Herb & supplement monograph

Coffee Drug Interactions, Uses, Effectiveness, Safety & More

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

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

But these pages have grown well beyond that into a full monograph — what Coffee 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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Coffee Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a serious Coffee drug interaction is low for most people, though coffee's caffeine can meaningfully change how certain medicines work. Only a small handful of the many listed interactions are rated major, and nearly all of them trace back to caffeine rather than to coffee itself.

Interactions deserving the most attention

The clearest danger is combining coffee with ephedrine or other stimulant drugs, since adding caffeine can push blood pressure and heart strain to risky levels. Human studies also show coffee sharply cuts absorption of the bone medicine alendronate and can lower levels of the seizure medicine lamotrigine, where steady levels matter. Coffee may also reduce levothyroxine absorption, and drugs such as cimetidine, fluvoxamine, and oral contraceptives can slow caffeine clearance, making its jittery effects stronger and longer lasting.

What the rest of the list means

Most of this long list reflects one ingredient: caffeine. Many entries are theoretical, based on how caffeine might affect enzymes the body uses to clear medicines, and some predicted problems, such as extra bleeding with blood thinners, have not actually shown up in people. For many medicines, the real-world result is a stronger or weaker caffeine effect rather than harm.

Check your medications against Coffee

Based on HelloPharmacist’s Coffee interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Coffee

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

8 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 Coffee.

2,830 drugs
Aminophylline, Amobarbital, EphedrineAmesec
Major Ephedrine

Theoretically, concomitant use might increase the risk of stimulant adverse effects.

Read the full Coffee + Aminophylline, Amobarbital, Ephedrine interaction
Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine TannateQuadratuss, Ry Tuss, Rynatuss, Tri Tannate Plus
Major Ephedrine

Theoretically, concomitant use might increase the risk of stimulant adverse effects.

Read the full Coffee + Carbetapentane Tannate, Chlorpheniramine Tannate, Ephedrine Tannate, Phenylephrine Tannate interaction
Dyphylline, Ephedrine, Guaifenesin, PhenobarbitalLufyllin-EPG
Major Ephedrine

Theoretically, concomitant use might increase the risk of stimulant adverse effects.

Read the full Coffee + Dyphylline, Ephedrine, Guaifenesin, Phenobarbital interaction
Ephedrine, Guaifenesin (otc Drug)Ephedrine Formula 400, Ephedrine Plus Tabs
Major Ephedrine

Theoretically, concomitant use might increase the risk of stimulant adverse effects.

Read the full Coffee + Ephedrine, Guaifenesin (otc Drug) interaction
Ephedrine, Guaifenesin, Phenobarbital, TheophyllineMudrane GG
Major Ephedrine

Theoretically, concomitant use might increase the risk of stimulant adverse effects.

Read the full Coffee + Ephedrine, Guaifenesin, Phenobarbital, Theophylline interaction
Ephedrine, Hydroxyzine, TheophyllineAmi Rax, Marax
Major Ephedrine

Theoretically, concomitant use might increase the risk of stimulant adverse effects.

Read the full Coffee + Ephedrine, Hydroxyzine, Theophylline interaction
Ephedrine, Phenobarbital, Potassium Iodide, TheophyllineMudrane, Quadrinal
Major Ephedrine

Theoretically, concomitant use might increase the risk of stimulant adverse effects.

Read the full Coffee + Ephedrine, Phenobarbital, Potassium Iodide, Theophylline interaction
Ephedrine, Phenobarbital, TheophyllineTedral
Major Ephedrine

Theoretically, concomitant use might increase the risk of stimulant adverse effects.

Read the full Coffee + Ephedrine, Phenobarbital, Theophylline interaction
AbciximabReoPro
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, coffee may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Coffee + Abciximab interaction
AbrocitinibCibinqo
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, coffee may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Coffee + Abrocitinib interaction Abrocitinib drug page: uses, dosage & side effects
AcenocoumarolSintrom
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, coffee may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Coffee + Acenocoumarol interaction
Acetaminophen, AspirinGemnisyn
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, coffee may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Coffee + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, coffee may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Coffee + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Brompheniramine, Phenylpropanolamine interaction
Acetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Butalbital, Caffeine interaction Acetaminophen, Butalbital, Caffeine drug page: uses, dosage & side effects
Acetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Butalbital, Caffeine, Codeine interaction
Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interaction
Acetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Caffeine, Codeine interaction
Acetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Caffeine, Codeine, Salicylamide interaction
Acetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Caffeine, Dihydrocodeine interaction
Acetaminophen, Caffeine, IsomethepteneMigralam
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Caffeine, Isometheptene interaction
Acetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Caffeine, Pyrilamine interaction
Acetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interaction
Acetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interaction
Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interaction
Acetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Chlorpheniramine, Phenylephrine interaction
Acetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interaction
Acetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interaction
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
Moderate Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.

Read the full Coffee + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interaction
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 Coffee 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 Coffee affects

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

All 33 drug categories Coffee interacts with
EphedrineAdenosine (adenocard)Alendronate (fosamax)Anticoagulant/antiplatelet DrugsBeta-adrenergic AgonistsCimetidine (tagamet)Clozapine (clozaril)Contraceptive DrugsDipyridamole (persantine)Disulfiram (antabuse)Diuretic DrugsEstrogensFluvoxamine (luvox)Lamotrigine (lamictal)Levothyroxine (synthroid, Others)LithiumMonoamine Oxidase Inhibitors (maois)NicotinePentobarbital (nembutal)PhenylpropanolaminePioglitazone (actos)Quinolone AntibioticsRiluzole (rilutek)Stimulant DrugsTheophyllineVerapamil (calan, Others)Alcohol (ethanol)Antidiabetes DrugsFluconazole (diflucan)Mexiletine (mexitil)PhenothiazinesTerbinafine (lamisil)Tricyclic Antidepressants (tcas)
Ephedrine

Theoretically, concomitant use might increase the risk of stimulant adverse effects.
Coffee 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. Tell patients to avoid taking caffeine with ephedrine and other stimulants.

Likelihood Probable Evidence D
Adenosine (Adenocard)

Theoretically, coffee might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Coffee contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine does not seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines such as caffeine, as well as methylxanthine-containing products, be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Possible Evidence B
Alendronate (Fosamax)

Coffee reduces alendronate bioavailability.
Separate coffee ingestion and alendronate administration by two hours. Coffee reduces alendronate bioavailability by 60%.

Likelihood Probable Evidence B
Anticoagulant/Antiplatelet Drugs

Theoretically, coffee may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Coffee contains caffeine. Caffeine is reported to have antiplatelet activity. Theoretically, the caffeine in coffee might increase the risk of bleeding when used concomitantly with these agents. However, this interaction has not been reported in humans. There is some evidence that caffeinated coffee might increase the fibrinolytic activity in blood.

Likelihood Unlikely Evidence D
Beta-Adrenergic Agonists

Theoretically, concomitant use of large amounts of coffee might increase cardiac inotropic effects of beta-agonists.
Coffee contains caffeine. Caffeine can increase cardiac inotropic effects of beta-agonists.

Likelihood Probable Evidence D
Cimetidine (Tagamet)

Theoretically, cimetidine might increase the effects and adverse effects of caffeine in coffee.
Coffee contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.

Likelihood Likely Evidence B
Clozapine (Clozaril)

Theoretically, coffee might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Coffee contains caffeine. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.

Likelihood Possible Evidence B
Contraceptive Drugs

Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in coffee.
Coffee contains caffeine. Oral contraceptive drugs can decrease caffeine clearance by 40% to 65%.

Likelihood Probable Evidence B
Dipyridamole (Persantine)

Theoretically, coffee might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Coffee contains caffeine. Caffeine is a methylxyanthine that may inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines such as caffeine, as well as methylxanthine-containing products such as coffee, be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Probable Evidence B
Disulfiram (Antabuse)

Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
Coffee contains caffeine. In human research, disulfiram decreases the clearance and increases the half-life of caffeine.

Likelihood Probable Evidence B
Diuretic Drugs

Theoretically, concomitant use might increase the risk of hypokalemia.
Coffee contains caffeine. Caffeine, especially in excessive amounts, can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.

