Background

Pu-erh tea is made by parching and then fermenting the leaves of Camellia sinsensis, the same plant that is used for making green, oolong, and black teas.

Pu-erh tea is mainly made in southwestern China and Taiwan. It contains caffeine, which stimulates the central nervous system, heart, and muscles. Pu-erh tea also contains antioxidants that might help protect the heart and blood vessels.

People use pu-erh tea for improving mental alertness and thinking, high cholesterol, obesity, diabetes, and many other conditions, but there is no good scientific evidence to support these uses.

Don't confuse pu-erh tea with other caffeine sources, such as coffee, green coffee, black tea, green tea, and oolong tea. These are not the same.

Safety Safety definitions

When taken by mouth: Drinking pu-erh tea in moderate amounts (about 4 cups daily) is possibly safe for most people. Pu-erh tea extract is also possibly safe when used for up to 12 weeks.

Drinking more than 4 cups of pu-erh tea daily is possibly unsafe. Drinking large amounts might cause side effects due to the caffeine content. These side effects can range from mild to serious and include headache and irregular heartbeat.

Special Precautions & Warnings:

Pregnancy: Drinking moderate amounts of pu-erh tea during pregnancy is possibly safe. Do not drink more than 3 cups of pu-erh tea daily. This provides about 300 mg of caffeine. Consuming more than this during pregnancy is possibly unsafe and has been linked to an increased risk of miscarriage, increased risk of sudden infant death syndrome (SIDS), and other negative effects, including symptoms of caffeine withdrawal in newborns and lower birth weight.

Breast-feeding: Drinking moderate amounts of pu-erh tea while breast-feeding is possibly safe. But drinking more than 3 cups of pu-erh tea daily is possibly unsafe. The caffeine in pu-erh tea is passed into breastmilk. It might cause irritability and increased bowel movements in nursing infants.

Children: Pu-erh tea is possibly safe in children when consumed in amounts found in food and beverages.

Anxiety disorders: The caffeine in pu-erh tea might make these conditions worse.

Bleeding disorders: Pu-erh tea contains caffeine. Caffeine might slow blood clotting. Use caffeine cautiously if you have a bleeding disorder.

Heart conditions: Pu-erh tea contains caffeine. Caffeine can cause irregular heartbeat in certain people. If you have a heart condition, use caffeine with caution.

Diabetes: Pu-erh tea contains caffeine. Caffeine might affect blood sugar levels. Use caffeine with caution if you have diabetes.

Diarrhea: Pu-erh tea contains caffeine. Caffeine, especially when taken in large amounts, can worsen diarrhea.

Seizures: Pu-erh tea contains caffeine. High doses of caffeine might cause seizures or decrease the effects of drugs used to prevent seizures. If you have ever had a seizure, don't take high doses of caffeine.

Glaucoma: Pu- tea contains caffeine. Caffeine can increase the pressure inside the eye. The increase occurs within 30 minutes and lasts for at least 90 minutes.

High blood pressure: Pu-erh tea contains caffeine. Caffeine might increase blood pressure. But this doesn't seem to happen in people who regularly drink pu-erh tea or other caffeinated products.

Irritable bowel syndrome (IBS): Pu-erh tea contains caffeine. Caffeine, especially when taken in large amounts, might worsen the diarrhea some people have with IBS.

Weak bones (osteoporosis): Drinking pu-erh tea can increase the amount of calcium that is flushed out in the urine. This might weaken bones. If you have osteoporosis, don't drink more than 4 cups of pu-erh tea daily. If you are generally healthy and get enough calcium from your food or supplements, drinking about 3 cups of pu-erh tea daily doesn't seem to increase the risk of getting osteoporosis.

Parkinson disease: The caffeine in pu-erh tea might make Parkinson disease worsen faster when taken with creatine. If you have Parkinson disease and take creatine, use caffeine with caution.

Schizophrenia: The caffeine in pu-erh tea might worsen symptoms of schizophrenia.

Effectiveness

Dosing & administration

Pu-erh tea is consumed as a beverage in some parts of the world, especially southwestern China and Taiwan. As medicine, there isn't enough reliable information to know what an appropriate dose of pu-erh tea might be. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult a healthcare professional before using.

Interactions with pharmaceuticals

Adenosine (Adenocard)

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. Caffeine might block the effects of adenosine, which is often used by doctors to do a test called a cardiac stress test. Stop consuming pu-erh tea at least 24 hours before a cardiac stress test.

Alcohol (Ethanol)

Interaction Rating=Minor Be watchful with this combination.

The body breaks down the caffeine in pu-erh tea to get rid of it. Alcohol can decrease how quickly the body breaks down caffeine. Taking pu-erh tea along with alcohol might cause too much caffeine in the bloodstream and caffeine side effects including jitteriness, headache, and fast heartbeat.

