FOOD AND DRUG INTERACTIONS*
* U.S. Food and Drug Administration. National Consumers League, 1998.
Medicines can treat and cure many health problems. However, they must be taken properly to ensure that they are safe and effective. Many medicines have powerful ingredients that interact with the human body in different ways, and diet and lifestyle can sometimes have a significant impact on a drug’s ability to work in the body. Certain foods, beverages, alcohol, caffeine, and even cigarettes can interact with medicines. This may make them less effective or may cause dangerous side effects or other problems.
When a medicine is taken, the doctor’s instructions should be followed carefully to obtain the maximum benefit with the least risk. Changes in a medicine’s effect due to an interaction with food, alcohol or caffeine can be significant; however, there are many individual factors that influence the potential for such variations, like dose, age, weight, sex, and overall health.
The following is information about possible interactions between many common prescription and nonprescription (over-the-counter) medications with food, alcohol and caffeine. But it should not replace the advice from the physician, pharmacist, or other health care professional. Any questions or concerns about possible drug interactions, should be discussed with the doctor.
The doctor and pharmacist should be informed about every drug the patient is taking, including nonprescription drugs and any dietary supplements such as vitamins, minerals and herbals.
If problems or side effects related to medication prescribed appear, the doctor should be informed immediately. It is also important to remember that many drugs interact with other drugs and may cause serious medical conditions.
In the following text, the generic name for each drug is stated first. Brand names vary according to the market and can be obtained from Section 3 of this index.
ARTHRITIS AND PAIN
Analgesic / Antipyretic
They treat mild to moderate pain and fever.
An example is:
acetaminophen
Interactions
Food: For rapid relief, take on an empty stomach because food may slow the body’s absorption of acetaminophen.
Alcohol: Avoid or limit the use of alcohol because chronic alcohol use can increase your risk of liver damage or stomach bleeding. If patient consumes three or more alcoholic drinks per day their doctor or pharmacist should be informed before taking these medications.
Non-Steroidal Anti-inflammatory Drugs (NSAID)
NSAIDs reduce pain, fever, and inflammation.
Some examples are:
- aspirin
- ibuprofen
- naproxen
- ketoprofen
- nabumetone
Interaction
Food: Because these medications can irritate the stomach, it is best to take them with food or milk.
Alcohol: Avoid or limit the use of alcohol because chronic alcohol use can increase your risk of liver damage or stomach bleeding. If patient consumes three or more alcoholic drinks per day their doctor or pharmacist should be informed before taking these medications. Buffered aspirin or enteric coated aspirin may be preferable to regular aspirin to decrease stomach bleeding.
Corticosteroids
They are used to provide relief to inflamed areas of the body. Corticosteroids reduce swelling and itching, and help relieve allergic, rheumatoid, and other conditions.
Some examples are:
- methylprednisolone
- prednisone
- prednisolone
- cortisone acetate
Interaction
Food: Take with food or milk to decrease stomach upset.
Narcotic Analgesics
Narcotic analgesics are available only with a prescription. They provide relief for moderate to severe pain. Codeine can also be used to suppress cough. Some of these medications can be found in combination with non-narcotic drugs such as acetaminophen, aspirin, or cough syrups. Use caution when taking these medications: take them only as directed by a doctor or pharmacist because they may be habit forming and can cause serious side effects when used improperly.
Some examples are:
- codeine combined with acetaminophen
- morphine
- oxycodone combined with acetaminophen
- meperidine
- hydrocodone with acetaminophen
Interaction
Alcohol: Avoid alcohol because it increases the sedative effects of the medications. Use caution when motor skills are required, including operating machinery and driving.
INFECTIONS
Antibiotics and Antifungals
Many different types of drugs are used to treat infections caused by bacteria and fungi. Some general advice to follow when taking any such product is:
* Patients must tell their doctor about any skin rashes they may have had with antibiotics or that they might get while taking this medication. A rash can be a symptom of an allergic reaction, and allergic reactions can be very serious.
* Patients must tell their doctor if they experience diarrhea.
* If patient is using birth control, they must consult with their health care provider because some methods may not work when taken with antibiotics.
* Patients must be sure to finish all their medication even if they are feeling better.
* Take with plenty of water.
Penicillin
Some examples are:
- penicillin V
- amoxicillin
- ampicillin
Interaction
Food: Take on an empty stomach, but if it upsets your stomach, take it with food.
Quinolones
Some examples are:
- ciprofloxacin
- levofloxacin
- ofloxacin
- trovafloxacin
Interactions
Food: Take on an empty stomach one hour before or two hours after meals. If the patient’s stomach gets upset, they should take it with food. However, they should avoid calcium-containing products like milk, yogurt, vitamins or minerals containing iron, and antacids because they significantly decrease drug concentration.
Caffeine: Taking these medications with caffeine- containing products (e.g., coffee, colas, tea, and chocolate) may increase caf- feine levels, leading to excitability and nervousness.
Cephalosporins
Some examples are:
- cefaclor
- cefadroxil
- cefixime
- cefprozil
- cephalexin
Interaction
Food: Take on an empty stomach one hour before or two hours after meals. If your stomach gets upset, take with food.
Macrolides
Some examples are:
- azithromycin
- clarithromycin
- erythromycin
- erythromycin + sulfisoxazole
Interaction
Food: Take on an empty stomach one hour before or two hours after meals. If your stomach gets upset, take with food.
Sulfonamides
An example is:
- sulfamethoxazole + trimethoprim
Interaction
Food: Take on an empty stomach one hour before or two hours after meals. If your stomach gets upset, take with food.
Tetracyclines
Some examples are:
- tetracycline
- doxycycline
- minocycline
Interaction
Food: Take on an empty stomach one hour before or two hours after meals. If the patients stomach gets upset, they should take it
with food. However, it is important to avoid taking tetracycline with dairy products, antacids and vitamins containing iron because
these can interfere with the medication’s effectiveness.
Nitromidazole
An example is:
- metronidazole
Interaction
Alcohol: Patients should avoid drinking alcohol or using medications that contain alcohol or eating foods prepared with alco-
hol while they are taking metronidazole and for at least three days after they finish the medication. Alcohol may cause nausea,
abdominal cramps, vomiting, headaches, and flushing.
Antifungals
Some examples are:
- fluconazole
- griseofulvin
- ketoconazole
- itraconazole
Interaction
Food: It is important to avoid taking these medications with dairy products (milk, cheeses, yogurt, ice cream), or antacids.
Alcohol: Patients should avoid drinking alcohol or using medications that contain alcohol or eating foods prepared with alcohol
while they are taking ketoconazole and for at least three days after they finish the medication. Alcohol may cause nausea, abdominal cramps, vomiting, headaches and flushing.
POISONS