Likelihood Possible Evidence D
Estrogens

Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Estrogen inhibits caffeine metabolism.

Likelihood Probable Evidence B
Fluvoxamine (Luvox)

Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Fluvoxamine reduces caffeine metabolism.

Likelihood Probable Evidence B
Lamotrigine (Lamictal)

Coffee consumption can decrease the levels and clinical effects of lamotrigine.
A pharmacokinetic study in patients taking lamotrigine shows that consumption of coffee, both caffeinated and decaffeinated, can decrease the area under the concentration-time curve (AUC) and the peak plasma level (Cmax) of lamotrigine. Each additional cup of coffee reduced the AUC and Cmax by 4% and 3%, respectively. It is unclear whether this interaction is due to induction of lamotrigine metabolism or inhibition of lamotrigine absorption.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Coffee can reduce the absorption of levothyroxine.
In some patients, coffee can reduce levothyroxine absorption, possibly through the formation of non-absorbable complexes. A pharmacokinetic study in these patients found that 25-30 mL of espresso coffee consumed with levothyroxine tablets delayed the time to peak plasma levels by 38-43 minutes, reduced the peak plasma level (Cmax) by 19% to 36%, and reduced the area under the curve (AUC) by 27% to 36%. Coffee consumed one hour after levothyroxine did not affect absorption. It is not known whether this interaction occurs with other types of coffee. Tell patients to avoid drinking coffee at the same time that they take their levothyroxine, and for up to an hour afterwards.

Likelihood Possible Evidence B
Lithium

Theoretically, abrupt coffee withdrawal might increase the levels and adverse effects of lithium.
Coffee contains caffeine. Abrupt caffeine withdrawal can increase serum lithium levels. Two cases of lithium tremor that worsened with abrupt coffee withdrawal have been reported. There is also one case of a 2.8-fold increase in blood lithium levels after a patient taking lithium reduced his coffee consumption from 13-20 cups daily to 10 cups daily.

Likelihood Probable Evidence D
Monoamine Oxidase Inhibitors (Maois)

Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Coffee contains caffeine. Caffeine has been shown to inhibit monoamine oxidase (MAO) A and B in laboratory studies. Concomitant intake of large amounts of caffeine with MAOIs might precipitate a hypertensive crisis. In a case report, a patient that consumed 10-12 cups of caffeinated coffee and took the MAOI tranylcypromine presented with severe hypertension. Hypertension was resolved after the patient switched to drinking decaffeinated coffee.

Likelihood Possible Evidence D
Nicotine

Theoretically, concomitant use might increase the risk of hypertension.
Coffee contains caffeine. Concomitant use of caffeine and nicotine has been shown to have additive cardiovascular effects, including increased heart rate and blood pressure. Blood pressure was increased by 10.8/12.4 mmHg when the agents were used concomitantly.

Likelihood Probable Evidence B
Pentobarbital (Nembutal)

Theoretically, coffee might reduce the effects of pentobarbital.
Coffee contains caffeine. Theoretically, caffeine might negate the hypnotic effects of pentobarbital.

Likelihood Possible Evidence B
Phenylpropanolamine

Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of caffeine.
Coffee contains caffeine. Concomitant use of phenylpropanolamine and caffeine might cause an additive increase in blood pressure. Phenylpropanolamine also seems to increase caffeine serum levels.

Likelihood Probable Evidence B
Pioglitazone (Actos)

Theoretically, coffee might increase the levels and clinical effects of pioglitazone.
Coffee contains caffeine. Animal research suggests that caffeine can modestly increase the maximum concentration, area under the curve, and half-life of pioglitazone, and also reduce its clearance. This increased the antidiabetic effects of pioglitazone. However, the exact mechanism of this interaction is unclear.

Likelihood Possible Evidence D
Quinolone Antibiotics

Theoretically, quinolone antibiotics might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Concomitant use of caffeine and quinolones can decrease caffeine clearance and increase effects and risk of adverse effects.

Likelihood Probable Evidence B
Riluzole (Rilutek)

Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Coffee contains caffeine. Caffeine and riluzole are both metabolized by cytochrome P450 1A2 (CYP1A2), and concomitant use might reduce metabolism of one or both agents.

Likelihood Possible Evidence D
Stimulant Drugs

Theoretically, concomitant use might increase stimulant adverse effects.
Coffee 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.

Likelihood Probable Evidence C
Theophylline

Theoretically, coffee might increase the levels and adverse effects of theophylline.
Coffee contains caffeine, which can increase theophylline levels.

Likelihood Probable Evidence B
Verapamil (Calan, Others)

Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Verapamil increases plasma caffeine concentrations by 25%.

Likelihood Possible Evidence D
Alcohol (Ethanol)

Theoretically, alcohol might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Concomitant use of alcohol and caffeine can increase caffeine serum concentrations and the risk of caffeine adverse effects. Alcohol reduces caffeine metabolism.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, concomitant use of coffee and antidiabetes drugs might interfere with blood glucose control.
Coffee contains caffeine. Reports claim that caffeine might increase or decrease blood sugar levels.

Likelihood Unlikely Evidence B
Fluconazole (Diflucan)

Theoretically, fluconazole might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Fluconazole decreases caffeine clearance by approximately 25%.

Likelihood Possible Evidence B
Mexiletine (Mexitil)

Theoretically, mexiletine might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Mexiletine can decrease caffeine elimination by 50%.

Likelihood Possible Evidence B
Phenothiazines

Theoretically, phenothiazines might increase the levels and adverse effects of caffeine. Also, coffee may bind to phenothiazines and reduce their absorption.
Coffee contains caffeine. Phenothiazines can reduce the metabolism of caffeine by inhibiting cytochrome P450 1A2 (CYP1A2). Additionally, the tannins in coffee may bind to phenothiazines in the gastrointestinal tract and reduce their absorption.

Likelihood Possible Evidence D
Terbinafine (Lamisil)

Theoretically, terbinafine might increase the levels and adverse effects of caffeine.
Coffee contains caffeine. Terbinafine decreases the clearance of intravenous caffeine by 19%.

Likelihood Possible Evidence B
Tricyclic Antidepressants (Tcas)

Theoretically, TCAs might bind with coffee constituents when taken at the same time.
In vitro research suggests that the tannins in coffee might cause precipitation of TCAs. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Monograph

Coffee: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Coffee is a widely consumed beverage made from roasted coffee beans, valued mainly for its caffeine, which boosts alertness and energy. For most healthy adults, moderate coffee intake is generally safe and may have some health benefits, but too much can cause jitteriness, poor sleep, and a faster heartbeat. People who are pregnant, breastfeeding, or sensitive to caffeine should limit their intake and check with a doctor or pharmacist.

Scientific name
Coffea arabica
Family
Rubiaceae
Part used
Roasted seeds (beans) of the coffee fruit
Common forms
Brewed coffee, instant coffee, espresso, capsules, green coffee bean extract, decaffeinated coffee
People commonly use it for
  • Alertness and reducing fatigue
  • Mental focus and concentration
  • Athletic performance
  • Headache relief
  • Weight management

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

Safety at a glance
OverallUse caution

Moderate intake is generally safe for healthy adults, but high amounts can cause side effects.

PregnancyPossibly Safe

When used orally in moderate amounts. Intake of caffeine from coffee and other sources should be monitored during pregnancy. Caffeine crosses the huma...

Read the full pregnancy detail
BreastfeedingPossibly Safe

When used orally. Drinking one or two caffeine-containing beverages daily during lactation is not associated with unacceptable levels of caffeine in h...

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.

Jump to a section

Overview

Coffee is one of the most popular drinks in the world. It is made by roasting and brewing the seeds, often called beans, of the coffee plant (Coffea). The two main types grown commercially are Coffea arabica and Coffea canephora (robusta). These plants grow in warm, tropical regions of Central and South America, Africa, and Asia.

People drink coffee mainly for its caffeine, a natural stimulant that helps them feel more awake and alert. Coffee is also used in capsules and extracts as a dietary supplement. Green coffee bean extract, made from unroasted beans, is sometimes sold for weight loss.

How it works

The main active compound in coffee is caffeine. Caffeine works by blocking a brain chemical called adenosine, which normally makes you feel sleepy. By blocking it, caffeine helps you feel more awake and alert.

