Interaction of chlorpromazine with tea and coffee

1 The interaction between phenothiazine neuroleptics with tea and coffee was studied in vitro. 2 Filtered infusions of tea and coffee caused precipitation of all the neuroleptics studied. Tea always caused a heavier precipitate than coffee. 3 The constituent or constituents of tea and coffee responsible for precipitating the neuroleptics was not identified. Solutions of caffeine, caffeine citrate and sodium chloride did not form a precipitate with chlorpromazine but precipitates were formed by sodium salicylate, sodium benzoate and trisodium citrate. 4 The interaction between chlorpromazine (CPZ) and tea was studied quantitatively using radiolabelled drug and it was found that the precipitation of [3H]-CPZ with a given quantity of tea was 'saturable'. The proportion of CPZ precipitated by a 'standard cup of tea' was 80% at low doses of the drug (10-40 mg) whilst at high doses (800 mg), the proportion of the drug precipitated was approximately 20%. 5 The interaction was further studied in vivo by the oral administration of tea and CPZ to rats. The cataleptic effect of CPZ was significantly reduced by the simultaneous administration of tea and this was apparently not due to the caffeine present in tea. 6 The results suggest that a substantial proportion of orally administered neuroleptic may be precipitated as a highly insoluble compound if coffee, or more especially tea, is taken close to drug administration. This interaction might affect the absorption of phenothiazines given orally to patients.