Drug & supplement interaction

Guarana + Moxifloxacin

Moxifloxacin brand name: Avelox.

Minor Interaction
The bottom line Minor

Guarana has a minor interaction with Moxifloxacin. Theoretically, quinolone antibiotics 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

Guarana and Moxifloxacin

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

Minor

QUINOLONE ANTIBIOTICS

Why this applies to Moxifloxacin

Moxifloxacin falls under QUINOLONE ANTIBIOTICS — the group Guarana interacts with.

Theoretically, quinolone antibiotics might increase the levels and adverse effects of caffeine.
Guarana contains caffeine. Theoretically, concomitant use might increase serum caffeine concentrations and the risk of adverse effects. Quinolones (also called fluoroquinolones) can decrease caffeine clearance by inhibiting the cytochrome P450 1A2 enzyme.
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: guarana is basically a concentrated source of caffeine, and while you're taking moxifloxacin (Avelox), your body may not clear that caffeine as quickly as usual. Fluoroquinolones can slow down the liver enzyme (CYP1A2) that breaks caffeine down, so the caffeine can hang around longer and pile up. In other words, the antibiotic doesn't get stronger here, the caffeine does.

What that can feel like is too much coffee: jitteriness, a racing or pounding heart, trouble sleeping, and feeling anxious or shaky. The good news is this is rated a minor, mostly theoretical interaction, and it's only for the short time you're on the antibiotic. If you're sensitive to caffeine or notice these effects, it's worth easing back on guarana and checking with your pharmacist or doctor.

References
  1. 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
  2. Carbo M, Segura J, De la Torre R, et al. Effect of quinolones on caffeine disposition. Clin Pharmacol Ther 1989;45:234-40. PubMed
  3. 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
  4. Staib, A. H., Stille, W., Dietlein, G., Shah, P. M., Harder, S., Mieke, S., and Beer, C. Interaction between quinolones and caffeine. Drugs 1987;34 Suppl 1:170-174. PubMed
  5. Stille, W., Harder, S., Mieke, S., Beer, C., Shah, P. M., Frech, K., and Staib, A. H. Decrease of caffeine elimination in man during co-administration of 4-quinolones. J.Antimicrob.Chemother. 1987;20(5):729-734. PubMed
  6. Fuhr, U., Strobl, G., Manaut, F., Anders, E. M., Sorgel, F., Lopez-de-Brinas, E., Chu, D. T., Pernet, A. G., Mahr, G., Sanz, F., and . Quinolone antibacterial agents: relationship between structure and in vitro inhibition of the human cytochrome P450 isof

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

Guarana Also Interacts With Other Medications

Guarana has 8 major, 462 moderate, 184 minor known drug interactions in our database — the Moxifloxacin 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 Guarana

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

From our Q&A

Questions About Guarana or Moxifloxacin

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

This page covers Guarana only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Moxifloxacin page lists 155 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Apple (major), Arsenic (major) and Asarabacca (major).

By severity: 13 major · 121 moderate · 21 minor.

From our pharmacist’s overview on the Moxifloxacin page

“The supplement list for moxifloxacin (Avelox), a fluoroquinolone antibiotic, deserves genuine care, and the everyday items are the surprising part. Ordinary juices, apple, grapefruit, and sweet orange among them, block a transporter the drug needs for absorption and can cut how much reaches your blood, which for an antibiotic means the…”

Reviewed by 2 · Jul 18, 2026

Open the Moxifloxacin 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. Your product may carry other ingredients that interact with Moxifloxacin too, on top of Guarana — 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 Guarana and Moxifloxacin 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%

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

29 days ago today
Medication Moxifloxacin
Steady interest

#1,702 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 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.

Read the full Guarana monograph & all interactions
Medication

About Moxifloxacin

What Is Moxifloxacin Used For?

Brand name: Avelox

Moxifloxacin tablets and intravenous (IV) injection are approved for adults 18 and older to treat bacterial infections including community-acquired pneumonia, uncomplicated and complicated skin infections, complicated abdominal infections, plague, acute bacterial sinusitis, and acute bacterial flare-ups of chronic bronchitis. Note: moxifloxacin should only be used for sinusitis and chronic bronchitis flare-ups when no other antibiotic option is available, due to the risk of serious side effects.

Moxifloxacin ophthalmic solution (eye drops) — including the brand Vigamox — is a separate, topical formulation used only in the eye to treat bacterial conjunctivitis (pink eye) caused by susceptible bacteria. The eye drop form is not used for body-wide infections.

See full Moxifloxacin 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
184Minor
2,175No known interaction
Major

8 interactions

Moderate

462 interactions

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

Minor

184 interactions

Showing 60 of 184 minor interactions — see all 184 on the Guarana 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 Guarana and Moxifloxacin Together: Common Questions

Can you take Guarana with Moxifloxacin?
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 Guarana and Moxifloxacin 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 Moxifloxacin 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.