(1)butorphanol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium acetateMinor (1)caffeine decreases levels of calcium acetate by increasing renal clearance. Minor/Significance Unknown.calcium carbonateMinor (1)caffeine decreases levels of calcium carbonate by increasing renal clearance. Minor/Significance Unknown.calcium chlorideMinor (1)caffeine decreases levels of calcium chloride by increasing renal clearance. Minor/Significance Unknown.calcium citrateMinor (1)caffeine decreases levels of calcium citrate by increasing renal clearance. Minor/Significance Unknown.calcium gluconateMinor (1)caffeine decreases levels of calcium gluconate by increasing renal clearance. Minor/Significance Unknown.carbamazepineMinor (1)carbamazepine will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.carbinoxamineMonitor Closely (1)carbinoxamine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chloral hydrateMonitor Closely (1)chloral hydrate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlordiazepoxideMonitor Closely (1)chlordiazepoxide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlorpheniramineMonitor Closely (1)chlorpheniramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlorpromazineMonitor Closely (1)chlorpromazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cigarette smokingMinor (1)cigarette smoking will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.cimetidineMinor (1)cimetidine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.cinnarizineMonitor Closely (1)cinnarizine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ciprofloxacinMonitor Closely (1)ciprofloxacin will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. The hepatic metabolism of caffeine may be decreased by ciprofloxacin; pharmacologic effects of caffeine may be increased.clemastineMonitor Closely (1)clemastine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clomipramineMonitor Closely (1)clomipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clonazepamMonitor Closely (1)clonazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clorazepateMonitor Closely (1)clorazepate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clotrimazoleMinor (1)clotrimazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.clozapineMonitor Closely (1)clozapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.codeineMonitor Closely (1)codeine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cyclizineMonitor Closely (1)cyclizine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cyproheptadineMonitor Closely (1)cyproheptadine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.deferasiroxMonitor Closely (1)deferasirox increases levels of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.desipramineMonitor Closely (1)desipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexfenfluramineMonitor Closely (1)caffeine and dexfenfluramine both decrease sedation. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)dexmedetomidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)caffeine and dexmethylphenidate both decrease sedation. Use Caution/Monitor.dextroamphetamineMonitor Closely (1)caffeine and dextroamphetamine both decrease sedation. Use Caution/Monitor.dextromoramideMonitor Closely (1)dextromoramide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diamorphineMonitor Closely (1)diamorphine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diethylpropionMonitor Closely (1)caffeine and diethylpropion both decrease sedation. Use Caution/Monitor.difenoxin hclMonitor Closely (1)difenoxin hcl increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dimenhydrinateMonitor Closely (1)dimenhydrinate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diphenhydramineMonitor Closely (1)diphenhydramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)diphenoxylate hcl increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dipipanoneMonitor Closely (1)dipipanone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dipyridamoleSerious - Use Alternative (1)caffeine decreases effects of dipyridamole by pharmacodynamic antagonism. Contraindicated.dobutamineMonitor Closely (1)dobutamine and caffeine both decrease sedation. Use Caution/Monitor.dopamineMonitor Closely (1)caffeine and dopamine both decrease sedation. Use Caution/Monitor.dopexamineMonitor Closely (1)dopexamine and caffeine both decrease sedation. Use Caution/Monitor.doxepinMonitor Closely (1)doxepin increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.droperidolMonitor Closely (1)droperidol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.droxidopaMonitor Closely (1)caffeine and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertensionephedrineMonitor Closely (1)ephedrine and caffeine both decrease sedation. Use Caution/Monitor.epinephrineMonitor Closely (1)epinephrine and caffeine both decrease sedation. Use Caution/Monitor.epinephrine inhaledMonitor Closely (1)caffeine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.epinephrine racemicMonitor Closely (1)epinephrine racemic and caffeine both decrease sedation. Use Caution/Monitor.erythromycin baseMinor (1)erythromycin base will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.erythromycin ethylsuccinateMinor (1)erythromycin ethylsuccinate will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.erythromycin lactobionateMinor (1)erythromycin lactobionate will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.erythromycin stearateMinor (1)erythromycin stearate will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.esketamine intranasalMonitor Closely (1)esketamine intranasal, caffeine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .estazolamMonitor Closely (1)estazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ethanolMonitor Closely (1)ethanol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ethinylestradiolMonitor Closely (1)ethinylestradiol will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.eucalyptusMinor (1)eucalyptus increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.fenfluramineMonitor Closely (1)caffeine and fenfluramine both decrease sedation. Use Caution/Monitor.fexinidazoleMonitor