Coffee also contains chlorogenic acids and other antioxidants. Laboratory and animal studies suggest these compounds may affect blood sugar and inflammation, but it is not clear how much these effects matter in people. Much of the proposed benefit beyond alertness is based on early or indirect research.

Effectiveness

Does Coffee work?

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

Evidence overview · 48 uses evaluated
1 Likely effective 5 Possibly effective 1 Leans ineffective 41 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 Effective Mental alertness
Rating & evidence shown verbatim from Natural Medicines

Consumption of caffeinated coffee attenuates changes in alertness and cognitive capacity that occur throughout the day. It also improves mental performance and alertness following sleep deprivation.

Possibly Effective Diabetes
Rating & evidence shown verbatim from Natural Medicines

Population research has found that consumption of caffeinated coffee is associated with a reduced risk of developing type 2 diabetes. Consumption of coffee also seems to be associated with a reduced risk of mortality in patients with type 2 diabetes.

Possibly Effective Heart failure
Rating & evidence shown verbatim from Natural Medicines

Consumption of caffeinated coffee seems to reduce the long-term risk of heart failure in those without cardiovascular disease (CVD) at baseline.

Possibly Effective Overall mortality
Rating & evidence shown verbatim from Natural Medicines

Consumption of coffee seems to reduce all-cause mortality. The effects of coffee on specific causes of mortality are variable.

Possibly Effective Parkinson disease
Rating & evidence shown verbatim from Natural Medicines

Consumption of coffee seems to reduce the risk of developing Parkinson disease. This effect seems to be dose related in males, but not in females.

Possibly Effective Postoperative ileus
Rating & evidence shown verbatim from Natural Medicines

Consumption of coffee seems to decrease the time to first stool and first flatus, and possibly time to discharge, after gynecological or colorectal surgeries.

Possibly Ineffective Esophageal cancer
Rating & evidence shown verbatim from Natural Medicines

Consumption of coffee does not seem to be associated with a reduced risk of esophageal cancer.

Also studied for 41 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Atherosclerosis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if consuming coffee is beneficial for atherosclerosis.

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

It is unclear if consuming coffee affects the risk of atrial fibrillation. The available research is conflicting.

Insufficient Reliable Evidence To Rate Attention deficit-hyperactivity disorder (ADHD)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in consuming coffee for ADHD, there is insufficient reliable information about the clinical effects of coffee for this purpose.

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

Population research suggests that coffee consumption does not reduce the risk of bladder cancer.

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

It is unclear if consuming coffee reduces the risk of brain cancer.

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

Population research suggests that coffee consumption does not reduce the risk of breast cancer.

Insufficient Reliable Evidence To Rate Cardiovascular disease (CVD)
Rating & evidence shown verbatim from Natural Medicines

Some population research has found that drinking coffee is associated with a reduced risk of heart failure, but not with a reduced risk of major adverse cardiac events, coronary heart disease, or CVD in general. In patients with a history of CVD, coffee consumption may reduce CVD-related mortality. However, at least some evidence suggests that there is a J-shaped association between coffee consumption and the risk of acute coronary syndromes.

Insufficient Reliable Evidence To Rate Chronic kidney disease (CKD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if consuming coffee is beneficial for the prevention or management of CKD.

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

It is unclear if consuming coffee is beneficial for cognitive function.

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

It is unclear if consuming coffee is beneficial for the prevention or treatment of colorectal cancer.

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

Although there has been interest in consuming coffee for constipation, there is insufficient reliable information about the clinical effects of coffee for this purpose.

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

It is unclear if consuming coffee is beneficial for preventing dementia.

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

It is unclear if consuming coffee is beneficial for reducing the risk of depression.

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

It is unclear if consuming coffee is beneficial for the prevention of endometrial cancer; the available research is conflicting.

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

It is unclear if consuming coffee is beneficial for fracture prevention.

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

Population research suggests that consuming coffee may reduce the risk of developing symptomatic gallstone disease.

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

It is unclear if consuming coffee reduces the risk of gastric cancer.

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

It is unclear if consuming coffee is beneficial for preventing gout.

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

Although caffeine is an established treatment for certain types of headache, there is insufficient reliable information about the clinical effects of coffee, specifically, for this purpose.

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

It is unclear if consuming coffee is beneficial for hearing loss.

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

It is unclear if consuming coffee is beneficial for hepatitis B.

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

It is unclear if consuming caffeinated coffee is beneficial for hyperlipidemia.

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

It is unclear if consuming caffeinated coffee is beneficial in older adults with postprandial hypotension.

Insufficient Reliable Evidence To Rate Irritable bowel syndrome (IBS)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if consuming coffee is beneficial for preventing IBS.

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

It is unclear if consuming coffee is beneficial for preventing progression to kidney failure or reducing the risk of chronic kidney disease (CKD)-related death.

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

It is unclear if consuming coffee reduces the risk of liver cancer.

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

It is unclear if consuming coffee reduces the risk of chronic liver disease.

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

It is unclear if consuming caffeinated coffee reduces the risk of lung cancer; the available research is conflicting.

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

It is unclear if consuming coffee reduces the risk of malignant melanoma.

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

It unclear if consuming decaffeinated coffee is beneficial in patients with metabolic syndrome.

Insufficient Reliable Evidence To Rate Nonalcoholic fatty liver disease (NAFLD)
Rating & evidence shown verbatim from Natural Medicines

Observational research suggests that consuming coffee may reduce the risk of NAFLD. Observational and clinical research on liver fibrosis is conflicting.

Insufficient Reliable Evidence To Rate Nonmelanoma skin cancer
Rating & evidence shown verbatim from Natural Medicines

It is unclear if consuming caffeinated coffee reduces the risk of nonmelanoma skin cancer.

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

It is unclear if consuming coffee is beneficial for weight loss in patients who are overweight or obese; the available research is conflicting.

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

It is unclear if consuming coffee is beneficial for osteoporosis prevention.

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

It is unclear if consuming coffee reduces the risk of pancreatitis.

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

It is unclear if consuming coffee reduces the risk of pharyngeal cancer.

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

It is unclear if consuming coffee is beneficial for reducing the risk of pneumonia.

Insufficient Reliable Evidence To Rate Pregnancy-induced hypertension
Rating & evidence shown verbatim from Natural Medicines

It is unclear if consuming coffee reduces the risk of pregnancy-induced hypertension.

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

Population research has found that coffee consumption is associated with a modestly reduced risk of prostate cancer.

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

It is unclear if coffee consumption, alone or in combination with tea, is beneficial for stroke, post-stroke dementia, all-cause mortality, or stroke-related mortality. The available research is conflicting. <b>Details</b>: Several meta-analyses of population research in patients with and without cardiovascular disease (CVD) have found no association between coffee consumption and risk of stroke. However, another meta-analysis of population research and an individual observational study have found that coffee consumption (e.g., 2-3 cups of coffee daily) is associated with an 8% to 12% reduced risk of stroke, especially ischemic stroke, when compared with no consumption. The validity of the findings from the meta-analysis is limited by the lack of a dose-response analysis. Additionally, this analysis found that consumption of 2-3 cups of coffee daily is associated with a 20% reduced risk of post-stroke dementia when compared with not drinking coffee.

Sources Ref 104597 Ref 104882 Ref 107204 Ref 107828
Insufficient Reliable Evidence To Rate Thyroid cancer
Rating & evidence shown verbatim from Natural Medicines

It is unclear if consuming coffee reduces the risk of thyroid cancer.

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

For most healthy adults, drinking moderate amounts of coffee is generally considered safe. However, some people are more sensitive to caffeine and may feel its effects strongly even with small amounts.

Be cautious if you have heart problems, high blood pressure, anxiety disorders, acid reflux, or trouble sleeping. Large amounts of caffeine can worsen these conditions. Older adults and people taking certain medications should also be careful.

During pregnancy, experts generally advise limiting caffeine, since high intake has been linked to risks for the baby; talk with your doctor about a safe amount. While breastfeeding, caffeine passes into breast milk and may make some babies fussy or unable to sleep, so keep your intake low. Children and teens should also limit caffeine. Always check with a pharmacist or doctor if you are unsure.

