Herb & supplement monograph

Coca Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Coca interacts with medications. The heart of this page is the interaction list — every drug Coca is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Coca is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Interaction report

Drugs that interact with Coca

259 medications have a known interaction with Coca, graded by severity. Select any drug for the full evidence-based detail.

2 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Coca.

2,830 drugs
EthanolEthanol› NifedipineAdalat, Adalat CC, Adalat LA, Adalat PA, Adalat Retard, Adalat XL +15 more› AcarboseGlucobay, Prandase, Precose› AcebutololRhotral, Sectral› AcetazolamideAk-Zol, Diamox› AcetohexamideDymelor› AlbiglutideTanzeum› AliskirenTekturna› AlogliptinNesina› Alogliptin, MetforminKazano› Alogliptin, PioglitazoneOseni› AmbrisentanLetairis, Volibris› AmilorideAmilamont, Midamor› Amiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic› AmlodipineNorliqva› Amlodipine BenzoateKaterzia› Amlodipine BesilateIstin› Amlodipine BesylateNorvasc› Amlodipine Besylate, BenazeprilLotrel› Amlodipine, CelecoxibConsensi› Ammonium ChlorideAmmonium Chloride› Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi› AprocitentanTryvio› AtenololAtenix, Tenormin› Atenolol, ChlortalidoneAtenixCo, Tenoret 50, Totaretic› Atenolol, ChlorthalidoneTenoretic› AzilsartanEdarbi› Azilsartan, ChlorthalidoneEdarbyclor› BenazeprilLotensin› Benazepril, HydrochlorothiazideLotensin HCT›
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Coca combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Coca affects

Every type of medication (drug category) Coca is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 4 drug categories Coca interacts with
Alcohol (ethanol)Nifedipine (procardia)Antidiabetes DrugsAntihypertensive Drugs
Alcohol (Ethanol)

Theoretically, concomitant use can increase the risk for neurologic adverse effects.
Concomitant use of alcohol and coca may have additive negative effects on neurocognitive functioning.

Likelihood Probable Evidence B
Nifedipine (Procardia)

Theoretically, concomitant use may increase the risk of serious adverse effects.
Coca contains cocaine. Nifedipine use just prior to cocaine use is thought to increase the likelihood of seizures and death.

Likelihood Probable Evidence D
Antidiabetes Drugs

Theoretically, coca might reduce the effects of antidiabetes drugs.
Some clinical research suggests that coca and the coca constituent cocaine have hyperglycemic effects. Theoretically, concomitant use of coca with antidiabetes drugs might interfere with glucose control and decrease the effectiveness of antidiabetes drugs.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, coca might reduce the effects of antihypertensive drugs.
Some clinical research suggests that coca and the coca constituent cocaine have hypertensive effects. Theoretically, concomitant use of coca with antihypertensive drugs might interfere with blood pressure control and decrease the effectiveness of antihypertensive drugs.

Likelihood Probable Evidence B
Monograph

Coca: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Coca is a South American plant best known as the natural source of cocaine. While the leaves have a long history of traditional use for altitude sickness, fatigue, and hunger, the whole plant contains cocaine and other alkaloids that make it legally controlled and potentially dangerous in most countries. Only decocainized (cocaine-free) coca extract is used in foods, and there is little reliable evidence to recommend coca as a supplement.

Coca
Scientific name
Erythroxylum coca
Family
Erythroxylaceae
Part used
Leaves (and decocainized extract)
Common forms
Tea (mate de coca), chewed leaves, decocainized extract used as a flavoring
People commonly use it for
  • Altitude sickness
  • Fatigue and low energy
  • Appetite and hunger suppression
  • Digestive upset
  • Flavoring agent in foods and drinks

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallBest avoided

Coca leaf naturally contains cocaine and is a controlled substance in most countries; only cocaine-free extract is legal as a flavoring.

PregnancyUnsafe

When inhaled or used orally. Coca, and the constituent cocaine, are contraindicated due to abortifacient and teratogenic effects. Coca use is also ass...

