Quick Summary: Coca tea (mate de coca) is legal in Peru and offered almost everywhere in Cusco, which sits at about 3,399 m (11,150 ft), but no controlled trial shows that it prevents altitude sickness, and the Wilderness Medical Society says it should not replace proven measures. In a 2022 study of 142 students in Cusco, drinking it did not lower the risk, while acetazolamide did. One cup can also produce a positive urine test for cocaine, and the leaf remains a controlled drug in the US, UK, Canada, Australia and EU countries after a WHO review that ended in March 2026 kept it under international control. This guide is for travellers deciding whether to drink it or pack it; for symptoms and when to descend, read our altitude sickness guide.
What Coca Tea Is and How Cusco Serves It
Mate de coca is an infusion of the leaves of Erythroxylum coca, the plant cocaine is extracted from. It comes as a tea bag or loose leaves in hot water, and a 2019 travel-medicine review notes that it is served in eateries, on trains and in accommodation of every standard. It is legal in Peru, where the state company ENACO describes itself as the only Peruvian state company authorised to buy, process and sell coca leaf and its products.
It is not just another herbal tea. A bag holds about 1 g of leaf, and a 1996 laboratory study found about 4.14 mg of cocaine in a brewed cup of Peruvian tea. That is small next to the 20 to 50 mg estimated for a street "line" (Biondich and Joslin, 2016), but enough to matter for drug tests and customs. Most visitors try it: in a 2010 survey of 991 travellers leaving Cusco airport, 62.8% had used coca products to prevent altitude sickness, against 16.6% who took acetazolamide.
Does It Prevent Altitude Sickness? What the Studies Say
There is no good evidence that it does. As of October 2026 we found no randomised controlled trial of coca for acute mountain sickness (AMS). The Wilderness Medical Society's 2019 guidelines say its usefulness for prevention "has not been properly studied" and that it should not replace established measures; an American Family Physician summary puts it as "not recommended". The society's 2024 update kept its prevention advice. Studies from Cusco point the same way:
- 2022 cohort, 142 language students: 39% got AMS in their first 48 hours. Coca tea was not linked to a lower risk; acetazolamide was (Journal of Travel Medicine).
- 2010 airport survey, 991 travellers: 48.5% reported AMS, and coca users reported it more often. That is only an association, since people may reach for coca after symptoms start.
- 2017 airport survey, 1,274 travellers: 37% had AMS; 69% of them drank coca tea to treat it and 24% took acetazolamide. The authors cite "very scarce scientific evidence" for coca (2020 report).
- Questionnaire, 136 travellers in Peru and Bolivia: 51% noticed no effect, 31% a pleasant one and 19% unwanted effects such as nausea, as summarised in the 2019 review.
So the evidence is weak and mostly missing: observational studies cannot prove benefit or harm, and even the 2019 review, which is sympathetic to coca, concedes there may never be proof. Coca has a long Andean tradition as a stimulant against fatigue and hunger, and a warm cup can feel good. That is comfort, not protection.
What Actually Prevents Altitude Sickness
The CDC Yellow Book 2026 and the Wilderness Medical Society agree on the basics:
- Ascend gradually: above 3,000 m (9,800 ft), raise your sleeping altitude by no more than 500 m (1,650 ft) a night. A flight from Lima breaks that rule by definition.
- Sleep lower first: the CDC notes that from Cusco you can descend below the airport's altitude to sleep for one or two nights, which may make medication unnecessary. In practice that means the Sacred Valley.
- Acetazolamide: a strong recommendation on high-quality evidence from the Wilderness Medical Society. The CDC's adult preventive dose is 125 mg every 12 hours from the day before ascent, and it advises considering it for a first night at 2,750 to 3,400 m (9,000 to 11,150 ft). Cusco sits at the top of that band. Ask a doctor or travel clinic before you fly.
- Ibuprofen and rest: ibuprofen helps prevent AMS, though less well than acetazolamide, and the CDC advises no alcohol and only mild exercise for the first 48 hours.
Our guide to days in Cusco before Machu Picchu shows how to build in that buffer.
Coca Tea and Drug Tests
The body breaks cocaine down into benzoylecgonine, which standard urine tests look for, and coca tea produces it too.
- One cup, one volunteer: urine benzoylecgonine peaked at 3,940 ng/mL ten hours after a cup of Peruvian tea (Jenkins and colleagues, 1996).
- Five volunteers: all tested positive within 2 hours, and three were still positive at 36 hours (Mazor and colleagues, 2006).
- Horse racing: Britain's Jockey Club commissioned a study after several jockeys tested positive; every urine sample in the 24 hours after one infusion was positive (British Journal of Sports Medicine, 2005).
For scale, US federal workplace testing flags urine at 150 ng/mL on the first screen (SAMHSA, March 2026). Every study tested a single cup, so nobody has published a safe gap after several days of drinking. If you face workplace, military or sports testing, skip coca products for the whole trip.
