Herb & supplement monograph

Cola Nut Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

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

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

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Cola Nut drug interaction appears low for most people, because nearly every concern traces back to cola nut acting as a source of caffeine. None of the hundreds of listed interactions are rated major, and most are moderate, largely theoretical concerns based on caffeine's known effects.

Interactions deserving the most attention

The best-supported concerns involve caffeine directly. Cola nut can interfere with dipyridamole and adenosine when they are used for heart stress tests, and it may raise levels of clozapine, worsening its side effects. Suddenly stopping cola nut can push up lithium levels, which is a narrow-margin medicine. Pairing it with stimulants such as ephedrine, nicotine, or phenylpropanolamine can add to blood pressure and heart-rate effects.

What the rest of the list means

A long interaction list does not mean every combination is harmful. Most entries are theoretical, based on how caffeine may affect an enzyme the body uses to clear certain medications, or on animal and lab research. Several predicted effects, including reduced seizure control with some anticonvulsants, have not actually been shown to cause problems in people.

Check your medications against Cola Nut

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

Interaction report

Drugs that interact with Cola Nut

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

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Cola Nut using our pharmacist-reviewed interaction data.

AI summaries are generated from our Cola Nut interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

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 Cola Nut 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 Cola Nut affects

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

All 41 drug categories Cola Nut interacts with

Adenosine (adenocard)Alcohol (ethanol)Anticoagulant/antiplatelet DrugsBeta-adrenergic AgonistsCarbamazepine (tegretol)Clozapine (clozaril)Cytochrome P450 1a2 (cyp1a2) InhibitorsDipyridamole (persantine)Disulfiram (antabuse)Diuretic DrugsEphedrineEstrogensEthosuximide (zarontin)Felbamate (felbatol)Flutamide (eulexin)Fluvoxamine (luvox)LithiumMonoamine Oxidase Inhibitors (maois)NicotinePentobarbital (nembutal)Phenobarbital (luminal)PhenylpropanolaminePhenytoin (dilantin)Pioglitazone (actos)Quinolone AntibioticsRiluzole (rilutek)Stimulant DrugsTheophyllineValproateVerapamil (calan, Others)Antidiabetes DrugsCimetidine (tagamet)Contraceptive DrugsFluconazole (diflucan)Metformin (glucophage)Methoxsalen (oxsoralen)Mexiletine (mexitil)PhenothiazinesTerbinafine (lamisil)Tiagabine (gabitril)Ticlopidine (ticlid)

Adenosine (Adenocard)

Theoretically, cola nut might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Cola nut 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 and methylxanthine-containing products (including cola nut) 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

Alcohol (Ethanol)

Theoretically, alcohol might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut 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 Probable Evidence D

Anticoagulant/Antiplatelet Drugs

Theoretically, cola nut may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Cola nut contains caffeine. Caffeine is reported to have antiplatelet activity. This interaction has not been reported in humans.

Likelihood Unlikely Evidence D

Beta-Adrenergic Agonists

Theoretically, the caffeine in cola nut might increase the clinical effects of beta-adrenergic agonists.
Cola nut contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase the cardiac inotropic effects of beta-agonists.

Likelihood Probable Evidence D

Carbamazepine (Tegretol)

Theoretically, cola nut might reduce the effects of carbamazepine and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.

Likelihood Possible Evidence D

Clozapine (Clozaril)

Theoretically, cola nut might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Cola nut 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 more sensitive to the interaction between clozapine and caffeine.

Likelihood Possible Evidence B

Cytochrome P450 1A2 (Cyp1A2) Inhibitors

Theoretically, CYP1A2 inhibitors might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Caffeine is metabolized by CYP1A2,.

Likelihood Possible Evidence D

Dipyridamole (Persantine)

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

Likelihood Probable Evidence B

Disulfiram (Antabuse)

Theoretically, disulfiram might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. In human research, disulfiram decreases the rate of caffeine clearance.

Likelihood Probable Evidence D

Diuretic Drugs

Theoretically, using cola nut with diuretic drugs might increase the risk of hypokalemia.
Cola nut contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Certain diuretics can also lower potassium levels.

Likelihood Possible Evidence D

Ephedrine

Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Cola nut 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.

Likelihood Possible Evidence D

Estrogens

Theoretically, estrogens might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Estrogen inhibits caffeine metabolism.

