Caffeine Clash: What Medications Not to Mix With Coffee

Many of us rely on coffee to kickstart our mornings, while others enjoy it occasionally. But here's a twist: caffeine can mess with how some medications work. It can change how these drugs are absorbed, broken down, and removed from our bodies, making them less effective or causing unexpected side effects. Keep reading to learn about 10 drugs you should avoid mixing with your coffee.

How does coffee interact with medications?

Coffee contains caffeine and is metabolized in the liver by the system of enzymes known as Cytochrome P450. More specifically the enzyme, cytochrome 450 1A2, is responsible for the metabolism of caffeine as well as other drugs. Therefore, when caffeine and certain medications are taken together, this can lead to cardiovascular, gastrointestinal, respiratory, and dermatological problems.

8 medications you should avoid mixing with coffee

Metabolism of certain drugs and caffeine involves the same enzymes. If this is the case, it's best to avoid taking them together. Medications that shouldn't be mixed with coffee include but are not limited to:

  1. Adenosine
  2. Anticoagulant drugs
  3. Quinolone antibiotics
  4. Mexiletine (Mexitil)
  5. Selective serotonin reuptake inhibitors (SSRIs)
  6. Disulfiram (Antabuse)
  7. Osteoporosis drugs (Bisphosphonates)
  8. Bronchodilators

1. Adenosine

Adenosine can be given before the cardiac stress test and is also used to treat supraventricular tachycardia (SVT), a condition characterized by an increased heart rate. Caffeine can block the effects of adenosine; therefore, it should be avoided to not affect the drug's efficacy.

2. Anticoagulant drugs

Anticoagulants, also known as blood drugs, slow down blood clotting. Caffeine has been shown to inhibit warfarin (commonly used anticoagulant) metabolism because caffeine binds to enzymes and prevents it from metabolizing the drug. As a result, blood warfarin levels increase, which enhances the anticoagulant effects of the drug.

Therefore, caffeine-rich foods, drinks, and products should be limited, especially when taking warfarin.

3. Quinolone antibiotics

Quinolones are antibiotics used to treat bacterial infections such as urinary tract infections, sexually transmitted infections, and gastrointestinal, bone, and joint infections.

Some of the quinolone antibiotics are ciprofloxacin (Cipro), ofloxacin (Floxin), norfloxacin (Noroxin), and moxifloxacin (Avelox).

Quinolones can slow down caffeine clearance, which means it stays in your body for longer. Decreased caffeine clearance can cause enhanced side effects such as increased heart rate, palpitations, nervousness, and headaches.

4. Mexiletine

Mexiletine is used to treat ventricular arrhythmias (abnormal heart rhythm). Research showed that although caffeine does not affect mexiletine clearance, mexiletine decreased caffeine clearance by 50%. Therefore, adverse effects of mexiletine can be exacerbated by increased caffeine concentration.

5. Selective serotonin reuptake inhibitors

Selective serotonin reuptake inhibitors (SSRIs) are antidepressants used for the treatment of mental health conditions such as depression, obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and severe phobias.

Examples of SSRIs are fluoxetine (Prozac or Oxactin), fluvoxamine (Faverin), citalopram (Cipramil), paroxetine (Seroxat), and sertraline (Lustral).

Caffeine is advised to be avoided, especially when taking fluvoxamine. Caffeine clearance has been shown to decrease by 80% when taken with fluvoxamine, which can exacerbate the side effects of caffeine, such as rapid heart rate, feeling sick and insomnia.

6. Disulfiram

Disulfiram (Antabuse) is used for chronic alcoholism treatment. Disulfiram has been shown to decrease caffeine clearance by about 30%. Due to increased caffeine concentration, patients can experience side effects such as nervousness, anxiety, and sleep problems.

Experiencing more side effects can negatively affect the treatment; therefore, it's recommended to consult a healthcare provider about coffee consumption while taking disulfiram.

7. Osteoporosis drugs

Bisphosphonates such as alendronate, ibandronate, and risedronate are used in osteoporosis treatment. They help inhibit the breakdown of bone. Coffee has been shown to reduce the absorption of bisphosphonates, diminishing their effects.

8. Bronchodilators

Bronchodilators furafylline and theophylline are used to treat asthma and chronic obstructive pulmonary disease (COPD).

Furafylline hase been shown to affect caffeine metabolism, resulting in excessive accumulation of caffeine in the blood. Taking caffeine with furafylline can cause caffeine-related side effects such as heartburn, nausea, and headache. On the other hand, caffeine has been shown to increase the half-life and decrease clearance of theophylline. Therefore, coffee and caffeine consumption should be considered while taking bronchodilators.

Before taking drugs, always ask your healthcare provider about potential interactions between food-drug and drug-drugs. Additionally, it's essential to read labels and drug prospectus to be informed about possible interactions between food-drug and drug-drug.

Before starting any medication regimen, it's crucial to consult your healthcare provider about potential interactions between foods, drugs, and medications. The same goes for reading labels and drug information leaflets. Being informed about these interactions can help ensure the safety and effectiveness of your treatment plan.


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