What the Yuck: Can I mix coffee with my meds?
June 24th, 2012
08:12 AM ET

What the Yuck: Can I mix coffee with my meds?

Too embarrassed to ask your doctor about sex, body quirks, or the latest celeb health fad? In a regular feature and a new book, "What the Yuck?!," Health magazine medical editor Dr. Roshini Raj tackles your most personal and provocative questions. Send 'em to Dr. Raj at whattheyuck@health.com.

Q: Is it true that coffee doesn't mix well with some medications?

A: That's true, unless you're drinking decaf. It's best not to combine large amounts of caffeine with any drug that has stimulant effects, such as pseudoephedrine (which is found in some cold and allergy meds), because the caffeine can heighten the drug's side effects, which may include weakness, nausea, and an irregular heartbeat.

Meanwhile, certain antibiotics, such as ciprofloxacin (Cipro), can interfere with the breakdown of caffeine in your body, extending the amount of time it stays in your system and prolonging its effects, such as insomnia or a bad case of the jitters. The herbal supplement echinacea can also do this.

Finally, never mix caffeine with ephedrine (a stimulant that was banned from dietary supplements in the U.S. but is still found in some congestion relievers). The combo can lead to increased blood pressure or even more serious heart problems.

If you're a java junkie, consider cutting back on the coffee or opting for decaf while you're on any of these meds, and ask your doctor or pharmacist about potential side effects when he prescribes a new medication.

Copyright Health Magazine 2011

soundoff (81 Responses)
  1. Organic1

    Who ever answered this question has no knowledge of chemistry, even at the 101 level. All coffee and tea contain tanic acid, found in the leaves and beans. Tanic acid neutralizes medication taken by mouth before it can break down in the stomach. Caffeine or decaf does not make any difference in effectiveness of the medication. Let someone with a clue answer these questions for public viewing, at least tell the truth !

    June 25, 2012 at 07:46 | Report abuse | Reply
    • Paulse

      Its "tannic" acid, not "tanic" acid.

      June 25, 2012 at 08:56 | Report abuse |
    • Scuromondo

      I have no knowledge of tannic acid. However, it sounds counterintuitive that it could "neutralize medication taken by mouth before it can break down in the stomach" unless (perhaps) the medication you are taking is in some elemental form such as a liquid or powder. Most medicines are taken in capsule or tablet form and must reach the stomach before releasing their active ingredients; they don't release their active ingredients while they are in your mouth.

      June 25, 2012 at 09:39 | Report abuse |
    • truebob

      Instantly neutralizes ALL medicines ? Seriously? The nuclear bomb of antidotes? Silly rabbit.

      June 25, 2012 at 11:52 | Report abuse |
    • common sense

      Where does it say there's a difference in the medication's effectiveness? It says it can increase the side effects of the medication. Learn to read before you go all Nancy Grace.

      June 25, 2012 at 19:37 | Report abuse |
    • awedduct

      You say the tannins "NEUTRALIZE medication taken by mouth before it can break down in the stomach...." How can you then state that:

      "Caffeine or decaf does not make any difference in effectiveness of the medication."

      If something's neutralized, it's not effective!

      June 25, 2012 at 20:46 | Report abuse |
    • pusencer

      i'm a pharmacist. I think the most polite way to respond to your concern is to say you're mistaken. I would add theophylline (another xanthine family drug) to the list to be concerned with. In addition, almost no medications are absorbed in the stomach and only basic medications would be "neutralized" be tannic acid. Most medications are weak acids and the mechanism of the majority of drug interactions is through protein binding in blood or through liver enzyme activation/deactivation (cytochrome p450).

      June 25, 2012 at 21:08 | Report abuse |
    • mike monahan

      YOU are confused, Organic 1

      June 26, 2012 at 07:42 | Report abuse |
    • DM

      Chem 101 does not one make a chemistry, or biochemistry, expert it seems.... A little knowledge is indeed dangerous.