Likelihood Probable Evidence B

Ethosuximide (Zarontin)

Theoretically, cola nut might reduce the effects of ethosuximide and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans

Likelihood Possible Evidence D

Felbamate (Felbatol)

Theoretically, cola nut might reduce the effects of felbamate and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.

Likelihood Possible Evidence D

Flutamide (Eulexin)

Theoretically, cola nut might increase the levels and adverse effects of flutamide.
Cola nut contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. This effect has not been reported in humans.

Likelihood Possible Evidence D

Fluvoxamine (Luvox)

Theoretically, fluvoxamine might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Fluvoxamine reduces caffeine metabolism.

Likelihood Probable Evidence D

Lithium

Theoretically, abrupt cola nut withdrawal might increase the levels and adverse effects of lithium.
Cola nut contains caffeine. Abrupt caffeine withdrawal can increase serum lithium levels. There are two case reports of lithium tremor that worsened upon abrupt coffee withdrawal.

Likelihood Probable Evidence D

Monoamine Oxidase Inhibitors (Maois)

Theoretically, concomitant use might increase the risk of a hypertensive crisis.
Cola nut 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.
Cola nut 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 D

Pentobarbital (Nembutal)

Theoretically, cola nut might decrease the effects of pentobarbital.
Cola nut contains caffeine. Theoretically, caffeine might negate the hypnotic effects of pentobarbital.

Likelihood Possible Evidence B

Phenobarbital (Luminal)

Theoretically, cola nut might reduce the effects of phenobarbital and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenobarbital. However, this effect has not been reported in humans.

Likelihood Possible Evidence D

Phenylpropanolamine

Theoretically, phenylpropanolamine might increase the risk of hypertension, as well as the levels and adverse effects of the caffeine in cola nut.
Cola nut 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

Phenytoin (Dilantin)

Theoretically, cola nut might reduce the effects of phenytoin and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of phenytoin. The effect does not seem to be related to the seizure threshold-lowering effects of caffeine. However, the exact mechanism of this interaction is unclear.

Likelihood Possible Evidence D

Pioglitazone (Actos)

Theoretically, cola nut might increase the levels and clinical effects of pioglitazone.
Cola nut 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 the caffeine in cola nut.
Cola nut contains caffeine. Quinolones (also called fluoroquinolones) can decrease caffeine clearance by inhibiting cytochrome P450 1A2 (CYP1A2).

Likelihood Probable Evidence B

Riluzole (Rilutek)

Theoretically, concomitant use might increase the levels and adverse effects of both caffeine and riluzole.
Cola nut contains caffeine. Caffeine and riluzole are both metabolized by cytochrome P450 1A2, 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.
Cola nut 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, cola nut might increase the levels and adverse effects of theophylline.
Cola nut contains caffeine. Large amounts of caffeine might inhibit theophylline metabolism.

Likelihood Probable Evidence B

Valproate

Theoretically, cola nut might reduce the effects of valproate and increase the risk for convulsions.
Cola nut contains caffeine. Animal research suggests that caffeine can decrease the anticonvulsant activity of valproate. However, this effect has not been reported in humans.

Likelihood Possible Evidence D

Verapamil (Calan, Others)

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

Likelihood Possible Evidence D

Antidiabetes Drugs

Theoretically, taking cola nut with antidiabetes drugs might interfere with blood glucose control.
Cola nut contains caffeine. Some conflicting reports claim that caffeine might increase or decrease blood sugar.

Likelihood Unlikely Evidence B

Cimetidine (Tagamet)

Theoretically, cimetidine might increase the effects and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Cimetidine decreases the rate of caffeine clearance by 31% to 42%.

Likelihood Possible Evidence B

Contraceptive Drugs

Theoretically, contraceptive drugs might increase the effects and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Oral contraceptives can decrease the rate of caffeine clearance by 40% to 65%.

Likelihood Possible Evidence B

Fluconazole (Diflucan)

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

Likelihood Possible Evidence B

Metformin (Glucophage)

Theoretically, metformin might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Animal research suggests that metformin can reduce caffeine metabolism.

Likelihood Possible Evidence D

Methoxsalen (Oxsoralen)

Theoretically, methoxsalen might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Methoxsalen can reduce caffeine metabolism.

Likelihood Possible Evidence B

Mexiletine (Mexitil)

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

Likelihood Possible Evidence B

Phenothiazines

Theoretically, phenothiazines might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Phenothiazines can reduce the metabolism of caffeine by inhibiting cytochrome P450 1A2 (CYP1A2).

