Drug & supplement interaction

Cocoa + Fluconazole

Fluconazole brand names: Diflucan, Diflucan Injection.

Minor Interaction
The bottom line Minor

Cocoa has a minor interaction with Fluconazole. Theoretically, fluconazole might increase the levels and adverse effects of caffeine.

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

Cocoa and Fluconazole

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

Minor

FLUCONAZOLE (Diflucan)

Theoretically, fluconazole might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Fluconazole decreases caffeine clearance by approximately 25%.
Severity Minor Likelihood Possible Evidence B

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: this isn't really about your fluconazole getting stronger or weaker. It's the other way around. Fluconazole slows down how fast your body clears caffeine, and cocoa happens to contain a little caffeine. With fluconazole on board, that caffeine sticks around about 25% longer than usual.

In real life, this is a minor issue and mostly theoretical. If you're sensitive to caffeine, you might notice slightly more jitteriness, a faster heartbeat, or trouble sleeping while taking fluconazole, especially if you're also having coffee, tea, or soda. A normal piece of chocolate or cup of cocoa is unlikely to cause trouble. Concentrated cocoa supplements plus other caffeine sources are where it could add up. If you feel wired, just cut back, and check with your pharmacist if you have questions.

References
  1. Nix D, Zelenitsky S, Symonds W, et al. The effect of fluconazole on the pharmacokinetics of caffeine in young and elderly subjects. Clin Pharmacol Ther 1992;51:183. DOI

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

Cocoa Also Interacts With Other Medications

Cocoa has 635 moderate, 25 minor known drug interactions in our database — the Fluconazole one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cocoa

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

From our Q&A

Questions About Cocoa or Fluconazole

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

This page covers Cocoa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fluconazole page lists 81 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Adrafinil (moderate).

By severity: 4 major · 54 moderate · 23 minor.

From our pharmacist’s overview on the Fluconazole page

“Fluconazole (Diflucan) treats fungal infections, and I would pair it with supplements carefully. Nearly half of the 81 ingredients with an interaction on file, 38 of them, put extra strain on the liver, which is already busy processing the antifungal.”

Reviewed by 2 · Jul 18, 2026

Open the Fluconazole interaction page

One more smart check

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

We hold 844 real supplement products containing Cocoa, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cocoa. Your product may carry other ingredients that interact with Fluconazole too, on top of Cocoa — 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 Cocoa and Fluconazole 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 Cocoa
Top 25%

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

29 days ago today
Medication Fluconazole
Top half

#906 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 Cocoa

What is Cocoa?

Cocoa
  • Heart and blood vessel health
  • High blood pressure
  • High cholesterol
  • Mental focus and mood
  • Skin moisturizing (cocoa butter)

Cocoa is rich in plant compounds called flavanols that may modestly support blood vessel function and blood pressure, but most chocolate products are high in sugar, fat, and calories, which can offset any benefit. Enjoy cocoa as part of a balanced diet, and talk to your pharmacist before using concentrated cocoa supplements, especially if you have heart or blood pressure conditions.

Read the full Cocoa monograph & all interactions
Medication

About Fluconazole

What Is Fluconazole Used For?

Brand names: Diflucan, Diflucan Injection

Fluconazole treats infections caused by Candida and Cryptococcus fungi. Diflucan tablets and oral suspension, fluconazole tablets, and fluconazole oral suspension and tablets are approved for vaginal yeast infections (vaginal candidiasis), mouth and throat yeast infections (oropharyngeal candidiasis), and esophageal candidiasis. All formulations, including the intravenous injection, are used for cryptococcal meningitis (a fungal infection of the brain lining). In smaller studies, fluconazole was also effective for Candida urinary tract infections, peritonitis (abdominal lining infection), and serious systemic infections such as candidemia (Candida in the bloodstream) and disseminated candidiasis.

Fluconazole is also used as preventive therapy: Diflucan, fluconazole tablets, fluconazole oral suspension, and fluconazole injection are all indicated to reduce the risk of candidiasis in patients undergoing bone marrow transplantation who receive chemotherapy and/or radiation therapy. Note that the oral suspension formulations are not approved for vaginal candidiasis — that indication applies only to Diflucan tablets/suspension and fluconazole tablets/tablet-suspension products.

See full Fluconazole drug information
Keep checking

Other Drugs & Cocoa

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

0Major
635Moderate
25Minor
2,169No known interaction
Moderate

635 interactions

Showing 60 of 635 moderate interactions — see all 635 on the Cocoa page.

Minor

25 interactions

No interaction 2,169 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 Cocoa and Fluconazole Together: Common Questions

Can you take Cocoa with Fluconazole?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Cocoa and Fluconazole interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Fluconazole and Cocoa?

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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.