Drug & supplement interaction

Cocoa + Guaifenesin, Phenylpropanolamine

Guaifenesin, Phenylpropanolamine brand names: Entex LA, Miraphen PE, Dura-Vent, Guaifed, Guaifed-PD, and others.

Moderate Interaction
The bottom line Moderate

Guaifenesin, Phenylpropanolamine falls into 2 drug categories that Cocoa can interact with; the most serious is rated moderate. Theoretically, concomitant use might increase stimulant adverse effects.

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

Cocoa and Guaifenesin, Phenylpropanolamine

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

Why Are There 2 Interactions?

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

Moderate

STIMULANT DRUGS

1 of 2

Why this applies to Guaifenesin, Phenylpropanolamine

Guaifenesin, Phenylpropanolamine falls under STIMULANT DRUGS — the group Cocoa interacts with.

Theoretically, concomitant use might increase stimulant adverse effects.
Cocoa contains caffeine. Concomitant use might increase the risk of stimulant adverse effects.
Severity Moderate Likelihood Probable Evidence C

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

The piece of this combo that matters here is phenylpropanolamine, which is a stimulant decongestant. (The guaifenesin part just loosens mucus and isn't really the concern.) Cocoa naturally contains a bit of caffeine, which is also a stimulant. The thinking is that stacking two stimulants together could nudge up the usual stimulant-type side effects, like a faster or pounding heartbeat, jitteriness, trouble sleeping, or a higher blood pressure reading.

To be honest, this is based on expert reasoning rather than strong studies, and a normal cup of cocoa or a square of chocolate isn't likely to cause trouble for most people. Concentrated cocoa supplements are a different story. If you have heart issues or high blood pressure, please check with your pharmacist or doctor before pairing them.

References
  1. Institute of Medicine. Caffeine for the Sustainment of Mental Task Performance: Formulations for Military Operations. Washington, DC: National Academy Press, 2001. Available at: http://books.nap.edu/books/0309082587/html/index.html. DOI
Moderate

PHENYLPROPANOLAMINE

2 of 2

Guaifenesin, Phenylpropanolamine also falls under PHENYLPROPANOLAMINE.

Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Cocoa contains caffeine. Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.
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 deal with this combo. Your product pairs guaifenesin (a mucus thinner) with phenylpropanolamine, a decongestant that tightens blood vessels and can nudge your blood pressure up. Cocoa naturally contains a little caffeine, and caffeine is also a mild stimulant. Used together, the two can have an additive effect on blood pressure, and the phenylpropanolamine may also slow how fast your body clears caffeine, letting it build up a bit.

In real life that might mean a faster heart rate, jitteriness, a headache, or feeling wired. A cup of hot cocoa is unlikely to cause trouble, but concentrated cocoa supplements (or lots of chocolate plus other caffeine) are where I'd be careful. If you have high blood pressure or heart issues, check with your pharmacist or doctor first.

References
  1. Brown NJ, Ryder D, Branch RA. A pharmacodynamic interaction between caffeine and phenylpropanolamine. Clin Pharmacol Ther 1991;50:363-71. PubMed
  2. Lake CR, Rosenberg DB, Gallant S, et al. Phenylpropanolamine increases plasma caffeine levels. Clin Pharmacol Ther 1990;47:675-85. 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

Cocoa Also Interacts With Other Medications

Cocoa has 634 moderate, 26 minor known drug interactions in our database — the Guaifenesin, Phenylpropanolamine 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 Cocoa

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

Everything else you take

See Every Supplement That Interacts With Guaifenesin, Phenylpropanolamine

This page covers Cocoa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Guaifenesin, Phenylpropanolamine page lists 62 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Ephedra (major), Peyote (major), Rauvolfia Vomitoria (major) and Sida Cordifolia (major).

By severity: 5 major · 44 moderate · 13 minor.

From our pharmacist’s overview on the Guaifenesin, Phenylpropanolamine page

“Ephedra is the entry I'd want anyone taking guaifenesin with phenylpropanolamine (Entex LA, Guaifed, Dura-Vent) to understand first. Phenylpropanolamine is a stimulant decongestant that can raise blood pressure on its own, and ephedra, along with three other stimulant herbs rated major, can stack on that effect and strain the heart.”

Reviewed by 2 · Jul 18, 2026

Open the Guaifenesin, Phenylpropanolamine 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 Guaifenesin, Phenylpropanolamine 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 Guaifenesin, Phenylpropanolamine 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%

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

29 days ago today
Medication Guaifenesin, Phenylpropanolamine
Steady interest

#1,624 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
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
634Moderate
26Minor
2,169No known interaction
Moderate

634 interactions

Showing 60 of 634 moderate interactions — see all 634 on the Cocoa page.

Minor

26 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 Guaifenesin, Phenylpropanolamine Together: Common Questions

Can you take Cocoa with Guaifenesin, Phenylpropanolamine?
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 Cocoa and Guaifenesin, Phenylpropanolamine?
Guaifenesin, Phenylpropanolamine belongs to more than one drug category, and Cocoa 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 Cocoa and Guaifenesin, Phenylpropanolamine 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.