Danger in the coffee cup: The daily habit of drinking coffee close to taking medications may be more problematic than we previously thought. New studies show that caffeine interferes with the absorption of hormones, affects the breakdown rate of psychiatric medications and even increases the risk of bleeding in people who take blood thinners.
To maintain health and prevent a situation in which the medication does not work as required, it is important to keep at least a one-hour gap between the drink and the pills, and to pay attention to the list of medications that are most sensitive to caffeine.
1. Antidepressant medications
If your doctor prescribed you a medication for depression, it is advisable to make sure you do not drink coffee too close to the time you take it. The caffeine found in coffee may create a complex compound with the medication escitalopram, which makes it difficult for the body to properly absorb the active substance. When less of the medication is absorbed into the blood, it becomes less effective in treating symptoms and the patient does not feel the expected improvement.
Other medications such as clomipramine are broken down by the same enzyme that breaks down caffeine in the liver. When they are consumed together, the medications are not broken down at the required rate, which leads to high and dangerous levels of the substance in the blood. At the same time, this combination increases the effect of caffeine and causes nervousness, hand tremors and extreme restlessness.
2. Thyroid medications
Hypothyroidism is a condition in which the gland does not produce enough hormones, leading to fatigue, joint pain and weight gain. The absorption of the medication levothyroxine, which is used to treat this condition, can be significantly reduced due to drinking coffee. Medical studies show that coffee reduces the absorption of the medication by up to 50%, which causes unstable hormone levels in the blood.
This decrease leads to ongoing symptoms such as brain fog and chronic fatigue, even though the patient consistently takes the pill every day. The updated expert recommendation is to wait at least 30 to 60 minutes between taking the medication and drinking coffee, and this also applies to drinking tea, which interferes with absorption in exactly the same way.
3. Osteoporosis medications
Medications intended to treat calcium loss and strengthen bones, such as alendronate, should not be taken with coffee under any circumstances. It does not matter whether it is strong coffee, decaffeinated instant coffee or even coffee mixed with a little milk, all of these reduce absorption due to the way the medication binds to other substances in the stomach. When the medication is taken with coffee, the active substance does not dissolve properly and cannot enter the bloodstream.
The safest and only recommended method is to take the pill with plain water only on an empty stomach, to ensure that the substance reaches its destination in the bones and is not excreted from the body without any medical use.
4. Cold and allergy medications
Pseudoephedrine is a substance found in many medications used to treat a blocked nose and it is considered a stimulant of the nervous system. Similar to pseudoephedrine, caffeine is also a stimulant, and therefore the combination between them worsens the side effects of both and causes strong heart palpitations, high blood pressure and a feeling of anxiety.
People who suffer from diabetes should be especially careful with this combination, because some studies have shown that consuming caffeine together with these medications may raise blood sugar levels and cause an increase in body temperature. It is important to remember that this effect can last for several hours and disrupt the body’s metabolic balance.
5. Antipsychotic medications
People who take medications such as clozapine, haloperidol or olanzapine need to be very cautious regarding the timing of their coffee consumption. Coffee negatively affects the body’s ability to properly metabolize these chemical substances in the liver.
This disruption may cause unexpected changes in the concentration of the medication in the blood, which directly affects mental stability and the effectiveness of the treatment of complex symptoms. At the same time, excessively high levels of the medication in the blood due to slow breakdown may cause tremors, excessive drowsiness or movement disorders, therefore monitoring caffeine consumption in these cases is essential.
6. Medications for asthma treatment
In cases of inflammation or irritation in the respiratory tract, doctors sometimes prescribe bronchodilator medications such as theophylline. These medications relax the muscles in the airways and make it easier for the patient to breathe, but they include side effects such as nausea, headaches and restlessness.
Consuming a large amount of caffeine from coffee, tea or energy drinks significantly increases the intensity of these side effects. Since caffeine and the medication act through similar mechanisms on the nervous system, the combination between them creates an excessive load on the body and makes the treatment very difficult for daily use for patients who need it.
7. Blood thinners
Medications for preventing blood clots are given to people who are at risk after surgery or due to heart problems. Taking these medications together with coffee is dangerous because caffeine itself can slow blood clotting, which increases the risk of dangerous internal bleeding or the appearance of bruises on the skin from any minor impact.
Studies indicate that coffee lowers the level of acidity in the stomach, which shortens the absorption time of aspirin and leads to a very large amount of the medication reaching the blood at once. This situation increases the potential for bleeding in the stomach and in other parts of the body, therefore it is important to follow the doctor’s instructions and not mix the drink with blood thinners.
*This is of course a general list, in any case you should always consult the treating physician and pharmacist before taking medications.
Dr. Itay Gal is a specialist in pediatrics, a sports and aviation physician and a researcher of infectious diseases. Health writer and medical commentator for Maariv and a lecturer in the fields of medicine and innovation. For more articles click here