Guidelines for Avoiding Food-Drug Interactions

A food-drug interaction is when medications are affected by the food we eat or vice versa. You
may need to make some minor changes as to when or what you eat or drink when taking
certain drugs. The following are some common food-drug interactions. Take the following
precautions to avoid undesirable interactions, always read the prescription insert carefully, and
ask your doctor or pharmacist about any potential interactions when starting a new medication.

Antianxiety drugs
Lorazepam, diazepam, alprazolam Limit alcohol, which may impair mental
and motor performance (eg, driving and
operating machinery)

Limit caffeine, which may cause

excitability, nervousness, and hyperactivity,
and reduce the effectiveness of the drug

Antibiotics
Antibacterials: penicillin, amoxicillin,
ampicillin
Cephalosporins: cefaclor, cefadroxil,
cefixime, cefprozil, cephalexin
Sulfonamides: sulfamethoxazole
Macrolides: azithromycin, clarithromycin,
erythromycin
Take on an empty stomach 1 hour before
or 2 hours after meals, unless it upsets
your stomach
Do not take penicillin with acidic fruit or
vegetable juices (eg, citrus juices and
tomato juice) or with carbonated
beverages

Quinolones: ciprofloxacin, levofloxacin, Take on an empty stomach 1 hour before

ofloxacin, trovafloxacin
Tetracyclines: tetracycline, doxycycline,
minocycline
or 2 hours after meals, unless it upsets
your stomach, then take with meals
Avoid taking with dairy products, antacids,
and vitamins containing iron because these
can interfere with the medication’s
effectiveness

Nitroimidazole: metronidazole Take with food to avoid stomach upset

Avoid drinking alcohol, using medications

that contain alcohol, or eating foods
prepared with alcohol while taking this
medication and for at least 3 days after
 finishing the medication (may cause
nausea, abdominal cramps, vomiting,
headaches, dizziness, or flushing)

Antidepressants
Paroxetine, sertraline, fluoxetine Take with or without food

Avoid alcohol

Monoamine oxidase inhibitors: phenelzine, Avoid foods high in tyramine, which can
tranylcypromine cause severe headaches, high blood
pressure, or stroke:
 Aged cheeses (cream and cottage
cheeses are acceptable)
 Alcohol
 Avocados
 Bananas
 Bean curd (tofu)
 Beef or chicken liver
 Broad (fava) beans
 Caffeine-containing products
 Canned soups
 Cured meat: sausage, bologna,
pepperoni, salami
 Fish: smoked, fermented, pickled or
aged; caviar
 Ginseng
 Meat tenderizers
 Miso soup
 Raisins
 Sauerkraut
 Shrimp paste
 Sour cream
 Soy sauce
 Yogurt
 Yeast extracts

Antifungal drugs
Fluconazole, griseofulvin, ketoconazole, Avoid drinking alcohol, using medications
itraconazole that contain alcohol, or eating foods
prepared with alcohol, while taking this
medication and for at least 3 days after
finishing the medication (may cause
 nausea, abdominal cramps, vomiting,
headaches, dizziness, or flushing)

Antihistamines
Over-the-counter: brompheniramine, Take without regard to food
chlorpheniramine, diphenhydramine

Prescription: fexofenadine, loratadine,

cetirizine, astemizole

Asthma medications
Bronchodilators: theophylline, albuterol, Avoid eating or drinking large quantities of
epinephrine caffeine-containing foods and beverages
(eg, chocolate, colas, coffee, and tea)

Arthritis or pain medications

Analgesics: acetaminophen Take on an empty stomach 1 hour before
or 2 hours after meals to maximize
absorption

Avoid or limit the use of alcohol; chronic

alcohol use can increase the risk of liver
damage or stomach bleeding

Nonsteroidal anti-inflammatory drugs Take with food or milk to reduce stomach

(NSAIDs): aspirin, ibuprofen, naproxen, upset
ketoprofen, nabumetone
Avoid or limit the use of alcohol; chronic
Corticosteroids: prednisone, prednisolone, alcohol use can increase the risk of liver
methylprednisolone damage or stomach bleeding

Cardiovascular drugs
Diuretics: furosemide, hydrochlorothiazide, Take on an empty stomach
bumetanide, metolazone
Eat potassium-rich and magnesium-rich
foods:
 Fresh fruits (bananas, oranges, and
cantaloupe)
 Dried fruits (raisins, prunes, and dates)
 Lentils (lima beans, peanuts, and black-
 eyed peas)
 Green, leafy vegetables (spinach and
broccoli)

Potassium-sparing diuretic: triamterene Take after meals to avoid gastrointestinal

(GI) irritation.

Avoid large amounts of potassium-rich

foods, such as:
 Green, leafy vegetables
 Bananas
 Oranges
 Salt substitutes containing potassium

Angiotensin converting enzyme (ACE) Take captopril and moexipril one hour
inhibitors: captopril, enalapril, Lisinopril, before meals. ACE inhibitors may increase
moexipril, quinapril, ramipril potassium levels in the body. Avoid large
amounts of potassium-rich foods as above.

Beta blockers: tenolol, metoprolol, Avoid drinking alcohol with propranolol;

propranolol, nadolol the combination may lower blood pressure
too much.

Nitrates: isosorbide dinitrate, nitroglycerin Avoid alcohol; the combination may reduce
blood pressure too much

ACE inhibitors: captopril, enalapril, Take on an empty stomach 1 hour before

lisinopril, quinapril, moexipril or 2 hours after meals

HMG-CoA reductase inhibitors: Avoid drinking large amounts of alcohol; it

atorvastatin, cerivastatin, fluvastatin, may increase the risk of liver damage.
lovastatin, pravastatin
Limit grapefruit juice. Large amounts can
increase the amount of some statins in
your body.
Anticoagulants: warfarin Limit foods high in vitamin K:
 Broccoli
 Brussels sprouts
 Cabbage
 Cauliflower
 Collard greens
 Kale
 Spinach
 Turnips
 Do not make large changes in the amounts
of foods you eat daily that are high in
vitamin K while taking this drug.

Limit alcohol to one or two drinks/day.

Talk to your doctor before taking vitamin E,

which may have an anticoagulant effect.

Iron compounds
Ferrous fumarate, glaciate, sulfate Take between meals unless stomach upset
occurs, then take with food.

Do not take with milk or antacids

Thyroid medications
levothyroxine Take on an empty stomach at least 30 minutes to
1 hour before eating.

For more information on specific medications, consult with the manufacturer. New medications
come on the market frequently. This list is not all-inclusive.

References and recommended readings

Avoid food-drug interactions. National Consumer’s League and U.S. Food and Drug
Administration. Food and Drug Administration website.
http://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafe
ly/EnsuringSafeUseofMedicine/GeneralUseofMedicine/UCM229033.pdf. Accessed April 28,
2016.

Pronsky ZM, Elbe D, Ayoob K. Food-Medication Interactions. 18th Ed. Birchrunville, PA: Food
Medication Interactions; 2015.

Youdim A. Nutrient-drug interactions. Merck Manual professional version website.

http://www.merckmanuals.com/professional/nutritional-disorders/nutrition,-c-,-general-
considerations/nutrient-drug-interactions. Updated November 2013. Accessed April 28, 2016.

Updated by Nurition411.com staff

Review date: 4/26/16