Butalbital, aspirin, caffeine, and codeine and Fluvoxamine interaction
Butalbital, aspirin, caffeine, and codeine and Fluvoxamine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Butalbital, aspirin, caffeine, and codeine (BUTALBITAL, ASPIRIN, CAFFEINE and CODEINE PHOSPHATE) label · effective 2026-01-15
Intervention: Avoid concomitant use Serotonergic Drugs : Concomitant use may result in serotonin syndrome.
Serotonergic Drugs Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome.
Examples: Selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT 3 receptor antagonists, drugs that effect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e.,cyclobenzaprine, metaxalone), monoamine oxidase…
From the Fluvoxamine (fluvoxamine maleate) label · effective 2026-04-23
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ).
These studies have also shown that concurrent use of an NSAID or aspirin may potentiate this risk of bleeding.
Patients should be cautioned about the increased risk of bleeding associated with the concomitant use of Fluvoxamine Maleate Tablets and NSAIDs, aspirin, or other drugs that affect coagulation [see Warnings and Precautions ( 5.8 )] .
Warfarin and Other Drugs That Interfere With Hemostasis (NSAIDs, Aspirin, etc.): See Warnings and Precautions ( 5.8 , 5.10 ) .
Theophylline: Clearance decreased; reduce theophylline dose by one-third ( 5.8 ).
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.