Side effects

Common side effects of too much coffee or caffeine include jitteriness, nervousness, a fast or pounding heartbeat, trouble sleeping, headache, upset stomach, and frequent urination. Coffee can also worsen heartburn in some people.

Very high doses of caffeine, especially from concentrated supplements or energy products, can cause more serious problems such as a very rapid or irregular heartbeat, vomiting, and in rare cases dangerous reactions. Suddenly stopping coffee after regular use may cause withdrawal symptoms like headache and tiredness.

Coffee: Reported Adverse Effects

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

Orally, caffeinated or decaffeinated coffee is well tolerated in moderate amounts.

Most Common Adverse Effects:

Orally: Drinking coffee containing caffeine can cause agitation, anxiety, chest pain, diuresis, gastric distress, headache, insomnia, nervousness, premature heart rate, ringing in the ears, and vomiting. These effects are more likely with increasing intake of caffeine and in certain populations (e.g., children, elderly). With chronic caffeine use, especially in large amounts, habituation, tolerance, and psychological dependence can occur.

Abrupt discontinuation of caffeine may result in physical withdrawal symptoms, including anxiety, decreased physical energy, depressed mood, difficulty concentrating, drowsiness, fatigue, headache, irritability, reduced alertness, and rhinorrhea.

Rectally: Coffee enemas have been linked to proctocolitis, severe electrolyte abnormalities, and septicemia leading to death.

Reports by condition
Allergic rhinitis (hay fever) Immunologic

Caffeine can cause anaphylaxis in sensitive individuals, although true IgE-mediated caffeine allergy seems to be relatively rare.

Rectally, coffee enemas have been linked to septicemia leading to death.

  1. Infante S, Baeza ML, Calvo M, et al. Anaphylaxis due to caffeine. Allergy 2003;58:681-2.
  2. Margolin KA, Green MR. Polymicrobial enteric septicemia from coffee enemas. West J Med 1984;140:460.
  3. Green S. A critique of the rationale for cancer treatment with coffee enemas and diet. JAMA 1992;268:3224-7.
  4. Shils ME, Herman MG. Unproved dietary claims in the treatment of patients with cancer. Bull N Y Acad Med 1982;58:323-39.
  5. Brown BT. Treating cancer with coffee enemas and diet. JAMA 1993;269:1635-6.
Anxiety Psychiatric

Orally, coffee containing caffeine can cause anxiety. This is more likely with increasing intake of caffeine and in certain populations (e.g., children, elderly). With chronic use, especially in large amounts, habituation, tolerance, and psychological dependence can occur. Other researchers suggest symptoms such as depressed mood are typical of caffeine withdrawal. However, withdrawal symptoms may be due to nonpharmacological factors related to knowledge and expectation of effects. Clinically significant symptoms caused by caffeine withdrawal may be uncommon.

  1. Anon. Filtering the news about coffee. University of California, Berkeley Wellness Letter 2001:17:1-2.
  2. Benowitz NL, Osterloh J, Goldschlager N, et al. Massive catecholamine release from caffeine poisoning. JAMA 1982;248:1097-8.
  3. Boozer CN, Nasser JA, Heymsfield SB, et al. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Relat Metab Disord 2001;25:316-24.
  4. 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.
  5. 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.
  6. Dews PB, O'Brien CP, Bergman J. Caffeine: behavioral effects of withdrawal and related issues. Food Chem Toxicol 2002;40:1257-61.
Arrhythmia Cardiovascular

Orally, coffee containing caffeine can cause chest pain and premature heartbeat. These effects are more likely with increasing intake of caffeine and in certain populations (e.g., children, elderly). Excessive doses of caffeine can cause massive catecholamine release and subsequent sinus tachycardia.

Although acute administration of caffeine can cause increased blood pressure, regular consumption does not seem to increase either blood pressure or pulse, even in hypertensive patients. Drinking one or more cups of caffeinated coffee daily also doesn't seem to increase the risk of developing hypertension in habitual coffee drinkers.

Epidemiological research has found that regular caffeine intake of up to 400 mg daily, or approximately 4 cups of caffeinated coffee, is not associated with an increased incidence of atrial fibrillation, atherosclerosis, cardiac ectopy, stroke, ventricular arrhythmia, or cardiovascular disease (CVD) in general. However, some observational research suggests that drinking at least 1 cup of coffee per week is associated with a 40% increased risk of atrial fibrillation, with the highest incidence of atrial fibrillation occurring in adults consuming at least 6 cups daily. Also, one large, observational study found a J-shaped association between regular coffee consumption and the risk of developing acute coronary syndromes. Moderate consumption of less than 300 mL daily (about 1.3 cups) was associated with a lower risk of developing acute coronary syndromes, whereas regular consumption of 300 mL daily or more was associated with an increased risk. In contrast, other observational research in people without a history of CVD has found that drinking more than 6 cups of coffee daily does not appear to be associated with an increased risk of developing coronary heart disease. Also, in people with a history of CVD, population research has found that coffee consumption is associated with a reduction in CVD-related mortality; however not all research agrees. However, in current smokers with a history of acute coronary syndrome, consuming more than 3 cups of coffee daily is associated with more than a two-fold increased risk of overall mortality. Also, population research in patients with severe hypertension, but not mild hypertension, suggests that drinking at least two cups of coffee daily is associated with a 2-fold increase in CVD mortality compared with non-coffee drinkers.

Caffeine intake may pose a greater cardiovascular risk to subjects who are not regular caffeine users. Population research suggests that drinking caffeinated coffee might trigger a myocardial infarction (MI) in some people. People who drink one or fewer cups of coffee daily and are sedentary and have multiple risk factors for heart disease have a significantly increased risk of MI within an hour after drinking coffee. However, this risk appears diminished in people who routinely consume greater amounts of coffee on a daily basis. In another population study, caffeinated coffee consumption was associated with an increased risk of ischemic stroke in subjects who didn't regularly drink coffee.

Boiled coffee that is prepared without a filter appears to increase serum cholesterol and triglyceride levels. Drinking one liter of strong, unfiltered coffee daily for two weeks can raise serum cholesterol by 10% and serum triglycerides by 36%. Tell patients to use coffee filters since these effects do not seem to occur with filtered coffee.

Coffee can adversely affect homocysteine levels. Higher homocysteine levels have been associated with CVD. One liter of unfiltered strong coffee daily for two weeks can increase plasma homocysteine levels by 10%. The same amount of filtered strong coffee appears to raise plasma homocysteine levels by 20%, although there have been no head-to-head comparisons of filtered versus unfiltered coffee.

