Foods that normally are considered to be healthy, may not be so if you take certain medications.
If you are taking the following medications you may want to take a look and change how or when you take them, or eliminate them. It is best to check with your Doctor and talk to the pharmacist. I know having taken some medications for migraines at one time I had to eliminate grapefruit from my diet. After taking medications for years you tend to forget the specifics, so as a reminder, update, and rationale, I have gone through my 2022 Davis’s Drug Guide and some research analysis, and this is what I found.
Grapefruit juice interacts with medications the most as it changes the way the body metabolizes medications and affects how the liver filters the medication. Cytochrome P450 3A4 (CYP 3A4) is the most important enzyme in drug metabolism.
With some medications the interaction of grapefruit juice
and the medication is when taken together, or within a few hours of taking the medications. If you happen to love grapefruit juice and take a medication that interacts with it; it is important
to know you must alter when you drink it, or eliminate it completely.
When taking Statin medication to lower cholesterol, like simvastatin or atorvastatin, anti-anxiety medication such as buspirone hydrochloride/BuSpar, or antidepressants like Sertaline Hydrochloride/Zoloft, corticosteroids such as Entocort EC, used to treat ulcerative colitis and Crohn’s disease, Verapamil used to treat a variety of heart, renal, and GI conditions, you will want to eliminate grapefruit from your diet completely.
Grapefruit & Juice :
Anti-anxiety BuSpar, Midazolam
Anti-arrhythmics Amiodorone, Multaq
Antibiotics/Macrolides Clarithromycin, Erythromycin
Antidepressants/SSRI Sertaline hydrochloride
Anti-emetic Marinol, Cinvanti
Anti-lipemic/Statins Simvastatin, Lipitor, Vytorin
Anti-platelet Plavix, Clopidrogrel bisulfate
Anti-psychotic Abilify, Rexulti
Anti-spasmodic Detrol/Tolterodine tartrate
Beta Blockers Atenolol
Calcium Channel Blockers Procardia, Filodipine, Plendil
CNS Stimulants Dexedrine
Corticosteroids Entocort EC
Estrogens/Contraception Menest, Bijuva, CombiPatch
Hematologic Oxbryta, Voxelotor
Hormone Thyroid Levothyroxine
Metabolic Agent Trikafta
If you are on the vitamin K inhibitor warfarin/Coumadin and some ACE inhibitors like Capoten or Univasc you will want to reduce or eliminate the following foods:
Leafy Greens such as, kale, seaweed, spinach and swiss chard
Sevillian oranges, pomelos and star fruit reduce this enzymes ability to metabolize (Bushra, Aslam, & Khan, 2010). Additional foods to stay away from if taking Warfarin include:
some vegetable oils
soy such as tofu and miso
Soy can increase or decrease the absorption of warfarin either causing bleeding or clotting. You may also want to limit or eliminate salt substitutes, garlic, ginger and some vegetable oils. The reason for this is these foods can either deactivate the medication completely, reduce its effectiveness, or can cause bleeding.
If you are taking MAOI’s Parnate, Nardil, Marplan, Emsam you will not want to eat the following foods due to causing hypertension
soy such as tofu and miso
draft beer & red wine
very ripe bananas
Antibiotics Oxazolidinones: Zyvox & MS Drugs like Zeposa can increase blood pressure
Foods & fluids high in tyramine like aged cheese, air dried meat, red wines, sauerkraut, soy sauce, & tap beer
Ace Inhibitors like Capoten/Univasc you should not eat the following due to due to causing arrhythmias
Salt Substitutes containing potassium can cause hyperkalemia
Antihypertensives: Vasotec/enclaprilat, Dyazide can increase risk for hyperkalemia
Salt Substitutes containing potassium
Calcium supplements: can impede calcium absorption
Oxolic acid like rhubarb & Spinach
Phytic acid like bran, whole grain cereals
Phosphorus like dairy
Antiarrhythmics: Flecainide Acetate can cause tachycardia in your children according to Thompson et al. doi: 10.1136/bar.02.2012.5810
Anti-tuberculosis: Isonazid can cause headache, sweating, palpitations, flushing, & wheezing
Histamine foods saury fish, skip jack tuna, & tropical fish
Antiparkinsonian: Sinemet/Levodopa Carbidopa will decrease absorption
Foods high in protein
Anti-manic: Lithium can decrease levels and Bronchodilators Striverdi Respimat increased risk for hyperkalemia CNS Stimulants like Ritalin and Dexedrine can increase excitability.
Potassium Sparing Diuretics: Aldactone can increase hyperkalemia
Potassium rich foods, citrus, tomatoes, salt substitutes
Nicotine: Nicoderm, Nicolette, Habitrol
Acidic Foods & Fluids and Caffeine
Anorectic: Phentermine Hydrochloride Topiramate due to high risk of kidney stones
Anti-ulcer: Prilosec/Omeprazole when treated with this medicine over 2 years can lead to malabsorption of B12
Cholinergic Agonists: Pilocarpine Hydrochloride & Hypnotic Lunesta
High Fat Meals
The following medications should be taken one hour before a meal or two hours after a meal
This is not an all inclusive list however, this is a list of many common medication and food and drink interactions, listed in my nursing drug book. I am not a medical doctor or pharmacist, I am a nurse helping share with the community about common interactions between food and medications. Please always refer to your physician and pharmacist regarding further concerns.