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Taking a brand new medicine might imply switching up your way of life a bit — and that features the meals you eat. A food-drug interplay implies that a selected nutrient or compound throughout the meals adjustments the way in which your physique metabolizes the medicine. This could both improve or scale back the dose your physique will get, in keeping with Johns Hopkins Medication. The potential outcomes: an elevated threat of unintended effects, a lot of which could be harmful, or the drug not working because it was supposed.
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Earlier than introducing a medicine, ask your pharmacist about any meals interactions, together with with alcohol, and any changes you will have to make to your weight-reduction plan. Listed below are 10 drugs that work together with meals, plus what you are able to do to remain protected.
1. Acetaminophen + Alcohol
In the event you’re popping acetaminophen (Tylenol) after consuming to thrust back a hangover, it’s possible you’ll be placing your self in peril. “When mixed with alcohol, it’s possible you’ll be at an elevated threat of liver toxicity,” says Jessica Nouhavandi, PharmD, co-CEO and cofounder of Honeybee Well being in Culver Metropolis, California.
This threat is highest if you’re a daily drinker and use acetaminophen day by day, and she or he says particularly keep away from this mix when you drink greater than three alcoholic drinks a day. (The Facilities for Illness Management and Prevention recommends that women and men restrict themselves to 2 and one drinks per day, respectively.)
2. Some Antibiotics + Dairy
Nouhavandi says sure antibiotics shouldn’t be taken alongside milk, yogurt, or cheese. “Dairy merchandise bind to the medication and intervene with its absorption within the bloodstream,” she says. This goes for fluoroquinolones like ciprofloxacin (Cipro), levofloxacin (Levaquin), moxifloxacin (Avelox), and sure tetracyclines. Keep away from consuming that bowl of yogurt or ice cream not less than two hours earlier than and 6 hours after taking your antibiotics, Nouhavandi advises.
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3. Calcium Channel Blockers and Statins + Grapefruit
Calcium channel blockers are used for hypertension and angina. Some, together with felodipine (Plendil) and nifedipine (Procardia, Adalat), are recognized to work together with grapefruit juice. This additionally occurs with statins used for top ldl cholesterol, akin to atorvastatin (Lipitor) and simvastatin (Zocor).
“Grapefruit incorporates a compound that inhibits a standard drug-metabolizing enzyme known as CYP3A4. Ingesting numerous the juice or consuming the fruit inhibits this enzyme, and the drug accumulates in your system, which could be harmful,” says Aaron Emmel, PharmD, founding father of Pharmacy Tech Scholar in St. Augustine, Florida. This doesn’t occur with different citrus, so you’ll be able to confidently sip orange juice as a substitute.
4. MAOIs + Aged Cheeses
In the event you take an antidepressant that’s a monoamine oxidase inhibitor (MAOI), akin to isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), or tranylcypromine (Parnate), you’ll want to look at high-tyramine meals in your weight-reduction plan. Tyramine is an amino acid concerned in blood stress regulation.
“This mix could cause a hypertensive disaster,” says Emmel, referring to a sudden and extreme enhance in blood stress, in keeping with the Mayo Clinic. Excessive-tyramine meals embrace aged cheeses, particular kinds of wine, pickled herring, brewer’s yeast, and fava beans, he notes. That mentioned, MAOIs aren’t as regularly prescribed as different kinds of antidepressants (like selective serotonin reuptake inhibitors, or SSRIs), and if this interplay is a fear for you, discuss to your physician about different choices.
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5. Ziprasidone + Small Meals
The antipsychotic medication ziprasidone (Geodon) is used to deal with bipolar dysfunction and schizophrenia. You’ll need to take it with a meal of not less than 500 energy, notes the Nationwide Alliance on Psychological Sickness. As one examine exhibits, consuming it with a considerable snack or meal optimizes absorption of the drug so it may well work most effectively, says Howard.
6. Hypothyroid Medicine + (Any) Meals
You probably have been identified with hypothyroidism (an underactive thyroid), you might be most likely taking levothyroxine (Synthroid) to revive your ranges. There’s a purpose that the label instructs you to take this primary factor within the morning with a 30- to 60-minute buffer earlier than consuming any meals.
“There are a few dozen totally different dosages your physician can prescribe. That’s as a result of the dosage needs to be good on your thyroid to perform accurately,” says Ashley Ellis, PharmD, ImPAcT Program Director on the College of Tennessee Well being Science Middle. Meals can block absorption of the drug in your small gut, successfully decreasing your dose in a manner that may have an effect on your thyroid, she explains. Sadly, sure, this contains espresso, too.
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7. Spironolactone + Licorice
The diuretic spironolactone (Aldactone) is used to deal with low potassium and coronary heart failure, in keeping with MedlinePlus. Take inventory when you eat licorice tea, sweet, or dietary supplements. “Licorice competes with the identical receptors as spironolactone, which makes the drug ineffective,” says Ellis. She recommends avoiding licorice in meals or complement type when you’re taking this water tablet.
8. SSRIs + Alcohol
SSRIs are antidepressants that deal with despair. They will additionally assist deal with anxiousness. However utilizing alcohol to quell the signs of hysteria or despair can result in extreme issues. “The danger of mixing these with alcohol is abdomen or gastrointestinal bleeding,” says Ellis. She calls this a “black field warning,” that means it’s obligatory for the pharmacy to warn sufferers about this interplay.
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9. Warfarin + Kale
The blood thinner warfarin (Jantoven, Coumadin) treats blood clots. Greens like kale and broccoli pack in vitamin Okay. The issue is that “vitamin Okay negates what warfarin is making an attempt to do,” says Mitchell Howard, PharmD, medical assistant professor on the College of Toledo Faculty of Pharmacy and Pharmaceutical Sciences.
With out warfarin working correctly, your threat of a blood clot will increase. You don’t should keep away from vitamin Okay — that’s a standard misnomer. Fairly, “your weight-reduction plan wants to remain constant,” says Howard. If you’re consuming extra produce due to the season or all of a sudden cease consuming many greens, you possibly can undergo unintended effects like blood clots or bleeding. In that case, your physician can regulate your medicine dose.
10. Metronidazole + Alcohol
The medicine metronidazole (Flagyl) is used to deal with infections, together with the vaginal an infection bacterial vaginosis, in keeping with the Mayo Clinic. Don’t — and this bears repeating, don’t — drink any alcohol whereas on it, because it interferes with alcohol metabolism. “This mix causes extreme vomiting,” says Ellis. She recommends ready 48 hours after stopping the medicine earlier than having that tumbler of wine.
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