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Shocking common foods and fluids that interact with medications

Updated: Aug 13, 2022

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

Anticonvulsants Tegretol/Carbomazepine

Antidepressants/SSRI Sertaline hydrochloride

Anti-emetic Marinol, Cinvanti

Anti-gout Cochicine

Antihistamines Allegra

Anti-lipemic/Statins Simvastatin, Lipitor, Vytorin

Anti-migraine Ubrelvy

Anti-neoplastic Zortress

Anti-platelet Plavix, Clopidrogrel bisulfate

Anti-psychotic Abilify, Rexulti

Anti-retroviral Crixivan

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

Immunosuppressants Cyclosporine

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

  • broccoli

  • cabbage

  • beans

  • avocados

  • bananas

  • dried apricots

  • potatoes

  • cooked onions

  • charbroiled foods

  • watermelon

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:

  • garlic

  • ginger

  • some vegetable oils

  • coconut water

  • parsley

  • brussel sprouts

  • soy such as tofu and miso

  • salt substitute

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

  • cured meats

  • aged cheeses

  • soy such as tofu and miso

  • draft beer & red wine

  • shrimp paste

  • 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

  • Avocado

  • Dried-Apricots

  • Tomato

  • 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

  • Milk

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.

  • Caffeine

  • 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

  • Keto Diet

Anti-ulcer: Prilosec/Omeprazole when treated with this medicine over 2 years can lead to malabsorption of B12

  • Vitamin 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

  • Anti-asthmatics

  • Antifungal

  • Antihypertensives/Apresoline

  • Antilipemic

  • Antiviral

  • Antineoplastic

  • Antiosteoporotics/Boniva

  • Antiretrovirals

  • Anti-ulcer

  • Immunosupressants

  • Loop diuretics/Lasix

  • Protease Inhibitors

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.

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