Drug & supplement interaction

Cocoa + Pregabalin

Pregabalin brand names: Lyrica, Lyrica CR.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Cocoa and Pregabalin in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Cocoa and Pregabalin

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Pregabalin and Cocoa in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Cocoa safety at a glance

Cocoa overall Use caution Cocoa in food amounts is generally safe, but it contains caffeine and related stimulants, and chocolate products are often high in sugar and calories.
Pregnancy Possibly Safe When used orally in moderate amounts. However, due to the caffeine content of cocoa preparations, intake should be closely monitored during pregnancy to ensure... Read the full pregnancy detail
Breastfeeding Possibly Safe When used in moderate amounts or in amounts commonly found in foods. Due to the caffeine content of cocoa preparations, intake should be closely monitored while... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Pregabalin and Cocoa? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Pregabalin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Pregabalin is filed under 3 classifications — including cns depressants, oral drugs. Cocoa has documented interactions with 37 drug classes — the most serious being ace inhibitors (aceis) (moderate), adenosine (adenocard) (moderate) and alcohol (ethanol) (moderate) — and none of Pregabalin’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Cocoa Does Interact With Other Medications

Cocoa has 635 moderate, 26 minor known drug interactions in our database — Pregabalin isn’t 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.

What to actually watch for

No Interaction Found — But Data Suggests Cocoa and Pregabalin May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Tremor or shakiness Additional detail

    Cocoa

    “In some cases, when taken orally, cocoa can cause shakiness and might trigger migraine and other headaches.”

    Cocoa · Natural Medicines adverse-effect record, reported in migraine headache.

    3 sources cited
    1. 13161. Vlachopoulos C, Aznaouridis K, Alexopoulos N, et al. Effect of dark chocolate on arterial function in healthy individuals. Am J Hypertens 2005;18:785-91.. PubMed
    2. 42169. Ried, K., Sullivan, T. R., Fakler, P., Frank, O. R., and Stocks, N. P. Effect of cocoa on blood pressure. Cochrane.Database.Syst.Rev. 2012;8:CD008893. PubMed
    3. 92271. Ottaviani JI, Balz M, Kimball J, et al. Safety and efficacy of cocoa fl avanol intake in healthy adults: a randomized, controlled, double-masked trial. Am J Clin Nutr 2015;102(6):1425-35.

    Pregabalin

    Listed in the ADVERSE REACTIONS section of the FDA label for Pregabalin. Read the label on DailyMed ›

  • Bloating or gas / Vomiting Additional detail

    Cocoa

    “In human trials, chocolate consumption was associated with a higher incidence of flatulence, irritable bowel syndrome, upset stomach, gastric upset, borborygmi (a gurgling noise made by fluid or gas in the intestines), bloating, nausea, vomiting, and constipation or obstipation. Chocolate consumption has been implicated as a provoking factor in gastroesophageal reflux disease (GERD).”

    Cocoa · Natural Medicines adverse-effect record, reported in constipation.

    6 sources cited
    1. 41986. Zumbe, A. and Brinkworth, R. A. Comparative studies of gastrointestinal tolerance and acceptability of milk chocolate containing either sucrose, isomalt or sorbitol in healthy consumers and type II diabetics. Z.Ernahrungswiss. 1992;31(1):40-48. PubMed
    2. 42221. Storey, D. M., Koutsou, G. A., Lee, A., Zumbe, A., Olivier, P., Le Bot, Y., and Flourie, B. Tolerance and breath hydrogen excretion following ingestion of maltitol incorporated at two levels into milk chocolate consumed by healthy young adults with and w
    3. 41921. Lee, A. and Storey, D. M. Comparative gastrointestinal tolerance of sucrose, lactitol, or D-tagatose in chocolate. Regul.Toxicol.Pharmacol. 1999;29(2 Pt 2):S78-S82.
    4. 1374. Friedman G. Diet and the irritable bowel syndrome. Gastroenterol Clin North Am 1991;20:313-24. DOI
    5. 42220. Rossner, S. Chocolate--divine food, fattening junk or nutritious supplementation? Eur.J Clin.Nutr. 1997;51(6):341-345. PubMed
    6. 1373. Baron AM, Donnerstein RL, Samson RA, et al. Hemodynamic and electrophysiologic effects of acute chocolate ingestion in young adults. Am J Cardiol 1999;84:370-3. PubMed

    Pregabalin

    Listed in the ADVERSE REACTIONS section of the FDA label for Pregabalin. Read the label on DailyMed ›

  • Stomach upset / Constipation / Nausea Additional detail

    Cocoa

    “Orally and topically, cocoa is generally well tolerated.

