Kola Nut

Generic name: Cola Acuminata, Cola Nitidi
Brand names: Abata Cola, Bissy Nut, Cola, Cola Nut, Guru Nut

Usage of Kola Nut

CNS effects

Animal and in vitro data

Limited animal and in vitro studies suggest kola nut extract and caffeine exert similar neurological effects.(Burdock 2009) Anticholinesterase activity of aqueous C. acuminata seed extract has also been demonstrated in vitro, leading to claims regarding potential protective effects against neurodegenerative disease.(Oboh 2014)

Clinical data

Clinical studies are lacking. The CNS stimulant effects of 1 nut have been reported to be equal to or greater than effects of the caffeine content of 2 large cups of coffee.(Burdock 2009)

Erectile dysfunction

In a study documenting medicinal plants used in the treatment of sexual impotence and erectile dysfunction disorders in Uganda, C. acuminata was identified as a plant used for erectile dysfunction,(Kamatenesi-Mugisha 2005) although reports of use may be due to misidentification of the unrelated G. kola, which contains garcinoic acid and exhibits an affinity for the phosphodiesterase type 5 receptor.(Ojo 2021)

Hypoglycemic effects

Animal and ethnobotanical data

Limited studies in rats and ethnobotanical investigations suggest C. acuminata may possess hypoglycemic effects.(Ekalu 2020)

Ultraviolet A protection

Animal data

In a study evaluating the ultraviolet A (UVA) protective potential of plant extracts and phytochemicals, the methylxanthine content of C. acuminata was suggested to be responsible for observed effects in reducing harm from UVA radiation in mice.(Skarupova 2020)

Kola Nut side effects

Case reports and evidence from clinical studies are lacking. A report of increased gastric acid secretion in rodents exists; avoid use in individuals with known peptic ulcer.(Ibu 1986)

Before taking Kola Nut

Kola nut has FDA GRAS status.(FDA 2021b) A study in pregnant mice using high-dose kola nut reported a significant decrease in pup body weights.(Burdock 2009)

How to use Kola Nut

Clinical studies are lacking to provide dosing guidance. The CNS stimulant effects of 1 nut have been reported to be equal to or greater than effects of the caffeine content of 2 large cups of coffee.(Burdock 2009)

Warnings

Kola nut has FDA GRAS status, and is used in the food industry.(FDA 2021b)

Subacute toxicity studies in rats showed findings consistent with methylxanthine toxicity, including restlessness, excitement, and irritability.(Burdock 2009)

A study in pregnant mice using high-dose kola nut reported a significant decrease in pup body weights.(Burdock 2009)

It has been suggested that the high amine content is possibly related to oral and GI cancers observed among habitual chewers of kola nut.(Atawodi 1995)

Primarily dose-dependent increases in blood pressure were observed in both normotensive and hypertensive rats, with diastolic pressure more sensitive to dose.(Igbinovia 2009) Increases in metabolic rate were noted in a rat study examining 3 species of kola nut, with C. accuminata having the greatest effect. Researchers also examined effects on isolated rat heart, noting increases in both force of contraction and rate with low doses of kola nut extract, with higher doses resulting in decreases in contraction and rate, until heart failure occurred.(Chukwu 2006)

What other drugs will affect Kola Nut

Potential for kola nut to interact with various drugs has been theorized, including with ephedrine, monoamine oxidase inhibitors, adenosine, clozapine, benzodiazepines, beta-blockers, phenylpropanolamine, and quinolone antibiotics; however, case reports are lacking.(Burdock 2009)

CNS stimulants/Acebrophylline: Acebrophylline may enhance the stimulatory effect of CNS stimulants. Avoid combination.(Acebrophylline 2014)

Doxofylline/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may enhance the adverse/toxic effect of doxofylline. Avoid combination.(Doxofylline 2015)

Iobenguane radiopharmaceutical products/CNS stimulants: CNS stimulants may diminish the therapeutic effect of iobenguane radiopharmaceutical products. Avoid combination.(Adaniya 2021, AdreView March 2020, Azedra July 2018, Estorch 2004, Muraoka 2008, Nakajo 1984, Yokoyama 2014)

Sympathomimetics/Kratom: Kratom may enhance the adverse/toxic effect of sympathomimetics. Avoid combination.(Boyer 2008, Castillo 2017, FDA 2018, FDA 2021a, Holler 2011, Khan 2021, Schmuhl 2020, Warner 2016)

