Drug & supplement interaction

Black Tea + Enoxacin

Enoxacin brand name: Penetrex.

Moderate Interaction
The bottom line Moderate

Enoxacin falls into 3 drug categories that Black Tea can interact with; the most serious is rated moderate. Theoretically, concomitant use might increase the levels and adverse effects of caffeine.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Black Tea and Enoxacin

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Black Tea interacts with whole categories of medication. Enoxacin falls into 3 of those categories, so it can interact with Black Tea in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS

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Why this applies to Enoxacin

Enoxacin falls under CYTOCHROME P450 1A2 (CYP1A2) INHIBITORS — the group Black Tea interacts with.

Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Black tea contains caffeine. Caffeine is metabolized by CYP1A2,. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from black tea and increase caffeine levels.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with enoxacin (Penetrex), an antibiotic in the fluoroquinolone family. Enoxacin happens to slow down a liver enzyme called CYP1A2, which is the very same enzyme your body uses to clear out the caffeine in black tea. So while you're on this antibiotic, that caffeine can hang around longer and stack up.

In real terms, your usual cup or two of tea might hit harder than normal: think jitteriness, a racing or pounding heart, trouble sleeping, or feeling wired. This is a theoretical concern based on how the drug works, not something proven in studies, so don't panic. Still, cutting back on tea (and coffee, soda, energy drinks) during your short course of enoxacin is a reasonable move. Check with your pharmacist if you're unsure.

References
  1. Weisburger JH. Tea and health: the underlying mechanisms. Proc Soc Exp Biol Med 1999;220:271-5. PubMed
  2. Hagg S, Spigset O, Mjorndal T, Dahlqvist R. Effect of caffeine on clozapine pharmacokinetics in healthy volunteers. Br J Clin Pharmacol 2000;49:59-63. PubMed
  3. Carrillo JA, Benitez J. Clinically significant pharmacokinetic interactions between dietary caffeine and medications. Clin Pharmacokinet 2000;39:127-53. PubMed
  4. Kot, M. and Daniel, W. A. Effect of diethyldithiocarbamate (DDC) and ticlopidine on CYP1A2 activity and caffeine metabolism: an in vitro comparative study with human cDNA-expressed CYP1A2 and liver microsomes. Pharmacol Rep. 2009;61(6):1216-1220. PubMed
  5. Wojcikowski, J. and Daniel, W. A. Perazine at therapeutic drug concentrations inhibits human cytochrome P450 isoenzyme 1A2 (CYP1A2) and caffeine metabolism--an in vitro study. Pharmacol Rep. 2009;61(5):851-858. PubMed
  6. Wang, X. and Yeung, J. H. Effects of the aqueous extract from Salvia miltiorrhiza Bunge on caffeine pharmacokinetics and liver microsomal CYP1A2 activity in humans and rats. J Pharm Pharmacol 2010;62(8):1077-1083.
  7. Kot M, Daniel WA. Caffeine as a marker substrate for testing cytochrome P450 activity in human and rat. Pharmacol Rep 2008;60:789-97.
  8. Kjaerstad MB, Nielsen F, Nohr-Jensen L, et al. Systemic uptake of miconazole during vaginal suppository use and effect on CYP1A2 and CYP3A4 associated enzyme activities in women. Eur J Clin Pharmacol 2010;66:1189-97. PubMed
  9. Goh BC, Reddy NJ, Dandamudi UB, et al. An evaluation of the drug interaction potential of pazopanib, an oral vascular endothelial growth factor receptor tyrosine kinase inhibitor, using a modified Cooperstown 5+1 cocktail in patients with advanced solid t
  10. Chen Y, Kang Z, Yan J, et al. Liu wei di huang wan, a well-known traditional Chinese medicine induces CYP1A2 while suppressing CYP2A6 and N-acetyltransferase 2 acivities in man. J Ethnopharmacol 2010;132:213-8.
  11. Suzuki S, Murayama Y, Sugiyama E, et al. Estimating pediatric doses of drugs metabolized by cytochrome P450 (CYP) isozymes, based on physiological liver development and serum protein levels. Yakugaku Zasshi 2010;130:613-20. PubMed
  12. Chien CF, Wu YT, Lee WC, et al. Herb-drug interaction of Andrographis paniculata extract and andrographolide on the pharmacokinetics of theophylline in rats. Chem Biol Interact 2010;184:458-65. PubMed
  13. Mills BM, Zaya MJ, Walters RR, et al. Current cytochrome P450 phenotyping methods applied to metabolic drug -drug interaction prediction in dogs. Drug Metab Dispos 2010;38:396-404. PubMed
  14. Turpault S, Brian W, Van Horn R, et al. Pharmacokinetic assessment of a five-probe cocktail for CYPs 1A2, 2C9, 2C19, 2D6, and 3A. Br J Clin Pharmacol 2009;68:928-35. PubMed
  15. Filimonova AA, Ziganshina LE, Ziganshin AU, Chichirov AA. On the possibility of patient phenotyping on the basis of cytochrome p-450 1A2 isoenzyme activity using caffeine as the test substrate. Eksp Klin Farmakol 2009;72:61-5.
  16. Jenkins J, Williams D, Deng Y, et al. Eltrombopag, an oral thrombopoietin receptor agonist, has no impact on the pharmacokinetic profile of probe drugs for cytochrome P450 isoenzymes CYP3A4, CYP1A2, CYP2C9 and CYP2C19 in healthy men: a cocktail analysis.
  17. Perera, V., Gross, A. S., and McLachlan, A. J. Caffeine and paraxanthine HPLC assay for CYP1A2 phenotype assessment using saliva and plasma. Biomed.Chromatogr. 2010;24(10):1136-1144. PubMed
  18. Izzo, A. A. and Ernst, E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 2009;69(13):1777-1798. PubMed
Moderate

ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP)

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Enoxacin also falls under ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP).

Theoretically, black tea might reduce the absorption of organic anion-transporting polypeptide (OATP) substrates.
In vitro, black tea extract inhibits organic anion-transporting polypeptide (OATP)2B1. OATP2B1 is expressed in the small intestine and liver and is responsible for the uptake of drugs and other compounds. In an animal model, black tea extract was found to inhibit the absorption of rosuvastatin, a substrate of OATP2B1. However, this effect has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with enoxacin and your cup of black tea. This is a 'just in case' flag, not a red alert. In lab dishes and one animal study, compounds in black tea blocked a transporter (called OATP2B1) that helps pull certain drugs into the body from the gut. The worry is that this could lower how much of a drug gets absorbed. Enoxacin works only when enough of it reaches your bloodstream, so in theory less absorption could mean a weaker antibiotic and a harder time clearing your infection.

That said, this has not actually been shown in people, so I wouldn't lose sleep over it. To be safe, it's reasonable to space your tea a couple hours apart from your dose, and check with your pharmacist or doctor if you drink a lot of tea.

References
  1. Kondo A, Narumi K, Okuhara K, et al. Black tea extract and theaflavin derivatives affect the pharmacokinetics of rosuvastatin by modulating organic anion transporting polypeptide (OATP) 2B1 activity. Biopharm Drug Dispos. 2019;40(8):302-306. PubMed
Moderate

QUINOLONE ANTIBIOTICS

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Enoxacin also falls under QUINOLONE ANTIBIOTICS.

Theoretically, quinolone antibiotics might increase the levels and adverse effects of caffeine.
Black tea contains caffeine. Concomitant use of caffeine and quinolones can decrease caffeine clearance and increase effects and risk of adverse effects.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing with enoxacin and your cup of black tea. Enoxacin is one of the stronger quinolone antibiotics when it comes to slowing down how your body clears caffeine. It blocks the liver enzyme (CYP1A2) that normally breaks caffeine down, so the caffeine from your tea sticks around longer and builds up more than usual.

What does that feel like? You might notice the familiar too much caffeine signs: jitteriness, a racing or pounding heart, trouble sleeping, restlessness, or mild stomach upset. It's not dangerous for most healthy people, but it can be uncomfortable. While you're on enoxacin, it's reasonable to ease back on tea, coffee, and energy drinks. If you feel wired or your heart races, mention it to your pharmacist or doctor.

