Caffeine

Also indexed as:

Cafcit, Caffedrine, Enerjets, NoDoz, Quick Pep, Snap Back, Stay Alert, Vivarin

Combination drugs:

• Anacin
• Darvon Compound
• Fioricet
• Fiorinal

Caffeine is a central nervous system stimulant drug used as an aid to stay awake, for mental alertness due to fatigue, and as an adjunct with other drugs for pain relief. Caffeine is available alone as a nonprescription drug, in combination with other nonprescription drugs, and in prescription drug combinations for relief of pain and headache.

Summary of Interactions for Caffeine

Calcium

In 205 healthy postmenopausal women, caffeine consumption (three cups of coffee per day) was associated with bone loss in women with calcium intake of less than 800 mg per day.¹ In a group of 980 postmenopausal women, lifetime caffeine intake equal to two cups of coffee per day was associated with decreased bone density in those who did not drink at least one glass of milk daily during most of their life.² However, in 138 healthy postmenopausal women, long-term dietary caffeine (coffee) intake was not associated with bone density.³ Until more is known, postmenopausal women should limit caffeine consumption and consume a total of approximately 1,500 mg of calcium per day (from diet and supplements).

Guaraná (Paullinia cupana)

Guaraná is a plant with a high caffeine content. Combining caffeine drug products and guaraná increases caffeine-induced side effects.

Ephedra

Until 2004, many herbal weight loss and quick energy products combined caffeine or caffeine-containing herbs with ephedra. This combination may lead to dangerously increased heart rate and blood pressure and should be avoided by people with heart conditions, hypertension, diabetes, or thyroid disease.⁴

Food

Caffeine is found in coffee, tea, soft drinks, and chocolate. To reduce side effects, people taking caffeine-containing drug products should limit their intake of caffeine-containing foods/beverages.

Tobacco

Smoking can increase caffeine metabolism,⁵ decreasing effectiveness. Smokers who use caffeine-containing drug products may require higher amounts of caffeine to achieve effectiveness.

1. Harris SS, Dawson-Hughes B. Caffeine and bone loss in healthy postmenopausal women. Am J Clin Nutr 1994;60:573-8.
2. Barrett-Connor E, Chang JC, Edelstein SL. Coffee-associated osteoporosis offset by daily milk consumption. The Rancho Bernardo Study. JAMA 1994;271:280-3.
3. Lloyd T, Rollings N, Eggli DF, et al. Dietary caffeine intake and bone status of postmenopausal women. Am J Clin Nutr 1997;65:1826-30.
4. Tyler VE. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, Pharmaceutical Press, 1994, 88-9.
5. Joeres R, Klinker H, Heusler H, et al. Influence of smoking on caffeine elimination in healthy volunteers and in patients with alcoholic liver cirrhosis. Hepatology 1988;8:575-9.

Last Review: 09-07-2006

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