Drug interactions of cola-containing drinks

Clin Nutr. 2019 Dec;38(6):2545-2551. doi: 10.1016/j.clnu.2019.01.029. Epub 2019 Feb 10.


Cola-containing drinks (CCDs) are among the most common drinks in the world. There are some reports on interactions between CCDs and some drugs. However, there is no review on reported and possible interactions of CCDs. Thus, this paper attempted to provide a comprehensive review on this subject. It is well-accepted that CCDs are acidic and contain caffeine. It has been suggested that these two properties potentiate interactions of CCDs with different drugs in the context of both pharmacodynamics and pharmacokinetic, which includes drug absorption, metabolism, and renal excretion of drugs. It has been shown that serum concentrations of MTX, clozapine, carbamazepine, phenytoin, and ibuprofen increased following CCD consumption; these interactions can be toxic. Additionally, it has been reported that serum levels of lithium and warfarin were decreased and their efficacy reduced when simultaneously administered with CCDs. Serum concentrations of erlotinib and different azoles, including itraconazol, posaconazole, and ketoconazole, have been shown to increase when these drugs were co-administered with a CCD. As proposed and discussed here, CCDs have the potential for interactions with numerous other drugs and thus clinicians should be aware of reported and potential interactions of CCDs with various medications in order to avoid adverse reactions and achieve expected clinical response.

Keywords: Cola-containing drinks; Drug interactions; Pharmacodynamics; Pharmacokinetics.

Publication types

  • Review

MeSH terms

  • Animals
  • Biomedical Research
  • Carbonated Beverages*
  • Cola
  • Drug Interactions*
  • Humans
  • Pharmaceutical Preparations* / chemistry
  • Pharmaceutical Preparations* / metabolism


  • Pharmaceutical Preparations