Drug & supplement interaction

Cocoa + Terbinafine

Terbinafine brand name: Lamisil.

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

Cocoa has a minor interaction with Terbinafine. Theoretically, terbinafine 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 Terbinafine

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

Minor

TERBINAFINE (Lamisil)

Theoretically, terbinafine might increase the levels and adverse effects of caffeine.
Cocoa contains caffeine. Terbinafine decreases the rate of caffeine clearance.
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 simple version: cocoa naturally contains a little caffeine, and terbinafine slows down how fast your body clears caffeine. So while you're taking terbinafine, the caffeine from cocoa (and from coffee, tea, or soda) can hang around a bit longer than usual. The terbinafine itself isn't affected, it's the caffeine that builds up slightly.

In real life this is a minor issue, and it's largely theoretical. If you're sensitive, you might notice things like feeling jittery, a faster heartbeat, or trouble sleeping. The small amount of caffeine in a cup of cocoa usually isn't a big deal, but concentrated cocoa supplements plus lots of other caffeine could add up. If you feel wired, ease off the caffeine and check with your pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Wahllander A, Paumgartner G. Effect of ketoconazole and terbinafine on the pharmacokinetics of caffeine in healthy volunteers. Eur J Clin Pharmacol 1989;37:279-83. 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 635 moderate, 25 minor known drug interactions in our database — the Terbinafine 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. Terbinafine)
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 Terbinafine

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 Terbinafine, 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 Terbinafine

This page covers Cocoa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Terbinafine page lists 72 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 Ashwagandha (moderate).

By severity: 4 major · 45 moderate · 23 minor.

From our pharmacist’s overview on the Terbinafine page

“Liver strain is the risk that dominates this list. Terbinafine (Lamisil), the antifungal most people take for months to clear a nail infection, can injure the liver in rare cases on its own, and 38 of the 72 supplements catalogued here carry liver risks that could stack on top of that.”

Reviewed by 2 · Jul 18, 2026

Open the Terbinafine 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 Terbinafine 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 Terbinafine 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 Terbinafine
Top 25%

#506 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 Terbinafine

What Is Terbinafine Used For?

Brand name: Lamisil

Terbinafine tablets are used to treat onychomycosis — a fungal infection of the fingernails or toenails caused by dermatophytes (a type of fungus). Before starting the tablets, a doctor will confirm the diagnosis with a nail test.

Topical terbinafine products — creams and sprays — treat athlete's foot (tinea pedis), jock itch (tinea cruris), and ringworm (tinea corporis) on the skin. They also relieve the itching, burning, cracking, and scaling that come with these infections. Lamisil AT Spray is indicated for athlete's foot between the toes specifically; its effectiveness on the bottom or sides of the foot is unknown.

See full Terbinafine 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
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 Terbinafine, 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 Terbinafine supplement interactions › Every supplement checked against Terbinafine, ranked by severity Terbinafine 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 Cocoa and Terbinafine Together: Common Questions

Can you take Cocoa with Terbinafine?
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 Terbinafine 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 Terbinafine and Cocoa?

Our pharmacists answer your medication & supplement questions — free.

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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.