Caffeine interactions

Caffeine is a stimulant cleared by the CYP1A2 enzyme; drugs that block that enzyme can make coffee hit much harder.

Caffeine has 13 documented interactions across the FDA labels and fact sheets we index: 3 major, 5 moderate, 4 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This food and drink page is a starting point, not a verdict for your situation.

Major interactions (3)

  • PentoxifyllinemethylxanthineMajor

    CONTRAINDICATIONS Pentoxifylline extended-release tablets should not be used in patients with recent cerebral and/or retinal hemorrhage or in patients who have previously exhibited intolerance to this product or methylxanthines such as caffeine, theophylline, and theobromine. (Pentoxifylline label, Contraindications)

  • PhenelzineMAO inhibitorMajor

    Excessive amounts of caffeine and chocolate may also cause hypertensive reactions. (Phenelzine label, Contraindications)

  • TranylcypromineMAO inhibitorMajor

    …hot dogs, breakfast sausage, and cooked sliced ham) Vegetables Broad bean pods (fava bean pods) All other vegetables Dairy Aged cheeses Processed cheeses, mozzarella, ricotta cheese, cottage cheese, and yogurt Beverages All varieties of tap beer and beers that have not been pasteurized so as to allow for ongoing fermentation and excessive amounts of caffeine. (Tranylcypromine label, Drug interactions)

Moderate interactions (5)

  • CiprofloxacinfluoroquinoloneModerate

    Co-administration of ciprofloxacin and other drugs primarily metabolized by CYP1A2 (for example, theophylline, methylxanthines, caffeine, tizanidine, ropinirole, clozapine, olanzapine and zolpidem), results in increased plasma concentrations of the co-administered drug and could lead to clinically significant pharmacodynamic adverse reactions of the co-administered… (Ciprofloxacin label, Warnings and precautions)

  • Deferasiroxiron supplementModerate

    Agents Metabolized by CYP1A2 Deferasirox inhibits CYP1A2 resulting in an increase in CYP1A2 substrate (e.g., alosetron, caffeine, duloxetine, melatonin, ramelteon, tacrine, theophylline, tizanidine) concentration when these drugs are coadministered. (Deferasirox label, Drug interactions)

  • DuloxetineSNRIModerate

    Therefore, an increase in the metabolism of CYP1A2 substrates (e.g., theophylline, caffeine) resulting from induction is not anticipated, although clinical studies of induction have not been performed. (Duloxetine label, Drug interactions)

  • TerbinafineantifungalModerate

    Terbinafine decreases the clearance of caffeine by 19%. (Terbinafine label, Drug interactions)

  • WarfarinanticoagulantModerate

    …metronidazole, miconazole, oxandrolone, sulfinpyrazone, tigecycline, voriconazole, zafirlukast aprepitant, bosentan, carbamazepine, phenobarbital, rifampin CYP1A2 acyclovir, allopurinol, caffeine, cimetidine, ciprofloxacin, disulfiram, enoxacin, famotidine, fluvoxamine, methoxsalen, mexiletine, norfloxacin, oral contraceptives, phenylpropanolamine, propafenone, propranolol,… (Warfarin label, Drug interactions)

Minor mentions (4)

  • ClozapineantipsychoticMinor

    Moderate or weak CYP1A2 inhibitors include oral contraceptives and caffeine. (Clozapine label, Drug interactions)

  • OfloxacinfluoroquinoloneMinor

    Caffeine Interactions between ofloxacin and caffeine have not been detected. (Ofloxacin label, Drug interactions)

  • TheophyllinemethylxanthineMinor

    Other xanthines such as caffeine, dyphylline, and pentoxifylline are not detected by these assays. (Theophylline label, Drug interactions)

  • VenlafaxineSNRIMinor

    This finding was confirmed in vivo by a clinical drug interaction study in which venlafaxine did not inhibit the metabolism of caffeine, a CYP1A2 substrate. (Venlafaxine label, Drug interactions)

No significant interaction reported (1)

  • Posaconazoleazole antifungalNo interaction

    …Clinically Important Interaction with Noxafil and Noxafil PowderMix Additional clinical studies demonstrated that no clinically important effects on zidovudine, lamivudine, indinavir, or caffeine were observed when administered with Noxafil 200 mg once daily; therefore, no dose adjustments are required for these drugs when coadministered with Noxafil 200 mg once daily. (Posaconazole label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.