Antibiotics (Quinolone antibiotics)

Interaction Rating=Minor Be watchful with this combination.

The body breaks down caffeine from pu-erh tea to get rid of it. Some antibiotics can decrease how quickly the body breaks down caffeine. Taking these antibiotics along with pu-erh tea might increase the risk of side effects including jitteriness, headache, increased heart rate, and others.

Birth control pills (Contraceptive drugs)

Interaction Rating=Minor Be watchful with this combination.

The body breaks down the caffeine in pu-erh tea to get rid of it. Birth control pills can decrease how quickly the body breaks down caffeine. Taking pu-erh tea along with birth control pills can cause jitteriness, headache, fast heartbeat, and other side effects.

Carbamazepine (Tegretol)

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. Caffeine might lower the effects of carbamazepine. Taking caffeine with carbamazepine can reduce its effects and increase the risk of seizures in some people.

Cimetidine (Tagamet)

Interaction Rating=Major Do not take this combination.

Pu-erh tea contains caffeine. The body breaks down caffeine to get rid of it. Cimetidine can decrease how quickly your body breaks down caffeine. Taking cimetidine along with pu-erh tea might increase the chance of caffeine side effects including jitteriness, headache, fast heartbeat, and others.

Clozapine (Clozaril)

Interaction Rating=Moderate Be cautious with this combination.

The body breaks down clozapine to get rid of it. The caffeine in pu-erh tea seems to decrease how quickly the body breaks down clozapine. Taking pu-erh tea along with clozapine can increase the effects and side effects of clozapine.

Dipyridamole (Persantine)

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. The caffeine in pu-erh tea might block the effects of dipyridamole. Dipyridamole is often used by doctors to do a test on the heart. This test is called a cardiac stress test. Stop consuming pu-erh tea or other caffeine-containing products at least 24 hours before a cardiac stress test.

Disulfiram (Antabuse)

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. The body breaks down caffeine to get rid of it. Disulfiram can decrease how quickly the body gets rid of caffeine. Taking pu-erh tea along with disulfiram might increase the effects and side effects of caffeine including jitteriness, hyperactivity, irritability, and others.

Ephedrine

Interaction Rating=Major Do not take this combination.

Pu-erh tea contains caffeine. Caffeine is a stimulant drug. Stimulant drugs speed up the nervous system. Ephedrine is also a stimulant drug. Taking pu-erh tea along with ephedrine might cause too much stimulation and sometimes serious side effects and heart problems.

Estrogens

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. The body breaks down caffeine to get rid of it. Estrogens can decrease how quickly the body breaks down caffeine. Taking estrogen and drinking pu-erh tea can increase the risk of side effects from caffeine, such as jitteriness, headache, and fast heartbeat.

Ethosuximide (Zarontin)

Interaction Rating=Moderate Be cautious with this combination.

Ethosuximide is a drug used to treat seizures. Caffeine in pu-erh tea can decrease the effects of ethosuximide. Taking pu-erh tea with ethosuximide might decrease the effects of ethosuximide and increase the risk of seizures in some people.

Felbamate (Felbatol)

Interaction Rating=Moderate Be cautious with this combination.

Felbamate is a drug used to treat seizures. Caffeine in pu-erh tea might decrease the effects of felbamate. Taking pu-erh with felbamate might decrease the effects of felbamate and increase the risk of seizures in some people.

Fluconazole (Diflucan)

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains caffeine. The body breaks down caffeine to get rid of it. Fluconazole might decrease how quickly the body gets rid of caffeine. Taking pu-erh tea along with fluconazole might increase the risk of caffeine side effects such as nervousness, anxiety, and insomnia.

Flutamide (Eulexin)

Interaction Rating=Moderate Be cautious with this combination.

The body breaks down flutamide to get rid of it. Caffeine in pu-erh tea might decrease how quickly the body gets rid of flutamide. This could increase the levels of flutamide in the body and increase the risk of side effects.

Fluvoxamine (Luvox)

Interaction Rating=Moderate Be cautious with this combination.

The body breaks down the caffeine in pu-erh tea to get rid of it. Fluvoxamine can decrease how quickly the body breaks down caffeine. Taking pu-erh tea along with fluvoxamine might cause too much caffeine in the body, and increase the effects and side effects of caffeine.

Lithium

Interaction Rating=Moderate Be cautious with this combination.

The caffeine in pu-erh tea can increase how quickly the body gets rid of lithium. If you take lithium and want to stop taking caffeine, don't stop using caffeine all at once. Instead, slowly reduce the use of caffeine products. Stopping pu-erh tea too quickly can increase the side effects of lithium.

Medications for asthma (Beta-adrenergic agonists)

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. Caffeine can stimulate the heart. Some medications for asthma can also stimulate the heart. Taking caffeine with some medications for asthma might cause too much stimulation and cause heart problems.

