Drug & supplement interaction

Cola Nut + Acetazolamide

Acetazolamide brand names: Diamox, Ak-Zol.

Moderate Interaction
The bottom line Moderate

Cola Nut has a moderate interaction with Acetazolamide. Theoretically, using cola nut with diuretic drugs might increase the risk of hypokalemia.

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

Cola Nut and Acetazolamide

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

Moderate

DIURETIC DRUGS

Why this applies to Acetazolamide

Acetazolamide falls under DIURETIC DRUGS — the group Cola Nut interacts with.

Theoretically, using cola nut with diuretic drugs might increase the risk of hypokalemia.
Cola nut contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Certain diuretics can also lower potassium levels.
Severity Moderate 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: acetazolamide (Diamox) is a diuretic, and one of its known quirks is that it can nudge your potassium levels down. Cola nut is basically a caffeine source, and in large amounts caffeine can also shift potassium lower. Put the two together and, in theory, you could lower potassium a bit more than either one alone.

I want to be honest about how soft this is. It's a theoretical concern based on how these things work, not strong human studies. A cup or two of a caffeinated drink is unlikely to matter much. The bigger question is concentrated cola nut supplements or heavy daily caffeine. Low potassium can cause muscle weakness, cramps, or an irregular heartbeat, so if you notice those, check in. Before adding a cola nut supplement, it's worth a quick word with your pharmacist or doctor.

References
  1. Norager, C. B., Jensen, M. B., Weimann, A., and Madsen, M. R. Metabolic effects of caffeine ingestion and physical work in 75-year old citizens. A randomized, double-blind, placebo-controlled, cross-over study. Clin Endocrinol (Oxf) 2006;65(2):223-228. PubMed
  2. Simmonds, M. J., Minahan, C. L., and Sabapathy, S. Caffeine improves supramaximal cycling but not the rate of anaerobic energy release. Eur.J Appl Physiol 2010;109(2):287-295. PubMed
  3. Rigato, I., Blarasin, L., and Kette, F. Severe hypokalemia in 2 young bicycle riders due to massive caffeine intake. Clin J Sport Med. 2010;20(2):128-130. PubMed
  4. Ernest, D., Chia, M., and Corallo, C. E. Profound hypokalaemia due to Nurofen Plus and Red Bull misuse. Crit Care Resusc. 2010;12(2):109-110. DOI
  5. Clausen, T. Hormonal and pharmacological modification of plasma potassium homeostasis. Fundam.Clin Pharmacol 2010;24(5):595-605. 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

Cola Nut Also Interacts With Other Medications

Cola Nut has 546 moderate, 108 minor known drug interactions in our database — the Acetazolamide 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 Cola Nut

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

From our Q&A

Questions About Cola Nut or Acetazolamide

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

This page covers Cola Nut only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetazolamide page lists 284 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), American Hellebore (major), American Mistletoe (major) and Asarabacca (major).

By severity: 15 major · 242 moderate · 27 minor.

From our pharmacist’s overview on the Acetazolamide page

“Acetazolamide, taken for glaucoma, altitude sickness, and certain seizure types, works partly as a diuretic and can make people drowsy, and most of the supplements that interact with it press on one of those two points. The biggest group adds to its blood-pressure and fluid effects, a second deepens sedation (alcohol and kava sit at th…”

Reviewed by 2 · Jul 18, 2026

Open the Acetazolamide interaction page

One more smart check

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

We hold 2 real supplement products containing Cola Nut, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cola Nut. Your product may carry other ingredients that interact with Acetazolamide too, on top of Cola Nut — 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 Cola Nut and Acetazolamide 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 Cola Nut
Steady interest

#1,051 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Acetazolamide
Top half

#1,054 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 Cola Nut

What is Cola Nut?

Cola Nut
  • Energy and alertness
  • Mental focus
  • Physical performance
  • Weight loss support
  • Traditional digestive aid

Cola nut is a caffeine-containing seed from West Africa used mainly as a natural stimulant for energy and alertness. Most of its effects come from caffeine, and strong human evidence for specific health benefits is limited. Because of its caffeine content, people sensitive to stimulants and those who are pregnant or have heart conditions should be cautious.

Read the full Cola Nut monograph & all interactions
Medication

About Acetazolamide

What Is Acetazolamide Used For?

Brand names: Diamox, Ak-Zol

Acetazolamide is used as an add-on treatment for several conditions. Across tablets and the intravenous injection, it treats glaucoma (including open-angle and secondary glaucoma, and before surgery for acute angle-closure glaucoma), certain types of epilepsy (centrencephalic seizures, including petit mal), edema (fluid buildup) due to congestive heart failure, and drug-induced edema.

Acetazolamide extended-release capsules are specifically indicated for the prevention or reduction of acute mountain sickness symptoms — such as headache, nausea, and dizziness — in climbers attempting rapid ascent. Acetazolamide tablets and the intravenous injection are also indicated for acute mountain sickness.

See full Acetazolamide drug information
Keep checking

Other Drugs & Cola Nut

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

0Major
546Moderate
108Minor
2,175No known interaction
Moderate

546 interactions

Showing 60 of 546 moderate interactions — see all 546 on the Cola Nut page.

Minor

108 interactions

Showing 60 of 108 minor interactions — see all 108 on the Cola Nut page.

No interaction 2,175 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 Cola Nut and Acetazolamide Together: Common Questions

Can you take Cola Nut with Acetazolamide?
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.
How serious is the Cola Nut and Acetazolamide 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

Still Have a Question About Acetazolamide and Cola Nut?

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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.