      June 26, 2012 at 08:31 | Report abuse |
    • Che

      I am a chemical engineer with a masters in biochemical engineering and I formulate drugs for a living. I will be a little less than "polite" here to Organic 1. Where did you take your chemistry 101 – Devry? Most active ingredients are not affected by tannic acid or other mild acids in coffee. Your stomach is much more acidic than a cup of coffee. The point about caffeine taken with some stimulants is a valid one by the author but as far as acidity, taking medication with coffee is no worse than fruit juice or soda.

      June 26, 2012 at 11:20 | Report abuse |
    • steven harnack

      You're hilarious. Wine has more tannic acid than tea or coffe has, so you're saying that if I wash my valium down with a big glass of wine then the valium will have no effect on me? I'll call you from the emergency room to let you know how that works out.

      June 26, 2012 at 15:33 | Report abuse |
  2. Tallulah "Lulu" Stark

    I just followed my instinct on that question and decided that it was probably a bad idea. It's probably not a good idea to medication with any hot liquid, because it just seems like it would have more to do with capsules disintegrating and bursting before they are meant to. I don't know these as fact, and I never really looked up the truth on that theory. But, it seems to be sound logic anyway.

    Besides, has anyone here tried to take medication with coffee? I've done it a few times, just to see, and it tastes horrible! It's harder to get the medication down, and it seems to cause digestive upset. So, again, common sense. Do the healthy thing, grab a bottle of water from the fridge and down the meds. It's better to drink water in the morning anyway.

    June 25, 2012 at 09:24 | Report abuse | Reply
  3. JavaJunkie

    I take 4 different pills in the morning, and I take them all at the same time – with my coffee. I actually 'dry swallow' them all before I take a drink of coffee. I've never had a problem with them 'not going down' or tasting bad. However, they are all small pills. I'm used to drinking coffee every a.m. so it doesn't seem to upset my stomach either. I would check your Rx labels (or ask your pharmacist if you're worried) – I know calcium and some fruit juices should not be taken with your medication, but they are labeled as such. I must agree though :), common sense seems to point to water being a better option, but I just can't wait for my a.m. coffee.

    June 25, 2012 at 10:31 | Report abuse | Reply
  4. my reply

    yes, take it with water! a more conservative view would say don't take meds with coffee to aviod any side effects. Or better yet, make lifestyle changes that can lower the need for meds in the first place and you won't even have to take them

    June 25, 2012 at 10:56 | Report abuse | Reply
    • Steph

      Sure, no problem. I'll just change my lifestyle and rewrite my genetic code.

      June 26, 2012 at 06:55 | Report abuse |
    • KC

      At the time I became disabled, I was exercising daily, eating a healthy diet, didn't drink/smoke/do drugs. The only thing I did wrong was leave my nice safe home on that fateful day. So, no, I don't think that a lifestyle change would improve my condition enough to give up my prescription medications. Being a paragon of virtue hasn't cured me over the past few decades.

      June 26, 2012 at 10:06 | Report abuse |
    • Cynthia

      All the lifestyle changes in the world won't eliminate my bipolar, so... Nope!

      August 6, 2020 at 06:36 | Report abuse |
  5. Cherry Pop

    Ever since I ripped my knee cap off and my genius dr prescribed ibuprofen I have dealt with daily pain management on my own. Caffeine is a miracle to add to most pain relievers. Makes them work faster and act stronger. Ofc taking 2500mg of ibus plus coffee daily tears up my stomach, but unless knee specialist start working for free that is my only recourse.

    June 25, 2012 at 11:17 | Report abuse | Reply
  6. TP

    Caffeine does interact with thyroid medication, (levothyroxine, specifically) and caffeine should not be consumed for at least an hour after taking the meds.

    June 25, 2012 at 11:52 | Report abuse | Reply
    • Elizabeth

      I've asked my endocrinologist specifically about drinking coffee after taking my synthroid medication. He said that it dissolves so quickly that as long as I wait 20-30 min. to drink coffee, it shouldn't be an issue.