  1. Anon. Filtering the news about coffee. University of California, Berkeley Wellness Letter 2001:17:1-2.
  2. Marcus GM, Rosenthal DG, Nah G, et al. Acute effects of coffee consumption on health among ambulatory adults. N Engl J Med. 2023;388(12):1092-1100.
  3. 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.
  4. Holmgren P, Norden-Pettersson L, Ahlner J. Caffeine fatalities--four case reports. Forensic Sci Int 2004;139:71-3.
  5. Benowitz NL, Osterloh J, Goldschlager N, et al. Massive catecholamine release from caffeine poisoning. JAMA 1982;248:1097-8.
  6. Leson CL, McGuigan MA, Bryson SM. Caffeine overdose in an adolescent male. J Toxicol Clin Toxicol 1988;26:407-15.
  7. 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.
  8. Hodgson JM, Puddey IB, Burke V, et al. Effects on blood pressure of drinking green and black tea. J Hypertens 1999;17:457-63.
  9. Nurminen ML, Niittynen L, Korpela R, Vapaatalo H. Coffee, caffeine and blood pressure: a critical review. Eur J Clin Nutr 1999;53:831-9.
  10. Winkelmayer WC, Stampfer MJ, Willett WC, Curhan GC. Habitual caffeine intake and the risk of hypertension in women. JAMA 2005;294:2330-5.
  11. Mesas AE, Leon-Muñoz LM, Rodriguez-Artalejo F, Lopez-Garcia E. The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: a systematic review and meta-analysis. Am J Clin Nutr. 2011;94(4):1113-26.
  12. Klag MJ, Wang NY, Meoni LA, et al. Coffee intake and risk of hypertension: The John Hopkins precursors study. Arch Intern Med 2002;162:657-62.
  13. Han M, Oh Y, Myung SK. Coffee intake and risk of hypertension: A meta-analysis of cohort studies. J Korean Med Sci 2022;37(45):e332.
  14. Conen, D., Chiuve, S. E., Everett, B. M., Zhang, S. M., Buring, J. E., and Albert, C. M. Caffeine consumption and incident atrial fibrillation in women. Am J Clin Nutr 2010;92(3):509-514.
  15. Gronroos, N. N. and Alonso, A. Diet and risk of atrial fibrillation - epidemiologic and clinical evidence -. Circ.J 2010;74(10):2029-2038.
  16. Caldeira D, Martins C, Alves LB, Pereira H, Ferreira JJ, Costa J. Caffeine does not increase the risk of atrial fibrillation: a systematic review and meta-analysis of observational studies. Heart. 2013;99(19):1383-9. doi: 10.1136/heartjnl-2013-303950. Re
  17. Cheng M, Hu Z, Lu X, Huang J, Gu D. Caffeine intake and atrial fibrillation incidence: dose response meta-analysis of prospective cohort studies. Can J Cardiol. 2014 Apr;30(4):448-54. doi: 10.1016/j.cjca.2013.12.026. Epub 2014 2. Review.
  18. Lagier D, Nee L, Guieu R, et al. Peri-operative oral caffeine does not prevent postoperative atrial fibrillation after heart valve surgery with cardiopulmonary bypass: a randomized controlled clinical trial. Eur J Anaesthesiol. 2018 Apr 26. [Epub ahead of
  19. Voskoboinik A, Kalman JM, Kistler PM. Caffeine and arrhythmias: time to grind the data. JACC: Clin Electrophysiol. 2018;4(4):425-32.
  20. Kim EJ, Hoffmann TJ, Nah G, Vittinghoff E, Delling F, Marcus GM. Coffee consumption and incident tachyarrhythmias: Reported behavior, mendelian randomization, and their interactions. JAMA Intern Med. 2021.
  21. Reis, J. P., Loria, C. M., Steffen, L. M., Zhou, X., van, Horn L., Siscovick, D. S., Jacobs, D. R., Jr., and Carr, J. J. Coffee, decaffeinated coffee, caffeine, and tea consumption in young adulthood and atherosclerosis later in life: the CARDIA study. A
  22. Dixit S, Stein PK, Dewland TA, Dukes JW, Vittinghoff E, Heckbert SR, Marcus GM. Consumption of Caffeinated Products and Cardiac Ectopy. J Am Heart Assoc. 2016 26;5(1). pii: e002503. doi: 10.1161/JAHA.115.002503.
  23. Lopez-Garcia, E., Rodriguez-Artalejo, F., Rexrode, K. M., Logroscino, G., Hu, F. B., and van Dam, R. M. Coffee consumption and risk of stroke in women. Circulation 3-3-2009;119(8):1116-1123.
  24. Zuchinali P, Riberio PA, Pimentel M, da Rosa PR, Zimerman LI, Rohde LE. Effect of caffeine on ventricular arrhythmia: a systematic review and meta-analysis of experimental and clinical studies. Europace 2016 Feb;18(2):257-66.
  25. Zhang, W., Lopez-Garcia, E., Li, T. Y., Hu, F. B., and van Dam, R. M. Coffee consumption and risk of cardiovascular diseases and all-cause mortality among men with type 2 diabetes. Diabetes Care 2009;32(6):1043-1045.
  26. Wikoff D, Welsh BT, Henderson R, et al. Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children. Food Chem Toxicol 2017;109:585-648.
  27. Ribeiro EM, Alves M, Costa J, Ferreira JJ, Pinto FJ, Caldeira D. Safety of coffee consumption after myocardial infarction: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2020;30(12):2146-2158.
  28. Sehrawat O, Mehra NS, Kowlgi NG, et al. Association between coffee consumption and incident atrial fibrillation (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol 2023;186:5-10.
  29. Panagiotakos DB, Pitsavos C, Chrysohoou C, et al. The J-shaped effect of coffee consumption on the risk of developing acute coronary syndromes: the CARDIO2000 case-control study. J Nutr 2003;133:3228-32.
  30. Lopez-Garcia E, van Dam RM, Willett WC, et al. Coffee consumption and coronary heart disease in men and women: a prospective cohort study. Circulation 2006;113:2045-53.
  31. Crippa A, Discacciati A, Larsson SC, Wolk A, Orsini N. Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis. Am J Epidemiol. 2014 Oct 15;180(8):763-75. doi: 10.1093/aje/kwu194.
  32. Loftfield E, Cornelis MC, Caporaso N, Yu K, Sinha R, Freedman N. Association of coffee drinking With mortality by genetic variation in caffeine metabolism: findings from the UK biobank. JAMA Intern Med. 2018 Aug 1;178(8):1086-1097. doi: 10.1001/jamaintern
  33. Tverdal A, Selmer R, Cohen JM, Thelle DS. Coffee consumption and mortality from cardiovascular diseases and total mortality: Does the brewing method matter? Eur J Prev Cardiol. 2020:2047487320914443.
  34. Yamakawa M, Wada K, Goto Y, et al. Associations between coffee consumption and all-cause and cause-specific mortality in a Japanese city: the Takayama study. Public Health Nutr. 2019;22(14):2561-2568.
  35. Ruggiero E, Di Castelnuovo A, Costanzo S, et al. Daily coffee drinking is associated with lower risks of cardiovascular and total mortality in a general Italian population: Results from the Moli-sani study. J Nutr. 2020:nxaa365.
  36. Kim Y, Je Y, Giovannucci E. Coffee consumption and all-cause and cause-specific mortality: a meta-analysis by potential modifiers. Eur J Epidemiol. 2019 Aug;34(8):731-752. doi: 10.1007/s10654-019-00524-3. Epub 2019 May 4.
  37. Grosso G, Micek A, Godos J, ET AL. Coffee consumption and risk of all-cause, cardiovascular, and cancer mortality in smokers and non-smokers: a dose-response meta-analysis. Eur J Epidemiol. 2016;31(12):1191-1205.
  38. Loftfield E, Freedman ND, Graubard BI, et al. Association of coffee consumption with overall and cause-specific mortality in a large US prospective cohort study. Am J Epidemiol. 2015;182(12):1010-22.
  39. Miranda AM, Goulart AC, Benseñor IM, Lotufo PA, Marchioni DM. Moderate coffee consumption is associated with lower risk of mortality in prior Acute Coronary Syndrome patients: a prospective analysis in the ERICO cohort. Int J Food Sci Nutr. 2020:1-11.
  40. Nordestgaard AT, Nordestgaard BG. Coffee intake, cardiovascular disease and all-cause mortality: observational and Mendelian randomization analyses in 95?000-223?000 individuals. Int J Epidemiol. 2016;45(6):1938-1952.
  41. Abtan J, Ducrocq G, Elbez Y, et al. Association between coffee or tea consumption and cardiovascular outcomes in patients with stable coronary artery disease: Analysis from the CLARIFY registry. Arch Cardiovasc Dis 2023;116(8-9):382-389.
  42. Teramoto M, Yamagishi K, Muraki I, Tamakoshi A, Iso H. Coffee and green tea consumption and cardiovascular disease mortality among people with and without hypertension. J Am Heart Assoc 2023;12(2):e026477.
  43. Baylin A, Hernandez-Diaz S, Kabagambe EK, et al. Transient exposure to coffee as a trigger of a first nonfatal myocardial infarction. Epidemiology 2006;17:506-11.
  44. Mostofsky, E., Schlaug, G., Mukamal, K. J., Rosamond, W. D., and Mittleman, M. A. Coffee and acute ischemic stroke onset: the Stroke Onset Study. Neurology 11-2-2010;75(18):1583-1588.
  45. Grubben MJ, Boers GH, Blom HJ, et al. Unfiltered coffee increases plasma homocysteine concentrations in healthy volunteers: a randomized trial. Am J Clin Nutr 2000;71:480-4.
  46. Bak AA, Grobbee DE. The effect of serum cholesterol levels of coffee brewed by filtering or boiling. N Engl J Med 1989;321:1432-7.
  47. Jee SH, He J, Appel LJ, et al. Coffee consumption and serum lipids: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol 2001:153:353-62.
  48. Urgert R, Meyboom S, Kuilman M, et al. Comparison of effect of cafetiere and filtered coffee on serum concentrations of liver aminotransferases and lipids: six month randomised controlled trial. BMJ 1996;313:1362-6..
  49. Urgert R, Vliet TV, Zock PL, et al. Heavy coffee consumption and plasma homocysteine: a randomized controlled trial in healthy volunteers. Am J Clin Nutr 2000;72:1107-10.
Bladder cancer Oncologic

The association between consumption of coffee and pancreatic cancer is controversial. Coffee may increase the incidence of some types of pancreatic cancers, but it may decrease other types. Some studies do not support this association, especially in patients that have never smoked. Patients who are at risk of pancreatic cancer (pancreatitis) should limit their consumption of coffee.

