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Nutrient-Drug Interactions and Food no. 9.361
by J. Anderson and H. Hart 1
It is a difficult and complex problem to accurately determine the effects of food and nutrients on a particular drug. There are many dramatic results or problems caused by food-drug, drug-drug and alcohol-food-druginteractions. The following table is designed to help the reader become moreknowledgeable about drug interactions and their effect on food, a nutrient or another drug that may produce unexpected results or cause additional health Generic drugs often are substituted for brand-name counterparts. They usually are more economical than brand-name drugs. Possible exceptions might Patients may have concerns about the quality, efficacy, potency or consistency of generic drugs. Generics are therapeutically equivalent to brands approved and rated by the Food and Drug Administration. Many are made by pharmacist before taking anymedication. Drugs taken by the Points to remember:• OTC drugs usually are meant only to relieve symptoms, not cure a • Improper use can make symptoms worse or conceal a serious condition that should be brought to a doctor’s attention. Never take OTC drugs longer than recommended on the label. If symptoms persist or if new • Read the label carefully before taking an OTC product and every time an OTC product is bought. There may be important changes inindications, warnings or directions.
• People with allergies or chronic health problems should be especially careful to read the ingredient, warning and caution statementscarefully. If there are any questions, consult a doctor or pharmacist.
• Check expiration dates from time to time. Destroy in the safest way possible any drugs that are outdated or that have deteriorated, such asdiscolored eyedrops or ointment, or vinegar-smelling aspirin.
• Keep all drugs and medications out of the reach of children.
• When pregnant or nursing a baby, check with a health professional Aspirin, acetaminophen and ibuprofen all have analgesic (pain control) and antipyretic (fever control) properties. Only aspirin and ibuprofen also containanti-inflammatory properties. Acetaminophen does not produce the stomachor intestinal irritation or allergic reactions that aspirin can. Gastrointestinalside effects observed with aspirin are greatly reduced with ibuprofen,although patients with aspirin hypersensitivity can have similar reactions.
To reduce stomach upset from ibuprofen, take it with food or an antacid. Avoid alcohol or aspirin with ibuprofen.
Naproxen sodium, which has analgesic, antipyretic and anti- inflammatory properties, is indicated for the same conditions as aspirin,ibuprofen and acetaminophen but should not be taken with them. Anyone whogenerally has three or more alcoholic drinks per day should consult a physicianon when and how to take naproxen sodium and other pain relievers.
Table 1: Food and Drug Interactions.
FOOD: Take prescription on an empty
stomach to increase its effectiveness.
ALCOHOL: Avoid alcohol because it
FOOD: For rapid relief, take on empty
ALCOHOL: Avoid or limit the use of
alcohol because chronic alcohol use can
increase the risk of liver damage or
stomach bleeding.
FOOD: Take with food or milk because
medications can irritate the stomach.
ALCOHOL: Avoid or limit the use of
increase the risk of liver damage orstomach bleeding.
FOOD: Take with food or milk to decrease
rheumatoid arthritis, andother conditions.
ALCOHOL: Avoid alcohol because it
FOOD: High-fat meals may increase the
amount of theophylline in the body, while high-carbohydrate meals may decrease it.
It is important to check with the pharmacist PROVENTIL, COMBIVENTabout which form you are taking because food can have different effects depending
on the dose form.
CAFFEINE: Avoid eating or drinking large
amounts of foods and beverages that contain
ALCOHOL: Avoid alcohol because it can
increase the risk of side effects such as
nausea, vomiting, headache and irritability.
FOOD: Some diuretics cause loss of
potassium, calcium and magnesium. Triamterene/hydrochlorothiazide DISORDERS
sparing” diuretic. When taking triamterene green leafy vegetables or salt substitutes.
ALCOHOL: Avoid drinking alcohol with
drugs lower blood pressure too much.
ALCOHOL: Avoid alcohol because it may
add to the blood vessel-relaxing effect of FOOD: Take one hour before or two hours Captopril/CAPOTEN
potassium in the body. Too much potassium Lisinopril/PRINIVIL, can be harmful. Avoid eating large amounts ZESTRILof potassium-rich foods such as bananas, oranges and green leafy vegetables or salt Moexipril/UNIVASCsubstitutes.
