I'm a pharmacist, these are the medications you should NEVER take with coffee... they could trigger a heart attack
Whether you're a morning person or not, many of us struggle to start the day without a caffeine hit. And whilst coffee has been shown to slash the risk of a number of serious health concerns, from cancer to heart disease, washing down your medication with a cup of coffee could not only reduce its effectiveness but increase the risk of serious side effects, a leading pharmacist has warned. From everyday painkillers to over-the-counter cold and flu tablets and blood pressure meds, caffeine can cause interactions that change the way drugs are absorbed, processed and excreted by the body, and it's not always for the best. 'Your morning coffee might seem harmless enough, but caffeine can affect how your body processes drugs,' prescribing pharmacist at Chemist4U, Ian Budd explained. 'The main interactions occur in your liver, which can either speed how quickly some medications are broken down or intensify their side effects. 'If you regularly take prescription medication, it’s worth thinking about when and how much coffee you drink.'Even small timing adjustments, like waiting an hour after your dose to have a coffee, can make a difference to how well your medication works and how you feel,' he added. Here, we break down exactly how coffee can interfere with your medications and the problematic pairings to avoid... Whether it's a flat white, cortado or double espresso, many of us can't start the day without coffeeCold and flu 'A lot of cold and flu medicines contain caffeine, to counteract drowsiness, or decongestants like pseudoephedrine.' Pseudoephedrine is a type of decongestant medicine which can help you breathe more easily when you have a stuffy or blocked nose, and is branded commercially as Sudafed. It is also an ingredient in scores of over the counter cold and flu remedies. Mr Budd warned: 'Combining these with coffee can overstimulate your nervous system, leading to jitteriness, palpitations or increased blood pressure.'This is because whilst decongestants can relieve nasal congestion and allow you to breathe more easily, they are also powerful stimulants which have a similar effect on the central nervous system as caffeine, resulting in restlessness and exacerbating symptoms. The NHS also warns that pseudoephedrine can also raise blood pressure and heart rate—just like coffee. Painkillers Paracetamol and ibuprofen—used by millions to treat everything from headaches to fevers—is safe when taken correctly, and this means avoiding washing the pills down with a cup of coffee says Mr Budd. The problem with the pairing comes from how painkillers are processed by the body, with overuse irritating the stomach lining and increasing the risk of stomach ulcers. 'The acidity of coffee can worsen this irritation and increase the risk of heartburn,' Mr Budd said. This is because caffeine stimulates the production of stomach acid and relaxes the valve at the top of the stomach, increasing the risk of acid escaping back up the oesophagus and causing a burning suggestion. Over the counter painkillers, like paracetamol, are used by millions of Britons everyday to deal with headaches, muscle pain, or fevers - but can cause serious irritation to the stomach lining Heavy painkiller use can also irritate the stomach, amplified by the effects of caffeine, which in some cases can lead to an infection known as peritonitis.Left untreated the condition can be life threatening. Blood pressure medication Some 13million people in the UK are affected by high blood pressure—it's the leading cause of heart attack and stroke.Whilst there are many lifestyle changes people can make to help lower blood pressure, such as cutting back on alcohol, managing stress and quitting smoking, medication may still be needed to protect the heart, brain and kidneys. One such medication are ACE inhibitors, which help blood vessels to relax and widen, lowering blood pressure. But caffeine can cause less of the drug to be absorbed, hampering its ability to relax blood vessels, putting added stress on blood vessels, heart and other organs and increasing the risk of heart attack, stroke and even dementia. Thyroid medication Levothyroxine, the most common treatment for an underactive thyroid is highly time-sensitive, and your morning coffee can interfere with the drug's effectiveness.Studies have even shown that drinking coffee too soon after taking levothyroxine can reduce its absorption by up to 50 per cent—meaning symptoms such as fatigue, weight gain and digestive issues can return, even if you're taking your medicine correctly. Drinking coffee close to when you take your blood pressure medication can temporarily hamper their ability to relax blood vessels and increase blood flow to your heart
This is because caffeine speeds up gut mobility, reducing how much time the drug has to be absorbed. Therefore, the pharmacist suggests waiting at least half an hour after your dose before having your morning coffee.' Antidepressants Drinking coffee, especially lots of it, can increase the effects of several antidepressants—forming a complex with the drugs which makes them harder for the body to absorb. 'Some antidepressants, especially selective serotonin reuptake inhibitors, (SSRIs) are processed by the same liver enzyme as caffeine,' Mr Budd added. 'This means that coffee can slow down how your body clears caffeine or the medicine, therefore increasing side effects like restlessness, insomnia, or rapid heartbeat.'In rare cases, where people have consumed a significant amount of coffee in a short period of time, it can even contribute to serotonin syndrome—a serious drug interaction caused by high levels of serotonin in the body. Symptoms can vary from mild to severe, including confusion, agitation, rapid heart rate, excessive sweating and shaking, and should be treated immediately Osteoporosis medication Osteoporosis affects 3.5million people in the UK, and one in two women over 50 will break a bone because of the disease. Osteoporosis is a health condition that weakens bones, making them fragile and more likely to break. If you're at risk of developing the condition, the NHS advises eating more calcium and vitamin D rich foods to keep bones healthy With the number of people who will suffer life-threatening hip fractures set to double by 2060, those taking bone-strengthening medicines may want to reconsider their caffeine intake. 'Medicines like alendronate or risedronate need to be taken on an empty stomach, and coffee can stop them from being absorbed properly,' Mr Budd warned. 'So it's best to wait at least 30 minutes before you have your morning coffee to get the full benefit of the drug.'But people with the bone thinning condition, which develops slowly over several years, may want to switch to decaf as caffeine can hinder the absorption of essential vitamins and minerals, such as vitamin D and calcium, from foods which support bone health. Currently, there is not enough evidence to conclude that consuming caffeine—in any quantity—contributes to osteoporosis. But, Mr Budd said: 'Bear in mind that over time, excess caffeine can also reduce calcium absorption. What can you do? 'It’s always important to check the patient information leaflet that comes with your medication, and if you’re ever unsure, speak to your pharmacist or GP,' Mr Budd advised. 'They can help you understand whether it’s best to limit anything like coffee or adjust when you take it to avoid unwanted interactions,' he added. He also suggested considering switching to decaf if you're worried about your caffeine intake, and keeping an eye on how your medication is working, to see if caffeine has any effect.
