Drug & supplement interaction

Guarana + Baloxavir Marboxil

Baloxavir Marboxil brand name: Xofluzanda.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Guarana and Baloxavir Marboxil 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

Guarana and Baloxavir Marboxil

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 Baloxavir Marboxil and Guarana 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.

Guarana safety at a glance

Guarana overall Use caution Generally tolerated in small amounts but it is high in caffeine, which can cause problems with overuse.
Pregnancy Possibly Safe When consumed in amounts commonly found in foods. Due to the caffeine content of guarana, intake should be closely monitored during pregnancy to ensure moderate... Read the full pregnancy detail
Breastfeeding Possibly Safe When used orally in amounts commonly found in foods. Due to the caffeine content of guarana, intake should be closely monitored when breast-feeding. Breast milk... 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 Baloxavir Marboxil and Guarana? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Baloxavir Marboxil

Interactions in our licensed database are recorded against drug classes, not just single drug names. Baloxavir Marboxil is filed under a single classification — oral drugs. Guarana has documented interactions with 41 drug classes — the most serious being ephedrine (major), adenosine (adenocard) (moderate) and anticoagulant/antiplatelet drugs (moderate) — and none of Baloxavir Marboxil’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

Guarana Does Interact With Other Medications

Guarana has 8 major, 462 moderate, 185 minor known drug interactions in our database — Baloxavir Marboxil 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 Guarana

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

What to actually watch for

No Interaction Found — But Data Suggests Guarana and Baloxavir Marboxil 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.

  • Vomiting Additional detail

    Guarana

    “Guarana contains caffeine. The existence or clinical importance of caffeine withdrawal is controversial. Some researchers think that if it exists, it appears to be of little clinical significance. Other researchers suggest symptoms such as headache; tiredness and fatigue; decreased energy, alertness, and attentiveness; drowsiness; decreased contentedness; depressed mood; difficulty concentrating; irritability;”

    Guarana · Natural Medicines adverse-effect record, reported in anxiety.

    3 sources cited
    1. 11839. Dews PB, O'Brien CP, Bergman J. Caffeine: behavioral effects of withdrawal and related issues. Food Chem Toxicol 2002;40:1257-61. PubMed
    2. 13738. Juliano LM, Griffiths RR. A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features. Psychopharmacology (Berl) 2004;176:1-29. PubMed
    3. 2723. Dews PB, Curtis GL, Hanford KJ, O'Brien CP. The frequency of caffeine withdrawal in a population-based survey and in a controlled, blinded pilot experiment. J Clin Pharmacol 1999;39:1221-32. PubMed

    “Orally, guarana can cause a sensation of burning in the stomach and vomiting. These effects may be due to caffeine in guarana. Orally, caffeine can cause gastric irritation, nausea, and vomiting. In infants, caffeine may also cause feeding intolerance and gastrointestinal irritation.”

    Guarana · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    6 sources cited
    1. 54414. Galduroz, J. C. and Carlini, E. A. The effects of long-term administration of guarana on the cognition of normal, elderly volunteers. Sao Paulo Med.J. 1996;114(1):1073-1078. PubMed
    2. 91487. Palma CG, Lera AT, Lerner T, de Oliveira MM, de Borta TM, Barbosa RP, Brito GM, Guazzelli CA, Cruz FJ, del Giglio A. Guarana (Paullinia cupana) Improves Anorexia in Patients with Advanced Cancer. J Diet Suppl. 2016;13(2):221-31.
    3. 11832. 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
    4. 11838. Holmgren P, Norden-Pettersson L, Ahlner J. Caffeine fatalities--four case reports. Forensic Sci Int 2004;139:71-3. PubMed
    5. 13735. Leson CL, McGuigan MA, Bryson SM. Caffeine overdose in an adolescent male. J Toxicol Clin Toxicol 1988;26:407-15. PubMed
    6. 6023. Tobias JD. Caffeine in the treatment of apnea associated with respiratory syncytial virus infection in neonates and infants. South Med J 2000;93:297-304. DOI

    Baloxavir Marboxil

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

  • Headache Additional detail

    Guarana

    “Orally, guarana can cause dizziness. The caffeine in guarana can cause insomnia (especially in children), nervousness, restlessness, dizziness, tremors, delirium, and convulsions. Other symptoms include headache, anxiety, and agitation.

    Taking guarana with ephedra can cause insomnia, irritability, dizziness, and headache.”

    Guarana · Natural Medicines adverse-effect record, reported in anxiety.

