← The ApothecaryErythroxylaceaeleavesFact-checked 23 October 2026

Significant riskCocaine has a high potential for abuse and dependence and can cause paranoia, psychosis, hypertension, stroke, seizures and heart attack. Leaf chewing delivers cocaine slowly and in far smaller amounts, but the leaf and its extracts are not for home medicinal use outside the Andean traditions and laws where it is legal.In an emergency, call your local emergency number or poison centre.

EvidenceStrong evidence

SafetySignificant risk

PregnancyContraindicated

Actions

stimulant · analgesic · psychoactive

What the regulators say

Medicine derived from itCocaine hydrochloride nasal solution (Goprelto 2017, Numbrino 2018; US Schedule II)

Coca leaf is in Schedule I of the 1961 UN Single Convention on Narcotic Drugs, whose Article 49 required leaf chewing to be abolished within 25 years; Article 27 allows decocainised leaf as a flavouring. Bolivia withdrew from the Convention in 2012 and re-acceded in 2013 with a reservation permitting traditional chewing. In October 2025 the WHO Expert Committee on Drug Dependence completed its first critical review of the leaf since the 1990s, found traditional chewing and tea pose no major public-health risks, but recommended keeping it in Schedule I because cocaine is easily extracted from it. Peru is the only legal exporter of coca leaf. Coca leaf and its products are controlled substances in most countries outside the Andes.

Coca

Erythroxylum coca

Also calledKuka (Quechua) · Hoja de coca (Spanish) · Mama Coca

An Andean shrub whose leaves have been chewed and drunk as tea for thousands of years against hunger, fatigue and the strain of high altitude, and the source of cocaine, the first local anaesthetic. The leaf contains well under 1% cocaine and WHO's 2025 review found traditional chewing and tea pose no major public-health risk, yet the leaf stays under the strictest treaty controls because cocaine is easily extracted from it. Cocaine itself is addictive and can cause heart attack, stroke and seizures; none of this is for home use.

Full natural-history sheet →

What it is used for

Pain (general)
Strong
Cocaine hydrochloride 4% nasal solution (Goprelto, FDA-approved 2017) is licensed to anaesthetise the lining of the nose for diagnostic procedures and surgery in adults; it also constricts blood vessels.^1,2
Fatigue and convalescence
Traditional
Chewed in the Andes against hunger, tiredness and altitude sickness. A 2019 review found no trials showing coca prevents altitude sickness in travellers; one study found Bolivian chewers could sustain hard work longer, but chewers and non-chewers did not differ in aerobic capacity.³
Toothache
Traditional
Leaves used in Andean medicine as a local anaesthetic for toothache and mouth pain.³
Sore throat
Traditional
Andean use for mouth and throat pain, reflecting the local-anaesthetic action of cocaine.³
Indigestion and dyspepsia
Traditional
Coca tea (mate de coca) is drunk in the Andes for stomach complaints; no clinical trials.³

How it is prepared

infusion

Mate de coca, made from leaves or tea bags, is sold legally in Peru and Bolivia. Each cup contains a few milligrams of cocaine and causes positive urine drug tests (benzoylecgonine) for up to about 24–36 hours. It is illegal in most other countries.

Amounts are as recorded by the named source, not a recommendation.

Safety

Pregnancy: Contraindicated
Breastfeeding: Contraindicated
Children: Not for children.

Interactions with medicines

disulfiramMajorRaises blood cocaine levels several-fold (FDA label for cocaine nasal solution).
epinephrine, phenylephrine and other vasoconstrictorsMajorReports of myocardial ischaemia, heart attack and ventricular arrhythmias when used with topical cocaine.
plasma cholinesterase inhibitors (some MAOIs, echothiophate, organophosphates, some cancer drugs), and long-term oral contraceptives or glucocorticoidsModerateCan reduce the breakdown of cocaine and increase exposure.

Interaction checker →

Do not use if

Uncontrolled high blood pressure, coronary artery disease, unstable angina, recent heart attack, heart failure
History of seizures
Pregnancy and breastfeeding (no level of cocaine exposure is considered safe for a breastfed infant)
Low plasma cholinesterase activity
Competitive athletes and anyone subject to drug testing

Side effects

Raised heart rate and blood pressure
Headache, nosebleed (with nasal cocaine)
Nausea or stomach pain reported by some travellers drinking coca tea

In the healing traditions

Andean / Amazonian
Kuka / Mama Coca
Leaves chewed with an alkaline lime or ash (llipta) or drunk as tea against hunger, fatigue, cold and altitude, for toothache and stomach complaints, and to ease childbirth; central to offerings, reciprocity and Andean identity.
Modern pharmacology
Cocaine
Purified cocaine, isolated by Albert Niemann in 1859–60, became the first local anaesthetic after Karl Koller used it in eye surgery in 1884; still used topically in nose and throat procedures.

Active compounds

cocaine: about 0.13–0.7% of the dried leaf; blocks nerve sodium channels (local anaesthesia) and the reuptake of dopamine, noradrenaline and serotonin (stimulant, addictive)
cinnamoylcocaine, tropacocaine, hygrine: minor alkaloids among about 15 in the leaf

History

Coca leaves have been found in Andean burials thousands of years old, and under the Inca the leaf was a sacred and elite good. Albert Niemann isolated cocaine at Göttingen in 1859–60; in 1884 Karl Koller showed it numbed the eye, launching local anaesthesia, while Freud promoted it as a tonic. Coca wines and the original Coca-Cola used the leaf before cocaine's harms led to international control in the 20th century.

Sources

Reference, not prescription. Nothing here is medical advice. Herbs can interact with medicines and be dangerous in pregnancy; tell your doctor or pharmacist about anything you take.