Drug & supplement interaction

Coca + Ramipril

Ramipril brand name: Altace.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Coca has a moderate interaction with Ramipril. Theoretically, coca might reduce the effects of antihypertensive drugs.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Coca and Ramipril

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Ramipril

Ramipril falls under ANTIHYPERTENSIVE DRUGS — the group Coca interacts with.

Theoretically, coca might reduce the effects of antihypertensive drugs.
Some clinical research suggests that coca and the coca constituent cocaine have hypertensive effects. Theoretically, concomitant use of coca with antihypertensive drugs might interfere with blood pressure control and decrease the effectiveness of antihypertensive drugs.
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 to know if you take ramipril (Altace) for blood pressure or heart protection. Coca leaves contain cocaine and related alkaloids that act as stimulants, and they tend to raise blood pressure and quicken the heart. Ramipril is working in the opposite direction, relaxing your blood vessels to bring pressure down. So coca can push against your medication and may keep it from controlling your numbers as well as it should.

In plain terms, you might see your blood pressure creep back up, or feel symptoms like headache or a racing heart. This concern is partly theoretical and based on limited research, but the direction is logical. Please don't change anything on your own. Just check in with your pharmacist or doctor before using coca in any form.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Favier R, Caceres E, Guillon L, et al. Coca chewing for exercise: hormonal and metabolic responses of nonhabitual chewers. J Appl Physiol 1996;81:1901-7.. PubMed
  2. Favier R, Caceres E, Sempore B, et al. Fluid regulatory hormone response to exercise after coca-induced body fluid shifts. J Appl Physiol 1997;83:376-82.. PubMed
  3. Spielvogel H, Rodriguez A, Sempore B, et al. Body fluid homeostasis and cardiovascular adjustments during submaximal exercise: influence of chewing coca leaves. Eur J Appl Physiol Occup Physiol 1997;75(5):400-6. PubMed
  4. Spielvogel, H., Caceres, E., Koubi, H., Sempore, B., Sauvain, M., and Favier, R. Effects of coca chewing on metabolic and hormonal changes during graded incremental exercise to maximum. J.Appl.Physiol 1996;80(2):643-649. 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

Coca Also Interacts With Other Medications

Coca has 2 major, 256 moderate known drug interactions in our database — the Ramipril one above is one of them. If you take anything else, check it against the full list below.

Major 2 Moderate 256 No known interaction 2,572 (incl. Ramipril)
Taking anything else?

Check Another of Your Medications Against Coca

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

From our Q&A

Questions About Coca or Ramipril

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Coca or Ramipril, 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 Ramipril

This page covers Coca only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ramipril page lists 149 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 Siberian Cocklebur (major).

By severity: 6 major · 119 moderate · 24 minor.

From our pharmacist’s overview on the Ramipril page

“Ramipril (Altace) is an ACE inhibitor for high blood pressure and heart protection, and its supplement list is one I would treat with real seriousness. Most interacting ingredients either deepen its pressure-lowering effect or push back against it, so readings can drift too low or creep back up.”

Reviewed by 2 · Jul 18, 2026

Open the Ramipril interaction page

How much people look this up

Where Coca and Ramipril 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 Coca
Steady interest

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

29 days ago today
Medication Ramipril
Top half

#862 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 Coca

What is Coca?

Coca
  • Altitude sickness
  • Fatigue and low energy
  • Appetite and hunger suppression
  • Digestive upset
  • Flavoring agent in foods and drinks

Coca is a South American plant best known as the natural source of cocaine. While the leaves have a long history of traditional use for altitude sickness, fatigue, and hunger, the whole plant contains cocaine and other alkaloids that make it legally controlled and potentially dangerous in most countries. Only decocainized (cocaine-free) coca extract is used in foods, and there is little reliable evidence to recommend coca as a supplement.

Read the full Coca monograph & all interactions
Medication

About Ramipril

What Is Ramipril Used For?

Brand name: Altace

Ramipril capsules are used to treat high blood pressure (hypertension), either alone or combined with a thiazide diuretic (water pill). Lowering blood pressure reduces the risk of heart attack and stroke.

In adults 55 and older at high cardiovascular risk, ramipril capsules are used to reduce the risk of heart attack, stroke, or death from cardiovascular causes. Ramipril capsules are also used in stable patients who develop signs of heart failure within the first days after a heart attack, to lower the risk of death and hospitalization related to heart failure.

See full Ramipril drug information
Keep checking

Other Drugs & Coca

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

2Major
256Moderate
0Minor
2,571No known interaction
2 Major 256 Moderate 2,571 No interaction
Major

2 interactions

Moderate

256 interactions

Showing 60 of 256 moderate interactions — see all 256 on the Coca page.

No interaction 2,571 drugs checked — show the list

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

Showing the 60 most looked-up of 2,571 medications checked with no known interaction — see the full Coca list.

See the full Coca interactions page
See every supplement checked against Ramipril, ranked by severity
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
Coca monograph › Uses, safety, and every drug interaction in one place Ramipril supplement interactions › Every supplement checked against Ramipril, ranked by severity Ramipril drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Coca and Ramipril Together: Common Questions

Can you take Coca with Ramipril?
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.
How serious is the Coca and Ramipril 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 Ramipril and Coca?

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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.