Certain Foods and Meds Don’t Mix

Raise your hand if you typically ignore the tiny little writing on your prescription medication bottles or on the box that comes with your over-the-counter meds. You are not alone because according to medical researchers, millions of Americans—by some estimates, half or more of the people using medications or drugs – ignore the warning labels, either partially or completely.

Medical compliance broadly applies to how well you adhere to the directions, warnings, and advice you’ve received from your physician, pharmacist, or the drug company. It concerns frequency, dosage, time of day for taking a medication, and what foods, other medications or liquids to avoid when using certain drugs.

While it may be hard to imagine that food would play such an important role in how well our medications work, think vitamins, digestion, compounds, and chemicals . . . . lots and lots of chemicals. That’s what food and the medications we ingest, inhale, or otherwise insert into our bodies are made of.  How they work together – and if they work well together – is important information for medical consumers to understand and employ. Failure to comply with these warnings can minimize the effectiveness of the medications you are taking and, in some cases, endanger your life.

The range of foods that can counteract, boost, or reduce medicinal potency are far reaching. Some may be surprising — the list includes everyday items such as bananas, kale, grapefruit, black licorice, caffeine, alcohol, salami, and walnuts, just to name a few. Here’s a rundown on some common food/drug interactions consumers should be aware of:

Bananas shouldn’t be mixed with ACE inhibitors and so-called “potassium-sparing” diuretics, which can increase the amount of potassium in our bodies. Too much potassium can cause an irregular heartbeat and heart palpitations. So people who take those drugs should avoid large amounts of food high in potassium, including bananas, oranges, green leafy vegetables, and salt substitutes such as Morton Lite Salt. The meds that fall into these categories include captopril (Capoten), enalapril (Vasotec), and lisinopril (Prinivil, Zestril), which are used to lower blood pressure or treat heart failure. Also avoid mixing with certain diuretics, such as triamterene (Dyrenium), used to reduce fluid retention and treat high blood pressure.

Kale shouldn’t be mixed with blood thinners such as warfarin (Coumadin). Kale and other greens, including broccoli, cabbage, spinach, and brussels sprouts are rich in vitamin K, which can reduce the drug’s anti-clotting effects. It’s good to eat a balanced diet with lots of greens, but if you have the urge to start drinking a daily kale smoothie, speak with your doctor first.

Black licorice shouldn’t be mixed with Digoxin (Lanoxin), which is used to treat heart failure and abnormal heart rhythms. Glycyrrhizin, a component of black licorice, can cause irregular heartbeat or even death when combined with digoxin. Licorice also appears to make certain drugs less effective. The list includes blood-pressure medications, blood thinners, pain relievers, and birth-control pills. Be careful if you eat a lot of it (only the real stuff counts; some candy is just licorice-flavored, so look for “licorice extract” on labels) or if you take licorice-root supplements for heartburn.

Grapefruit juice shouldn’t be mixed with cholesterol drugs such as atorvastatin (Lipitor) and lovastatin (Mevacor). Drinking grapefruit juice can raise the level of the drug in your bloodstream and increase the risk of side effects, especially leg pain. Grapefruit and grapefruit juice can interfere with other drugs, too.

 Walnuts shouldn’t be mixed with thyroid drugs such as levothyroxine (Levothroid, Levoxyl, Synthroid). Walnuts, soybean flour, cottonseed meal, and high-fiber foods can prevent your body from absorbing those medications. So if you eat a high-fiber diet, you might need a higher dosage.

Milk shouldn’t be mixed with Tetracycline antibiotics (Sumycin). Calcium, which we derive from dairy foods such as milk, yogurt, and cheese, and calcium supplements and fortified foods can prevent the body from absorbing the drug. In general, tetracycline works better if taken one hour before or two hours after eating.

Salami shouldn’t be mixed with drugs such as metronidazole (Flagyl) and linezolid (Zyvox), used to treat bacterial infections. If you eat or drink too much of anything that contains the amino acid tyramine, your blood pressure could spike. Tyramine is found in foods that are aged, pickled, fermented, or smoked such as processed cheeses, anchovies, and dry sausage. It’s also in avocados, bananas, chocolate, and alcoholic drinks.

Alcohol doesn’t mix well with most medications. Many medications come with instructions not to drink alcohol while you’re taking them. It’s an important warning—even a single glass of wine could be too much. Alcohol alone can make you drowsy, light-headed, and less coordinated; mixing it with certain drugs can magnify those effects. Even worse, it can cause serious problems, including internal bleeding and breathing and heart problems. And alcohol can make a drug less effective, even useless, or it can make a drug toxic. For example, just a few drinks mixed with acetaminophen (Tylenol) can damage your liver.

Finally, beware of mixing supplements with your prescription and over-the-counter medications without consulting your physician or pharmacist. Like the foods and drinks above, some dietary supplements, including vitamins, minerals, and herbals, can cause problems if you take them with some drugs.

Even a multivitamin with iron can negate the effects of many drugs. But herbs are the worst offenders. For example, combining St. John’s wort with over-the-counter cough medicines or prescription antidepressants or migraine drugs can cause serotonin syndrome, a dangerous condition that can cause rapid blood-pressure changes, confusion, muscle spasms, and even death.

The most common drugs involved in negative interactions with supplements were, in order, warfarin (Coumadin), insulin, aspirin, digoxin (a heart drug), and ticlopidine. The supplements that most often caused problems were St. John’s wort, magnesium, calcium, iron, and ginkgo biloba.

Just because these foods and supplements might interact with certain drugs you’re taking doesn’t mean you have to avoid them completely. Speak with your physician about any short- or long-term medication you’re taking, read labels carefully, and learn when it’s safe to eat what you like, when you like it.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!