    Most Common Adverse Effects:

    Orally: Borborygmi, constipation, diuresis, gastrointestinal discomfort, headaches, and nausea.

    Serious Adverse Effects (Rare):

    Orally: Tachycardia.”

    Cocoa · Natural Medicines adverse-effect record, reported in constipation.

    Pregabalin

    Listed in the ADVERSE REACTIONS section of the FDA label for Pregabalin. Read the label on DailyMed ›

  • A skin rash Additional detail

    Cocoa

    “In some cases, when taken orally, cocoa can cause allergic skin reactions. Topically, cocoa butter has occasionally caused a rash. In animals, it has been shown to block pores and cause acne; however, this has not been found in humans (11).”

    Cocoa · Natural Medicines adverse-effect record, reported in acne.

    2 sources cited
    1. 13161. Vlachopoulos C, Aznaouridis K, Alexopoulos N, et al. Effect of dark chocolate on arterial function in healthy individuals. Am J Hypertens 2005;18:785-91.. PubMed
    2. 11. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.

    Pregabalin

    Listed in the ADVERSE REACTIONS section of the FDA label for Pregabalin. Read the label on DailyMed ›

  • Headache Additional detail

    Cocoa

    Recorded for Cocoa in the same Natural Medicines adverse-effect record shown under Stomach upset / Constipation / Nausea above.

    Pregabalin

    Listed in the ADVERSE REACTIONS section of the FDA label for Pregabalin. Read the label on DailyMed ›

Reported for Cocoa but not commonly for Pregabalin: heartburn, a fast or pounding heartbeat, migraine and passing urine more often.

Effects for Pregabalin come from the ADVERSE REACTIONS section of its FDA label; effects for Cocoa come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Cocoa in Pregnancy & Breastfeeding

Pregnancy Possibly Safe

When used orally in moderate amounts. However, due to the caffeine content of cocoa preparations, intake should be closely monitored during pregnancy to ensure moderate consumption. Fetal blood concentrations of caffeine approximate maternal concentrations. Some research has found that intrauterine exposure to even modest amounts of caffeine, based on maternal blood levels during the first trimester, is associated with a shorter stature in children ages 4-8 years. While many cocoa products contain only small amounts of caffeine (about 2-35 mg per serving), unsweetened, dry cocoa powder can contain up to 198 mg of caffeine per cup. According to a review by Health Canada, and a subsequent large meta-analysis conducted in the US, doses of up to 300 mg daily can be consumed during pregnancy without an increased risk of spontaneous abortion, still birth, preterm birth, fetal growth retardation, or congenital malformations. To be on the safe side, cocoa should be used in amounts that provide less than 300 mg of caffeine daily. Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as cocoa, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product.

Pregnancy Possibly Unsafe

When used orally in large amounts. Caffeine found in cocoa crosses the placenta producing fetal blood concentrations similar to maternal levels. Consumption of caffeine in amounts over 300 mg daily is associated with a significantly increased risk of miscarriage in some studies. Additionally, high intake of caffeine during pregnancy have been associated with premature delivery, low birth weight, and loss of the fetus. While many cocoa products contain only small amounts of caffeine (about 2-35 mg per serving), unsweetened, dry cocoa powder can contain up to 198 mg of caffeine per cup. To be on the safe side, cocoa should be used in amounts that provide less than 300 mg of caffeine daily. Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as cocoa, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product. Cocoa and dark chocolate products worldwide also contain heavy metals such as lead and cadmium. In the US, one ounce (approximately 28 grams) of most commercially available dark chocolate products tested contained levels of lead and/or cadmium above the maximum allowable dose level for California, with cadmium levels generally increasing with the percentage of cocoa. Large doses or excessive intake of cocoa should be avoided during pregnancy.