Can You Take Coca Tea Home? Country by Country
Not to the usual home countries. Coca leaf sits in Schedule I of the UN's 1961 Single Convention on Narcotic Drugs. The WHO reviewed it in 2025 and recommended keeping it there, so the UN Commission on Narcotic Drugs held no vote at its 9 to 13 March 2026 session (WHO, April 2026). National laws cover the leaf whether it is loose or in a tea bag.
| Country | Can you bring coca tea or leaves in? | Source |
|---|---|---|
| Peru (buying and drinking) | Yes, legal. ENACO is the state company authorised to buy and sell coca leaf. | ENACO |
| United States | No. Coca leaves and their preparations are Schedule II controlled substances; only decocainized leaves are excluded. CBP says officers find coca leaves in travellers' baggage. | 21 CFR 1308.12; CBP, 2020 |
| United Kingdom | No. The government says importing coca leaves or coca tea is illegal. Coca leaf is a Class A drug. | FCDO, October 2026; Misuse of Drugs Act 1971 |
| Canada | No. Coca leaves are in Schedule I of the Controlled Drugs and Substances Act, and importing Schedule I substances is banned unless authorised. | CDSA, s. 6 and Schedule I |
| Australia | No. The prohibited-imports list includes the leaf of any coca plant from which cocaine can be extracted. | Customs (Prohibited Imports) Regulations 1956, Sch. 4 |
| EU countries | No. Each country applies its own drug law; Germany, for example, lists coca plants and plant parts in its Narcotics Act. | EU Council, 2025; BtMG Annex II |
Canada's travel advice for Peru adds that Peruvian law prohibits the export of coca products. At minimum you lose the box, and because the leaf is legally a controlled drug, a fine or charges are possible. Finish it or leave it at your hotel before you head to the airport.
Pregnancy, Children and Medicines
Herbal does not mean tested. We found no published studies of coca tea in pregnancy or in children, so there is no evidence that it is safe for either.
- Pregnancy: the CDC says there are no reports of fetal harm from brief high-altitude travel, but suggests pregnant travellers avoid sleeping above 3,050 m (10,000 ft), and Cusco is higher. Talk to your obstetrician before you book.
- Breastfeeding: the US LactMed database says nursing mothers should not use cocaine and that newborns are extremely sensitive to it. There are no data on coca tea itself, so we would skip it.
- Children: the CDC says children are as susceptible to altitude illness as adults. Given how sensitive newborns are to cocaine, do not give coca tea to babies, and ask a paediatrician about older children.
- Heart conditions and medicines: we found no studies of interactions with prescription drugs. A 2025 case report described a 56-year-old woman who developed a sudden severe headache and narrowed brain arteries after high altitude and coca tea. One case proves nothing about risk, but with heart disease, high blood pressure or regular medication, ask your doctor first.
Tea Bags, Leaves and Candies: Practical Notes
- How much: there is no standard dose, and no study shows that more cups protect you better. Longer steeping pulls out more cocaine: 3.94 to 5.88 mg per cup of Peruvian tea in the 1996 study.
- Chewing leaves: the traditional method is a wad of leaves in the cheek with a little alkaline lime (llipta), such as plant ash or bicarbonate of soda; most travellers skip the lime. Traditional chewers use an estimated 60 g of leaf a day (Biondich and Joslin), against about 1 g in a tea bag.
- Candies and biscuits: the 2019 review says they have no effect, and legally they are still coca products. Munich airport customs confiscated 60 coca candies from a student returning from Peru and fined her (The Local, 2008).
Our Position: Drink It for Comfort, Then Leave It Behind
Coca tea is overhyped as altitude medicine and underrated as a drug-test and customs risk.
- Drink it if you like it: for a healthy adult who is not pregnant and has no drug test ahead, we see no reason to refuse the cup your hotel offers.
- Do not rely on it: plan a gentle ascent, sleep lower first if you can, and ask a doctor about acetazolamide. Our first days in Cusco guide covers pacing your first 48 hours.
- Skip it if: you are pregnant or breastfeeding, travelling with a baby, facing a drug test, or have a heart condition or regular medication your doctor has not cleared.
- Leave it behind: do not pack leaves, tea bags or candies, and follow the UK government's advice never to carry anything through customs for someone else.
FAQ
Does coca tea help with altitude sickness?
There is no good evidence that it prevents it. A 2022 Cusco study found no lower risk among tea drinkers, and the Wilderness Medical Society says it should not replace proven measures.
Is coca tea legal in Peru?
Yes. It is legal to buy and drink in Peru, where the state company ENACO is authorised to sell coca leaf. The problems start at the border.
Will one cup of coca tea make me fail a drug test?
It can. In published studies one cup pushed urine benzoylecgonine far above the 150 ng/mL US federal screening cutoff, and some volunteers were still positive at 36 hours.
Can I bring coca tea back to the United States?
No. Coca leaves and their preparations are Schedule II controlled substances under federal law, and only decocainized leaves are excluded.
Can I bring coca tea into the UK, Canada, Australia or the EU?
No. All four control the leaf as a drug, and the UK government says importing coca leaves or coca tea is illegal. Leave it in Peru.
Will coca tea get me high?
The dose is far smaller than cocaine: a cup held about 4 mg in a 1996 study, against an estimated 20 to 50 mg in a street line. It is still enough to show up on a drug test.
Are soroche pills the same as coca tea or Diamox?
Neither. The Sorojchi Pills brand sold in Peru lists 325 mg of aspirin, 160 mg of salophen and 15 mg of caffeine per capsule in its Peruvian drug monograph, so it is not acetazolamide and contains no coca. The monograph says not to combine it with anti-inflammatories such as ibuprofen or take it in pregnancy.
Can children drink coca tea?
We found no studies in children, so there is no evidence it is safe. Do not give it to babies, and ask a paediatrician about older children.
Is coca tea safe in pregnancy?
No research shows that it is. The CDC also suggests pregnant travellers avoid sleeping above 3,050 m, and Cusco is higher, so speak to your obstetrician before you book.
Can I take coca candies home instead of tea?
No. Candies contain coca, and US and Canadian law cover coca preparations, not just leaves. German customs have fined a traveller for coca candies bought in Peru.
Limitations
Drug laws, customs practice and travel advice can change, and enforcement varies by airport. The medical evidence on coca is thin, the drug-test studies are small and old, and cocaine content varies by brand and steeping time. This guide reflects sources read as of October 2026 and is not medical advice. Work-around: before you book, read your home country's customs guidance and any testing policy that applies to you, and see a doctor or travel clinic about altitude medication.