People who consume 2-4 or more cups of caffeinated coffee dail might have a significantly increased risk of developing lung cancer. But drinking decaffeinated coffee seems to be associated with a decreased risk of lung cancer.

Coffee consumption has also been associated at various times with an increased risk of breast cancer, bladder cancer, colon cancer, and other types of cancers, but there's no good evidence that coffee consumption increases cancer risk. Most human studies that have examined caffeine or coffee intake have found that they do not play a role in the development of various cancers, including breast or most gastric cancers. However, drinking caffeinated coffee might increase the risk of gastric cardia cancer.

  1. Jacobsen BK, Heuch I. Coffee, K-ras mutations and pancreatic cancer: a heterogeneous aetiology or an artefact? J Epidemiol Community Health 2000;54:654-5.
  2. Porta M, Malats N, Alguacil J, et al. Coffee, pancreatic cancer, and K-ras mutations: updating the research agenda. J Epidemiol Community Health 2000;54:656-9.
  3. Kuper HE, Mucci LA, Trichopoulos D. Coffee, pancreatic cancer, and the question of causation. J Epidemiol Community Health 2000;54:650-1.
  4. Michaud DS, Giovannucci E, Willett WC, et al. Coffee and alcohol consumption and risk of pancreatic cancer in two prospective United States cohorts. Cancer Epidemiol Biomarkers Prev 2001;10:429-37.
  5. Tavani A, La Vecchia C. Coffee and cancer: a review of epidemiological studies, 1990-1999. Eur J Cancer Prev 2000;9:241-56.
  6. Turati F, Galeone C, Talamini R, et al. Coffee, decaffeinated coffee, tea, and pancreatic cancer risk: a pooled-analysis of two Italian case-control studies. Eur J Cancer Prev 2011;20(4):287-92.
  7. Zhou CD, Kuan AS, Reeves GK, et al. Coffee and pancreatic cancer risk among never-smokers in the UK prospective Million Women Study. Int J Cancer. 2019;145(6):1484-1492.
  8. Baker JA, McCann SE, Reid ME, et al. Associations between black tea and coffee consumption and risk of lung cancer among current and former smokers. Nutr Cancer 2005;52:15-21.
  9. Wang Y, Yu X, Wu Y, Zhang D. Coffee and tea consumption and risk of lung cancer: a dose-response analysis of observational studies. Lung Cancer. 2012;78(2):169-70.
  10. Tavani A, Pregnolato A, La Vecchia C, et al. Coffee consumption and the risk of breast cancer. Eur J Cancer Prev 1998;7:77-82.
  11. Hartman TJ, Tangrea JA, Pietinen P, et al. Tea and coffee consumption and risk of colon and rectal cancer in middle-aged Finnish men. Nutr Cancer 1998;31:41-8.
  12. Jiang W, Wu Y, Jiang X. Coffee and caffeine intake and breast cancer risk: an updated dose-response meta-analysis of 37 published studies. Gynecol Oncol. 2013 Jun;129(3):620-9. doi: 10.1016/j.ygyno.2013.03.014. Epub 2013 25. Review.
  13. Sanikini H, Dik VK, Siersema PD, Bhoo-Pathy N, Uiterwaal CS, Peeters PH, González CA, Zamora-Ros R, Overvad K, Tjønneland A, Roswall N, Boutron-Ruault MC, Fagherazzi G, Racine A, Kühn T, Katzke V, Boeing H, Trichopoulou A, Trichopoulos D, Lagiou P, Palli
  14. Wikoff D, Welsh BT, Henderson R, et al. Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children. Food Chem Toxicol 2017;109:585-648.
Bone loss Musculoskeletal

Orally, there is preliminary evidence that use of greater than four cups of coffee daily can increase the risk of rheumatoid factor positive rheumatoid arthritis, but this association has not been confirmed.

Epidemiological evidence regarding the relationship between caffeine use and the risk for osteoporosis is contradictory. Caffeine can increase urinary excretion of calcium. Females identified with a genetic variant of the vitamin D receptor appear to be at an increased risk for the detrimental effect of caffeine on bone mass. However, moderate caffeine intake of less than 400 mg daily does not seem to significantly increase osteoporosis risk in most postmenopausal adults with normal calcium intake.

Caffeine withdrawal symptoms, such as muscle tension and muscle pains, have been described. However, these symptoms may be due to nonpharmacological factors related to knowledge and expectation of effects. Clinically significant symptoms caused by caffeine withdrawal may be uncommon.

  1. Heliovaara M, Aho K, Knekt P, et al. Coffee consumption, rheumatoid factor, and the risk of rheumatoid arthritis. Ann Rheum Dis 2000;59:631-5.
  2. 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.
  3. Massey LK. Is caffeine a risk factor for bone loss in the elderly? Am J Clin Nutr 2001;74:569-70.
  4. Massey LK, Whiting SJ. Caffeine, urinary calcium, calcium metabolism and bone. J Nutr 1993;123:1611-4.
  5. Lloyd T, Johnson-Rollings N, Eggli DF, et al. Bone status among postmenopausal women with different habitual caffeine intakes: a longitudinal investigation. J Am Coll Nutr 2000;19:256-61.
  6. Wikoff D, Welsh BT, Henderson R, et al. Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children. Food Chem Toxicol 2017;109:585-648.
  7. 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.
  8. Dews PB, O'Brien CP, Bergman J. Caffeine: behavioral effects of withdrawal and related issues. Food Chem Toxicol 2002;40:1257-61.
Breast cancer Endocrine

Orally, excessive doses of caffeine can cause massive catecholamine release and subsequent metabolic acidosis, hyperglycemia, and ketosis. Other symptoms include hypokalemia and respiratory alkalosis.

Some evidence shows that caffeine, a constituent of coffee, is associated with fibrocystic breast disease, breast cancer, and endometriosis in females; however, this is controversial since findings are conflicting. Restricting caffeine intake in patients with fibrocystic breast conditions doesn't seem to affect breast nodularity, swelling, or pain. Population research suggests that exposure to caffeine is not associated with an increased risk of endometriosis.

A population analysis of the Women's Health Initiative observational study has found no association between consumption of caffeine-containing beverages, such as coffee, and the incidence of invasive breast cancer in models adjusted for demographic, lifestyle, and reproductive factors. Also, a dose-response analysis of 2 low-quality observational studies has found that high consumption of caffeine is not associated with an increased risk of breast cancer.

  1. Benowitz NL, Osterloh J, Goldschlager N, et al. Massive catecholamine release from caffeine poisoning. JAMA 1982;248:1097-8.
  2. 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.
  3. Holmgren P, Norden-Pettersson L, Ahlner J. Caffeine fatalities--four case reports. Forensic Sci Int 2004;139:71-3.
  4. Leson CL, McGuigan MA, Bryson SM. Caffeine overdose in an adolescent male. J Toxicol Clin Toxicol 1988;26:407-15.
  5. Ferrini RL, Barrett-Connor E. Caffeine intake and endogenous sex steroid levels in postmenopausal women. The Rancho Bernardo Study. Am J Epidemiol 1996:144:642-4.
  6. Horner NK, Lampe JW. Potential mechanisms of diet therapy for fibrocystic breast conditions show inadequate evidence of effectiveness. J Am Diet Assoc 2000;100:1368-80.
  7. Chiaffarino F, Bravi F, Cipriani S, Parazzini F, Ricci E, Viganò P, La Vecchia C. Coffee and caffeine intake and risk of endometriosis: a meta-analysis. Eur J Nutr. 2014 Oct;53(7):1573-9. doi: 10.1007/s00394-014-0662-7. Epub 2014 31.
  8. Zheng KH, Zhu K, Wactawski-Wende J, et al. Caffeine intake from coffee and tea and invasive breast cancer incidence among postmenopausal women in the Women's Health Initiative. Int J Cancer 2021;149(12):2032-2044.
  9. Wang S, Li X, Yang Y, et al. Does coffee, tea and caffeine consumption reduce the risk of incident breast cancer? A systematic review and network meta-analysis. Public Health Nutr 2021;24(18):6377-6389.
Cluster headache Neurologic/CNS

Orally, coffee containing caffeine can cause agitation, headache, insomnia, and nervousness, . These effects are more likely with increasing intake of caffeine and in certain populations (e.g., children, elderly).

