Some medications can be affected byfoods. Following some precautions canhelp your medicine to work better andprevent some potential side effects. This pamphlet includes only some of thepotential food-drug interactions that areknown. Since there are many whichcould not be included here, pleasediscuss your specific medications withyour health careproviders.
Drinking alcohol can potentially cause problems with a variety ofmedications. Some of these include medications that affect bloodpressure or blood sugar, as well as medicines that can causedrowsiness. Avoiding alcohol is typically recommended whentaking such medication. Some additional medications for whichalcohol avoidance is recommended are included in this pamphlet.
You should discuss with your doctor or pharmacist if you candrink alcoholic beverages while taking your specific medications.
In this brochure, the class name of the drug is listed first, followedby the generic name with the brand name in parenthesis. Brandnames represent only some examples of the medications.
Macrolides: erythromycin (Ery-tab,EES, EryC, others),
Most types of erythromycin are best absorbed when taken on an empty
stomach (1 hour before meals or 2 hours after meals). Erythromycin
estolate (Ilosone®) and erythromycin ethylsuccinate (EES) are less
susceptible to stomach acid, so if stomach upset occurs with these
formulations, they may be taken with food. Clarithromycin should be
taken with food to minimize stomach upset.
Penicillin and Ampicillin should be taken on an empty stomach.
Tetracycline (Sumycin®), minocycline, doxycycline
Fluoroquinolones: Levofloxacin (Levoquin®), ciprofloxacin
Take on an empty stomach. Avoid milk, milk products, iron-
containing products, or antacids containing calcium, magnesium, and
aluminum one hour before or 2 hours after taking these medications.
Sulfonamides: Bactrim®, Septra®
Take on an empty stomach with a full glass of water.
Avoid alcohol. Drinking alcohol while taking this medicine may lead
to flushing, headaches, nausea, vomiting, and dizziness. Avoid
alcohol while taking metronidazole and for at least 3 days after
finishing the drug. Avoid liquid medications which contain alcohol,
such as common cough and cold preparations.
Take this medication one hour before meals, on an empty stomach.
Eating foods that contain histamine, such as sauerkraut and yeast
extract, while taking isoniazid can produce symptoms like facial
flushing, headache, nausea, dizziness, abdominal cramps, and rash,
because isoniazid inhibit’s your body’s breakdown of histamine.
Proton Pump Inhibitors: lansoprazole (Prevacid®), omeprazole
(Prilosec®), pantoprazole (Protonix®), rabeprazole (Aciphex®),
Take Aciphex‚ and Nexium‚ on an empty stomach. Prevacid‚ and
Prilosec‚ should be taken at least 15 minutes prior to the morning
meal for best results.
Maintain a balanced diet, as keeping a consistent level of vitamin K
in your diet is important. Avoid large changes in the amounts of
vitamin K-containing foods you eat. Avoid excessive use of alcohol
while taking warfarin. Also, avoid taking high doses (> 400 IU/day)
of vitamin E. Some of the foods high in vitamin K include the
(Heart/Blood Pressure Medications)
For these groups of medications, it is recommended to avoid(natural) licorice. Most licorice in the US is artificial, howeverimported licorice candy or flavoring from Europe is often natural.
Nitrates: nitroglycerin (Nitrostat®, others)
Take oral nitrates on an empty stomach. Avoid drinking alcoholic
beverages within one hour or more of taking a nitrate product. This
combination can cause a drop in your blood pressure and you may
feel light-headed or dizzy.
Calcium Channel Blockers: nisoldipine (Sular®), felodipine
(Plendil®), nifedipine (Adalat‚ CC, Procardia‚ XL®), amlodipine
(Norvasc®), diltizem (Cardizem CD®, various), verapamil
Avoid grapefruit juice with nisoldipine and felodipine. Consult with
your pharmacist or physician if you are taking any of the others; the
interaction is lessened with the other drugs. Diltizem,verapamil, and
amlodipine have no significant interactions with grapefruit juice.
ACE Inhibitors: captopril (Capoten®), moexipril (Univasc®),
enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Zestril®,
Prinivil®) & others
Take captopril and moexipril one hour before meals, on an empty
stomach. These medicines can cause your body to retain potassium.
Your doctor may want you to avoid eating foods rich in potassium.
Potassium-sparing Diuretics: spironolactone (Aldactone®),
triamterene (Dyazide®, Maxide®)
These medicines can cause your body to retain potassium. Your
doctor may want you to avoid eating large amounts of foods rich in
Potassium-depleting Diuretics: furosemide (Lasix®), bumetanide
(Bumex®), metolazone (Zaroxyln®), hydrochlorothiazide
These medicines cause your body to lose potassium and other
nutrients. Your doctor may advise you to include foods rich in
potassium, magnesium, and calcium in your diet, or start you on a
potassium supplement. Muscle pains or cramps are a sign of low
potassium, and should be reported to your doctor.
