The Cacao used in the ceremony should be from ceremonial grade cacao block that is rich in theobromine and cacao butter. It is usually much stronger than regular hot cocoa or chocolate drink with lesser additives, such as sugar and milk. While a cup of regular hot chocolate uses about 10 g of raw cacao from a block or cacao mass, a cup of ceremonial cacao should have at least 30 g of raw cacao. Some ceremonies serve cacao with no additives, making it very bitter but the onset will be shorter and the effects are more felt. Adding a bit of brown sugar and almond or coconut milk makes the cacao taste more pleasant and enjoyable for most people, with the tradeoff of slightly lesser effects.

To prepare for the cacao ceremony, it is best to keep the stomach empty 4-5 hours prior to drinking the cacao so the medicine can be absorbed quicker. The onset is typically around half an hour and lasts for about 3-4 hours depending on the amount consumed and the strength of the drink. Drinking too much cacao can cause sleeping difficulty.