Drug & supplement interaction

Cocoa + Meperidine, Promethazine

Meperidine, Promethazine brand names: Meprozine, Mepergan.

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

Cocoa has a minor interaction with Meperidine, Promethazine. Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.

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

Cocoa and Meperidine, Promethazine

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

Minor

PHENOTHIAZINES

Why this applies to Meperidine, Promethazine

Meperidine, Promethazine falls under PHENOTHIAZINES — the group Cocoa interacts with.

Theoretically, phenothiazines might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Phenothiazines can reduce the metabolism of caffeine by inhibiting cytochrome P450 1A2 (CYP1A2).
Severity Minor 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 for your Meprozine or Mepergan, which pairs meperidine (a narcotic pain reliever) with promethazine (a phenothiazine). The flagged interaction isn't really about the pain medicine itself. It's that the promethazine part can slow down a liver enzyme called CYP1A2, which is the same enzyme that clears caffeine from your body. Cocoa naturally contains a little caffeine, so in theory that caffeine could hang around longer and feel a bit stronger.

In practice, this is rated minor and is based only on lab data, not real patients, so I wouldn't lose sleep over a cup of cocoa. If you notice extra jitteriness, a racing heart, or trouble sleeping, especially with concentrated cocoa supplements, just mention it to your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wojcikowski, J. and Daniel, W. A. Perazine at therapeutic drug concentrations inhibits human cytochrome P450 isoenzyme 1A2 (CYP1A2) and caffeine metabolism--an in vitro study. Pharmacol Rep. 2009;61(5):851-858. PubMed
  2. Daniel, W. A., Syrek, M., Rylko, Z., and Kot, M. Effects of phenothiazine neuroleptics on the rate of caffeine demethylation and hydroxylation in the rat liver. Pol.J Pharmacol 2001;53(6):615-621.

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 Meperidine, Promethazine one above is one of them. If you take anything else, check it against the full list below.

Moderate 635 Minor 25 No known interaction 2,170 (incl. Meperidine, Promethazine)
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 Meperidine, Promethazine

This page covers Cocoa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Meperidine, Promethazine page lists 207 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Henbane (major).

By severity: 10 major · 160 moderate · 37 minor.

From our pharmacist’s overview on the Meperidine, Promethazine page

“Meprozine combines meperidine, an opioid painkiller, with promethazine, a sedating antihistamine, so it already slows the brain on two fronts. I would read this list of 207 supplements and herbal ingredients with genuine care, starting with the 10 rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Meperidine, Promethazine 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 Meperidine, Promethazine 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 Meperidine, Promethazine 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 Meperidine, Promethazine
Top half

#777 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
635Moderate
25Minor
2,169No known interaction
635 Moderate 25 Minor 2,169 No 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

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

Showing the 60 most looked-up of 2,169 medications checked with no known interaction — see the full Cocoa list.

See the full Cocoa interactions page
See every supplement checked against Meperidine, Promethazine, 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
Cocoa monograph › Uses, safety, and every drug interaction in one place Meperidine, Promethazine supplement interactions › Every supplement checked against Meperidine, Promethazine, ranked by severity 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 Cocoa and Meperidine, Promethazine Together: Common Questions

Can you take Cocoa with Meperidine, Promethazine?
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 Meperidine, Promethazine 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 Meperidine, Promethazine 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.