Adenosine/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may diminish the therapeutic effect of adenosine. Consider therapy modification.(Adenocard November 2009, Adenoscan November 2009, Aqel 2004, Reyes 2008, Rongen 1998, Smits 1990, Zoghbi 2006)

Sympathomimetics/Cocaine (topical): Cocaine (topical) may enhance the hypertensive effect of sympathomimetics. Consider therapy modification.(Ashchi 1995, Barnett 1998, Laffey 1999, Lormans 1992, McGovern 2015, Miller 1978, Nicholson 1995, Numbrino January 2020, Sundboll 2014)

Iohexol/Agents with seizure threshold–lowering potential: Agents with seizure threshold–lowering potential may enhance the adverse/toxic effect of iohexol. Specifically, the risk for seizures may be increased. Consider therapy modification.(Omnipaque July 2015)

Iomeprol/Agents with seizure threshold–lowering potential: Agents with seizure threshold–lowering potential may enhance the adverse/toxic effect of iomeprol. Specifically, the risk for seizures may be increased. Consider therapy modification.(Iomeron February 2009)

Iopamidol/Agents with seizure threshold–lowering potential: Agents with seizure threshold–lowering potential may enhance the adverse/toxic effect of iopamidol. Specifically, the risk for seizures may be increased. Consider therapy modification.(Isovue-M January 2017)

Sympathomimetics/Linezolid: Linezolid may enhance the hypertensive effect of sympathomimetics. Consider therapy modification.(Hendershot 2001, Zyvox June 2010)

Regadenoson/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may diminish the vasodilatory effect of regadenoson. Consider therapy modification.(Gaemperli 2008, Lexiscan October 2013, Tejani 2014, Zhao 2007)

Tizanidine/CYP1A2 inhibitors (weak): CYP1A2 inhibitors (weak) may increase the serum concentration of tizanidine. Consider therapy modification.(Granfors 2005, Zanaflex November 2013)

Amifampridine/Agents with seizure threshold–lowering potential: Agents with seizure threshold–lowering potential may enhance the neuroexcitatory and/or seizure-potentiating effect of amifampridine. Monitor therapy.(Firdapse November 2018)

Antipsychotic agents/Agents with seizure threshold–lowering potential: Agents with seizure threshold–lowering potential may enhance the adverse/toxic effect of antipsychotic agents. Specifically, the risk of seizures may be increased. Monitor therapy.(Abilify February 2020, Bonnet 2015, Caplyta April 2022, Clozapine July 2020, Deshauer 2000, Fanapt December 2010, Geodon January 2022, Haberfellner 2002, Hedges 2002, Invega December 2021, Latuda December 2019, Mahr 1987, Malek-Ahmadi 1988, Rexulti December 2021, Risperdal February 2021, Rucker 2008, Schmitz 2021, Secuado October 2019, Seroquel January 2022, Vraylar May 2019, Zyprexa October 2019)

Sympathomimetics/Atomoxetine: Atomoxetine may enhance the hypertensive effect of sympathomimetics. Atomoxetine may enhance the tachycardic effect of sympathomimetics. Monitor therapy.(Cantilena 2012, Hammerness 2009, Kelly 2005, Michelson 2003, Sofuoglu 2009, Spencer 2002, Strattera May 2017)

CYP1A2 substrates (high risk with inducers)/Broccoli: Broccoli may decrease the serum concentration of CYP1A2 substrates (high risk with inducers). Monitor therapy.(Bell 2000, McAlindon 2001, Rajoria 2011, Reed 2005)

Bromperidol/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may decrease the absorption of bromperidol. Monitor therapy.(Brom 2017)

Agents with seizure threshold–lowering potential/Bupropion: Bupropion may enhance the neuroexcitatory and/or seizure-potentiating effect of agents with seizure threshold–lowering potential. Monitor therapy.(Wellbutrin May 2017)

Sympathomimetics/Cannabinoid-containing products: Cannabinoid-containing products may enhance the tachycardic effect of sympathomimetics. Monitor therapy.(Benowitz 1977, Foltin 1987, Foltin 1990, Foltin 1995, Gash 1978, Kollins 2015, Lukas 1994, Williamson 2000)

CYP1A2 substrates (high risk with inducers)/Cannabis: Cannabis may decrease the serum concentration of CYP1A2 substrates (high risk with inducers). Monitor therapy.(Chetty 1994, Gardner 1983, Jusko 1978, Jusko 1979)