Likelihood Possible Evidence D

Terbinafine (Lamisil)

Theoretically, terbinafine might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. Terbinafine decreases the rate of intravenous caffeine clearance by 19%.

Likelihood Possible Evidence B

Tiagabine (Gabitril)

Theoretically, cola nut might increase the levels and adverse effects of tiagabine.
Cola nut contains caffeine. Animal research suggests that chronic caffeine administration can increase the serum concentrations of tiagabine. However, concomitant use does not seem to reduce the antiepileptic effects of tiagabine.

Likelihood Possible Evidence D

Ticlopidine (Ticlid)

Theoretically, ticlopidine might increase the levels and adverse effects of the caffeine in cola nut.
Cola nut contains caffeine. In vitro evidence suggests that ticlopidine can inhibit caffeine metabolism. However, this effect has not been reported in humans.

Likelihood Possible Evidence D

Monograph

Cola Nut: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Cola nut is a caffeine-containing seed from West Africa used mainly as a natural stimulant for energy and alertness. Most of its effects come from caffeine, and strong human evidence for specific health benefits is limited. Because of its caffeine content, people sensitive to stimulants and those who are pregnant or have heart conditions should be cautious.

Scientific name: Cola acuminata
Family: Malvaceae
Part used: Seeds (nuts)
Common forms: Capsules, powders, extracts, teas, energy drinks, and weight-loss products

People commonly use it for

Energy and alertness
Mental focus
Physical performance
Weight loss support
Traditional digestive aid

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

Safety at a glance

OverallUse caution

Generally tolerated in food amounts but contains caffeine, which can cause stimulant-related effects.

PregnancyPossibly Safe

When used orally in amounts found in foods. Due to the caffeine content of cola nut, pregnant patients should closely monitor their intake to ensure m...

Read the full pregnancy detail

BreastfeedingPossibly Safe

When used orally in amounts found in foods. Due to the caffeine content of cola nut, caffeine intake should be closely monitored while nursing. Breast...

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

Cola nut comes from the seeds of trees in the Cola genus, including Cola acuminata and the closely related Cola nitida. These trees grow in the tropical rainforests of West Africa, where the seeds have long been chewed and used in cultural and social traditions.

The seeds naturally contain caffeine and other plant compounds, which is why cola nut is valued as a stimulant. Historically, cola nut flavor and extracts were used in early cola soft drinks. Today it is found in some energy drinks, weight-loss blends, and herbal supplements.

How it works

The best-understood active ingredient in cola nut is caffeine, a stimulant that affects the central nervous system. Caffeine can increase alertness, reduce the feeling of tiredness, and mildly raise heart rate and blood pressure.

Cola nut also contains other natural compounds such as theobromine (also found in chocolate) and plant antioxidants called tannins and polyphenols. Some laboratory and animal studies suggest these compounds may have antioxidant or other biological activity, but this research is preliminary and does not prove benefits in people.

Effectiveness

Does Cola Nut work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 1 use evaluated

1 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.

For Cola Nut, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 1 condition — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Obesity

Rating & evidence shown verbatim from Natural Medicines

Oral cola nut has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

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

In the small amounts found in foods and beverages, cola nut is generally considered safe for most healthy adults. The main safety concerns come from its caffeine content, which can build up if you also drink coffee, tea, or energy drinks.

People with heart problems, high blood pressure, irregular heartbeat, anxiety, sleep problems, or stomach ulcers should be cautious or avoid it. Children and people sensitive to caffeine should also avoid it.

For pregnancy, it is best to limit or avoid cola nut because high caffeine intake during pregnancy is discouraged. For breastfeeding, caffeine passes into breast milk and may affect the infant, so limiting or avoiding cola nut is the safer choice. When in doubt, talk with your pharmacist or doctor before using it.

Side effects

Side effects are mostly related to caffeine and may include jitteriness, restlessness, nervousness, a fast or pounding heartbeat, trouble sleeping, headache, and an upset stomach.

Larger amounts may raise blood pressure or cause heart rhythm changes. Long-term heavy use of caffeine-containing products can lead to dependence and withdrawal symptoms such as headaches when you stop. Some traditional reports also link heavy chewing of the nut with mouth and digestive irritation.