Lactation Possibly Safe

When used in moderate amounts or in amounts commonly found in foods. Due to the caffeine content of cocoa preparations, intake should be closely monitored while breastfeeding. During lactation, breast milk concentrations of caffeine are thought to be approximately 50% of serum concentrations. Moderate consumption of cocoa would likely result in very small amounts of caffeine exposure to a nursing infant. Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as cocoa, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product.

Lactation Possibly Unsafe

When used orally in large amounts. Consumption of excess chocolate (16 oz per day) may cause irritability and increased bowel activity in the infant. Cocoa and dark chocolate products worldwide also contain heavy metals such as lead and cadmium. In the US, one ounce (approximately 28 grams) of most commercially available dark chocolate products tested contained levels of lead and/or cadmium above the maximum allowable dose level for California, with cadmium levels generally increasing with the percentage of cocoa. Large doses or excessive intake of cocoa should be avoided during lactation.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Overlapping uses

What Pregabalin Is Prescribed For, and What Cocoa Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Pregabalin is a prescription medicine with approved uses on its FDA label. Cocoa is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Pregabalin is prescribed for: Pregabalin is used to manage several types of nerve pain, including neuropathic pain from diabetic peripheral neuropathy (nerve damage caused by diabetes) and postherpetic neuralgia (lingering nerve pain after shingles). It is also used to treat fibromyalgia and neuropathic pain associated with spinal cord injury. Lyrica (capsule and oral solution), pregabalin capsules, and pregabalin oral solution are also approved as add-on therapy for partial-onset seizures — Lyrica for patients 1 month and older, and pregabalin capsules for patients 17 years and older. Lyrica CR and pregabalin extended-release tablets are approved only for diabetic peripheral neuropathy pain and postherpetic neuralgia — their effectiveness for fibromyalgia or as seizure add-on therapy has not been established.

Cocoa has been studied for:

  • Diabetes studied, not established Cocoa has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Cocoa for diabetes

    Several small clinical studies suggest that oral cocoa may cause small but clinically insignificant improvements in glycemic control in patients with diabetes. However, cocoa does not appear to be beneficial for the prevention of diabetes.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Pregabalin on your own; if you are taking Cocoa for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Cocoa or Pregabalin

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 Pregabalin, 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 Pregabalin

This page covers Cocoa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pregabalin page lists 95 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 Kava (major).

By severity: 7 major · 73 moderate · 15 minor.

From our pharmacist’s overview on the Pregabalin page

“Pregabalin (Lyrica) calms overactive nerves, which is how it eases nerve pain, seizures, and anxiety, and that calming action stacks with almost everything on this list. Of the 95 supplements and herbs, the large majority add their own sedation on top of pregabalin's, and a few can tip that into genuine danger, with deep sedation and s…”

Reviewed by 2 · Jul 18, 2026

Open the Pregabalin 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. Even though Cocoa itself has no known interaction with Pregabalin, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cocoa and Pregabalin 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 Pregabalin
Top 5%

#39 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Cocoa reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Cocoa and Pregabalin records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Theobroma cacao · Malvaceae · Seeds (cocoa beans), and the butter (fat) and powder made from them · Cocoa powder, dark chocolate, cocoa extract capsules, flavanol-standardized supplements, cocoa butter (topical)

An interaction check asks whether these two react with each other — it does not ask whether Cocoa is a good idea for someone in your situation. Here is what our Cocoa record says about it on its own.

Cocoa: dosing

There is no official standard dose for cocoa. Amounts used in research vary widely, and supplements differ in how much flavanol they contain.If you use a cocoa or cocoa flavanol supplement, follow the directions on the product label.

From our Cocoa monograph — the full record covers uses, side effects and every documented interaction.

Read the full Cocoa monograph & all interactions
Medication

About Pregabalin

What Is Pregabalin Used For?

