When Good Foods Can Be Bad: How to Avoid Drug-Food Interactions

There are over two million adverse drug reactions and over 100,000 deaths per year that could be prevented by asking questions and reading the labels and pamphlets provided with each prescription and over-the-counter drug. If there is something that seems unclear, ask the doctor and/or pharmacist to clarify the point for you.

Sometimes harmless foods we eat, or when we eat them, can pose a real threat to our health when combined with prescription and over-the-counter medications. For example, drinking grapefruit juice may interfere with some calcium channel blockers and cholesterol-lowering drugs. The chemicals in the juice and fruit pulp affect how the medicine is broken down in our bodies resulting in higher levels of the drug in the blood stream and an increased risk of serious side effects.

The following are some examples of drug interactions with food and beverages:

• Alcohol: can increase or decrease a drug’s effectiveness
• Grapefruit Juice: as mentioned above, can increase the level of drug in your blood stream.
• Licorice: can increase the risk of Lanoxin toxicity (digoxin-used to treat congestive heart failure and abnormal heart rhythms) and decrease the effects of blood pressure drugs and diuretic medications.
• Chocolate: excessive chocolate intake may sharply increase your blood pressure when combined with MAO inhibitors. The caffeine in chocolate interacts with stimulant drugs such as Ritalin and can increase its effect, and decrease the sedative effects of drugs such as Ambien.

Dietary supplement and drug interaction examples:

• St. John’s Wort: decreases the blood levels of certain drugs in the bloodstream such as Lanoxin, cholesterol-lowering medications and erectile dysfunction medications.
• Vitamin E: combined with blood-thinning medication (i.e. Coumadin) may increase the anti-clotting activity and increase your risk of bleeding.
• Ginseng: may also increase the risk of bleeding when taken with Coumadin, heparin, aspirin and non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen and ketoprofen. MAO inhibitors taken with ginseng can cause headaches, nervousness, trouble sleeping and hyperactivity.
• Ginkgo Biloba: can decrease the effectiveness of anti-seizure medications such as Tegretol, Depakote or carbamazepines.

Some tips about drug-food interactions to remember:

• Read all directions, warnings, interactions and precautions printed on the pamphlets, including all over-the-counter medications.
• Drink a full glass of water unless told otherwise by your doctor.
• Do not stir medication into food or drinks to avoid changing how the drug works in your body.
• Do not take vitamins and minerals at the same time as a drug due to the potential problems when combined with a drug.
• Do your research, ask questions and be sure you know which foods to avoid, when to take the medication (with or without meals) and if over-the-counter supplements or drugs will be a harmful combination. (i.e. some cough syrups should be avoided if you are on blood pressure medication.)
• Make sure to tell your doctor and pharmacist of all supplements and over-the-counter medications you might be using, even if they are not on a daily basis.
• Keep a list of all medications, supplements, over-the-counter drugs and any vitamins and minerals you are taking to your medical appointments as well as when you pick up any new prescriptions to go over the information with your pharmacist.

For more information, refer to the Food and Drug Administration’s website specific to drug interactions and the other listed resources. http://www.fda.gov/forconsumers/consumerupdates/ucm096386

Resources:

www.fda.gov (Food and Drug Administration)

www.familydoctor.org

www.Mayoclinic.com