Drug & supplement interaction

Black Tea + Levofloxacin (ophthalmic)

Levofloxacin (ophthalmic) brand name: Levofloxacin.

Moderate Interaction
The bottom line Moderate

Levofloxacin (ophthalmic) falls into 2 drug categories that Black Tea can interact with; the most serious is rated moderate. Theoretically, black tea might reduce the absorption of organic anion-transporting polypeptide (OATP) substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Black Tea and Levofloxacin (ophthalmic)

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Black Tea interacts with whole categories of medication. Levofloxacin (ophthalmic) falls into 2 of those categories, so it can interact with Black Tea in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP)

1 of 2

Why this applies to Levofloxacin (ophthalmic)

Levofloxacin (ophthalmic) falls under ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP) — the group Black Tea interacts with.

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 some good news that should put your mind at ease. The interaction on file talks about black tea possibly blocking a gut transporter (called OATP2B1) that helps pull certain swallowed drugs into your body. But you're asking about levofloxacin eye drops, which you place right into your eye to treat an infection there. They aren't swallowed, so how your intestines absorb things really doesn't come into play.

On top of that, this concern is only theoretical, based on lab dishes and an animal study, and it hasn't been shown in real people. With an eye drop, drinking your usual cup of tea shouldn't change how well the medicine works or cause more stinging or blurriness. If you have any doubts, your pharmacist is happy to double-check with you.

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

2 of 2

Levofloxacin (ophthalmic) 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 good news: the interaction on file describes oral levofloxacin, the kind you swallow for infections. The version you asked about is the eye drop. When you use levofloxacin drops in your eye, only a tiny amount gets into your bloodstream, far too little to meaningfully slow how your body clears caffeine.

The concern with the pill form is that levofloxacin can block the enzyme that breaks down caffeine, letting it build up and cause jitteriness, a racing heart, or trouble sleeping. With the ophthalmic drops, that effect is very unlikely, so your usual cup of black tea should be fine. Still, if you ever take the oral antibiotic, ask your pharmacist about your caffeine intake.

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 Levofloxacin (ophthalmic) 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.

From our Q&A

Questions About Black Tea or Levofloxacin (ophthalmic)

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Black Tea or Levofloxacin (ophthalmic), not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Levofloxacin (ophthalmic)

This page covers Black Tea only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levofloxacin (ophthalmic) page lists 64 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Apple (major), Grapefruit (major), Sweet Orange (major), Bacillus Coagulans (moderate) and Bacillus Subtilis (moderate).

By severity: 3 major · 49 moderate · 12 minor.

Open the Levofloxacin (ophthalmic) 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 Levofloxacin (ophthalmic) 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 Levofloxacin (ophthalmic) 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%

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

29 days ago today
Medication Levofloxacin (ophthalmic)
Top half

#1,177 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
Medication

About Levofloxacin

What Is Levofloxacin Used For?

Brand name: Levofloxacin

Levofloxacin tablets, oral solution and injection treat infections caused by susceptible bacteria in adults. These include several types of pneumonia, skin infections, urinary tract infections, chronic bacterial prostatitis, bronchitis flare-ups and sinus infections. They also include post-exposure treatment for inhalational anthrax and plague.

Levofloxacin tablets are also used in children for inhalational anthrax (post-exposure) and plague. The eye drops are different: they treat bacterial conjunctivitis or corneal ulcer, depending on the product. It only works on bacteria, not viruses.

See full Levofloxacin drug information
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

We also checked Black Tea against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,136 medications checked with no known interaction — see the full Black Tea 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

Keep exploring
Pharmacist Counseling Corner

Taking Black Tea and Levofloxacin (ophthalmic) Together: Common Questions

Can you take Black Tea with Levofloxacin (ophthalmic)?
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 2 interactions listed for Black Tea and Levofloxacin (ophthalmic)?
Levofloxacin (ophthalmic) 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 Levofloxacin (ophthalmic) 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

Still Have a Question About Levofloxacin (ophthalmic) and Black Tea?

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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.