For many of us, starting the day without a cup of coffee is unthinkable.
But, in some cases, when we are taking certain medications in the morning, it is better to wait a while before ingesting the longed-for drink.
Some medicines can be taken at different times of the day, but it is also recommended not to take them with liquids that contain caffeine.
“There are approximately 60 drugs that can have interactions with caffeine,” Antonio Javier Carcas Sansuán, professor of Pharmacology at the Autonomous University of Madrid, tells BBC Mundo, although most of those interactions are moderate.
When we take a medicine, it travels through our body and, once in the stomach or intestine, it passes into the blood and is then distributed throughout the body.
“This drug has to reach the place where it will execute the action for which it was designed, its pharmacological target,” Elena Puerta Ruiz de Azúa, tenured professor of Pharmacology at the University of Navarra, told BBC Mundo.
Think of that target as the strategic point to treat an ailment, the protein within our body -the receptor that the drug will activate or block- on which it will exert its effect.
And for it to do that, it needs to be absorbed and distributed efficiently.
Then, that medicine has to be metabolized, that is, eliminated from the body and the main organ in this process is the liver, which is in charge of purifying our body.
But what if coffee adds to all that travel? Depends on the drug and its purpose.
In the brain
Remember that caffeine is a stimulant of the central nervous system, which can cause nervousness and high blood pressure.
If we are talking about a drug aimed at producing a sedative or tranquilizing effect, mixing it with coffee or a caffeinated drink will be harmful because it will counteract the effects ofthe medicine.
Several of these drugs belong to the family of benzodiazepines, which are used in treatments, for example, for anxiety and insomnia.
“Caffeine would reach the brain at the same time as this drug,” says Puerta.
“Then, you would receive, on the one hand, the stimulation of the caffeine and, on the other, the relaxing action of the drug: opposite effects.”
“Taking those drugs together with caffeine-rich beverages is strongly discouraged because you’re taking in, through coffee or cola, a molecule that does the exact opposite of what the drugs are trying to do.”
in the liver
In addition, some drugs use the same enzymes and proteins as caffeine to be metabolized in the liver, so there is a kind of interference that could lead to the drug accumulates in the body more than necessary.
“For some drugs, perhaps this increase in plasma concentration may be irrelevant because they have a wide safety margin, but for other very specific ones, such as those prescribed for schizophrenia, in whose treatment it is essential that drug concentrations are optimal, It can pose a risk,” warns the expert.
“They are drugs that do not matter if there is a little more concentration. It can be dangerous if it increases.”
Caffeine, Carcas points out, can modify the effect of some drugs by enhancing or decreasing it.
There are also medicines that inhibit the metabolism of caffeine by block the action of the enzyme responsible for this process.
An example of this are some antibiotics such as quinolones.
“What can happen is that this drug inhibits or decreases the metabolism of caffeine and, therefore, causes caffeine concentrations in the body to increase and its effect to be greater,” says the professor.
question of absorption
It is also recommended that some drugs, such as the one used to treat hypothyroidism, be taken on an empty stomach.
“It is important that thyroxine be taken on an empty stomach, without having ingested any food or coffee, and that it wait a while before having breakfast to favor the complete absorption of the drug at the intestinal level and thus achieve optimal hormone levels in our body,” says Puerta.
And it is that the presence of food in the stomach and intestine can also potentially hinder the absorption of certain drugs.
“Even if you take the recommended dose, if a part of it is not absorbed, it will not have the pharmacological effect.”
However, for other medications, food is the golden rule: some anti-inflammatories can be very damaging to the gastric mucosa.
For this reason, “sometimes what is recommended is precisely to take it with meals to minimize this gastro-injurious effect.”
The dairy element of coffee
Don’t be fooled by a coffee with plenty of milk.
Tetracyclines, which are a type of antibiotic, form a “complex” with milk and this prevents its absorption, explains Puerta.
“This complex would pass through our entire digestive system until it was eliminated in the feces. without being absorbed at any time through the gastrointestinal walls, without reaching the blood and without fulfilling its objective”.
If you take that kind of antibiotic with a latte, “you’re throwing it away.”
And it is that this family of antibiotics, if it is ingested with dairy products, forms insoluble compounds with calcium, called chelates, which will not be absorbed at the intestinal level, so it will not have a pharmacological effect.
Carcas reminds us that the cola drinks They can also affect the absorption of some drugs: delaying or altering it.
read directions
If drugs that affect the central nervous system, such as antidepressants, are taken, it is essential to follow the doctor’s instructions, since caffeine itself is a great stimulant of that system.
For Puerta, it is essential that medications are taken as indicated by health specialists.
“Forget homemade inventions. If it’s a sachet that has to be dissolved in water, do it that way and not in a juice or other liquid because we completely change the composition.”
In addition, he clarifies, there are many drugs that have no contradiction to drink with coffee.
“You have to see each specific case” and the best way to make sure is by asking your pharmacist or doctor.
“In general, it’s important to drink coffee in moderation,” recommends Carcas.
Remember that you can receive notifications from BBC Mundo. Download the new version of our app and activate them so you don’t miss out on our best content.