Closely (1)fexinidazole will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.fezolinetantContraindicated (1)caffeine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsfluconazoleMinor (1)fluconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.fluphenazineMonitor Closely (1)fluphenazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.flurazepamMonitor Closely (1)flurazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fluvoxamineMonitor Closely (1)fluvoxamine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.formoterolMonitor Closely (1)formoterol and caffeine both decrease sedation. Use Caution/Monitor.givosiranSerious - Use Alternative (1)givosiran will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.grapefruitMinor (1)grapefruit increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.green teaMonitor Closely (1)green tea increases effects of caffeine by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of CNS stimulation due to caffeine component of green tea. Caution advised.guaranaMinor (1)guarana increases effects of caffeine by pharmacodynamic synergism. Minor/Significance Unknown.guselkumabMonitor Closely (1)guselkumab, caffeine. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, normalizing the formation of CYP450 enzymes. Upon initiation or discontinuation of guselkumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.haloperidolMonitor Closely (1)haloperidol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.hydromorphoneMonitor Closely (1)hydromorphone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.hydroxyzineMonitor Closely (1)hydroxyzine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.iloperidoneMonitor Closely (1)iloperidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.imipramineMonitor Closely (1)imipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.iobenguane I 131Serious - Use Alternative (1)caffeine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.isocarboxazidContraindicated (1)isocarboxazid increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.isoniazidMinor (1)isoniazid will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.isoproterenolMonitor Closely (1)isoproterenol and caffeine both decrease sedation. Use Caution/Monitor.itraconazoleMinor (1)itraconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.ketoconazoleMinor (1)ketoconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.ketotifen, ophthalmicMonitor Closely (1)ketotifen, ophthalmic increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.letermovirMonitor Closely (1)letermovir increases levels of caffeine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.levalbuterolMonitor Closely (1)levalbuterol and caffeine both decrease sedation. Use Caution/Monitor.levoketoconazoleMinor (1)levoketoconazole increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.levorphanolMonitor Closely (1)levorphanol increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.levothyroxineMonitor Closely (1)caffeine decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Caffeine (a sympathomimetic) concomitantly used with oral levothyroxine may increase the effects of sympathomimetics or thyroid hormone. Thyroid hormones may increase the risk of coronary insufficiency when sympathomimetic agents are administered to patients with coronary artery disease.linezolidContraindicated (1)linezolid increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.lisdexamfetamineMonitor Closely (1)caffeine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.lofepramineMonitor Closely (1)lofepramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lofexidineMonitor Closely (1)lofexidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loprazolamMonitor Closely (1)loprazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lorazepamMonitor Closely (1)lorazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lormetazepamMonitor Closely (1)lormetazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loxapineMonitor Closely (1)loxapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)loxapine inhaled increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.maprotilineMonitor Closely (1)maprotiline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.marijuanaMonitor Closely (1)marijuana increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.melatoninMonitor Closely (1)melatonin increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.meperidineMonitor Closely (1)meperidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.meprobamateMonitor Closely (1)meprobamate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaproterenolMonitor Closely (1)metaproterenol and caffeine both decrease sedation. Use Caution/Monitor.methadoneMonitor Closely (1)methadone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methamphetamineMonitor Closely (1)caffeine and methamphetamine both decrease sedation. Use Caution/Monitor.methotrexateMonitor Closely (1)caffeine decreases effects of methotrexate by pharmacodynamic antagonism. Use Caution/Monitor.methylenedioxymethamphetamineMonitor Closely (1)caffeine and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.methylphenidateMonitor Closely (1)caffeine increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.mexiletineMinor (1)mexiletine will increase the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.miconazole vaginalMinor (1)miconazole vaginal increases levels of caffeine by decreasing metabolism. Minor/Significance Unknown.midazolamMonitor Closely (1)midazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.midodrineMonitor Closely (1)caffeine and midodrine both decrease sedation. Use Caution/Monitor.mirtazapineMonitor Closely (1)mirtazapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.modafinilMonitor Closely (1)caffeine and modafinil both decrease sedation. Use Caution/Monitor.Minor (1)modafinil will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.morphineMonitor Closely (1)morphine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.motherwortMonitor Closely (1)motherwort increases and caffeine decreases sedation. Effect of interaction is not clear,