Drug & supplement interaction

Cola Nut + Ephedrine, Phenobarbital, Theophylline

Ephedrine, Phenobarbital, Theophylline brand name: Tedral.

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

Ephedrine, Phenobarbital, Theophylline falls into 4 drug categories that Cola Nut can interact with; the most serious is rated moderate. Theoretically, concomitant use might increase stimulant adverse effects.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions4
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cola Nut and Ephedrine, Phenobarbital, Theophylline

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Cola Nut interacts with whole categories of medication. Ephedrine, Phenobarbital, Theophylline falls into 4 of those categories, so it can interact with Cola Nut in 4 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 4

Why this applies to Ephedrine, Phenobarbital, Theophylline

Ephedrine, Phenobarbital, Theophylline falls under STIMULANT DRUGS — the group Cola Nut interacts with.

Theoretically, concomitant use might increase stimulant adverse effects.
Cola nut contains caffeine. Due to the central nervous system (CNS) stimulant effects of caffeine, concomitant use with stimulant drugs can increase the risk of 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

Here's the thing to keep in mind with Tedral (a combo of ephedrine, phenobarbital, and theophylline): two of those ingredients, ephedrine and theophylline, are already stimulants. Cola nut adds caffeine on top of that, and caffeine is chemically a close cousin of theophylline. So you're essentially stacking stimulant on stimulant.

When that happens, you may feel more of the jittery, overstimulated side: a racing or pounding heart, feeling shaky or anxious, trouble sleeping, and a bump in blood pressure. This is based mostly on expert reasoning rather than hard studies, so it's not a sure thing, and a small amount in a soda may not matter much. Still, concentrated cola nut supplements are worth a quick chat with your pharmacist or doctor before combining.

Contact Dr. Brian directly if you have additional questions on this interaction
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

THEOPHYLLINE

2 of 4

Ephedrine, Phenobarbital, Theophylline also falls under THEOPHYLLINE.

Theoretically, cola nut might increase the levels and adverse effects of theophylline.
Cola nut contains caffeine. Large amounts of caffeine might inhibit theophylline metabolism.
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 thing with Tedral: it contains theophylline, and theophylline is chemically very close to caffeine. Both are cleared by the same liver pathway. Cola nut is basically a natural caffeine source, so loading up on it can compete for that same exit route and slow theophylline's breakdown. The result is that theophylline can quietly build up to higher levels than intended.

Theophylline already has a narrow safety window, so even a modest bump matters. Watch for jitteriness, a racing or pounding heart, nausea, trouble sleeping, or feeling shaky. The ephedrine piece is also a stimulant, which can add to that. A casual cup of cola isn't likely the issue; concentrated cola nut supplements are. Please check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Carrillo JA, Benitez J. Clinically significant pharmacokinetic interactions between dietary caffeine and medications. Clin Pharmacokinet 2000;39:127-53. PubMed
Moderate

PHENOBARBITAL (Luminal)

3 of 4
Theoretically, cola nut might reduce the effects of phenobarbital and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenobarbital. However, this effect has not been reported in humans.
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

This combination pill includes phenobarbital, which calms the nervous system and, in some people, is used to help prevent seizures. The concern here is the caffeine in cola nut. In animal studies only, caffeine seemed to work against phenobarbital's seizure-calming effect, which could in theory make seizures more likely. This has not actually been seen in people, so I don't want to overstate it.

There's a second angle worth knowing: this product also contains a stimulant (ephedrine) and theophylline. Piling caffeine on top of those can add to jitteriness, a racing heart, and trouble sleeping. If you take this medicine, it's a smart idea to run cola nut by your pharmacist or doctor before adding it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Gasior, M., Borowicz, K., Buszewicz, G., Kleinrok, Z., and Czuczwar, S. J. Anticonvulsant activity of phenobarbital and valproate against maximal electroshock in mice during chronic treatment with caffeine and caffeine discontinuation. Epilepsia 1996;37(3 PubMed
  2. Jankiewicz, K., Chroscinska-Krawczyk, M., Blaszczyk, B., and Czuczwar, S. J. [Caffeine and antiepileptic drugs: experimental and clinical data]. Przegl.Lek. 2007;64(11):965-967.
  3. Chroscinska-Krawczyk, M., Jargiello-Baszak, M., Walek, M., Tylus, B., and Czuczwar, S. J. Caffeine and the anticonvulsant potency of antiepileptic drugs: experimental and clinical data. Pharmacol.Rep. 2011;63(1):12-18. PubMed
Moderate

EPHEDRINE

4 of 4
Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Cola nut contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.
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 thing to keep in mind with Tedral and cola nut: both bring stimulants to the table. Cola nut is basically a natural source of caffeine, and your Tedral already contains ephedrine plus theophylline, which act a lot like caffeine in the body. Stacking them can pile on the stimulant effects rather than blocking or speeding up how the drug is cleared.

What that might feel like is a racing or pounding heart, jitteriness, trouble sleeping, anxiety, or a bump in blood pressure. In rarer situations, mixing ephedrine with extra caffeine has been tied to more serious heart and blood pressure problems. To be fair, this is based on anecdotal reports, not strong studies, but I'd still play it safe. Please check with your pharmacist or doctor before pairing them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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.
  2. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. PubMed
  3. Kockler DR, McCarthy MW, Lawson CL. Seizure activity and unresponsiveness after hydroxycut ingestion. Pharmacotherapy 2001;21:647-51.. 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 Ephedrine, Phenobarbital, Theophylline one above is among them. If you take anything else, check it against the full list below.

Moderate 546 Minor 108 No known interaction 2,176 (incl. Ephedrine, Phenobarbital, Theophylline)
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.

Everything else you take

See Every Supplement That Interacts With Ephedrine, Phenobarbital, Theophylline

This page covers Cola Nut only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ephedrine, Phenobarbital, Theophylline page lists 184 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), Black Tea (major) and Caffeine (major).

By severity: 22 major · 140 moderate · 22 minor.

Open the Ephedrine, Phenobarbital, Theophylline 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 Ephedrine, Phenobarbital, Theophylline 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 Ephedrine, Phenobarbital, Theophylline 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

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

29 days ago today
Medication Ephedrine, Phenobarbital, Theophylline
Top half

#1,272 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
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
546 Moderate 108 Minor 2,175 No 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

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

Showing the 60 most looked-up of 2,175 medications checked with no known interaction — see the full Cola Nut list.

See the full Cola Nut interactions page
See every supplement checked against Ephedrine, Phenobarbital, Theophylline, 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
Cola Nut monograph › Uses, safety, and every drug interaction in one place Ephedrine, Phenobarbital, Theophylline supplement interactions › Every supplement checked against Ephedrine, Phenobarbital, Theophylline, 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 Cola Nut and Ephedrine, Phenobarbital, Theophylline Together: Common Questions

Can you take Cola Nut with Ephedrine, Phenobarbital, Theophylline?
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 4 interactions listed for Cola Nut and Ephedrine, Phenobarbital, Theophylline?
Ephedrine, Phenobarbital, Theophylline belongs to more than one drug category, and Cola Nut 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 Cola Nut and Ephedrine, Phenobarbital, Theophylline 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.