Coffee is solace — the wait for the perfect brew, the pouring of warmth into a cup, and finally, the first touch on your lips. It's just like falling in love. The first sip of the day is your moment alone, the companion for your whispered thoughts, lifting your brain fog, and kickstarting your day. Only then, the world begins to make sense.
But what if that steaming cup of comfort is quietly sabotaging your medicines?
This isn’t about coffee being ‘bad’. This is about coffee being potent. As potent as a chemical compound interacting with the effects of medication in ways you probably haven’t imagined.
Jars of Nescafe Gold coffee by Nestle are pictured in the supermarket of Nestle headquarters(Reuters)
“Most people don’t draw a connection between their daily cup of coffee and the way their medications behave,” says Amita Gadre, one of India’s leading clinical nutritionists. “They just don’t see it coming.”
Amita Gadre, Clinical Nutritionist
And how could they? Coffee feels so personal, so harmless. Yet science tells a different story.
The clash of the stimulants
Let’s start with something simple. You’re under the weather. Nose blocked, throat sore. You reach for a cold and flu tablet. What you may not realise is that you’ve just paired one stimulant (pseudoephedrine) with another (caffeine). It’s like downing two energy drinks and expecting your body to stay calm.
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“If you’re also having 2-3 cups of coffee on top of that, it’s like stacking stimulants without meaning to,” Gadre explains to My Kolkata. “That can lead to headaches or migraines, a faster heartbeat, higher blood pressure, feeling anxious and definitely poor sleep.”
And since cold medicines are temporary, we rarely think to question their chemistry. But the effects, especially for those with anxiety disorders, diabetes or sleep disturbances, can linger.
The war in your gut
But the real coffee clashes are sneakier. Take levothyroxine, the go-to drug for hypothyroidism. Its success depends on how much of it your body actually absorbs. Drink coffee too soon after taking it and you slash absorption by up to 50%.
Why? Coffee speeds up gut motility and may even bind to the medicine, giving it less time to be absorbed.
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Antidepressants face a similar fate. SSRIs like sertraline and citalopram can get caught up in caffeine’s rush through your digestive system, dulling their effects. Older antidepressants like amitriptyline or imipramine? They battle it out in the liver with caffeine, competing for the same enzyme (CYP1A2) like two rivals on a crowded stage, reported The Conversation.
And then there’s clozapine, an antipsychotic whose blood levels can spike by a staggering 97% after just 2-3 cups of coffee.
“Some people report sleep issues, brain fog, anxiety and palpitations if they have more than two cups of brewed black coffee,” Gadre notes. “Women tend to report more sleep issues with coffee than men.”
Why Indian coffee culture matters
Here’s the interesting twist. In India, most people don’t drink strong black brewed coffee. They opt for instant or milky blends. That changes the game.
“Brewed coffee typically contains 80-120mg of caffeine per cup,” Gadre says. “Instant coffee usually ranges between 50-70 mg, depending on brand and strength. And milk in coffee may reduce caffeine concentration further.”
That might explain why many Indian coffee drinkers fly under the radar of these harsh interactions…until they switch to international blends, health fads, or café culture.
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This doesn’t mean you need to quit your beloved cup of coffee. But it does mean you might need to time it better.
For Nabaruna Ganguly, consultant dietitian and founder of the popular Instagram page, The Petuk Dietician, coffee isn’t the villain — but it definitely needs boundaries.
A champion of traditional Bengali food with a nutritional lens, Ganguly blends nutrition advice with cultural relevance. And when it comes to caffeine, especially in the Bengali context, she has a lot to say.
“Coffee, when consumed on an empty stomach, can trigger the release of stomach acid or even cause acid reflux,” she explains. “And no, milk coffee isn’t necessarily better. In fact, for many, it makes things worse.”
Nabaruna Ganguly, Consultant Dietitian
Ganguly, who works with clients managing a range of health conditions, from clinical depression to metabolic issues, says that people rarely connect their coffee habits with symptoms like anxiety, sleep disruption, or acid reflux. But she sees a pattern. Particularly among young professionals and night-shift workers.
“Instead of quitting coffee altogether, I recommend balancing it. Have it after breakfast or mid-morning…not the moment you wake up. And definitely no coffee after 3pm. For night-shift workers, the rule is to stop six to seven hours after waking", she tell My Kolkata.
She often nudges clients toward tea or decaf coffee, and in more serious cases, like those dealing with depression, toward herbal teas such as chamomile.
“Chamomile tea is calming, it doesn’t mess with sleep, and it's a sustainable replacement. I’ve seen it help when nothing else does.”
“Take levothyroxine or bisphosphonates on an empty stomach with water,” recommends Rayaan Kapoor, a London-based clinical pharmacologist. “Wait at least 30–60 minutes before you sip coffee or eat breakfast.”
He adds, “For heart patients or those on SSRIs, it’s not about quitting coffee — it’s about understanding your threshold. Everyone metabolises caffeine differently. You have to know your body’s signals.”
And for those who can’t bear the thought of a caffeine-free morning, Gadre offers a softer route. “I’ve seen clients switch to decaf or half-caf, or move their first cup to mid-morning. That little shift can be game-changing.”
So next time you cradle your cup, consider this: what else is in your system? What invisible tug-of-war might be happening inside?
And most importantly, ask questions. A five-minute chat with your pharmacist or doctor might save you weeks of confusion, sleepless nights, or a medication that’s just not working like it should.
(With inputs from The Conversation)