Drug & supplement interaction

Caffeic Acid + Guanethidine, Hydrochlorothiazide

Guanethidine, Hydrochlorothiazide brand name: Esimil.

Moderate Interaction
The bottom line Moderate

Guanethidine, Hydrochlorothiazide falls into 2 drug categories that Caffeic Acid can interact with; the most serious is rated moderate. Theoretically, caffeic acid might increase the levels and clinical effects of OAT3 substrates.

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

Caffeic Acid and Guanethidine, Hydrochlorothiazide

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

Why Are There 2 Interactions?

Caffeic Acid interacts with whole categories of medication. Guanethidine, Hydrochlorothiazide falls into 2 of those categories, so it can interact with Caffeic Acid 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 TRANSPORTER 3 (OAT3) SUBSTRATES

1 of 2

Why this applies to Guanethidine, Hydrochlorothiazide

Guanethidine, Hydrochlorothiazide falls under ORGANIC ANION TRANSPORTER 3 (OAT3) SUBSTRATES — the group Caffeic Acid interacts with.

Theoretically, caffeic acid might increase the levels and clinical effects of OAT3 substrates.
In vitro, caffeic acid inhibits OAT3. This drug transport protein is involved in renal tubular uptake of some drugs from the blood and then elimination in the urine. Inhibition of this transporters decreases renal elimination and increases drug levels in the body. Although caffeic acid inhibits OAT3 in vitro, the clinical significance of this in humans is not known.
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 short version: your kidneys use a little doorway called OAT3 to clear certain drugs out into your urine. In lab tests, caffeic acid seems to block that doorway. The hydrochlorothiazide part of Esimil leans on OAT3 to be removed, so if that doorway is slowed, the medicine could build up a bit more than usual. In real life that might show up as extra dizziness, lightheadedness when you stand, more frequent urination, or shifts in potassium and sodium.

The big caveat: this is only seen in test tubes, not in people, so we honestly don't know if it matters at normal doses. Coffee and food amounts are very unlikely to be an issue. Before adding a concentrated caffeic acid supplement, check with your pharmacist or doctor.

References
  1. Uwai Y, Ozeki Y, Isaka T, et al. Inhibitory effect of caffeic acid on human organic anion transporters hOAT1 and hOAT3: a novel candidate for food-drug interaction. Drug Metab Pharmacokinet 2011;26:486-93. PubMed
Moderate

ORGANIC ANION TRANSPORTER 1 (OAT1) SUBSTRATES

2 of 2

Guanethidine, Hydrochlorothiazide also falls under ORGANIC ANION TRANSPORTER 1 (OAT1) SUBSTRATES.

Theoretically, caffeic acid might increase the levels and clinical effects of OAT1 substrates.
In vitro, caffeic acid inhibits OAT1. This drug transport protein is involved in renal tubular uptake of some drugs from the blood and then elimination in the urine. Inhibition of this transporter decreases renal elimination and increases drug levels in the body. Although caffeic acid inhibits OAT1 in vitro, the clinical significance of this in humans is not known.
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 this combo. Your kidneys use a little doorway protein called OAT1 to help clear certain medicines out into your urine. In lab studies (not in people), caffeic acid appears to block that doorway. If that same thing happened in the body, the hydrochlorothiazide piece of Esimil could hang around a bit longer, which might nudge up its usual effects: more urination at first, lightheadedness, dehydration, or low potassium or sodium. The guanethidine part could mean more dizziness when standing.

That said, this is only theoretical, based on test-tube work, so we honestly don't know if it matters in real life. The amount in foods like coffee is very unlikely to be an issue. If you're eyeing a concentrated caffeic acid supplement, just run it past your pharmacist or doctor first.

References
  1. Uwai Y, Ozeki Y, Isaka T, et al. Inhibitory effect of caffeic acid on human organic anion transporters hOAT1 and hOAT3: a novel candidate for food-drug interaction. Drug Metab Pharmacokinet 2011;26:486-93. PubMed

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

Caffeic Acid Also Interacts With Other Medications

Caffeic Acid has 176 moderate, 5 minor known drug interactions in our database — the Guanethidine, Hydrochlorothiazide 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 Caffeic Acid

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

Everything else you take

See Every Supplement That Interacts With Guanethidine, Hydrochlorothiazide

This page covers Caffeic Acid only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Guanethidine, Hydrochlorothiazide page lists 231 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 196 moderate · 25 minor.

From our pharmacist’s overview on the Guanethidine, Hydrochlorothiazide page

“Guanethidine with hydrochlorothiazide (Esimil) lowers blood pressure two ways at once, and 231 supplement and herbal ingredients on file can interfere with it, ten rated major and just 25 minor, so treat this page with genuine care. Most of the 196 moderate entries pile extra blood-pressure-lowering on top of the drug, and a second lar…”

Reviewed by 2 · Jul 18, 2026

Open the Guanethidine, Hydrochlorothiazide interaction page

One more smart check

Taking Caffeic Acid as Part of a Dietary Supplement Product? Check It for Interactions

We hold 20 real supplement products containing Caffeic Acid, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Caffeic Acid. Your product may carry other ingredients that interact with Guanethidine, Hydrochlorothiazide too, on top of Caffeic Acid — 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 Caffeic Acid and Guanethidine, Hydrochlorothiazide 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 Caffeic Acid
Steady interest

#1,274 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Guanethidine, Hydrochlorothiazide
Steady interest

#1,794 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 Caffeic Acid

What is Caffeic Acid?

  • Antioxidant support
  • General anti-inflammatory use
  • Skin and sun protection (topical)
  • Immune support
  • Cancer-prevention interest (research stage)

Caffeic acid is a natural plant compound found in coffee, many fruits, vegetables, and herbs, and it is studied mainly for its antioxidant and anti-inflammatory properties. Most evidence comes from laboratory and animal research, so its benefits in people are not yet proven. If you want to take it as a supplement, talk with your pharmacist or doctor first.

Read the full Caffeic Acid monograph & all interactions
Keep checking

Other Drugs & Caffeic Acid

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

0Major
176Moderate
5Minor
2,648No known interaction
Moderate

176 interactions

Showing 60 of 176 moderate interactions — see all 176 on the Caffeic Acid page.

Minor

5 interactions

No interaction 2,648 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 Caffeic Acid and Guanethidine, Hydrochlorothiazide Together: Common Questions

Can you take Caffeic Acid with Guanethidine, Hydrochlorothiazide?
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 Caffeic Acid and Guanethidine, Hydrochlorothiazide?
Guanethidine, Hydrochlorothiazide belongs to more than one drug category, and Caffeic Acid 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 Caffeic Acid and Guanethidine, Hydrochlorothiazide 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.