Why medicines should not be taken with coffee – 02/14/2023 – Equilibrium

For many people, starting the day without coffee is unthinkable.

But in some cases, when taking certain medications in the morning, it’s better to wait a bit before reaching for your cup.

Some remedies can be taken at different times of the day, but it is also recommended not to take them with liquids that contain caffeine – such as teas and hot chocolate.

“There are approximately 60 drugs that can interact with caffeine,” Antonio Javier Carcas Sansuán, professor of pharmacology at the Autonomous University of Madrid, Spain, tells BBC News Mundo, the BBC’s Spanish-language news service.

Most of these interactions are, however, moderate.

When we take a medicine, it travels through our organism – once in the stomach or intestine, it passes into the bloodstream and, subsequently, is distributed throughout the body.

“This medicine must arrive at the place where it will perform the action for which it was developed, its pharmacological target”, explains Elena Puerta Ruiz de Azúa, professor of pharmacology at the University of Navarra, to BBC News Mundo.

Think of this target as the strategist for treating a disease, the protein within our body – the receptor that the drug will activate or block – on which it will exert its effect.

And for that to happen, it needs to be absorbed and distributed efficiently.

Afterwards, this medicine has to be metabolized, that is, eliminated from the body – and the main organ in this process is the liver, which is responsible for purifying our organism.

But what happens if coffee is added to that journey? It depends on the medicine and its purpose.

In the brain

Remember that caffeine is a central nervous system stimulant, which can cause agitation and high blood pressure.

If we are talking about a medicine intended to produce a sedative or tranquilizing effect, mixing it with coffee or any caffeinated drink will be harmful because it will neutralize the effects of the drug.

Several of these drugs belong to the benzodiazepine family – used, for example, in treatments for anxiety and insomnia.

“Caffeine would reach the brain at the same time as this drug”, says Puerta.

“So you would get, on the one hand, the stimulation of caffeine and, on the other hand, the relaxing action of the drug: opposite effects.”

“Taking these drugs with caffeine-rich drinks is totally inadvisable because you are ingesting, through coffee or cola, a molecule that does exactly the opposite of what the drugs are trying to do”, he adds.

in the liver

Also, some meds use the same enzymes and proteins as caffeine to be metabolized in the liver, so there’s a kind of interference that can cause the med to build up in the body more than necessary.

“For some drugs, this increase in plasma concentration may be irrelevant because they have a wide safety margin. But for very specific others, such as those prescribed for schizophrenia, in whose treatment it is essential that drug concentrations are ideal, it may represent a risk”, warns the expert.

“These are drugs that will not be the same if there is a little more concentration. It could be dangerous if it increases.”

According to Carcas, caffeine can modify the effect of some drugs, by enhancing or decreasing it.

There are also medications that inhibit caffeine metabolism, blocking the action of the enzyme responsible for this process.

An example is some antibiotics, such as quinolones.

“What can happen is that this medicine inhibits or decreases the metabolism of caffeine and, with that, causes the concentrations of caffeine to increase in the organism and that its effect is greater”, says the professor.

absorption question

It is also recommended that some medications, such as those used to treat hypothyroidism, be taken on an empty stomach.

“It is important that thyroxine be taken on an empty stomach, without having ingested any food or coffee, and to wait a little before having breakfast to favor the complete absorption of the drug at the intestinal level, and thus reach the ideal levels of the hormone in our body”, says Puerta.

It’s just that the presence of food in the stomach and intestine can also make it difficult to absorb certain medications.

“Even if you take the recommended dose, if some of it isn’t absorbed, it won’t have the pharmacological effect.”

However, for other drugs, food is the golden rule: some anti-inflammatories can be very harmful to the gastric mucosa.

Therefore, “sometimes what is recommended is precisely to take it with meals to minimize this gastro-harmful effect”.

The dairy element of coffee

Don’t be fooled by a latte full of coffee.

Tetracyclines, which are a type of antibiotic, form a “complex” with milk and this prevents their absorption, explains Puerta.

“This complex would pass through our entire digestive system until it is eliminated in the feces without being absorbed at any time through the gastrointestinal walls, without reaching the blood and without fulfilling its purpose.”

If you take this type of antibiotic with a latte, “you’re throwing it away.”

This family of antibiotics, if taken with milk derivatives, forms insoluble compounds with calcium, called chelates, which will not be absorbed at the intestinal level – and, therefore, will not have a pharmacological effect.

Carcas recalls that cola-based drinks can also affect the absorption of some medications: delaying or altering it.

read the leaflet

If you are going to take a medicine that affects the central nervous system, such as antidepressants, it is essential to follow the doctor’s instructions, as caffeine alone is a great stimulant of this system.

For Puerta, it is essential that the medicines are taken as indicated by the health professionals.

“Forget homemade inventions. If it’s a sachet that has to be dissolved in water, do it this way – and not (dissolve) in juice or other liquid because it completely changes the composition.”

In addition, she clarifies, there are many medicines that do not have any contraindications to be taken with coffee.

“You have to see each specific case”, he says.

And the best way to be sure is to ask your pharmacist or doctor.

“In general, it’s important to drink coffee in moderation,” recommends Carcas.

This text was originally published here