Foods Rich in Potassium and Magnesium include:
Statins: atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin
(Mevacor®), pravastatin (Pravachol®), simvastatin (Zocor®)
Take lovastatin with the evening meal. The other statins may be taken
without regard to meals. Avoid drinking grapefruit juice with
atorvastatin, lovastatin, and simvastatin. Avoid alcohol, which
increases the risk of liver damage, while taking any of these
Fibrates: gemfibrozil (Lopid®)
Take twice daily, 30 minutes prior to morning and evening meals.
Bile Acid Binders: cholestyramine (Questran®), colestipol
Due to the nature of these medications, besides lowering cholesterol,
they also bind fat-soluble vitamins such vitamins A, D, E, and K.
This can lead to vitamin deficiencies.Consequently, your doctor may
recommend that you take certain vitamin supplements.
Avoid milk, milk products, iron-containing products, or antacids
containing calcium, magnesium, and aluminum one hour before or 2
hours after taking these medications.
Ketoconazole (Nizoral®), Itraconazole (Sporanox®)
Avoid alcohol while taking ketoconazole and for at least 3 days after
finishing the drug. Drinking alcohol while taking ketoconazole may
lead to flushing, headaches, nausea, vomiting, and dizziness. Take
itraconazole with food. Both these medications need an acidic
environment to dissolve. If antacids or proton pump inhibitors are
used concomitantly, they should be given at least 2 hours after the
antifungal. An alternative is to drink an acidic beverage, such as cola
or orange juice, with the antifungal.
Glyburide (Diabeta®, Micronase®), Glipizide (Glucotrol®),
Glimepiride (Amaryl®), Chlorpropamide (Diabinese®)
Following your prescribed diet is important. Take each of these
medications consistently at the same time each day. Limit alcohol
intake; alcohol should be avoided completely if a reaction of
flushing, headache, nausea, or vomiting occurs. Glipizide should be
taken 30 minutes before meals for best results. Glimepiride is
usually taken in the morning with breakfast.
OTHER ORAL ANTI-DIABETIC MEDICATIONS
Acarbose (Prandin®),miglitol (Glyset®), nateglinide (Starlix®)
Take with the first bite of food at meals. If you skip a meal, omit
that dose of medications.
Metformin (Glucophage®, Glucophage XL®)
Take with food. Glucophage XL®
‚ is best taken with your evening
Phenelzine (Nardil®), Tranylcypromine (Parnate®),
These medications reduce your body’s way of processing tyramine,
and the accumulation of tyramine from the foods you eat can cause
you to experience headaches, dizziness, sudden increases in blood
pressure, and even irregular heart beats. It is very important to
follow a diet that avoids foods containing tyramine. Wine and
domestic bottled or canned beer are considered safe in moderation.
Foods that are high in tyramine include:
Take with food. Phenytoin decreases the body’s ability to absorb
certain nutrients. Your pharmacist or doctor may recommend you
take a calcium + vitamin D supplement. Avoid alcohol.
Divalproex sodium, Valproic Acid (Depakote®, Depakene®)
Take with food or milk.
Aminophylline, theophylline (TheoDur®, Slobid®, Theo-24®,
Uniphyl®, & others)
Limit caffeine to 2-3 (8oz.) cups of coffee, tea, or colas per day.
The effect food has on these medications vary with the product.
Avoid taking Theo-24‚ or Uniphyl‚with meals high in fat content.
Check with your pharmacist or doctor for your specific product.
Levodopa (Dopar®, Larodopa®)
In the body, levodopa is coverted to dopamine. Vitamin B6
(pyridoxine) helps your body process the dopamine, and taking in
large amounts of it can decrease the dopamine available to your body.
It is not necessary to avoid foods rich in vitamin B6 altogether. Keep a
balanced diet with a constant amount of vitamin B6 intake.
Take on an empty stomach (30-60 minutes before breakfast) with a
full glass of water.
MEDICATIONS & GRAPE JUICE
Most often, grapefruit juice increases the amount of a drug availablein the body because it decreases the way a body breaks down themedication. The majority of the available published informationstudied double strength white grapefruit juice, not the more popularpink (“Ruby Red”) grapefruit juice. Until more definitive researchshows that grapefruit juice is safe with certain medicines, it is best toavoid grapefruit juice if you are taking any of the followingmedicines. Make sure to let your physician and pharmacist know ifyou regularly drink grapefruit juice.
Calcium Channel Blockers:
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