    6 sources cited
    1. 91483. del Giglio AB, Cubero Dde I, Lerner TG, Guariento RT, de Azevedo RG, Paiva H, Goldman C, Carelli B, Cruz FM, Schindler F, Pianowski L, de Matos LL, del Giglio A. Purified dry extract of Paullinia cupana (guaraná) (PC-18) for chemotherapy-related fatigue i
    2. 10755. Schechter MD, Timmons GD. Objectively measured hyperactivity--II. Caffeine and amphetamine effects. J Clin Pharmacol 1985;25:276-80.. PubMed
    3. 11832. 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
    4. 11838. Holmgren P, Norden-Pettersson L, Ahlner J. Caffeine fatalities--four case reports. Forensic Sci Int 2004;139:71-3. PubMed
    5. 13735. Leson CL, McGuigan MA, Bryson SM. Caffeine overdose in an adolescent male. J Toxicol Clin Toxicol 1988;26:407-15. PubMed
    6. 108016. de Araujo DP, Pereira PTVT, Fontes AJC, et al. The use of guarana (Paullinia cupana) as a dietary supplement for fatigue in cancer patients: a systematic review with a meta-analysis. Support Care Cancer 2021;29(12):7171-7182. PubMed

    Baloxavir Marboxil

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

  • Nausea Additional detail

    Guarana

    “Orally, guarana is typically well tolerated when used in moderation. Due to its caffeine content, use of large doses may be unsafe.

    Most Common Adverse Effects:

    Orally: Stomach burning and nausea.”

    Guarana · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    Baloxavir Marboxil

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

Reported for Guarana but not commonly for Baloxavir Marboxil: trouble concentrating, fainting, dependence or withdrawal symptoms and a stroke or mini-stroke.

Effects for Baloxavir Marboxil come from the ADVERSE REACTIONS section of its FDA label; effects for Guarana 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

Guarana in Pregnancy & Breastfeeding

Pregnancy Possibly Safe

When consumed in amounts commonly found in foods. Due to the caffeine content of guarana, intake should be closely monitored during pregnancy to ensure moderate consumption. Although it is not considered a teratogen, caffeine crosses the placenta and causes dose-dependent increases in fetal blood concentrations. The use of caffeine during pregnancy is controversial; however, moderate consumption has not been associated with clinically important adverse fetal effects. In some studies, consuming amounts over 200 mg daily is associated with a significantly increased risk of miscarriage. This increased risk may be most likely to occur in individuals with genotypes that confer a slow rate of caffeine metabolism. According to a review by Health Canada, and a subsequent large meta-analysis conducted in the US, caffeine can be safely consumed in doses up to 300 mg daily without an increased risk of spontaneous abortion, stillbirth, preterm birth, fetal growth retardation, or congenital malformations. However, some research has also 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. Advise individuals to keep caffeine consumption below 300 mg daily during pregnancy.

Pregnancy Possibly Unsafe

When used orally in amounts over 300 mg daily. Although it is not considered a teratogen, caffeine crosses the placenta and causes dose-dependent increases in fetal blood concentrations. Consumption of caffeine in amounts over 300 mg daily is associated with a significantly increased risk of miscarriage in some studies. Advise keeping caffeine consumption from all sources below 300 mg daily. High maternal doses of caffeine throughout pregnancy have resulted in symptoms of caffeine withdrawal in newborn infants. High doses of caffeine have also been associated with spontaneous abortion, premature delivery, and low birth weight.

Lactation Possibly Safe

When used orally in amounts commonly found in foods. Due to the caffeine content of guarana, intake should be closely monitored when breast-feeding. Breast milk concentrations of caffeine are thought to be approximately 50% of serum concentrations.

Lactation Possibly Unsafe

When used orally in large amounts. Consumption of guarana might cause irritability and increased bowel activity in nursing infants. Large doses or excessive intake of guarana should be avoided when breast-feeding.

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 Baloxavir Marboxil Is Prescribed For, and What Guarana Has Been Studied For

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

Baloxavir Marboxil is prescribed for: Baloxavir marboxil (sold as Xofluza) treats acute uncomplicated influenza in people 5 years and older. You should have had symptoms for no more than 48 hours. It is for people who are otherwise healthy or at high risk of flu-related complications. It is also used for post-exposure prophylaxis (preventing flu after contact with someone who has it) in people 5 years and older.

Guarana has been studied for:

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

    Guarana for headache

    Although there has been interest in using oral guarana for headache, there is insufficient reliable information about the clinical effects of guarana for this purpose.

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 Baloxavir Marboxil on your own; if you are taking Guarana for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Baloxavir Marboxil

This page covers Guarana only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Baloxavir Marboxil page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Baloxavir Marboxil page

“Activated charcoal is the supplement I would keep farthest from baloxavir marboxil (Xofluzanda), the single-dose flu antiviral, and it carries the only major rating among the 17 ingredients on file here. Charcoal adsorbs drugs in the gut, and because this whole flu treatment is one dose, a blunted dose has no follow-up pill to rescue it.”

Reviewed by 2 · Jul 18, 2026

Open the Baloxavir Marboxil interaction page

One more smart check

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

We hold 1,430 real supplement products containing Guarana, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Guarana. Even though Guarana itself has no known interaction with Baloxavir Marboxil, 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 Guarana and Baloxavir Marboxil 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 Guarana
Top 10%

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

29 days ago today
Medication Baloxavir Marboxil
Top 25%

#681 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 Guarana reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified October 4, 2026. The Guarana and Baloxavir Marboxil 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 Guarana

What is Guarana?