      June 25, 2012 at 13:21 | Report abuse |
    • pusencer

      don't take anything with thyroid. it should be taken on an empty stomach 30 minutes before anything else. the basis of the interaction is that anything else in the stomach will reduce the amount of thyroid absorbed and body thyroid levels are very sensitive

      June 25, 2012 at 21:10 | Report abuse |
    • lynn

      Elizabeth, your endo may not have seen these – Benvenga, S. et. al. “Altered Intestinal Absorption of L-Thyroxine Caused by Coffee.” Thyroid. Vvolume 18 Issue 3, pages 293-301. March 2008 Abstract.

      Mazzaferri, MD MACP, Ernest. "Thyroid Hormone Therapy," Clinical Thyroidology for Patients: Summaries for Patients from Clinical Thyroidology. August 2008 Vol 1, Iss 1. Online

      Sindoni, Alessandro et. al. "Case Report: Coffee Impairs intestinal Absorption of Levothyroxine: Report of Additional Cases," Hot Thyroidology, Article 5/09, Online (PDF)

      June 26, 2012 at 07:29 | Report abuse |
    • Sarah

      As long as you take your levothyroxine the same way every day it doesn't matter if you take it with or without medication. Food and drinks affect the medication, but that does not matter because your doctor bases your doses on your levels. So just be consistent and it doesn't matter.

      June 26, 2012 at 18:00 | Report abuse |
    • Elizabeth

      Lynn... I'm sure you're smarter than my doctor, thanks... I agree with Sarah. If I am consistent in how I take the meds and when I drink coffee every day, which I am, then it will be fine.

      June 27, 2012 at 10:10 | Report abuse |
  7. swohio

    I certainly hope this article isn't meant to be exhaustive, because I've also heard (and experienced firsthand) that you probably should also not have anything with caffeine in it if you're on blood pressure meds.

    June 25, 2012 at 12:36 | Report abuse | Reply
    • Sarah

      Well if you think about it caffeine raises blood pressure so when people who take high blood pressure medications drink caffeine, it works against their medications so they do not work as well. But now ask how many people on blood pressure medication actually drink caffeine and you'll find that tons of them still drink caffeine.

      June 26, 2012 at 18:11 | Report abuse |
  8. jerry

    the medicine manufacturers want their med's to work so they can sell them. If caffeine prevented their med's from working they would say "Don't take this with coffee, it won't work as well, you will remain sick as you were, and we won't make tons of money".

    However I wonder if coffe interferes with vitamin absorbtion.

    June 25, 2012 at 14:06 | Report abuse | Reply
  9. RodRoderick

    They should bann caffeine in NYC! The city that never sleeps – laughs

    June 25, 2012 at 14:23 | Report abuse | Reply
  10. Beth

    any drug interactions mixing certain drugs with grapefruit juice?

    June 25, 2012 at 14:30 | Report abuse | Reply
    • Karl

      Never take statins (drugs for controlling cholesterol) with grapefruit juice, especially Lipitor, Mevacor, or Zocor–grapefruit juice will cause dangerously high levels of statins to build up in your body, causing liver, muscle, and kidney damage.

      June 25, 2012 at 14:51 | Report abuse |
    • pusencer

      statin medications are metabolized by the same liver enzymes that the grapefruit juice inhibits, this increases the levels of the statin medication in the bloodstream to levels higher than the doctor had intended. benzodiazepines are also affected similarly, but i'll have to add that the studies that found this interaction involved on heckuva lot of grapefruit juice and that warning should be considered in that light. a grapefruit in the morning should not elicit a dangerous response, a quart of grapefruit juice may

      June 25, 2012 at 21:13 | Report abuse |
    • Sarah

      Amlodipine, a blood pressure medication, also interacts with grapefruit juice. Just ask your pharmacist if any of your meds interact, he/she will know and if they don't they can look it up fast.

      June 26, 2012 at 18:07 | Report abuse |
    • Brett Y

      Yep. Valuim. If you take Valuim with GF juice the blood satuation level remains high for longer, someting like that so if you want to get hammered then...else aviod GFJ while on this med.