Read the full pregnancy detail
BreastfeedingUnsafe

When inhaled or used orally. Coca and the constituent, cocaine, are contraindicated. Cocaine is excreted into human milk and intoxication can occur in...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Coca (Erythroxylum coca) is a shrub native to the Andes mountains of South America, where it grows in countries such as Bolivia, Peru, and Colombia. People in these regions have chewed the leaves or brewed them into a tea (often called mate de coca) for hundreds of years.

The coca plant is most famous as the natural source of cocaine, a powerful and addictive stimulant drug. Because of this, the plant and its leaves are tightly controlled or illegal in most parts of the world.

A decocainized (cocaine-removed) coca extract is sometimes used as a flavoring agent in foods and beverages. This processed extract is different from the raw leaf and does not contain the active drug.

How it works

Coca leaves contain a group of compounds called alkaloids, the best known of which is cocaine. Cocaine is a stimulant that affects the brain and nervous system by changing levels of chemical messengers like dopamine and norepinephrine. This can increase alertness and reduce feelings of hunger and tiredness.

The leaves also contain other nutrients and plant chemicals, and some people believe these help the body adjust to high altitude. However, much of this is based on tradition and laboratory or limited human observations rather than rigorous studies.

The decocainized extract has the cocaine removed, so it does not produce the drug's stimulant or addictive effects. It is mainly valued for its flavor.

Effectiveness

Does Coca work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 4 uses evaluated
1 Leans ineffective 3 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.
Likely Ineffective Athletic performance
Rating & evidence shown verbatim from Natural Medicines

Chewing coca leaves does not seem to improve physical performance.

Also studied for 3 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Altitude sickness
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral coca leaf tea is beneficial for altitude sickness.

Insufficient Reliable Evidence To Rate Cocaine dependence
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral coca leaf is beneficial for improving outcomes in adults with cocaine dependence.

Insufficient Reliable Evidence To Rate Fatigue
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral coca for fatigue, there is insufficient reliable information available about the use of coca for this purpose.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Raw coca leaf naturally contains cocaine, which is addictive, controlled, and potentially dangerous. Using it can lead to legal problems and serious health risks, including effects on the heart and blood pressure. For these reasons, we recommend avoiding coca products that contain cocaine.

People with heart disease, high blood pressure, anxiety disorders, or a history of substance use are at especially high risk and should not use coca.

Pregnancy and breastfeeding: Coca that contains cocaine should be avoided. Cocaine can harm a developing baby and can pass into breast milk, posing real danger to an infant. Even cocaine-free products have not been proven safe in these situations, so it is best to avoid them.

Always talk with a pharmacist or doctor before using any coca-containing product.

Side effects

Because raw coca contains cocaine, possible effects include increased heart rate, high blood pressure, restlessness, anxiety, trouble sleeping, and loss of appetite. Regular use can lead to dependence and addiction.

More serious and rare risks linked to cocaine include chest pain, irregular heartbeat, heart attack, stroke, and seizures. These can be life-threatening.

The cocaine-free extract used in foods is generally considered low-risk as a flavoring, but it has not been studied as a supplement.

Coca: Reported Adverse Effects

Documented safety reports on Coca from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

There is limited reliable information available about the safety of coca leaves when used orally. The cocaine constituent of coca can cause serious adverse effects.

Most Common Adverse Effects:

Orally: Anorexia and oral mucosal lesions when the leaves are chewed.

Serious Adverse Effects (Rare):

Orally: Cocaine, a constituent of coca, can cause cardiovascular disease, stroke, seizures, and death.

Reports by condition
Acute respiratory distress syndrome (ARDS) Pulmonary/Respiratory

Orally, the cocaine constituent of coca can cause serious adverse effects. Respiratory adverse effects include exacerbation of asthma, thermal airway injury, adult respiratory distress syndrome (ARDS), pneumothorax, pneumomediastinum, pulmonary thrombosis, bronchiolitis obliterans, pulmonary edema, pulmonary infiltrates, pulmonary vascular disease, and pulmonary hemorrhage.

Intranasally, chronic cocaine abuse is associated with orbital wall (bone) destruction, acquired nasolacrimal duct obstruction, and orbital cellulitis.