Combining ephedra with coffee can increase the risk of adverse effects, due to the caffeine contained in coffee. Jitteriness, seizures, and temporary loss of consciousness have been associated with the combined use of ephedra and caffeine.

Some researchers suggest that symptoms such as headache; tiredness and fatigue; decreased energy, alertness, and attentiveness; drowsiness; decreased contentedness; difficulty concentrating; irritability; and lack of clear-headedness are typical of caffeine withdrawal. Withdrawal symptoms such as delirium, nervousness, and restlessness have also been described. However, these symptoms may be due to nonpharmacological factors related to knowledge and expectation of effects. Clinically significant symptoms caused by caffeine withdrawal may be uncommon.

  1. Anon. Filtering the news about coffee. University of California, Berkeley Wellness Letter 2001:17:1-2.
  2. 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.
  3. Holmgren P, Norden-Pettersson L, Ahlner J. Caffeine fatalities--four case reports. Forensic Sci Int 2004;139:71-3.
  4. Benowitz NL, Osterloh J, Goldschlager N, et al. Massive catecholamine release from caffeine poisoning. JAMA 1982;248:1097-8.
  5. Leson CL, McGuigan MA, Bryson SM. Caffeine overdose in an adolescent male. J Toxicol Clin Toxicol 1988;26:407-15.
  6. FDA. Proposed rule: dietary supplements containing ephedrine alkaloids. Available at: www.verity.fda.gov (Accessed 25 January 2000).
  7. 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.
  8. 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.
  9. Dews PB, O'Brien CP, Bergman J. Caffeine: behavioral effects of withdrawal and related issues. Food Chem Toxicol 2002;40:1257-61.
Helicobacter pylori Gastrointestinal

Orally, coffee containing caffeine can cause gastric distress and vomiting. These effects are more likely with increasing intake of caffeine and in certain populations (e.g., children, elderly). There is also some evidence that consumption of three or more cups of caffeinated coffee might increase the risk of Helicobacter pylori infection.

Caffeine withdrawal symptoms such as nausea and vomiting have been described. However, these symptoms may be due to nonpharmacological factors related to knowledge and expectation of effects. Clinically significant symptoms caused by caffeine withdrawal may be uncommon.

Rectally, at least 5 cases of proctocolitis related to the use of coffee enemas have been reported.

  1. Anon. Filtering the news about coffee. University of California, Berkeley Wellness Letter 2001:17:1-2.
  2. Benowitz NL, Osterloh J, Goldschlager N, et al. Massive catecholamine release from caffeine poisoning. JAMA 1982;248:1097-8.
  3. Brenner H, Rothenbacher D, Bode G, Adler G. Relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection: cross sectional study. BMJ 1997;315:1489-92.
  4. 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.
  5. Dews PB, O'Brien CP, Bergman J. Caffeine: behavioral effects of withdrawal and related issues. Food Chem Toxicol 2002;40:1257-61.
  6. Acosta RD, Cash BD. Clinical effects of colonic cleansing for general health promotion: a systematic review. Am J Gastroenterol. 2009;104(11):2830-6.
  7. Lee AH, Kabashneh S, Tsouvalas CP, et al. Proctocolitis from coffee enema. ACG Case Rep J. 2020;7(1):e00292.
Interstitial cystitis Genitourinary

The caffeine found in coffee is a known diuretic and may increase voiding, give a sense of urgency, and irritate the bladder. In males with lower urinary tract symptoms, caffeine intake increased the risk of interstitial cystitis/painful bladder syndrome. Excessive caffeine consumption may worsen premenstrual syndrome. Consumption of up to 10 cups of caffeinated drinks daily has been associated with increased severity of premenstrual syndrome.

  1. Hashim, H. and Al, Mousa R. Management of fluid intake in patients with overactive bladder. Curr.Urol.Rep. 2009;10(6):428-433.
  2. Mevcha, A., Gulur, D. M., and Gillatt, D. Diagnosing urological disorders in ageing men. Practitioner 2010;254(1726):25-9, 2.
  3. Stojanovic E, Scanlan AT, Milanovic Z, Fox JL, Stankovic R, Dalbo VJ. Acute caffeine supplementation improves jumping, sprinting, and change-of-direction performance in basketball players when ingested in the morning but not evening. Eur J Sport Sci. 2021
  4. Li, G. Z., Zhang, N., Du, P., Yang, Y., Wu, S. L., Xiao, Y. X., Jin, R., Liu, L., Shen, H., and Dai, Y. Risk factors for interstitial cystitis/painful bladder syndrome in patients with lower urinary tract symptoms: a Chinese multi-center study. Chin Med
  5. Rossignol, A. M. and Bonnlander, H. Caffeine-containing beverages, total fluid consumption, and premenstrual syndrome. Am.J.Public Health 1990;80(9):1106-1110.
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 single official dose for coffee as a supplement. Many health authorities suggest that up to about 400 milligrams of caffeine per day is moderate for most healthy adults, which is roughly a few cups of brewed coffee, but individual tolerance varies a lot.

If you use coffee capsules or extracts, follow the directions on the product label, since caffeine content can differ widely between products. Pregnant people should aim for less, and anyone with health conditions should ask a pharmacist or doctor what amount is right for them.

Pregnancy & Breastfeeding

Coffee & Pregnancy

Possibly Safe

When used orally in moderate amounts. Intake of caffeine from coffee and other sources should be monitored during pregnancy. Caffeine crosses the human placenta, but is not considered a teratogen. Fetal blood and tissue levels are similar to maternal concentrations. The use of caffeine during pregnancy is controversial; however, moderate consumption has not been associated with clinically important adverse fetal effects. 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. In some studies, consuming amounts over 200 mg daily has been associated with a significantly increased risk of miscarriage. This increased risk may be most likely to occur in people 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, most healthy pregnant patients can safely consume caffeine in doses up to 300 mg daily without an increased risk of spontaneous abortion, stillbirth, preterm birth, fetal growth retardation, or congenital malformations. Advise patients to keep caffeine consumption below 300 mg daily during pregnancy. This is similar to the amount of caffeine in about 3 cups of coffee. Keep in mind that only the amount of ADDED caffeine must be stated on product labels. The amount of caffeine found in ingredients such as coffee, which naturally contains caffeine, does not need to be provided. This can make it difficult to determine the total amount of caffeine in a given product.

  1. Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
  2. 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.
  3. 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.
  4. Eskenazi B. Caffeine—filtering the facts. N Engl J Med 1999;341:1688-9.
  5. 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.
  6. Bracken MB, Triche EW, Belanger K, et al. Association of maternal caffeine consumption with decrements in fetal growth. Am J Epidemiol 2003;157:456-66..
  7. Nawrot P, Jordan S, Eastwood J, et al. Effects of caffeine on human health. Food Addit Contam 2003;20:1-30.
  8. Weng X, Odouli R, Li DK. Maternal caffeine consumption during pregnancy and the risk of miscarriage: a prospective cohort study. Am J Obstet Gynecol 2008;198:279.e1-8.
  9. Savitz DA, Chan RL, Herring AH, et al. Caffeine and miscarriage risk. Epidemiology 2008;19:55-62.
  10. Gleason JL, Sundaram R, Mitro SD, et al. Association of maternal caffeine consumption during pregnancy with child growth. JAMA Netw Open. 2022;5(10):e2239609.
  11. Wikoff D, Welsh BT, Henderson R, et al. Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children. Food Chem Toxicol 2017;109:585-648.
Possibly Unsafe

When caffeinated coffee providing more than 300 mg of caffeine daily is consumed orally. Caffeine from coffee crosses the placenta, producing fetal blood concentrations similar to maternal levels. Consumption of caffeine in amounts over 300 mg daily is associated with a significantly increased risk of miscarriage in some studies. Advise patients to keep caffeine consumption from all sources below 300 mg daily during pregnancy. This is similar to the amount of caffeine in about 3 cups of coffee. High 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. Drinking more than 6 cups of coffee daily increases the risk of spontaneous abortion. Drinking 8 or more cups of coffee daily doubles the risk of stillbirth when compared with those who do not drink coffee during pregnancy.