Cola Nut: Reported Adverse Effects

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

Orally, cola nut is well tolerated when eaten in the amounts found in food. It seems to be well tolerated when used medicinally and appropriately, short-term. However, the caffeine found in cola nut may cause adverse effects when taken in large amounts.

Most Common Adverse Effects:

Orally: Dyspepsia, skin discoloration.

Serious Adverse Effects (Rare):

Orally: Increased risk of oral cancer, gastrointestinal cancer, and West African crystalline retinopathy with long-term use.

Reports by condition

Allergic rhinitis (hay fever) Immunologic

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

Infante S, Baeza ML, Calvo M, et al. Anaphylaxis due to caffeine. Allergy 2003;58:681-2.

Anxiety Psychiatric

Cola nut contains caffeine. Caffeine may lead to habituation and physical dependence with amounts as low as 100 mg daily. Higher doses of caffeine have caused nervousness, agitation, anxiety, irritability, delirium, depression, sleep disturbances, impaired attention, psychosis, and panic attacks. Abrupt discontinuation of caffeine may result in physical withdrawal symptoms, including headache, fatigue, drowsiness, decreased physical energy, difficulty concentrating, depression, anxiety, irritability, and reduced alertness.

Anxiety Neurologic/CNS

Orally, cola nut may prolong sleep latencies and suppress REM and 3rd and 4th stages of sleep. Cola nut has also been reported to cause insomnia in children and may exacerbate sleep disturbances in patients with acquired immunodeficiency syndrome (AIDS). Caffeine, a constituent of cola nut, can cause headaches, anxiety, jitteriness, restlessness, and nervousness.

Ogunremi OO and Mamora AO. Cola acuminata (Kolanut) and coffee: Acute effects on sleep of Nigerians. Psychopathologie Africaine 1980;16(1):69-75.
Schechter MD, Timmons GD. Objectively measured hyperactivity--II. Caffeine and amphetamine effects. J Clin Pharmacol 1985;25:276-80..
Dreher HM. The effect of caffeine reduction on sleep quality and well-being in persons with HIV. J Psychosom Res 2003;54:191-8..
Wrenn, K. D. and Oschner, I. Rhabdomyolysis induced by a caffeine overdose. Ann.Emerg.Med. 1989;18(1):94-97.
Doan, B. K., Hickey, P. A., Lieberman, H. R., and Fischer, J. R. Caffeinated tube food effect on pilot performance during a 9-hour, simulated nighttime U-2 mission. Aviat.Space Environ Med 2006;77(10):1034-1040.
Killgore, W. D., Rupp, T. L., Grugle, N. L., Reichardt, R. M., Lipizzi, E. L., and Balkin, T. J. Effects of dextroamphetamine, caffeine and modafinil on psychomotor vigilance test performance after 44 h of continuous wakefulness. J Sleep Res 2008;17(3):3
Killgore, W. D., Kahn-Greene, E. T., Grugle, N. L., Killgore, D. B., and Balkin, T. J. Sustaining executive functions during sleep deprivation: A comparison of caffeine, dextroamphetamine, and modafinil. Sleep 2-1-2009;32(2):205-216.
Addicott, M. A. and Laurienti, P. J. A comparison of the effects of caffeine following abstinence and normal caffeine use. Psychopharmacology (Berl) 2009;207(3):423-431.
Koran, L. M., Aboujaoude, E., and Gamel, N. N. Double-blind study of dextroamphetamine versus caffeine augmentation for treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry 2009;70(11):1530-1535.
Attwood, A., Terry, P., and Higgs, S. Conditioned effects of caffeine on performance in humans. Physiol Behav 3-3-2010;99(3):286-293.
Greden, J. F. Anxiety or caffeinism: a diagnostic dilemma. Am J Psychiatry 1974;131(10):1089-1092.
Lystrup RM, Leggit JC. Caffeine toxicity due to supplement use in caffeine - naïve individual: a cautionary tale. Mil Med. 2015 Aug;180(8):e936-40.

Arrhythmia Cardiovascular

Orally, acute administration of caffeine can cause increased blood pressure. However, regular consumption of caffeine does not seem to increase either blood pressure or pulse, even in mildly hypertensive patients. Epidemiological research suggests there is no association of caffeine consumption with incidence of hypertension. Habitual coffee consumption also doesn't seem to be related to hypertension, but habitual consumption of sugared or diet cola is associated with development of hypertension.