Medications for depression (MAOIs)

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. There is some concern that caffeine can interact with certain medications, called MAOIs. If caffeine is taken with these medications, it might increase the risk for serious side effects including fast heartbeat and very high blood pressure.

Some common MAOIs include phenelzine (Nardil), selegiline (Zelapar), and tranylcypromine (Parnate).

Medications for depression (Tricyclic antidepressants)

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains chemicals called tannins. Tannins can bind to many medications, including tricyclic antidepressants, and decrease how much medicine the body absorbs. To avoid this interaction, avoid pu-erh tea 1 hour before and 2 hours after taking tricyclic antidepressants.

Medications for diabetes (Antidiabetes drugs)

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains caffeine. Caffeine can either increase or decrease blood sugar. Diabetes medications are used to lower blood sugar. Taking some medications for diabetes along with caffeine might change the effects of the diabetes medications. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea might slow blood clotting. Taking pu-erh tea along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Metformin (Glucophage)

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains caffeine. Metformin can decrease how quickly the body breaks down caffeine. Taking pu-erh tea along with metformin might increase the effects and side effects of caffeine.

Methoxsalen (Oxsoralen)

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains caffeine. Methoxsalen can decrease how quickly the body breaks down caffeine. Taking caffeine along with methoxsalen might increase the effects and side effects of caffeine.

Mexiletine (Mexitil)

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains caffeine. The body breaks down caffeine to get rid of it. Mexiletine can decrease how quickly the body breaks down caffeine. Taking mexiletine along with pu-erh tea might increase the caffeine effects and side effects of pu-erh tea.

Nicotine

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. Caffeine can stimulate the heart. Nicotine can also stimulate the heart. Taking pu-erh tea with nicotine might cause too much stimulation and cause heart problems, such as increased heart rate or blood pressure.

Pentobarbital (Nembutal)

Interaction Rating=Moderate Be cautious with this combination.

The stimulant effects of the caffeine in pu-erh tea can block the sleep-producing effects of pentobarbital.

Phenobarbital (Luminal)

Interaction Rating=Moderate Be cautious with this combination.

Phenobarbital is a drug used to treat seizures. Caffeine in pu-erh tea might decrease the effects of phenobarbital and increase the risk of seizures in some people.

Phenothiazines

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains chemicals called tannins. Tannins can bind to phenothiazines and decrease how much medicine the body absorbs. Pu-erh tea also contains caffeine. Phenothiazines can decrease how quickly the body breaks down caffeine. Taking phenothiazines along with caffeine might increase the effects and side effects of caffeine.

Phenylpropanolamine

Interaction Rating=Moderate Be cautious with this combination.

The caffeine in pu-erh tea can stimulate the body. Phenylpropanolamine can also stimulate the body. Taking pu-erh tea along with phenylpropanolamine might cause too much stimulation and increase heartbeat, blood pressure, and cause nervousness.

Phenytoin (Dilantin)

Interaction Rating=Moderate Be cautious with this combination.

Phenytoin is a drug used to treat seizures. Caffeine in pu-erh tea can decrease the effects of phenytoin. Taking pu-erh tea with phenytoin might decrease the effects of phenytoin and increase the risk of seizures in some people.

Pioglitazone (Actos)

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. Caffeine might increase the amount of pioglitazone that the body absorbs. Taking caffeine might increase the effects and adverse effects of pioglitazone.

Riluzole (Rilutek)

Interaction Rating=Moderate Be cautious with this combination.

The body breaks down riluzole to get rid of it. Taking pu-erh tea can decrease how fast the body breaks down riluzole and increase the effects and side effects of riluzole.

Stimulant drugs

Interaction Rating=Moderate Be cautious with this combination.

Stimulants, such as amphetamines and cocaine, speed up the nervous system. By speeding up the nervous system, stimulant medications can increase blood pressure and speed up the heartbeat. Pu-erh tea contains caffeine. Caffeine can also speed up the nervous system. Taking pu-erh tea along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure.

Terbinafine (Lamisil)

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains caffeine. The body breaks down caffeine to get rid of it. Terbinafine can decrease how fast the body gets rid of caffeine and increase the risk of side effects including jitteriness, headache, increased heartbeat, and other effects.

Theophylline

Interaction Rating=Moderate Be cautious with this combination.

Pu-erh tea contains caffeine. Caffeine works similarly to theophylline. Caffeine can also decrease how quickly the body gets rid of theophylline. Taking pu-erh tea along with theophylline might increase the effects and side effects of theophylline.

Tiagabine (Gabitril)

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains caffeine. Taking caffeine over a long time period along with tiagabine can increase the amount of tiagabine in the body. This might increase the effects and side effects of tiagabine.

