Drug interactions with food, beverages, supplements, other medicines

drug interactions

by  James Hubbard, M.D., M.P.H.

The FDA wants you to know that drugs not only interact with other drugs; they also interact with dietary supplements, food and beverages.  Always talk to your doctor and read any information available before starting new medicines.

To prove the point, the FDA has listed examples.

Food and beverages that may cause drug interactions:

  • Alcohol
    -multiple medicines.  Don’t mix
  • Grapefruit Juice
    -certain blood pressure medicines, Buspar (sedative), Halcion (sleeping pill)
  • Licorice
    -Lanoxin/dioxin (heart medicine), certain blood pressure medications, diuretics (fluid pills)
  • Chocolate
    -MAO inhibitors (an old class of antidepressants).  The caffeine content does not mix well with stimulants (i.e., Ritalin) or sedatives (i.e., Ambien).

Dietary supplements that may cause interactions:

  • St. John’s Wort
    -Lanoxin/digoxin, statins (cholesterol lowering medications), Viagra (if you don’t know…)
  • Vitamin E
    -Coumadin/warfarin (blood thinner)
  • Ginseng
    -Coumadin/warfarin, ibuprofen, napoxen and other NSAIDs, MAOs
  • Ginkgo Biloba
    -seizure medicines

Drugs that interact with other drugs:

  • Amiodarone (for heart rhythm problems)
    -Zocor (a statin), Coumadin
  • