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Green tea interactions and adverse reactions:

While drinking green tea, patients should be advised to avoid drugs metabolized by the liver such as acetaminophen.

According to Schönthal, the following adverse reactions have been reported (116):

• 34 case reports of hepatotoxicity, tremor, headache, pain, paresthesias, insomnia, palpitations, nausea, dysphagia, flatulence, and bloating.
• Green tea may reduce absorption of iron supplements, pseudoephedrine, theophylline, aminophylline, warfarin, codeine, atropine, ephedrine, carbinoxamine, dextromethorphan, Lomotil®, and Lonox.
• Green tea may increase the action of ephedrine, pseudoephedrine, theophylline, aminophylline, and reduce the effectiveness of adenosine, bortezomib, and sunitinib.

Green tea contains caffeine which is generally recognized as safe by the FDA and AMA but can be dangerous with adverse effects such as high bp, stroke, and arrythmias reported. If more than 4 cups of caffeinated beverages are consumed per day, it is prudent to seek physician and/or pharmacist approval of caffeine consumption with any medications or supplements.