Can you take Pep-Back Ultra with Varenicline?
1 drug interaction and 30 additional warnings found for the following 2 drugs:
- Pep-Back Ultra (caffeine)
- varenicline
Drug interactions
Moderate drug interactions
Moderate:
caffeine varenicline
Applies to: Pep-Back Ultra (caffeine) and varenicline
As you stop smoking during treatment with varenicline, your dosage requirement of caffeine may need to be changed. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
varenicline Food/Lifestyle
Applies to: varenicline
Varenicline may alter the way you react to alcohol. Some patients treated with varenicline have experienced decreased tolerance to alcohol, including increased drunkenness, unusual or aggressive behavior, or they had no memory of things that happened. You should limit the consumption of alcohol until you know whether varenicline affects your tolerance for alcohol. Also use caution driving or operating machinery until you know how quitting smoking and/or varenicline may affect you. If you develop nervousness, agitation, hostility, aggressive behavior, depression, thoughts of suicide, or have other changes in your behavior or thinking that are
not typical for you, you should immediately stop taking varenicline and contact your doctor. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Minor food/lifestyle interactions
Minor:
caffeine Food/Lifestyle
Applies to: Pep-Back Ultra (caffeine)
Information for this minor interaction is available on the professional version.
Disease interactions
28 potential interactions Applies to: 22 conditions, including High Blood Pressure, Depression, GERD, Heart Attack, and Angina.
Acute Alcohol Intoxication
Moderate:
varenicline
Varenicline has a moderate potential interaction with Acute Alcohol Intoxication.
Varenicline can enhance the response to alcohol and patients may experience increased intoxicating effects. In patients who may use alcohol excessively, it should be kept in mind that the potentiation may increase the danger associated with the use of alcohol. Advise patients to reduce the amount of alcohol they consume and to use caution driving or operating machinery or engaging in other potentially hazardous activities while taking varenicline until they know how this agent may affect them.
Angina
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with Angina.
Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.
Cardiovascular Conditions and Disorders
Moderate:
varenicline
Varenicline has a moderate potential interaction with Cardiovascular Conditions and Disorders.
There have been reports of cardiovascular events, including ischemic and hemorrhagic events in patients taking varenicline. Caution is recommended when prescribing this agent. Patients should be monitored for signs of new or worsening symptoms of cardiovascular disease and appropriate therapy should be instituted according to medical guidelines.
Depression
Major:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a major potential interaction with Depression.
The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.
Depressive Psychosis
Major:
varenicline
Varenicline has a major potential interaction with Depressive Psychosis.
Serious neuropsychiatric events including, but not limited to, depression, suicidal ideation, suicide attempt, and completed suicide have been reported in patients taking varenicline. Caution is recommended and patients should be observed for neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood, and suicide-related events, including ideation, behavior, and attempted suicide.
GERD
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with GERD.
Methylxanthines increase gastric acidity and may also relax lower esophageal sphincter, which can lead to gastric reflux into the esophagus. Therapy with products containing methylxanthines should be administered cautiously in patients with significant gastroesophageal reflux.
Heart Attack
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with Heart Attack.
Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.
Moderate:
varenicline
Varenicline has a moderate potential interaction with Heart Attack.
There have been reports of cardiovascular events, including ischemic and hemorrhagic events in patients taking varenicline. Caution is recommended when prescribing this agent. Patients should be monitored for signs of new or worsening symptoms of cardiovascular disease and appropriate therapy should be instituted according to medical guidelines.
Heart Disease
Major:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a major potential interaction with Heart Disease.
Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.
High Blood Pressure
Major:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a major potential interaction with High Blood Pressure.
Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.
Major:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a major potential interaction with High Blood Pressure.
CNS stimulants increase blood pressure and heart rate; the use of some agents may be contraindicated in patients with severe/uncontrolled hypertension. Caution should be used when administering to patients with preexisting high blood pressure (even mild hypertension) and other cardiovascular conditions. All patients under treatment should be regularly monitored for potential tachycardia and hypertension.
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with High Blood Pressure.
Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.
History - Cerebrovascular Disease
Moderate:
varenicline
Varenicline has a moderate potential interaction with History - Cerebrovascular Disease.
There have been reports of cardiovascular events, including ischemic and hemorrhagic events in patients taking varenicline. Caution is recommended when prescribing this agent. Patients should be monitored for signs of new or worsening symptoms of cardiovascular disease and appropriate therapy should be instituted according to medical guidelines.
History - Myocardial Infarction
Moderate:
varenicline
Varenicline has a moderate potential interaction with History - Myocardial Infarction.
There have been reports of cardiovascular events, including ischemic and hemorrhagic events in patients taking varenicline. Caution is recommended when prescribing this agent. Patients should be monitored for signs of new or worsening symptoms of cardiovascular disease and appropriate therapy should be instituted according to medical guidelines.
Hyperthyroidism
Major:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a major potential interaction with Hyperthyroidism.
Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with Hyperthyroidism.
Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.
Liver Disease
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with Liver Disease.
In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly in certain agents. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury; laboratory testing should be done at the first sign/symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.
Peptic Ulcer
Major:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a major potential interaction with Peptic Ulcer.
Methylxanthines are known to stimulate peptic acid secretion. Therapy with products containing methylxanthines should be administered with extreme caution in patients with active peptic ulcer disease. Some manufacturers consider their use to be contraindicated under such circumstance.
Peripheral Arterial Disease
Major:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a major potential interaction with Peripheral Arterial Disease.
Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.
Pheochromocytoma
Major:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a major potential interaction with Pheochromocytoma.
Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.
Post MI Syndrome
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with Post MI Syndrome.
Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.
Psychiatric Disorders
Major:
varenicline
Varenicline has a major potential interaction with Psychiatric Disorders.
Serious neuropsychiatric events including, but not limited to, depression, suicidal ideation, suicide attempt, and completed suicide have been reported in patients taking varenicline. Caution is recommended and patients should be observed for neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood, and suicide-related events, including ideation, behavior, and attempted suicide.
Psychosis
Major:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a major potential interaction with Psychosis.
The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.
Renal Dysfunction
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with Renal Dysfunction.
Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly in certain agents.
Moderate:
varenicline
Varenicline has a moderate potential interaction with Renal Dysfunction.
Varenicline is substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Dose reduction is not required in patients with mild to moderate renal impairment. Dosage adjustment is needed in patients with severe renal impairment, and those with end-stage renal disease undergoing hemodialysis. Varenicline has been shown to be dialyzed in patients with end-stage renal disease. Monitoring of renal function is recommended.
Seizures
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with Seizures.
Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with history of seizures, with prior electroencephalogram (EEG) abnormalities without seizures, and very rarely, without history of seizures and no prior EEG evidence of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures occur, therapy should be discontinued.
Moderate:
varenicline
Varenicline has a moderate potential interaction with Seizures.
Seizures have been reported with varenicline therapy. Therapy with this drug should be administered with caution and monitoring is recommended in patients with a history of seizures or other factors that can lower the seizure threshold.
Tachyarrhythmia
Moderate:
Pep-Back Ultra
The caffeine in Pep-Back Ultra has a moderate potential interaction with Tachyarrhythmia.
Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.
More resources
Pep-Back Ultra
A total of 124 drugs are known to interact with Pep-Back Ultra.
- Pep-back ultra is in the drug class CNS stimulants.
- Pep-back ultra is used to treat the following conditions:
varenicline
A total of 68 drugs are known to interact with varenicline.
- Varenicline is in the following drug classes: cholinergic agonists, smoking cessation agents.
- Varenicline is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.