The 7 common medicines you must NEVER mix with caffeine – or risk deadly bleeds to psychosis
WHEN it comes to remembering to take your meds, it can be useful to follow certain cues.
You might be one of those people who knocks back your pills alongside your morning cup of coffee or tea.
But certain drugs might not make the best pairing with your morning cup of Joe, which can dull their effectiveness or even lead to unpleasant side effects.
“Caffeine can interact with various medications, potentially causing adverse effects or diminishing the efficacy of the medications,” Jacquie Lee, a medication safety officer and information pharmacist at Numark, told The Sun.
“Patients should keep caffeine intake fairly stable and moderate to alleviate any adverse effects or interactions with regular medicines,” she said.
“If patients want to reduce or eliminate caffeine within their diet, they should seek advice from their healthcare provider to check any potential effects this may have on their regular medicines.”
Jacquie named seven medications you should avoid or be cautious of popping with your coffee – from blood pressure pills to antibiotics and asthma drugs.
1. Ephedrine
Ephedrine is medication used to treat hypotension – also known as low blood pressure, when the force of blood pushing against artery walls is too low.
Some nasal sprays to ease congestion used to contain ephedrine – these are no longer sold in the UK but they may still be available in other countries, according Patient.info.
Jacquie warned that combining the drug with coffee may cause unintended and sometimes serious side effects.
“Ephedrine when combined with caffeine has been known to lead to hypertensive crises, subarachnoid haemorrhage and in some cases, psychosis,” she said.
“Caffeine needs to be avoided in patients taking this drug,” Jacquie warned.
A hypertensive crisis is a sudden, severe increase in blood pressure, which causes chest pain, shortness of breath, blurry vision, dizziness and vomiting.
You should get help immediately if you think you’re going through a hypertensive emergency.
Meanwhile, subarachnoid haemorrhage is an uncommon type of stroke caused by bleeding on the surface of the brain.
The NHS warns that you should dial 999 over this medical emergency, which causes symptoms like:
- A sudden severe headache unlike anything you’ve experienced before
- A stiff neck
- Feeling and being sick
- Sensitivity to light
- Blurred or double vision
- Stroke-like symptoms – such as slurred speech and weakness on one side of the body
- Loss of consciousness or convulsions (uncontrollable shaking)
2. ADHD drugs
Medications used to treat attention deficit hyperactivity disorder (ADHD) and amphetamines are both stimulants – a class of drugs that enhance brain activity.
Jacquie warned against mixing the drugs with coffee, due to risks of heightening their effects.
“Stimulants – such as amphetamines or ADHD drugs – can enhance effects such as increased heart rate, blood pressure, and anxiety, when combined with caffeine, which itself is a stimulant,” the pharmacist said.
3. Asthma medications
Bronchodilators are a type of medication that make breathing easier by relaxing the muscles in the lungs and widening the airways.
They’re often used to treat conditions such as asthma or chronic obstructive pulmonary disease (COPD), a group of lung conditions, usually caused by smoking, the NHS says.
Caffeine can actually act as a mild bronchiodilator.
According to Jacquie: “Bronchodilators – such as theophylline – alongside the consumption of caffeine-containing beverages can raise theophylline levels.
“Similarly, removal of caffeine-containing foods from the diet may reduce the length of effective action of each theophylline dose.”
4. Insomnia drugs
Benzodiazepines are a type of sedative medication that down the body and brain’s functions.
They can be used to help with anxiety and insomnia, according to mental health charity Mind.
A class of medicines known as Z-drugs can also be prescribed for sleep issues.
Diazepam and zopiclone are some common examples, according to Jacquie, who warned against taking them with coffee.
“With benzodiazepines and Z-drugs, caffeine appears to antagonise the sedative – and possibly anxiolytic – effects of these drugs,” the medicines expert explained.
5. Blood pressure medications
Beta blockers – such as propranolol and atenolol – and calcium channel blockers, including verapamil, are medicines used to lower high blood pressure.
Jacquie noted that both can interact with caffeine.