  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  2. Alexandrakis G, Tse DT, Rosa RH Jr, Johnson TE. Nasolacrimal duct obstruction and orbital cellulitis associated with chronic intranasal cocaine abuse. Arch Ophthalmol 1999;117:1617-22.
Anemia Hematologic

Chewing coca leaves can cause anorexia, which often leads to malnutrition. Poor eating habits may contribute to anemia in people that chew coca leaves.

Orally, the cocaine constituent of coca can cause serious adverse effects. Hematologic effects include mesenteric ischemia, pulmonary thrombosis, stroke, and intracranial and intracerebral hemorrhage.

  1. Buck AA, Sasaki TT, Hewitt JJ, Macrae AA. Coca chewing and health. An epidemiologic study among residents of a Peruvian village. Am J Epidemiol 1968;88:159-77..
  2. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
Arrhythmia Cardiovascular

Orally, the cocaine constituent of coca can cause serious adverse effects. Cocaine use is associated with a high incidence of coronary artery disease or other myocardial disease. Up to 38% of cocaine users may have a defect in left ventricular filling. Other cardiovascular adverse effects include extreme elevations of heart rate and blood pressure, vasoconstriction, myocardial ischemia, myocardial infarction, arrhythmias, cardiomyopathies, myocarditis, endocarditis, aortic rupture, and diffuse micro-aneurysms. There is also some evidence that cocaine use can cause platelet activation, platelet microaggregate formation, and platelet alpha granule release, which might increase the risk of thrombosis and accelerate the development of atherosclerosis.

  1. Roldan CA, Aliabadi D, Crawford MH. Prevalence of heart disease in asymptomatic chronic cocaine users. Cardiology 2001;95:25-30..
  2. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  3. Heesch CM, Wilhelm CR, Ristich J, et al. Cocaine activates platelets and increases the formation of circulating platelet containing microaggregates in humans. Heart 2000;83:688-95.
Depression Psychiatric

Orally, the cocaine constituent of coca can cause serious adverse effects. Psychiatric adverse effects include paranoia, depression, and violence.

  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
Epilepsy Neurologic/CNS

Orally, the cocaine constituent of coca can cause serious adverse effects. Initially, the neurologic effects of coca can include euphoria, hyperactivity, and restlessness. Tremors, hyperreflexia, and seizures can develop later on. Finally, coma, hyporeflexia, and death may occur. Cocaine can also cause migraine headaches, stroke, and intracranial and intracerebral hemorrhage.

  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  2. McEvoy AW, Kitchen ND, Thomas DG. Intracerebral haemorrhage in young adults: the emerging importance of drug misuse. BMJ 2000;320:1322-4.
Hypoglycemia Endocrine

Orally, the cocaine constituent of coca can cause serious adverse effects. Metabolic effects include hypoglycemia, lactic acidosis, and hyperthermia.

  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
Muscle breakdown Musculoskeletal

Orally, the cocaine constituent of coca can cause serious adverse effects. Musculoskeletal effects include rhabdomyolysis.

  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
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.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no established safe or standard dose of coca as a dietary supplement, and the cocaine-containing leaf is illegal in most countries. We do not recommend a dose.

For products that use cocaine-free coca extract as a flavoring, follow the directions on the product label. If you are considering any coca product, check with a pharmacist or doctor first to make sure it is legal and appropriate for you.

Pregnancy & Breastfeeding

Coca & Pregnancy

Unsafe

When inhaled or used orally. Coca, and the constituent cocaine, are contraindicated due to abortifacient and teratogenic effects. Coca use is also associated with a high incidence of sudden infant death syndrome (SIDS).

  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  2. Potter SM, Zelazo PR, Stack DM, Papageorgiou AN. Adverse effects of fetal cocaine exposure on neonatal auditory information processing. Pediatrics 2000;105:E40..

Coca & Breastfeeding

Unsafe

When inhaled or used orally. Coca and the constituent, cocaine, are contraindicated. Cocaine is excreted into human milk and intoxication can occur in infants consuming human milk after recent exposure to cocaine.