Ticlopidine (Ticlid)

Interaction Rating=Minor Be watchful with this combination.

Ticlopidine can decrease how quickly the body gets rid of caffeine. Taking pu-erh tea along with ticlopidine might increase the effects and side effects of caffeine, including jitteriness, hyperactivity, irritability, and others.

Valproate

Interaction Rating=Moderate Be cautious with this combination.

Valproate is a drug used to treat seizures. Caffeine in pu-erh tea might decrease the effects of valproate and increase the risk of seizures in some people.

Verapamil (Calan, others)

Interaction Rating=Moderate Be cautious with this combination.

The body breaks down the caffeine in pu-erh tea to get rid of it. Verapamil can decrease how quickly the body gets rid of caffeine. Taking pu-erh tea along with verapamil can increase the risk of caffeine side effects including jitteriness, headache, and an increased heartbeat.

Water pills (Diuretic drugs)

Interaction Rating=Minor Be watchful with this combination.

Pu-erh tea contains caffeine. Caffeine, especially in large amounts, can reduce potassium levels in the body. "Water pills" can also decrease potassium levels in the body. Taking large amounts of caffeine along with "water pills" might decrease potassium levels too much.

Interactions with herbs & supplements

Bitter orange: Pu-erh tea contains caffeine. Using bitter orange along with products that contain caffeine can increase blood pressure and heart rate in otherwise healthy adults with normal blood pressure. This could increase the risk of serious heart problems.
Caffeine-containing herbs and supplements: Pu-erh tea contains caffeine. Taking it with other herbs and supplements that also contain caffeine can increase both the harmful and helpful effects of caffeine. Other natural products that contain caffeine include coffee, black tea, green tea, oolong tea, guarana, mate, and cola.
Calcium: High caffeine intake from foods and beverages, including pu-erh tea, flushes calcium out of the body in the urine. This might lower calcium levels in the body.
Cordyceps: Pu-erh tea contains caffeine. Cordyceps might increase how quickly the body gets rid of caffeine. This might decrease the effects of caffeine.
Creatine: Pu-erh tea contains caffeine. Combining caffeine, ephedra, and creatine might increase the risk of serious unwanted side effects. One athlete who used this combination, as well as some other supplements to improve performance, suffered a stroke. Researchers worry the stroke might have been caused by the supplements.
Danshen: Pu-erh tea contains caffeine. Danshen can decrease how quickly the body gets rid of caffeine. Drinking pu-erh tea and taking danshen might increase the risk of side effects, including jitteriness, headache, and an increased heartbeat.
Echinacea: Pu-erh tea contains caffeine. Echinacea can decrease how quickly the body gets rid of caffeine. Drinking pu-erh tea and taking echinacea might increase the risk of side effects, including jitteriness, headache, and an increased heartbeat.
Ephedra: Pu-erh tea contains caffeine. Using ephedra with caffeine might increase the risk of serious life-threatening or disabling conditions such as hypertension, heart attack, stroke, seizures, and death. Avoid this combination.
Folic acid: Pu-erh might reduce the amount of folic acid that the body can absorb and use.
Genistein-containing herbs and supplements: Pu-erh tea contains caffeine. A chemical called genistein can decrease how quickly the body gets rid of caffeine. Drinking pu-erh tea and taking genistein might increase the risk of side effects for caffeine, including jitteriness, headache, and an increased heartbeat. Examples of supplements that contain genistein include cumin, dyer's broom, kudzu, red clover, and soy.
Herbs and supplements that might slow blood clotting: Pu-erh tea contains caffeine. Caffeine might slow blood clotting. Taking pu-erh tea along with other herbs that also slow clotting might increase the chances of bruising and bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.
Iron: Pu-erh tea might interfere with the body's ability to absorb iron. This probably isn't a problem for most people. If you are iron-deficient, drink tea between meals rather than with meals to reduce this concern.
Kudzu: Pu-erh tea contains caffeine. Kudzu can decrease how quickly the body gets rid of caffeine. Drinking pu-erh tea and taking kudzu might increase the risk of side effects, including jitteriness, headache, and an increased heartbeat.
Magnesium: Pu-erh tea contains caffeine. Drinking large amounts of caffeine can increase the amount of magnesium that is flushed out in the urine. This might lower magnesium levels in the body.
Melatonin: Pu-erh tea contains caffeine. Taking caffeine and melatonin together can increase melatonin levels. Caffeine can also increase natural melatonin levels in healthy individuals.

Interactions with foods

Pu-erh tea appears to reduce absorption of iron from foods. Drinking pu-erh tea in between meals rather than with meals should reduce this concern.

Adding milk to pu-erh tea appears to reduce some of the heart health benefits of drinking tea. Milk might bind with the antioxidants in tea and keep them from being absorbed. But it's not clear if this is a real concern.