Drug & supplement interaction

Yerba Mate + Ephedrine, Hydroxyzine, Theophylline

Ephedrine, Hydroxyzine, Theophylline brand names: Marax, Ami Rax.

Major Interaction
The bottom line Major

Ephedrine, Hydroxyzine, Theophylline falls into 3 drug categories that Yerba Mate can interact with; the most serious is rated major. Theoretically, the caffeine in yerba mate might increase the risk for stimulant adverse effects when used concomitantly with ephedrine.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Yerba Mate and Ephedrine, Hydroxyzine, Theophylline

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Yerba Mate interacts with whole categories of medication. Ephedrine, Hydroxyzine, Theophylline falls into 3 of those categories, so it can interact with Yerba Mate in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

EPHEDRINE

1 of 3
Theoretically, the caffeine in yerba mate might increase the risk for stimulant adverse effects when used concomitantly with ephedrine.
Use of ephedrine with caffeine can increase the risk of stimulatory adverse effects. 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 Major Likelihood Probable Evidence D

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 about combining yerba mate with this medication: your Marax-type pill already contains ephedrine, a nervous-system stimulant, plus theophylline, which is closely related to caffeine. Yerba mate adds even more caffeine on top. So you're essentially stacking stimulant upon stimulant. That can leave you feeling jittery, restless, or shaky, with a racing or pounding heart, trouble sleeping, and higher blood pressure.

This isn't about the medicine being broken down differently. It's simply additive overstimulation. The serious concerns (very high blood pressure, irregular heartbeat) are rare but real, and theophylline already has a narrow safety window. The evidence here is mostly anecdotal, but please play it safe and chat with your pharmacist or doctor before pairing them regularly.

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
Moderate

STIMULANT DRUGS

2 of 3

Why this applies to Ephedrine, Hydroxyzine, Theophylline

Ephedrine, Hydroxyzine, Theophylline falls under STIMULANT DRUGS — the group Yerba Mate interacts with.

Theoretically, concomitant use of stimulant drugs and yerba mate might increase stimulant adverse effects.
Yerba mate contains caffeine. Due to the CNS stimulant effects of the caffeine, concomitant use 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 simple version: your combo medicine already packs two stimulants. Ephedrine revs up your heart and nervous system, and theophylline is a caffeine-like compound that opens airways but also stimulates you. Yerba mate brings its own caffeine to the party. Stack them together and you're basically piling stimulant on top of stimulant.

What that can feel like: a racing or pounding heart, jitteriness, trouble sleeping, anxiety, or an upset stomach. Theophylline is a touchy drug where the right and the too-much dose aren't far apart, so I take this seriously even though the warning is based on expert opinion rather than hard studies. An occasional cup is unlikely to be a crisis, but I wouldn't load up on mate daily. Please check with your pharmacist or doctor first.

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

3 of 3

Ephedrine, Hydroxyzine, Theophylline also falls under THEOPHYLLINE.

Theoretically, the caffeine in yerba mate might increase the levels and adverse effects of theophylline.
Yerba mate contains caffeine. Caffeine decreases theophylline clearance by 23% to 29%.
Severity Moderate Likelihood Probable Evidence D

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 know about this combo product: it contains theophylline, a medication your body clears slowly and one that doesn't leave much room for error. Yerba mate brings caffeine to the table, and caffeine competes for the same liver pathway that breaks down theophylline. Studies suggest this can slow theophylline's clearance by roughly 23% to 29%, so the drug can quietly build up in your system.

What might you feel? More of theophylline's usual side effects, like a racing or pounding heart, jitteriness, trouble sleeping, nausea, or feeling shaky. The ephedrine in this product is also a stimulant, so adding a caffeine source can stack those effects. This is theoretical pharmacology, not proven harm, but it's worth a quick chat with your pharmacist before pairing them.

References
  1. Carrillo JA, Benitez J. Clinically significant pharmacokinetic interactions between dietary caffeine and medications. Clin Pharmacokinet 2000;39:127-53. 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

Yerba Mate Also Interacts With Other Medications

Yerba Mate has 7 major, 505 moderate, 573 minor known drug interactions in our database — the Ephedrine, Hydroxyzine, Theophylline one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Yerba Mate

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

Everything else you take

See Every Supplement That Interacts With Ephedrine, Hydroxyzine, Theophylline

This page covers Yerba Mate only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ephedrine, Hydroxyzine, Theophylline page lists 199 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Black Tea (major), Caffeine (major), Coffee (major) and Ephedra (major).

By severity: 17 major · 143 moderate · 39 minor.

From our pharmacist’s overview on the Ephedrine, Hydroxyzine, Theophylline page

“For anyone taking Marax (ephedrine, hydroxyzine, theophylline), nothing on this page matters more than caffeine. Paired with the ephedrine in this combination, caffeine from coffee, teas, guarana, and similar herbs has been linked to dangerous blood pressure spikes, heart attack, and stroke, and those stimulant pairings account for mos…”

Reviewed by 2 · Jul 18, 2026

Open the Ephedrine, Hydroxyzine, Theophylline interaction page

One more smart check

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

We hold 68 real supplement products containing Yerba Mate, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Yerba Mate. Your product may carry other ingredients that interact with Ephedrine, Hydroxyzine, Theophylline too, on top of Yerba Mate — 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 Yerba Mate and Ephedrine, Hydroxyzine, 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 Yerba Mate
Steady interest

#1,100 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ephedrine, Hydroxyzine, Theophylline
Steady interest

#1,813 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 Yerba Mate

What is Yerba Mate?

Yerba Mate
  • Energy and alertness
  • Weight loss
  • Mental focus
  • Digestive support
  • Antioxidant support

Yerba mate is a caffeine-containing herbal beverage from South America that is widely enjoyed for its stimulating, coffee-like effects. While it is rich in antioxidants and is being studied for weight, blood sugar, and cholesterol, strong human evidence for most health claims is limited. Drinking very hot mate over many years has been linked to higher risk of certain cancers, so enjoy it warm and in moderation.

Read the full Yerba Mate monograph & all interactions
Keep checking

Other Drugs & Yerba Mate

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

7Major
505Moderate
573Minor
1,744No known interaction
Major

7 interactions

Moderate

505 interactions

Showing 60 of 505 moderate interactions — see all 505 on the Yerba Mate page.

Minor

573 interactions

Showing 60 of 573 minor interactions — see all 573 on the Yerba Mate page.

No interaction 1,744 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 Yerba Mate and Ephedrine, Hydroxyzine, Theophylline Together: Common Questions

Can you take Yerba Mate with Ephedrine, Hydroxyzine, Theophylline?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Yerba Mate and Ephedrine, Hydroxyzine, Theophylline?
Ephedrine, Hydroxyzine, Theophylline belongs to more than one drug category, and Yerba Mate 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 Yerba Mate and Ephedrine, Hydroxyzine, Theophylline interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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.