  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
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

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 15 references that drive our Coca 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. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Alexandrakis G, Tse DT, Rosa RH Jr, Johnson TE. Nasolacrimal duct obstruction and orbital cellulitis associated with chronic intranasal cocaine abuse. Arch Ophthalmol 1999;117:1617-22. PubMed
  4. McEvoy AW, Kitchen ND, Thomas DG. Intracerebral haemorrhage in young adults: the emerging importance of drug misuse. BMJ 2000;320:1322-4.
  5. Potter SM, Zelazo PR, Stack DM, Papageorgiou AN. Adverse effects of fetal cocaine exposure on neonatal auditory information processing. Pediatrics 2000;105:E40.. PubMed
  6. Bolla KI, Funderburk FR, Cadet JL. Differential effects of cocaine and cocaine alcohol on neurocognitive performance. Neurology 2000;54:2285-92. PubMed
  7. Heesch CM, Wilhelm CR, Ristich J, et al. Cocaine activates platelets and increases the formation of circulating platelet containing microaggregates in humans. Heart 2000;83:688-95. PubMed
  8. Favier R, Caceres E, Guillon L, et al. Coca chewing for exercise: hormonal and metabolic responses of nonhabitual chewers. J Appl Physiol 1996;81:1901-7.. PubMed
  9. Favier R, Caceres E, Sempore B, et al. Fluid regulatory hormone response to exercise after coca-induced body fluid shifts. J Appl Physiol 1997;83:376-82.. PubMed
  10. Buck AA, Sasaki TT, Hewitt JJ, Macrae AA. Coca chewing and health. An epidemiologic study among residents of a Peruvian village. Am J Epidemiol 1968;88:159-77.. PubMed
  11. Roldan CA, Aliabadi D, Crawford MH. Prevalence of heart disease in asymptomatic chronic cocaine users. Cardiology 2001;95:25-30.. PubMed
  12. Galarza Guzman M, Penaloza Imana R, Echalar Afcha L, et al. Effects of coca chewing on glucose tolerance test. Medicina (B Aires) 1997;57(3):261-4.
  13. Spielvogel H, Rodriguez A, Sempore B, et al. Body fluid homeostasis and cardiovascular adjustments during submaximal exercise: influence of chewing coca leaves. Eur J Appl Physiol Occup Physiol 1997;75(5):400-6. PubMed
  14. Spielvogel, H., Caceres, E., Koubi, H., Sempore, B., Sauvain, M., and Favier, R. Effects of coca chewing on metabolic and hormonal changes during graded incremental exercise to maximum. J.Appl.Physiol 1996;80(2):643-649. PubMed
  15. Favier, R., Caceres, E., Koubi, H., Sempore, B., Sauvain, M., and Spielvogel, H. Effects of coca chewing on hormonal and metabolic responses during prolonged submaximal exercise. J.Appl.Physiol 1996;80(2):650-655. PubMed
Keep reading

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.

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

Pharmacist Counseling Corner

Coca: Common Questions

What is Coca used for, and does it work?
People use Coca for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Coca interact with prescription medications?
Yes. We list 259 medications with a known interaction with Coca, including 2 rated major. Use the checker above to see how Coca interacts with a specific drug.
How are Coca interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Coca with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Coca interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
Is Coca the same as Cocaine?
Coca is the plant, and Cocaine is one of the alkaloids found naturally in its leaves. The raw leaf contains Cocaine, while deCocainized extract used in foods has the Cocaine removed.
Is Coca legal to buy?
In most countries, raw Coca leaf is a controlled substance and illegal to possess or use. Only Cocaine-free Coca extract is generally allowed, mainly as a food flavoring.
Can I use Coca tea for altitude sickness?
Coca tea is a traditional remedy in the Andes, but it contains Cocaine and is illegal in most places. There are safer, well-studied options for altitude sickness, so talk to a doctor before traveling.
Is Coca safe during pregnancy or breastfeeding?
No. Coca that contains Cocaine can harm a developing baby and pass into breast milk, so it should be avoided. Even Cocaine-free products are not proven safe during these times.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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