Acetaminophen, Butalbital, Caffeine, Codeine & Nutrient Depletion
Also searched as Esgic with Codeine, Fioricet w/ Codeine. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Acetaminophen, Butalbital, Caffeine, Codeine has been associated with depletion of POTASSIUM and GLUTATHIONE. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Acetaminophen, Butalbital, Caffeine, Codeine long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Acetaminophen, Butalbital, Caffeine, Codeine pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Acetaminophen, Butalbital, Caffeine, Codeine
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
POTASSIUM
Moderate DepletionMETHYLXANTHINES
Methylxanthines like theophylline can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs. However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels. Monitor potassium levels in people with other risk factors for hypokalemia. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart and muscles depend on to work properly, and the caffeine component of this combination medication is worth paying attention to here. Caffeine belongs to a group of compounds called methylxanthines, which can nudge potassium out of your bloodstream and into your cells, temporarily lowering the level that shows up on a blood test. At regular doses this effect is usually mild, but it can be more significant if you already have other reasons your potassium might run low. If you take this medication regularly, it is worth mentioning to your pharmacist or doctor so they can decide whether your levels should be checked.
What Potassium does & food sources
Potassium keeps nerve signals, muscle contractions, and heart rhythm working normally.
Common food sources:
- Bananas and citrus fruits
- Potatoes and sweet potatoes
- Beans and lentils
- Tomatoes and leafy greens
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Potassium is routinely checked with basic blood work. If you take a medication associated with potassium loss (like some diuretics), ask your provider how often your electrolytes should be monitored.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Do not start potassium supplements on your own. Both low and high potassium can affect heart rhythm, and several common medications (ACE inhibitors, ARBs, potassium-sparing diuretics) raise potassium.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Potassium supplementation can be dangerous in kidney disease or alongside potassium-raising medications — this is a decision for your prescriber, guided by lab results.
Learn more about this nutrient: Potassium — uses, safety & interactions
References (5)
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Crane J, Burgess CD, Graham AN, Maling TJB. Hypokalemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease. NZ Med J 1987;100:309-11. DOI
- Zantvoort FA, Derkx FHM, Boomsma F, et al. Theophylline and serum electrolytes (letter). Ann Int Med 1986;104:134-5. PubMed
- Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7..
- Flack JM, Ryder KW, Strickland D, Whang R. Metabolic correlates of theophylline therapy: a concentration-related phenomenon. Ann Pharmacother 1994;28:175-9.. PubMed
GLUTATHIONE
Insufficient EvidenceACETAMINOPHEN
Chronic or excessive acetaminophen has been associated with low levels of glutathione. Usually a cysteine containing supplement is used to replenish glutathione. Cysteine is converted to glutathione in the body.
Glutathione is a natural antioxidant your body makes to protect cells from damage and help neutralize harmful byproducts. The acetaminophen in this combination product is processed by the liver, and that process uses up glutathione, so heavy or long-term use has been linked to lower glutathione levels. That said, current evidence is too limited to know whether this matters clinically for most people taking normal doses. If you use this medication regularly, it is worth mentioning to your pharmacist or doctor.
Learn more about this nutrient: Glutathione — uses, safety & interactions
References (1)
- Herzenberg LA, De Rosa SC, Dubs JG, et al. Glutathione deficiency is associated with impaired survival in HIV disease. Proc Natl Acad Sci USA 1997;94:1967-72. PubMed
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Acetaminophen, Butalbital, Caffeine, Codeine
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Acetaminophen, Butalbital, Caffeine, Codeine & nutrients: FAQs
Does Acetaminophen, Butalbital, Caffeine, Codeine deplete POTASSIUM?
Should I take a supplement because I take Acetaminophen, Butalbital, Caffeine, Codeine?
Should I stop taking Acetaminophen, Butalbital, Caffeine, Codeine?
Where does this information come from?
Questions about Acetaminophen, Butalbital, Caffeine, Codeine and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Acetaminophen, Butalbital, Caffeine, Codeine are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.