Brand names: Lyrica, Lyrica CR

Pregabalin is used to manage several types of nerve pain, including neuropathic pain from diabetic peripheral neuropathy (nerve damage caused by diabetes) and postherpetic neuralgia (lingering nerve pain after shingles). It is also used to treat fibromyalgia and neuropathic pain associated with spinal cord injury.

Lyrica (capsule and oral solution), pregabalin capsules, and pregabalin oral solution are also approved as add-on therapy for partial-onset seizures — Lyrica for patients 1 month and older, and pregabalin capsules for patients 17 years and older. Lyrica CR and pregabalin extended-release tablets are approved only for diabetic peripheral neuropathy pain and postherpetic neuralgia — their effectiveness for fibromyalgia or as seizure add-on therapy has not been established.

Most-Reported Side Effects for Pregabalin

From FAERS, the FDA’s public side-effect reporting system (270,557 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fatigue 15,629 reports
Dizziness 14,844 reports
Nausea 14,507 reports
Headache 13,067 reports
Malaise 12,884 reports
See full Pregabalin 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
26Minor
2,168No known interaction
Moderate

635 interactions

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

Minor

26 interactions

No interaction 2,168 drugs checked — show the list
Evidence & sources

Cocoa References

The 119 references that drive our Cocoa monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  4. Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.
  5. Harder S, Fuhr U, Staib AH, Wolff T. Ciprofloxacin-caffeine: a drug interaction established using in vivo and in vitro investigations. Am J Med 1989;87:89S-91S. PubMed
  6. Carbo M, Segura J, De la Torre R, et al. Effect of quinolones on caffeine disposition. Clin Pharmacol Ther 1989;45:234-40. PubMed
  7. Healy DP, Polk RE, Kanawati L, et al. Interaction between oral ciprofloxacin and caffeine in normal volunteers. Antimicrob Agents Chemother 1989;33:474-8. PubMed
  8. Mester R, Toren P, Mizrachi I, et al. Caffeine withdrawal increases lithium blood levels. Biol Psychiatry 1995;37:348-50. PubMed
  9. Jefferson JW. Lithium tremor and caffeine intake: two cases of drinking less and shaking more. J Clin Psychiatry 1988;49:72-3.
  10. Joeres R, Klinker H, Heusler H, et al. Influence of mexiletine on caffeine elimination. Pharmacol Ther 1987;33:163-9. PubMed
  11. Vahedi K, Domingo V, Amarenco P, Bousser MG. Ischemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for bodybuilding. J Neurol Neurosurg Psychiatr 2000;68:112-3.
  12. Baron AM, Donnerstein RL, Samson RA, et al. Hemodynamic and electrophysiologic effects of acute chocolate ingestion in young adults. Am J Cardiol 1999;84:370-3. PubMed
  13. Friedman G. Diet and the irritable bowel syndrome. Gastroenterol Clin North Am 1991;20:313-24. DOI
  14. The National Toxicology Program (NTP). Caffeine. Center for the Evaluation of Risks to Human Reproduction (CERHR). Available at: http://cerhr.niehs.nih.gov/common/caffeine.html.
  15. Pollock BG, Wylie M, Stack JA, et al. Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women. J Clin Pharmacol 1999;39:936-40. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Cocoa and Pregabalin Together: Common Questions

Is it safe to take Cocoa with Pregabalin?
We do not list a known interaction between Cocoa and Pregabalin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Cocoa and Pregabalin have any of the same side effects?
Yes — our sources link each of them separately to 8 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Cocoa and Pregabalin used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Cocoa in each. That is a conversation for your prescriber, especially if Pregabalin is being adjusted to a target.
How was the Cocoa and Pregabalin combination checked?
Interactions in our licensed database are recorded against drug classes. Pregabalin is filed under 3 classifications, and Cocoa has documented interactions with 37 drug classes — none of Pregabalin's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Cocoa interact with any other medications?
Yes. Cocoa has 661 documented drug interactions in our database — Pregabalin is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Pregabalin interact with any supplements?
Yes. Pregabalin has documented interactions with 95 supplements in our database — Cocoa is not one of them. The Pregabalin interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Pregabalin 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.