References
  1. Harder S, Fuhr U, Staib AH, Wolff T. Ciprofloxacin-caffeine: a drug interaction established using in vivo and in vitro investigations. Am J Med 1989;87:89S-91S. PubMed
  2. Carbo M, Segura J, De la Torre R, et al. Effect of quinolones on caffeine disposition. Clin Pharmacol Ther 1989;45:234-40. PubMed
  3. Healy DP, Polk RE, Kanawati L, et al. Interaction between oral ciprofloxacin and caffeine in normal volunteers. Antimicrob Agents Chemother 1989;33:474-8. PubMed
  4. Stille, W., Harder, S., Mieke, S., Beer, C., Shah, P. M., Frech, K., and Staib, A. H. Decrease of caffeine elimination in man during co-administration of 4-quinolones. J.Antimicrob.Chemother. 1987;20(5):729-734. PubMed
  5. Harder S, Staib AH, Beer C, et al. 4-quinolones inhibit biotransformation of caffeine. Eur J Clin Pharmacol 1988;35:651-6. PubMed
  6. Zhang LL, Zhang JR, Guo K, et al. Effects of fluoroquinolones on CYP4501A and 3A in male broilers. Res Vet Sci 2011;90:99-105. PubMed
  7. Cesana M, Broccali G, Imbimbo BP, Crema A. Effect of single doses of rufloxacin on the disposition of theophylline and caffeine after single administration. Int J Clin Pharmacol Ther Toxicol 1991:29:133-8.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Black Tea Also Interacts With Other Medications

Black Tea has 8 major, 571 moderate, 114 minor known drug interactions in our database — the Enoxacin one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Black Tea

Covers the 2,830 medications we’ve checked against Black Tea. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Enoxacin

This page covers Black Tea only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Enoxacin page lists 108 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Grapefruit (major), Sweet Orange (major) and Alfalfa (moderate).

By severity: 4 major · 84 moderate · 20 minor.

From our pharmacist’s overview on the Enoxacin page

“If you are starting Enoxacin (Penetrex), a quinolone antibiotic, this list of 108 supplements and foods deserves genuine care, and the four major-rated entries come first: fruit juices, grapefruit and apple among them, and activated charcoal all sharply cut how much of the drug your body absorbs. For an antibiotic, less drug in the blo…”

Reviewed by 2 · Jul 18, 2026

Open the Enoxacin interaction page

One more smart check

Taking Black Tea as Part of a Dietary Supplement Product? Check It for Interactions

We hold 271 real supplement products containing Black Tea, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Black Tea. Your product may carry other ingredients that interact with Enoxacin too, on top of Black Tea — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Black Tea and Enoxacin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Black Tea
Top 25%

#278 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Enoxacin
Steady interest

#1,452 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Black Tea

What is Black Tea?

  • Mental alertness and energy
  • Heart health support
  • Blood pressure and cholesterol
  • Digestive complaints
  • Weight management
  • Antioxidant support

Black tea is a popular caffeinated drink made from the fully oxidized leaves of the Camellia sinensis plant, and it contains caffeine and antioxidant plant compounds. Moderate tea drinking is generally safe for most adults and may modestly support heart health and alertness, but it is not a proven treatment for any disease. If you are pregnant, breastfeeding, sensitive to caffeine, or taking medicines, talk to your pharmacist or doctor.

Read the full Black Tea monograph & all interactions
Keep checking

Other Drugs & Black Tea

Browse every other medication we’ve checked against Black Tea — both the ones with a known interaction and the ones without. Select any drug for the full detail.

8Major
571Moderate
114Minor
2,136No known interaction
Major

8 interactions

Moderate

571 interactions

Showing 60 of 571 moderate interactions — see all 571 on the Black Tea page.

Minor

114 interactions

Showing 60 of 114 minor interactions — see all 114 on the Black Tea page.

No interaction 2,136 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Black Tea and Enoxacin Together: Common Questions

Can you take Black Tea with Enoxacin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Black Tea and Enoxacin?
Enoxacin belongs to more than one drug category, and Black Tea interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Black Tea and Enoxacin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.