Clozapine/CYP1A2 inhibitors (weak): CYP1A2 inhibitors (weak) may increase the serum concentration of clozapine. Monitor therapy.(Al Hadithy 2012, Carrillo 1998, Clozaril February 2017, Gabbay 2002, Hagg 2000, Raaska 2004, Rajkumar 2013, Sandson 2007, Schoretsanitis 2020, Szymanski 1991, Vainer 1994)

Caffeine and caffeine-containing products/CYP1A2 inducers (moderate): CYP1A2 inducers (moderate) may decrease the serum concentration of caffeine and caffeine-containing products. Monitor therapy.(Aubagio September 2019, Cafcit December 2018)

Caffeine and caffeine-containing products/CYP1A2 inhibitors (moderate): CYP1A2 inhibitors (moderate) may increase the serum concentration of caffeine and caffeine-containing products. Monitor therapy.(Bapiro 2005, Bendriss 1996, Cafcit December 2018, Fexinidazole 2021, Harder 1988, Harder 1989, Healy 1989, Joeres 1987a, Joeres 1987b, Kim 2003, Kinzig-Schippers 1999, Mahr 1992, Mays 1987, Nicolau 1995, Staib 1987, Stille 1987, Tabrecta May 2020, Tantcheva-Poor 2001, Vassiliou 2021, Xiao 2019)

Caffeine and caffeine-containing products/CYP1A2 inhibitors (strong): CYP1A2 inhibitors (strong) may increase the serum concentration of caffeine and caffeine-containing products.(Cafcit December 2018, Christensen 2002, Croft 2012, Culm-Merdek 2005, Jeppesen 1996a, Jeppesen 1996b, Kashuba 1998, Ozdemir 1998, Qelbree April 2021, Spigset 1998, Yoshimura 2002)

CNS stimulants/Esketamine: Esketamine may enhance the hypertensive effect of CNS stimulants. Monitor therapy.(Spravato March 2019)

Formoterol/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may enhance the adverse/toxic effect of formoterol. Caffeine and caffeine-containing products may enhance the hypokalemic effect of formoterol. Monitor therapy.(Dulera June 2010)

Sympathomimetics/Guanethidine: Guanethidine may enhance the arrhythmogenic effect of sympathomimetics. Guanethidine may enhance the hypertensive effect of sympathomimetics. Monitor therapy.(Deshmankar 1967, Gulati 1966, Ismelin July 2014, Laurence 1963, Muelheims 1965, Simonyi 1972)

Halofantrine/Kola nut: Kola nut may decrease serum concentrations of the active metabolite(s) of halofantrine. Kola nut may decrease the serum concentration of halofantrine. Monitor therapy.(Kolade 2008)

Indacaterol/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may enhance the adverse/toxic effect of indacaterol. Caffeine and caffeine-containing products may enhance the hypokalemic effect of indacaterol. Monitor therapy.(Arcapta July 2011)

Lithium/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may decrease the serum concentration of lithium. Monitor therapy.(Jefferson 1988, Kralovec 2011, Mester 1995, Shirley 2002)

Caffeine and caffeine-containing products/Norfloxacin: Norfloxacin may increase the serum concentration of caffeine and caffeine-containing products. Monitor therapy.(Carbo 1989, Harder 1988)

Olodaterol/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may enhance the adverse/toxic effect of olodaterol. Caffeine and caffeine-containing products may enhance the hypokalemic effect of olodaterol. Monitor therapy.(Strierdi Respimat July 2014)

Sympathomimetics/Ozanimod: Ozanimod may enhance the hypertensive effect of sympathomimetics. Monitor therapy.(Tran 2020, Zeposia March 2020)

Caffeine and caffeine-containing products/Pipemidic acid: Pipemidic acid may increase the serum concentration of caffeine and caffeine-containing products. Monitor therapy.(Cafcit September 1999, Carbo 1989, Fuhr 1990, Harder 1988, Urotractin July 2017)

Solriamfetol/Sympathomimetics: Sympathomimetics may enhance the hypertensive effect of solriamfetol. Sympathomimetics may enhance the tachycardic effect of solriamfetol. Monitor therapy.(Sunosi June 2019)

Sympathomimetics/Sympathomimetics: Sympathomimetics may enhance the adverse/toxic effect of other sympathomimetics. Monitor therapy.(Foradil September 2001, Lidocaine April 2017, Maxa 2020, ProAmatine February 2017)

Sympathomimetics/Tedizolid: Tedizolid may enhance the hypertensive effect of sympathomimetics. Tedizolid may enhance the tachycardic effect of sympathomimetics. Monitor therapy.(Flanagan 2013, Hendershot 2001, Sivextro June 2014, Zyvox September 2013)

Theophylline derivatives/CYP1A2 inhibitors (weak): CYP1A2 inhibitors (weak) may increase the serum concentration of theophylline derivatives. Monitor therapy.(Bauman 1982, Campbell 1981, Cohen 1985, Colli 1987, Conrad 1980, Gardner 1983, Granneman 1995, Koren 1985, Lee 1992, Lofgren 1982, Loi 1989, Lombardi 1987, Maeda 1996, Miners 1985, Mojtahedzadeh 2003, Mulkey 1983, Niki 1987, Powell 1984, Sato 1993, Spinler 1993, Staib 1989, Theo-24 August 2017, Tornatore 1982, Vestal 1983, Wijnands 1986, Wijnands 1987, Williams 1987)

Caffeine and caffeine-containing products/Tobacco (smoked): Tobacco (smoked) may decrease the serum concentration of caffeine and caffeine-containing products. Monitor therapy.(Acheson 1987, Benowitz 2003, Brown 1988, Casto 1990, Cusack 1980, Cusack 1985, Eldon 1987, Faber 2004, Gardner 1983, Grygiel 1981, Hunt 1976, Joeres 1988, Jusko 1978, Lee 1987, Matsunga 1989, Mayo 2001, Miners 1985, Parsons 1978, Powell 1977, Samaan 1989)

Warfarin/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may diminish the anticoagulant effect of warfarin. Monitor therapy.(Clapauch 2012)

Caffeine and caffeine-containing products/CYP1A2 inducers (weak): CYP1A2 inducers (weak) may decrease the serum concentration of caffeine and caffeine-containing products. No action needed.(Dumond 2010, Kirby 2011, Magnusson 2008, Wietholtz 1989, Wietholz 1995)

Caffeine and caffeine-containing products/CYP1A2 inhibitors (weak): CYP1A2 inhibitors (weak) may increase the serum concentration of caffeine and caffeine-containing products. No action needed.(Abernethy 1985, Bachmann 2020, Balogh 1995, Beach 1986, Carbo 1989, Edwards 2017, Epidiolex October 2020, Harder 1988, Kinzig 1999, Mavyret April 2020, Michaud 2006, Olysio November 2017, Pegintron January 2019, Thai 2021)

Caffeine and caffeine-containing products/Hibiscus: Hibiscus may increase the serum concentration of caffeine and caffeine-containing products. No action needed.(Johnson 2013, Showande 2019)

Caffeine and caffeine-containing products/L-Theanine: L-theanine may diminish the therapeutic effect of caffeine and caffeine-containing products. Specifically, the vasoconstrictive and cognition- and mood-enhancing effects of caffeine may be diminished. L-theanine may enhance the therapeutic effect of caffeine and caffeine-containing products. Specifically, caffeine effects on cognition and neurophysiologic performance may be enhanced. No action needed.(Dodd 2015, Foxe 2012, Kahathuduwa 2017, Owen 2008)

Caffeine and caffeine-containing products/Menthol: Menthol may decrease the absorption of caffeine and caffeine-containing products. Specifically, menthol may delay absorption of caffeine. No action needed.(Begas 2017, Gelal 2003)

Monoamine oxidase inhibitors/Caffeine and caffeine-containing products: Caffeine and caffeine-containing products may enhance the hypertensive effect of monoamine oxidase inhibitors. No action needed.(Pakes 1979, van der Hoeven 2014)

Sympathomimetics/Procarbazine: Procarbazine may enhance the adverse/toxic effect of sympathomimetics. No action needed.(Matulane August 2018)

Caffeine and caffeine-containing products/Quercetin: Quercetin may increase the serum concentration of caffeine and caffeine-containing products. No action needed.(Chen 2009, Xiao 2014)

Caffeine and caffeine-containing products/Terbinafine (systemic): Terbinafine (systemic) may increase the serum concentration of caffeine and caffeine-containing products. No action needed.(Trepanier 1998, Wahllander 1989)

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