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What Foods Shouldn’t I Eat with My Meds?

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It is easy to overlook this, doctors say. However, the information is in the packet you get when you pick up your prescription from the pharmacy. It is very important for older adults to be aware of potential food-drug interactions. A study from the Lown Institute shows that 42% of U.S. adults ages 65 and older take five or more prescription drugs per day and nearly 20% take 10 or more meds, complicating matters when it comes to remembering how to take each medication.

AARP’s recent article entitled “7 Foods That Don’t Mix With Prescription Drugs” explains that in some cases, eating a specific food could make a particular drug less effective or potentially increase blood levels of the drug. In other situations, the combination could trigger bad, or even dangerous, side effects. Therefore, you can see why it is so important to talk to your doctor or pharmacist to see if there are any foods that can interact with the medicines you are taking.

Here are some frequently used medications and the foods and beverages that could create a problematic pairing.

  1. Dairy and some antibiotics. With antibiotics in the tetracycline class (including doxycycline and minocycline, which are prescribed to treat bacterial pneumonia and other infections) and ciprofloxacin (from the quinolone class, also prescribed for pneumonia and other infections), the calcium in dairy products like milk, cheese and yogurt could lessen the drug’s absorption. This could compromise the medication’s ability to treat your infection effectively. Avoid calcium-containing foods an hour before, or two hours after, taking one of these antibiotics.
  2. Leafy greens and warfarin. A well-known food-drug interaction is the anticoagulant warfarin (brand names Jantoven and Coumadin) and foods containing vitamin K, like broccoli, cabbage, kale, spinach, swiss chard and other leafy greens. Certain vegetable oils also contain large amounts of vitamin K. These vegetables can reduce the effectiveness of the commonly prescribed medication and inhibit its ability to stop or prevent blood clotting. Ask your doctor if you should avoid these foods (or others) while taking warfarin.
  3. Cured meats, soy, other tyramine-containing foods, plus MAOIs. An older class of antidepressants called monoamine oxidase inhibitors (MAOIs) can have dangerous interactions with foods that contain high levels of tyramine (an amino acid). Taking MAOIs and consuming tyramine-rich foods can lead to a high tyramine level in the body. This can trigger a sudden, dangerous increase in blood pressure. Foods that are high in tyramine include smoked and cured meats, aged cheeses, fermented foods, red wine, some draft beer, soy products (soy sauce, miso, tofu) and very ripe bananas. MAOIs are used now to treat Parkinson’s disease.
  4. Grapefruit and cholesterol-lowering drugs. Eating grapefruit or grapefruit juice can inhibit an enzyme that is necessary for statins to be metabolized. That means that the drug stays in the blood and accumulates. This increases the chances of side effects like muscle pain. Of the statins, atorvastatin, lovastatin, and simvastatin (common brand names Lipitor, Altoprev/Mevacor and Zocor) are problematic as far as grapefruit juice goes. Avoid grapefruit and grapefruit juice entirely, while taking statins. In addition, grapefruit can also cause problems when mixed with other medications: a number of anti-anxiety drugs, such as BuSpar, and certain corticosteroids that treat Crohn’s disease or ulcerative colitis, such as Entocort EC and Uceris tablet (both budesonide), according to the FDA.
  5. Bananas and other potassium-rich foods, plus ACE inhibitors. If you take blood pressure-lowering ACE inhibitors with potassium-rich foods, including bananas, avocados, tomatoes and dried apricots, you can experience high potassium levels in your body. This can result in potentially dangerous heart arrhythmias. Therefore, limit your intake of potassium-rich foods while taking an ACE inhibitor. It is recommended that some ACE inhibitors, such as captopril and moexipril (brand names Capoten and Univasc), be taken at least an hour before meals.
  6. Fruit juice and some blood pressure drugs/ antihistamines. If you are taking a calcium channel blocker (another type of hypertension drug), do not drink grapefruit juice. It can render the drug ineffective, and if you are taking the beta blocker atenolol (Tenormin) or the renin inhibitor aliskiren (Tekturna), note that drinking apple juice or orange juice could decrease levels of the drug in your body. Some of the newer generation of antihistamines — such as fexofenadine (Allegra) — can also interact with acidic juices, such as apple, orange and grapefruit juice. These acidic juices could affect absorption and neutralize the effect of antihistamines, so they are not effective. If you are looking for allergy relief, avoid these juices within two to four hours of taking one of these antihistamines.
  7. High-fiber foods and levothyroxine, digoxin. Eating soybean flour, walnuts and other high-fiber foods can make levothyroxine (a drug listed under several brand names that is used to treat an underactive thyroid gland) less effective. The same thing is true, if you are taking digoxin, which is sold under several brand names and is used to treat heart failure. High-fiber foods can impact a person’s absorption of the drug, so take digoxin at least two hours before or after consuming meals or snacks that have fiber.

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Reference: AARP (Feb. 3, 2022) “7 Foods That Don’t Mix With Prescription Drugs”