“Caffeine may oppose the effects of beta-blockers and increase blood pressure,” she warned.
“There is no need to avoid moderate intake, but it would seem best to avoid excessive consumption.”
How to lower blood pressure
Persistent high blood pressure (hypertension) puts extra strain on your blood vessels, heart and other organs and it can raise your risk of serious conditions like heart disease, heart attacks and stroke. Here's how to reduce it.
Reduce salt
Adults are recommended to limit their salt to 6g per day (around one level teaspoon) to avoid health consequences including high blood pressure.
The top tip is to swap out table salt, according to the Salt Substitute and Stroke Study, replacing it with a reduced sodium and added potassium alternative.
Cut down on alcohol
Excessive boozing can narrow the blood vessels, which raises the risk of hypertension.
Official drinking guidelines advise that people should not regularly drink more than 14 units a week to keep health risks from alcohol low.
Get moving
Exercise is good for the heart and the blood vessels.
Although the guidelines recommend 150 minutes of activity per week, if you’re currently very inactive, just a walk to the shop every day is better than nothing, and you can work up from there.
Studies suggest that isometric exercises – when you hold the body in one position without moving, such as a wall squat or plank – are best for lowering blood pressure.
Stop smoking
Smoking cigarettes is a killer. It makes the arteries sticky and narrow, which can cause blockages.
While smoking is not a direct cause of high blood pressure, it can cause an instant rise to pressure, heart rate and reduce the amount of oxygen that gets to the body’s cells.
Skip coffee
Sadly, caffeine can cause a short, but dramatic increase in your blood pressure – even if you don’t have high blood pressure.
Therefore cutting back on coffee is recommended as a lifestyle tip for those with hypertension.
Lose weight
The above tips can help you to lose weight, which is beneficial because being overweight in itself is a risk factor for hypertension.
Being overweight forces your heart to work harder to pump blood around your body, which can raise your blood pressure.
The only way of knowing whether you have high blood pressure is to have a blood pressure test. All adults over 40 years old are advised to have their blood pressure checked at least every five years.
As for calcium channel blockers, these can increase the concentration of caffeine in the blood.
As a result, drinks like tea, coffee, cola and some medicines – such as caffeine-containing analgesics could cause adverse effects when combined with the drugs, such such as jitteriness or insomnia.
“If these become troublesome, it should be advised to reduce caffeine intake,” Jacquie said.
6. Antibiotics
Antibiotics are used to treat or prevent some types of bacterial infection.
It could be worth scaling down your caffeine intake when taking a common class of antibiotics, Jacquie added.
“Quinolone antibiotics – such as ciprofloxacin – may increase the effects of caffeine,” she explained.
You may be advised to limit your caffeine intake – including from tea, coffee and cola drinks – if you experience adverse effects, according to the pharmacist.
7. Diuretics
Finally, Jacquie named diuretics as drugs to watch out for in combination with coffee.
Diuretics are sometimes called “water tablets” because they make you pee more to help get rid of extra fluid in your body.
“The effects of diuretics, such as furosemide, and be compounded when taken alongside caffeine, she said.
“Caffeine also has diuretic properties.”
Furosemide is used to treat high blood pressure, heart failure and a build up of fluid in the body, called oedema.
Food and medicine combinations to avoid
Tea and coffee aren't only drink you need to be wary of combining with some medications.
Beverages like grapefruit juice – along with some foods – can make a difference on how our bodies process drugs.
Some drug and food combinations can even result in blood clots or liver damage.
Here are a few to know:
- Grapefruit and statins – the fruit or juice can increase the risk of side effects from cholesterol lowering meds
- Dairy and antibiotics – milk, cheese, and yogurt can interfere with the absorption of antibiotics
- Leafy greens and blood thinners – kale, spinach and romaine lettuce can reverse the effects of blood thinning medications like warfarin, increasing blood clotting
- Booze and painkillers – some painkillers can lead dizziness, drowsiness, liver damage, and other serious complications when combined with alcohol
Read more on drug and food combinations to be wary of here.