FOOD: Lovastatin (mevacor) should be
ALCOHOL: Avoid drinking large amounts
of alcohol because it may increase the risk Pravastatin/PRAVACHOLof liver damage.
FOOD: Vitamin K produces blood-clotting
substances and may reduce theeffectiveness of anticoagulants.
High doses of vitamin E (400 IU or more)may prolong clotting time and increase therisk of bleeding.
GENERAL GUIDELINES: Tell the doctor if
you experience skin rashes or diarrhea.
If you are using birth control, consult withyour health care provider because somemethods may not work when taken withantibiotics. Be sure to finish all of yourmedication even if you start feeling better.
Take medication with plenty of water.
Antibacterials/Penicillin To treat infections caused FOOD: Take on an empty stomach unless it Penicillin V/ VEETIDS
upsets your stomach, then take with food.
Amoxicillin/TRIMOX, AMOXILAmpicillin/PRINCIPEN,OMNIPEN FOOD: Take on empty stomach one hour
CAFFEINE: Taking these medications with
caffeine-containing products may increasecaffeine levels, leading to excitability andnervousness.
FOOD: Take on empty stomach one hour
ERYTHROMYCIN/E-MYCIN,ERY-TAB, ERYCErythromycin+ sulfisoxazole/PEDIAZOLE FOOD: Take on empty stomach one hour
FOOD: Avoid taking tetracycline with dairy
interfere with the medication’s effectiveness.
ALCOHOL: Avoid drinking alcohol and
while taking metronidazole and for at leastthree days after you finish the medication.
FOOD: It is important to avoid taking these Fluconazole/DIFLUCAN
medications with dairy products.
ALCOHOL: avoid drinking alcohol and
while taking keroconzole and for at leastthree days after you finish the medication.
FOOD: These medications have many
dietary restrictions and people taking them need to follow the dietary guidelines and
physician’s instructions very carefully.
A rapid, potentially fatal increase in blood
pressure can occur if foods or alcoholic
beverages containing tyramine are
consumed while taking MAO inhibitors.
ALCOHOL: do not drink beer, red wine,
other alcoholic beverages, non-alcoholic
and reduced alcohol beer and red-wine
CAFFEINE: may cause excitability,
the anti-anxiety effects of the drugs.
ALCOHOL: may impair mental and motor
FOOD: these medications can be taken
ALCOHOL: although alcohol may not
significantly interact with these drugs toaffect mental or motor skills, people who aredepressed should not drink alcohol FOOD: these mediations can be taken
healing and prevent irritation with or without food.
CAFFEINE: caffeine products may irritate
1The generic name for each drug is stated first. Brand names are in all capital letters and represent only some examples of those medications.
References: Food and Drug Interactions, 1998, U.S. Food and Drug Administration, National Consumers League.
Table 2: Aspirin vs. Acetaminophen vs. Ibuprofen
• used to treat arthritis, manyother conditions and injuries Cautions
• Should not be used to treat fever over • a skin condition called “angioedema” • Not to be used with aspirin, alcohol orsteroids.
• Insure adequate fluid intake/hydration Recommendations • Increase foods high in vitamin C and
folic acid with long-term, high dosage use• Avoid or limit garlic, ginger and Gingko • Works will for people who can’t take rare disorder called Reye’s Syndrome in • Safe for use by infants, children and Known Brands
Pregnant women should consult a doctor prior to taking any over-the-counter medication. Other people, including persons with medical conditions,are advised to read product labels carefully and consult a pharmacist if they have any questions about proper use.
Reference: Audio Health Library Topic 2001, Aspirin vs. Acetaminophen vs. Ibuprofen. 1996.
Issued in furtherance of Cooperative Extension work, Acts of May 8 and June 30, 1914, in Cooperative Extension foods and nutrition cooperation with the U.S. Department of Agriculture, Milan A. Rewerts, Director of Cooperative Extension, Colorado State University, Fort Collins, Colorado. Cooperative Extension programs associate specialist; food science and human are available to all without discrimination. No endorsement of products mentioned is intended nor is criticism implied of products not mentioned.


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