      June 27, 2012 at 09:14 | Report abuse |
  11. larry5

    Should I avoid coffee when shooting up with meth?

    June 25, 2012 at 20:25 | Report abuse | Reply

      yous bein' a major Dumbazzzzzzzzzzz, I expect no less from you.

      June 25, 2012 at 20:45 | Report abuse |
    • GaGaGooGoo

      No, you're fine. Hasn't had an adverse effect on me.

      June 25, 2012 at 21:44 | Report abuse |
  12. Annie

    I can't believe how many people take medications in this country! I bet Big Pharma here is the most powerful in the World! I developed thyroid condition and I refused to take hormone therapy prescribed by doctors. I saw a homeopath and homeopathic remedy and acupuncture have healed me. I no longer have the disease and I no longer need medications. I guess some people feel better taking their medications. I wonder if coffee interferes with supplements.

    June 25, 2012 at 22:43 | Report abuse | Reply
    • Sarah

      If you think the pharmaceutical company is making big bucks just look at supplement companies. No one regulates them so the majority of the time you're not getting what the bottle says you are.

      June 26, 2012 at 18:05 | Report abuse |
    • Elizabeth

      I'd be interested to know how you "cured" this condition. I no longer have a thyroid due to cancer, so I have to take synthroid every day for the rest of my life.

      June 27, 2012 at 10:13 | Report abuse |
  13. steven harnack

    So that was a wishy-washy report on the effects of coffee and 3 drugs, 2 actually since ephedrine and pseudoephedrine are basically the same compound. I'm gonna have to say that with about 50,000 different medications on the market, the question is still unanswered.

    June 26, 2012 at 15:39 | Report abuse | Reply
  14. MJSouth

    Another in-depth helpful CNN article.

    June 26, 2012 at 17:27 | Report abuse | Reply
  15. Rick Springfield

    I always warsh down my pills with a big squig of coke or some other soft drink. Haven't seen any evidence that they don't work. I just have to watch out on some of the ones that can open up in the esophogus though. I take those large cinnamon tabs and they do not go down well if they open up early.

    I remember when my grandad had alzheimers and he totally refused his meds. I'm talking 15 years ago. I made a mickey for him to take made of coke. He drank it and said, "that's aweful."

    June 26, 2012 at 21:58 | Report abuse | Reply
  16. Tester

    Fuel poverty is aerdaly a serious issue for some people in the UK, but will increasingly become a very serious issue for many in the UK. There is a tripple whammy at work. First, the green subsidies adding a3200 to a3400 per year for the typical user. Second, generally increasing energy costs.The price of gas, coal and oil has risen steadily these past 5 years and will continue to do so in the future and the effect of this is exacerbated with a weak pound which has devalued significantly. This has pushed up energy prices by about 40% Third, incomes are being squeezed due to the financial crisis. Many people are not receiving pay increases yet inflation is running at about 5% and tax liabilities are increasing. All of this inevitably means that energy costs are becoming an ever increasing proportion of people's disposal income and for many energy bills becoming unaffordable.If every one was to deduct say between a3200 to a3400 from their energy bills writing to the energy companies advising them that they are not interested in green renewables and are not willing to pay a surcharge for something not wanted, there would be little that the energy companies could do (being swamped by numbers) and this madness would soon die a natural death. If the English were more like the French, I am sure that this is what would happen. Not an issue for the French since their government had the foresight to invest in nuclear on a large scale.The death of this low CO2 energy production may be the only good thging to come out of the financial crisis.

    September 13, 2012 at 22:32 | Report abuse | Reply
    • Jona

      I welcome the hihegr profile given to promoting freedom of religion or belief in this report. Violence against religious minorities, and the difficulty even of inserting language in a UN resolution on the right to change religion, are cited as specific concerns in the report. What practical measures can be taken by the UK to address these persistent problems?

      October 14, 2012 at 01:59 | Report abuse |
  17. Susan

    Will tannins interfere with the effectiveness of antibiotics? Does anyone know the answer? Thanks

    March 7, 2013 at 14:03 | Report abuse | Reply
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