminophen, Butalbital, Caffeine answer

Can you take European Mandrake with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European...

Full European Mandrake + Acetaminophen, Butalbital, Caffeine answer

Can you take Evodia with Acetaminophen, Butalbital, Caffeine?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Evodia might reduce the levels and clinical effects of CYP1A2 substrates through induction of CYP1A2.

Full Evodia + Acetaminophen, Butalbital, Caffeine answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Acetaminophen, Butalbital, Caffeine is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Acetaminophen, Butalbital, Caffeine, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Acetaminophen, Butalbital, Caffeine sits in 13 interaction categories. Open any one to see what the group means:

Cytochrome P450 3A4 (Cyp3A4) Substrates 121 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

121 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Cytochrome P450 1A2 (Cyp1A2) Substrates 79 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

79 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Stimulant Drugs 44 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

44 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Hepatotoxic Drugs 38 ingredients

Medications with known liver considerations. Supplements that can stress the liver add to the load.

38 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Cytochrome P450 2E1 (Cyp2E1) Substrates 24 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

24 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Caffeine 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Glucuronidated Drugs 12 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

12 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Acetaminophen (Tylenol, Others) 8 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

8 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Barbiturates 6 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

6 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Nephrotoxic Drugs 6 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

6 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Methylxanthines 5 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

5 of the supplement ingredients on this page reach Acetaminophen, Butalbital, Caffeine through this category.

Cytochrome P450 1A2 (Cyp1A2) Substrates 1 ingredient

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

1 of the supplement ingredient on this page reaches Acetaminophen, Butalbital, Caffeine through this category.

About Acetaminophen, Butalbital, Caffeine

A combination of butalbital, acetaminophen, and caffeine used to relieve tension headaches across multiple oral products.

Generic name: Acetaminophen, Butalbital, Caffeine  ·  Brand names: Tecnal, Esgic Plus, Fiogesic, Triad, Repan, Esgic, Fioricet.

See the full Acetaminophen, Butalbital, and Caffeine drug information

Related: does Acetaminophen, Butalbital, Caffeine deplete any nutrients?

Acetaminophen, Butalbital, Caffeine has 14 reported nutrient associations in the research literature — see the Acetaminophen, Butalbital, Caffeine nutrient depletion report.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Acetaminophen, Butalbital, Caffeine

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Acetaminophen, Butalbital, Caffeine.

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Pharmacist Counseling Corner

Acetaminophen, Butalbital, Caffeine & Supplements: Common Questions

What supplements interact with Acetaminophen, Butalbital, Caffeine?
Our database currently documents 252 ingredients with a known Acetaminophen, Butalbital, Caffeine interaction (11 major, 197 moderate, 44 minor). The practical move: scan the major group first, then look up the exact supplements you take rather than reading all 252. The highest-ranked right now: Grapefruit, Siberian Cocklebur, Activated Charcoal.
Which Acetaminophen, Butalbital, Caffeine supplement interactions are the most serious?
Focus on the major group: Grapefruit, Siberian Cocklebur, Activated Charcoal, Beer and Ephedra, among others. A major rating means the combination can be clinically significant, not that harm is guaranteed — but it's exactly the kind of thing to run past your pharmacist before your next dose, not after. Jump to the ranked list.
Can I take vitamins or supplements while on Acetaminophen, Butalbital, Caffeine?
Plenty of supplements coexist fine with Acetaminophen, Butalbital, Caffeine; a shorter list does not. Rather than memorizing it, check the specific ingredients on your labels — the ranked list above covers every one we've checked, and multi-ingredient products can be checked label-by-label with our scanner. Try the label scanner or the interaction checker.
Do brands like Tecnal have the same supplement interactions as Acetaminophen, Butalbital, Caffeine?
Yes — Tecnal, Esgic Plus, Fiogesic, Triad, Repan and other brands all contain Acetaminophen, Butalbital, Caffeine, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
Does Acetaminophen, Butalbital, Caffeine deplete any vitamins or nutrients?
It might — Acetaminophen, Butalbital, Caffeine has 14 reported nutrient-depletion associations in the research literature, which is a different question from interactions: instead of a supplement changing the drug, the drug may lower a nutrient over time. See the Acetaminophen, Butalbital, Caffeine nutrient depletion report for the specifics and what to discuss with your pharmacist.
What about Acetaminophen, Butalbital, Caffeine and my other medications?
This page covers Acetaminophen, Butalbital, Caffeine against supplements and herbal ingredients. Checking Acetaminophen, Butalbital, Caffeine against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker, or read the full Acetaminophen, Butalbital, and Caffeine drug information.

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

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 22, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.