General Food-drug Interactions & Preventive Measures

Drug interactions may cause the drug to be more or less effective or cause effects on the body that are not expected.

 Mrs. Shubhangi Shelar

 December, 23 2022
 54
 Pharmacy

Drug Interaction:
Drug interaction is an interaction between a drug and some other substance, such as another drug or a certain type of food, which
prevents the drug from working correctly.

Drug interactions may cause the drug to be more or less effective or cause effects on the body that are not expected.

Types of Drug Interaction

Drug-drug interaction
Drug-food interaction
Drug-Chemical interaction
Drug-laboratory test interaction
Drug-disease interaction

What factors impact interactions

Genetics
Other medical conditions
Age
Lifestyle (Diet & Exercise)

Causes
1. Multiple drug therapy
2. Multiple prescribers
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 3. Multiple pharmacological effects of the drug
4. Multiple diseases/illness
5. Poor patient compliance
6. Advancing the age of the patient
7. Drug-related factors

Which Food and Drug Combinations Cause Issues?

A drug-food interaction occurs when your food and medicine interfere with one another. Interactions can happen with both prescription
and over-the-counter medications.

Cinnamon

Cinnamon should avoid in Diabetes This is because much like diabetes medications, cinnamon lowers blood sugar.

Too much cinnamon with diabetes medications can put your blood sugar at dangerously low levels

Safety: While you don’t have to avoid cinnamon altogether, be sure to limit your intake to a pinch for flavour.

Grapefruit Juice

Grapefruit juice has been known to increase the dosage levels of certain drugs. Medications known to be influenced by grapefruit juice
include anti-seizure medications, antidepressants, benzodiazepines, calcium channel blockers, anti-arrhythmic drugs, pain medications,
and impotence drugs.

Safety: Shouldn't take grape juice with certain blood pressure-lowering drugs or cyclosporine.

Spinach and Leafy Greens

Spinach and leafy greens such as kale and broccoli contain vitamins K & E, which are both known to increase blood-clotting compounds.

The vitamins found in these foods can reduce the effectiveness of blood thinners. Green, leafy vegetables, which are high in vitamin K,
can decrease how well aspirin thins the blood.

Safety: while taking the above drugs, avoid potassium-rich foods. Avoid herbal supplements such as dandelion, gossypol, liquorice.

Fish Oil

Fish oil is another supplement to avoid if you are on blood thinners. In large doses, fish oil can act as a blood thinner itself.

When on blood-thinning medication, taking fish oil can thin the blood too much, causing a variety of issues.

That doesn’t mean you’ll have to give up your favourite seafood meal, however.

Safety: It is recommended to consult the physician when the patients experience any unusual bleeding or swelling, vomiting, blood in
urine or stools, dizziness, or weakness during treatment with these medications.

Consuming a typical serving size of fish only exposes us to small amounts of fish oil, making it safe to consume in moderation, even if you
are on a blood thinner.

Milk, Dairy Products, and Calcium Supplements

When fluoroquinolones like ciprofloxacin, norfloxacin, or tetracyclines or bisphosphonates like alendronate, risedronate & ibadronate,
taken with dairy products like cheese, yogurt, milk containing multivalent cations (calcium), leads to the formation of insoluble chelates,
reduces the absorption of the drug, and reduces the therapeutic efficacy of the drug.
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 Safety: Calcium-rich dairy products and calcium supplements should be taken two hours before or six hours after the administration of
the drug. Ingesting too much calcium can work against these medications.

Alcohol

This should already be pretty common knowledge: drugs and alcohol don’t mix. If you are on antidepressants, mixing them can be
especially harmful.

Monoamine oxidase inhibitor (MAOI) antidepressants block the breakdown of enzymes in alcohol such as red wine.

These enzymes can cause an unhealthy rise in blood pressure. Alcohol affects insulin or oral diabetic pills.

Alcohol prolongs the effects of these drugs, which leads to low blood sugar. Moderate pain reliever drugs with acetaminophen should not
be taken with alcohol because it has a higher chance of causing severe liver damage.

Antihistamines, like Benadryl, should not be taken with alcohol because it will cause increased drowsiness.

Safety: Avoid alcohol when taking any medications. If you drink three or more alcoholic drinks every day, ask your doctor if you should
use medicines with NSAIDs or other pain relievers/ fever reducers.

Licorice:

This would appear to be a fairly harmless snack food. However, for someone taking Lanoxin (digoxin), some forms of licorice may
increase the risk for Lanoxin toxicity.

Lanoxin is used to treat congestive heart failure and abnormal heart rhythms. Licorice may also reduce the effects of blood pressure
drugs or diuretic (urine-producing) drugs, including Hydrodiuril (hydrochlorothiazide) and Aldactone (spironolactone).

Safety: Avoid ingesting Licorice concomitantly with blood pressure drugs or diuretics.

Fibre-Rich Foods:

When fiber-rich foods (Wheat bran, Oat bran, rolled oats, Sunflower seeds, Coconut shreds, Raisins, Bran muffins, green peas, beans,
etc.) react with Digoxin, Amoxicillin, Levothyroxine, TCAs (Doxipine & Desipramine), fiber binds to the drug in the gut. Then the absorption
of the drug will be delayed.

Safety: Avoid ingesting high-fiber foods concomitantly with the drugs mentioned.

Chocolate:

MAO inhibitors are just one category of drugs that shouldn’t be consumed with excessive amounts of chocolate.

The caffeine in chocolate can also interact with stimulant drugs such as Ritalin (methylphenidate), increasing their effect, or by decreasing
the effect of sedative-hypnotics such as Ambien (zolpidem).

Safety: Chocolate is concomitantly with the drugs mentioned.

Path to safety
1. Always talk with your doctor and pharmacist about any new medications. Make sure they know about any vitamins and supplements
you are currently taking.
2. Follow all the dosing instructions listed on each of your medications.
3. You can also use AARP’s online drug interaction checker (https://healthtools.aarp.org/drug-interactions/?intcmp=AE-HEA-DRUG-
TERTNAV-DITERC)
4. Read the prescription label on the container. If you don’t understand something, ask your doctor or pharmacist.
5. Read all directions, warnings, and interaction precautions. Even over-the-counter medicines can cause problems.
6. Take all medicine with a full glass of water unless your doctor tells you otherwise.
7. Do not stir medicine into your food or take capsules apart unless your doctor tells you to. This can change the way the drug works.
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 8. Do not mix medicine into hot drinks. Heat may keep the drug from working.
9. Do not take vitamins at the same time you take other medicine. Vitamins and minerals can cause problems if taken with some
drugs.
10. Never take medicine with alcohol.

Address

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