Butalbital, aspirin, caffeine, and codeine and Rasagiline interaction
Butalbital, aspirin, caffeine, and codeine and Rasagiline: 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
…respiratory depression [see Warnings and Precautions ( 5.9 ) ] Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment[see Warnings and Precautions ( 5.9 ) ] Concurrent use of monoamine oxidase inhibitors (MAOIs) or use of MAOIs within the last 14 days [see Warnings and Precautions ( 5.10 ) / Drug Interactions ( 7 ) ].
Concurrent use of monoamine oxidase inhibitors (MAOIs) or use of MAOIs within the last 14 days ( 4 )
BUTALBITAL, ASPIRIN, CAFFEINE and CODEINE PHOSPHATE should not be used in patients taking MAOIs or within 14 days of stopping such treatment.
Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (e.g., respiratory depression, coma) [see Warnings and Precautions ( 5.10 )].
Intervention: Do not use BUTALBITAL, ASPIRIN, CAFFEINE and CODEINE PHOSPHATE in patients taking MAOIs or within 14 days of stopping such treatment.
From the Rasagiline label · effective 2020-06-30
Hypertensive crisis has been reported in patients taking the recommended dose of rasagiline and sympathomimetic medications.
Severe hypertension has been reported in patients taking the recommended dose of rasagiline and ophthalmic drops containing sympathomimetic medications.
Nevertheless, caution should be exercised when concomitantly using recommended doses of rasagiline with any sympathomimetic medications including nasal, oral, and ophthalmic decongestants and cold remedies.
Sympathomimetic Medications The concomitant use of rasagiline and sympathomimetic medications was not allowed in clinical studies.
Severe hypertensive reactions have followed the administration of sympathomimetics and nonselective MAO inhibitors.
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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.