Epidemiological research has also found that regular caffeine intake of up to 400 mg daily is not associated with an increased incidence of atrial fibrillation, atherosclerosis, cardiac ectopy, stroke, ventricular arrhythmia, or cardiovascular disease in general.

Bone loss Musculoskeletal

Cola nut contains caffeine. 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.

Breast cancer Endocrine

Some evidence shows that caffeine, which is found in cola nut, is associated with fibrocystic breast disease, breast cancer, and endometriosis; however, this is controversial since findings are conflicting. Restricting caffeine in people with fibrocystic breast conditions doesn't seem to affect breast nodularity, swelling, or pain. Also, a population analysis of the Women's Health Initiative observational study has found no association between consumption of caffeine-containing beverages and the incidence of invasive breast cancer in models adjusted for demographic, lifestyle, and reproductive factors. Also, a dose-response analysis of two low-quality observational studies has found that high consumption of caffeine is not associated with an increased risk of breast cancer.

Clinical research in healthy adults shows that increased consumption of caffeine results in increased insulin resistance.

Cancer Oncologic

Orally, chewing cola nut has been associated with an increased risk of oral and gastrointestinal cancer. Cola nut contains high amounts of tannins and N-nitroso compounds, which are carcinogenic. The risk may be even higher in smokers.

Benton D, Donohoe RT, Sillance B, Nabb S. The influence of phosphatidylserine supplementation on mood and heart rate when faced with an acute stressor. Nutr Neurosci 2001;4:169-78.

Dyspepsia Gastrointestinal

Orally, cola nut may induce gastric acid secretion and cause dyspepsia and peptic ulceration. The caffeine found in cola nut may cause feeding intolerance and gastrointestinal irritation in infants.

Glaucoma Ocular/Otic

Orally, cola nut has been associated with an increased risk for West African crystalline retinopathy in one retrospective, observational case series.

Cola nut contains caffeine. In individuals with glaucoma, caffeine intake has been found to increase intraocular pressure. This did not occur in patients without glaucoma. The magnitude of this effect seems to depend on individual tolerance to caffeine. Some research in healthy young adults shows that caffeine increases intraocular pressure to a greater degree in low-consumers of caffeine (i.e., 1 cup of coffee or less daily) when compared to high-consumers (i.e., those consuming 2 cups of coffee or more daily). The peak increase of intraocular pressure seems to occur at about 1.5 hours after caffeine ingestion, and there is no notable effect 4 hours after ingestion.

Interstitial cystitis Genitourinary

Orally, the caffeine in cola nut 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.

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 well-established standardized dose for cola nut supplements. The amount of caffeine in products can vary widely depending on the form and brand.

If you choose to use a cola nut product, follow the directions on the label and do not exceed the recommended amount. Keep in mind your total daily caffeine from all sources, including coffee, tea, and energy drinks. Check with your pharmacist or doctor before starting, especially if you have a health condition or take other medicines.

Pregnancy & Breastfeeding

Cola Nut & Pregnancy

Possibly Safe

When used orally in amounts found in foods. Due to the caffeine content of cola nut, pregnant patients should closely monitor their intake to ensure moderate consumption. Fetal blood concentrations of caffeine approximate maternal concentrations. The use of caffeine during pregnancy is controversial; however, moderate consumption has not been associated with clinically important adverse fetal effects. In some studies, consuming amounts over 200 mg daily is associated with a significantly increased risk of miscarriage. This increased risk may be most likely to occur in those 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 keeping caffeine consumption below 300 mg daily. This is similar to the amount of caffeine in about 3 cups of coffee or tea. 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 cola nut, 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.

Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
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.
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.
Eskenazi B. Caffeine—filtering the facts. N Engl J Med 1999;341:1688-9.
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.
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..
Nawrot P, Jordan S, Eastwood J, et al. Effects of caffeine on human health. Food Addit Contam 2003;20:1-30.
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.
Savitz DA, Chan RL, Herring AH, et al. Caffeine and miscarriage risk. Epidemiology 2008;19:55-62.
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 caffeine, a constituent of cola nut, is used orally in amounts over 300 mg daily. Caffeine crosses the placenta, producing fetal blood concentrations similar to maternal levels. Advise keeping caffeine consumption from all sources below 300 mg daily. 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. 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 cola nut, 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. In a study that included 2 large cohorts of mother/infant pairs, the first cohort with a median maternal plasma caffeine level of 168.5 ng/mL (range 29.5-650.5 ng/mL) during pregnancy, suggests birth weights and lengths were lower in the 4th quartile of caffeine intake compared with the 1st. By age 7, heights and weights were lower by 1.5 cm and 1.1 kg, respectively. In the second cohort of mother/infant pairs with higher maternal pregnancy plasma caffeine levels, median 625.5 ng/mL (range 86.2 to 1994.7 ng/mL), heights at age 8 were 2.2 cm lower, but there was no difference in weights.

Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
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.
McGowan JD, Altman RE, Kanto WP Jr. Neonatal withdrawal symptoms after chronic maternal ingestion of caffeine. South Med J 1988;81:1092-4..
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.
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.
Chen LW, Wu Y, Neelakantan N, Chong MF, Pan A, van Dam RM. Maternal caffeine intake during pregnancy is associated with risk of low birth weight: a systematic review and dose-response meta-analysis. BMC Med. 2014 19;12:174. doi: 10.1186/s12916-014-0174-6
Greenwood DC, Thatcher NJ, Ye J, Garrard L, Keogh G, King LG, Cade JE. Caffeine intake during pregnancy and adverse birth outcomes: a systematic review and dose-response meta-analysis. Eur J Epidemiol. 2014;29(10):725-34. doi: 10.1007/s10654-014-9944-x.
Rhee J, Kim R, Kim Y, et al. Maternal caffeine consumption during pregnancy and risk of low birth weight: a dose-response meta-analysis of observational studies. PLoS One. 2015 Jul 20;10(7):e0132334.
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.

Cola Nut & Breastfeeding

Possibly Safe

When used orally in amounts found in foods. Due to the caffeine content of cola nut, caffeine intake should be closely monitored while nursing. Breast milk concentrations of caffeine are thought to be approximately 50% of maternal serum concentrations. Minimal consumption would likely result in limited exposure to a nursing infant.

Nehlig A, Debry G. Consequences on the newborn of chronic maternal consumption of coffee during gestation and lactation: a review. J Am Coll Nutr 1994;13:6-21..

Possibly Unsafe

When used orally in large amounts. Consumption of cola nut might cause sleep disturbances, irritability, and increased bowel activity in nursing infants due to its caffeine content. Large doses or excessive intake of cola nut should be avoided during lactation. It is unknown whether potentially carcinogenic constituents of cola nut are transferred via breast milk.

American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001;108:776-89.

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 157 references that drive our Cola Nut 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.

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Klebanoff MA, Levine RJ, DerSimonian R, et al. Maternal serum paraxanthine, a caffeine metabolite, and the risk of spontaneous abortion. N Engl J Med 1999;341:1639-44. PubMed
Eskenazi B. Caffeine—filtering the facts. N Engl J Med 1999;341:1688-9. PubMed
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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.

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.

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2 brands in our database make a supplement containing Cola Nut.

Floradix 44 products Gaia Herbs 700 products

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Supplement products with Cola Nut

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

Energy Vitality by Gaia Herbs Capsule 60 Vegan Liquid Phyto-Cap(s)(R) View ingredients & interactions Epresat Multivitamin by Floradix Liquid 8.5 fl. Oz. · 250 mL View ingredients & interactions

Pharmacist Counseling Corner

Cola Nut: Common Questions

What is Cola Nut used for, and does it work?

People use Cola Nut 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 Cola Nut interact with prescription medications?

Yes. We list 655 medications with a known interaction with Cola Nut. Use the checker above to see how Cola Nut interacts with a specific drug.

How are Cola Nut 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 Cola Nut 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 Cola Nut 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.

What is Cola Nut used for?

People commonly use Cola Nut as a natural stimulant for energy, alertness, and focus, and it is sometimes added to weight-loss and energy products. Most of its effects come from caffeine.

Does Cola Nut contain caffeine?

Yes. Cola Nut naturally contains caffeine, which is the main reason it acts as a stimulant. The exact amount can vary between products.

Is Cola Nut safe during pregnancy or breastfeeding?

It is best to limit or avoid Cola Nut during pregnancy and breastfeeding because of its caffeine content. Talk with your doctor or pharmacist first.

Can Cola Nut help with weight loss?

Cola Nut is often added to weight-loss blends, but there is little solid human evidence that it causes meaningful weight loss. Any effect is mostly tied to caffeine.

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

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Cola Nut Drug Interactions, Uses, Effectiveness, Safety & More

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