Guarana
  • Energy and alertness
  • Reducing fatigue
  • Weight loss support
  • Athletic performance
  • Mental focus

Guarana is an Amazonian seed that is naturally high in caffeine, which explains most of its stimulant and energy effects. While it may give a short-term boost in alertness and reduce fatigue, strong evidence for weight loss or major performance gains is limited, and it carries the same risks as too much caffeine. Talk to your pharmacist or doctor before using it, especially if you have heart problems, anxiety, or are pregnant.

Paullinia cupana · Sapindaceae · Seeds · Capsules, tablets, powders, energy drinks, liquid extracts

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

Guarana: dosing

There is no official standardized dose for guarana. The caffeine content varies widely between products, so the strength of one supplement may be very different from another.The safest approach is to follow the directions on the product label and to count guarana toward your total daily caffeine intake from all sources. Avoid combining several caffeine-containing products at once.

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

Read the full Guarana monograph & all interactions
Medication

About Baloxavir Marboxil

What Is Baloxavir Marboxil Used For?

Brand name: Xofluzanda

Baloxavir marboxil (sold as Xofluza) treats acute uncomplicated influenza in people 5 years and older. You should have had symptoms for no more than 48 hours. It is for people who are otherwise healthy or at high risk of flu-related complications.

It is also used for post-exposure prophylaxis (preventing flu after contact with someone who has it) in people 5 years and older.

See full Baloxavir Marboxil drug information
Keep checking

Other Drugs & Guarana

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

8Major
462Moderate
185Minor
2,174No known interaction
Major

8 interactions

Moderate

462 interactions

Showing 60 of 462 moderate interactions — see all 462 on the Guarana page.

Minor

185 interactions

Showing 60 of 185 minor interactions — see all 185 on the Guarana page.

No interaction 2,174 drugs checked — show the list

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

Showing the 60 most looked-up of 2,174 medications checked with no known interaction — see the full Guarana list.

Evidence & sources

Guarana References

The 114 references that drive our Guarana 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. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. 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
  3. Carbo M, Segura J, De la Torre R, et al. Effect of quinolones on caffeine disposition. Clin Pharmacol Ther 1989;45:234-40. PubMed
  4. 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
  5. Mester R, Toren P, Mizrachi I, et al. Caffeine withdrawal increases lithium blood levels. Biol Psychiatry 1995;37:348-50. PubMed
  6. Jefferson JW. Lithium tremor and caffeine intake: two cases of drinking less and shaking more. J Clin Psychiatry 1988;49:72-3.
  7. Joeres R, Klinker H, Heusler H, et al. Influence of mexiletine on caffeine elimination. Pharmacol Ther 1987;33:163-9. PubMed
  8. 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.
  9. Wakabayashi K, Kono S, Shinchi K, et al. Habitual coffee consumption and blood pressure: A study of self-defense officials in Japan. Eur J Epidemiol 1998;14:669-73. PubMed
  10. Hodgson JM, Puddey IB, Burke V, et al. Effects on blood pressure of drinking green and black tea. J Hypertens 1999;17:457-63. PubMed
  11. Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr 2001;74:694-700. PubMed
  12. 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.
  13. Klebanoff MA, Levine RJ, DerSimonian R, et al. Maternal serum paraxanthine, a caffeine metabolite, and the risk of spontaneous abortion. N Engl J Med 1999;341:1639-44. PubMed
  14. Eskenazi B. Caffeine—filtering the facts. N Engl J Med 1999;341:1688-9. PubMed
  15. Fernandes O, Sabharwal M, Smiley T, et al. Moderate to heavy caffeine consumption during pregnancy and relationship to spontaneous abortion and abnormal fetal growth: a meta-analysis. Reprod Toxicol 1998;12:435-44. 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 Guarana and Baloxavir Marboxil Together: Common Questions

Is it safe to take Guarana with Baloxavir Marboxil?
We do not list a known interaction between Guarana and Baloxavir Marboxil. 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 Guarana and Baloxavir Marboxil have any of the same side effects?
Yes — our sources link each of them separately to 3 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 Guarana and Baloxavir Marboxil 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 Guarana in each. That is a conversation for your prescriber, especially if Baloxavir Marboxil is being adjusted to a target.
How was the Guarana and Baloxavir Marboxil combination checked?
Interactions in our licensed database are recorded against drug classes. Baloxavir Marboxil is filed under 1 classification, and Guarana has documented interactions with 41 drug classes — none of Baloxavir Marboxil'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 Guarana interact with any other medications?
Yes. Guarana has 655 documented drug interactions in our database — Baloxavir Marboxil 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 Baloxavir Marboxil interact with any supplements?
Yes. Baloxavir Marboxil has documented interactions with 17 supplements in our database — Guarana is not one of them. The Baloxavir Marboxil 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 Baloxavir Marboxil and Guarana?

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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.