Drug and Food Interactions

Have you ever been told that you should avoid certain foods like grapefruit and broccoli, or alcoholic beverages, when taking certain medications? Certain foods and beverages can interfere with medications and herbal supplement, especially in the elderly.

Problems arise because natural chemicals or nutrients in foods or drinks can interfere with a medication, lessening its effectiveness or potentially having a stronger affect. Foods or beverages also can affect the enzymes that break down, or metabolize, the medication in your body. As a result, the medication may stay in your body for too short or too long a time.

A medication that’s broken down too quickly won’t have time to work. On the other hand, a medication that stays in the body too long may build up to potentially dangerous levels.

Don’t take these interactions lightly. Some can cause potentially dangerous health problems. It is important that you review your prescriptions, and other over-the-counter medications and supplements, with your pharmacist to determine any potential interactions or reactions.

Some of the most common foods and drinks that can cause problems:

  • Grapefruit, orange, and cranberry juice.
  • Vegetables rich in vitamin K: collards, spinach, kale, soybeans, broccoli, & carrot and pomegranate juice.
  • Tyramine, found in aged cheese, sauerkraut, kimchi, processed meats and soy sauce.
  • Licorice, or extract in candy or teas.
  • Milk and milk products.
  • Beverages: Beer, wine and spirits, and those that contain caffeine, such as coffee, tea or soda.

Examples to Keep you Healthy

DrugsFoodDrug-Food Interaction
WARFARINHigh-protein dietraise serum albumin levels, decrease in international normalized ratio (INR)
Vegetables containing vitamin kinterferes with the effectiveness and safety of warfarin therapy.
Charbroileddecrease warfarin activity
Cooked onionsincrease warfarin activity
Cranberry juiceelevated INR without bleeding in elderly patient
Leafy green vegetablesthromboembolic complications may develop
Charbroileddecrease warfarin activity
MONOAMNINE OXIDASESTyramine-containing food1hypertensive crisis
PROPRANOLOLRich protein foodserum level may be increased
CELIPROLOLOrange juicethe intestinal absorption is inhibited
ACES INHIBITORSEmpty stomachabsorption is increased
CA2 CHANNELGrapefruit juiceincreases the bioavailability
ANTIBIOTICSwith milk productsprevent their absorption. reduced bioavailability
ACETAMINOPHENPectindelays its absorption and onset
NSAIDSAlcoholcan increase risk of liver damage or stomach bleeding
Beveragesthe c max and auc0-alpha significantly increased
THEOPHYLINEHigh-fat meal and grapefruit juiceincrease bioavailability
Caffeineincreases the risk of drug toxicity
ESOMEPRAZOLEHigh-fat mealbioavailability was reduced
CIMETIDINE, RUPATADINEwith food (any type)increase bioavailability