  1. Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
  2. Weng X, Odouli R, Li DK. Maternal caffeine consumption during pregnancy and the risk of miscarriage: a prospective cohort study. Am J Obstet Gynecol 2008;198:279.e1-8.
  3. Wikoff D, Welsh BT, Henderson R, et al. Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children. Food Chem Toxicol 2017;109:585-648.
  4. McGowan JD, Altman RE, Kanto WP Jr. Neonatal withdrawal symptoms after chronic maternal ingestion of caffeine. South Med J 1988;81:1092-4..
  5. 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.
  6. 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.
  7. Wisborg K, Kesmodel U, Bech BH, et al. Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: prospective study. BMJ 2003;326:420..

Coffee & Breastfeeding

Possibly Safe

When used orally. Drinking one or two caffeine-containing beverages daily during lactation is not associated with unacceptable levels of caffeine in human milk.

  1. Food and Nutrition Board, Institute of Medicine. Nutrition during lactation. Washington, DC: National Academy Press, 1991. Available at: http://books.nap.edu/books/0309043913/html.
Possibly Unsafe

When used orally in large amounts. Caffeine from coffee can cause wakefulness or irritability in breast-fed infants. Caffeine can also cause feeding intolerance and gastrointestinal irritation in infants.

  1. American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001;108:776-89.
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 175 references that drive our Coffee 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. Lasswell WL Jr, Weber SS, Wilkins JM. In vitro interaction of neuroleptics and tricylic antidepressants with coffee, tea, and gallotannic acid. J Pharm Sci 1984;73:1056-8. PubMed
  8. Kulhanek F, Linde OK, Meisenberg G. Precipitation of antipsychotic drugs in interaction with coffee or tea. Lancet 1979;2:1130.
  9. Joeres R, Klinker H, Heusler H, et al. Influence of mexiletine on caffeine elimination. Pharmacol Ther 1987;33:163-9. PubMed
  10. 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.
  11. Grubben MJ, Boers GH, Blom HJ, et al. Unfiltered coffee increases plasma homocysteine concentrations in healthy volunteers: a randomized trial. Am J Clin Nutr 2000;71:480-4. PubMed
  12. 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
  13. 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
  14. 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
  15. 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.
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

Brand directory

Brands that make products with Coffee

740 brands in our database make a supplement containing Coffee.

Product directory

Supplement products with Coffee

2,556 products in our database contain Coffee. Open any to see its full ingredient list and every drug interaction we check.

AminoLean Max Maui Pineapple by RSP Powder 10.21 Ounce(s) · 290 Gram(s) View ingredients & interactions AminoLean Max Passion Fruit Punch by RSP Powder 8.92 Ounce(s) · 253 Gram(s) View ingredients & interactions AminoLean Max Sweet Peach by RSP Powder 8.8 Ounce(s) · 250 Gram(s) View ingredients & interactions AminoLean Pineapple Coconut by RSP Powder 7.94 Ounce(s) · 225 Gram(s) View ingredients & interactions AminoLean Pink Lemonade by RSP Powder 9.52 Ounce(s) · 270 Gram(s) View ingredients & interactions AminoLean Vegan Acai by RSP Powder 7.94 Ounce(s) · 225 Gram(s) View ingredients & interactions AminoLean Vegan Mango by RSP Powder 8.29 Ounce(s) · 235 Gram(s) View ingredients & interactions AminoLean Watermelon by RSP Powder 9.52 Ounce(s) · 270 Gram(s) View ingredients & interactions AminoLean x Alix Earle Berry Alixir by RSP Powder 8.04 Ounce(s) · 228 Gram(s) View ingredients & interactions AminoLean x Chase Byrd Cherry On Top by RSP Powder 10.16 Ounce(s) · 288 Gram(s) View ingredients & interactions Amplified Creatine XXX Ripped Orange Twist by GNC Pro Performance AMP Powder 13.54 Oz(s) · 383.8 Gram(s) View ingredients & interactions Amplified Focus by GNC AMP Advanced Muscle Performance Tablet Or Pill 60 Tablet(s) View ingredients & interactions Amplified Heat Extreme 180 by GNC Pro Performance AMP Tablet Or Pill 12 Tablet(s) View ingredients & interactions Amplified Ripped Fruit Punch by GNC Pro Performance AMP Powder 14.16 oz. · 401.6 Gram(s) View ingredients & interactions Amplified Ripped Watermelon by GNC Pro Performance AMP Powder 14.25 oz. · 404 Gram(s) View ingredients & interactions Amplified Wheybolic Extreme 60 Ripped Chocolate Fudge by GNC Pro Performance AMP Powder 44.89 oz. · 2.81 lb · 1275 Gram(s) View ingredients & interactions Amplified Wheybolic Extreme 60 Ripped Chocolate Peanut Butter by GNC Pro Performance AMP Powder 44.9 oz. · 2.81 lb · 1275 Gram(s) View ingredients & interactions Amplified Wheybolic Extreme 60 Ripped Cookies & Cream by GNC Pro Performance AMP Powder 46 Oz(s) · 2.87 lbs · 1305 Gram(s) View ingredients & interactions Amplified Wheybolic Extreme 60 Ripped French Vanilla by GNC Pro Performance AMP Powder 44.6 oz. · 2.79 lb · 1267 Gram(s) View ingredients & interactions Amplified Wheybolic Extreme 60 Ripped Strawberries & Cream by GNC Pro Performance AMP Powder 44 oz. · 2.76 lb · 1253 Gram(s) View ingredients & interactions Amplify XL Toffee Macchiato by PMD Powder 2.1 Pound(s) · 934 Gram(s) View ingredients & interactions Amplify XL Toffee Macchiato by PMD Powder 2.1 Pound(s) · 934 Gram(s) View ingredients & interactions Ancient Elixirs Superfood Matcha by Ancient Nutrition Powder 7.5 Ounce(s) · 214 Gram(s) View ingredients & interactions Ancient Probiotics Skin by Ancient Nutrition Capsule 90 Capsule(s) View ingredients & interactions
Pharmacist Counseling Corner

Coffee: Common Questions

What is Coffee used for, and does it work?
People use Coffee for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting Coffee for Mental alertness, Diabetes, Heart failure and Overall mortality. For most other uses it has been studied for, the evidence is currently insufficient to rate. See the graded list on this page, and always confirm with your pharmacist or doctor.
Does Coffee interact with prescription medications?
Yes. We list 591 medications with a known interaction with Coffee, including 8 rated major. Use the checker above to see how Coffee interacts with a specific drug.
How are Coffee 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 Coffee 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 Coffee 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 it safe to drink Coffee every day?
For most healthy adults, moderate daily Coffee intake is generally considered safe. If you notice problems like poor sleep, a racing heart, or anxiety, consider cutting back and talking with your doctor or pharmacist.
Can I drink Coffee while pregnant?
It is best to limit caffeine during pregnancy. High intake has been linked to risks for the baby, so ask your doctor about a safe daily amount for you.
Does decaf Coffee still have caffeine?
Decaffeinated Coffee has most of its caffeine removed, but it usually still contains a small amount. If you are very sensitive to caffeine, even decaf may affect you.
Why do I get a headache if I skip my Coffee?
This is a common caffeine withdrawal symptom. If you regularly drink Coffee and then stop suddenly, you may get headaches, tiredness, or irritability for a few days. Cutting back slowly can help.

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

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Products that contain Coffee

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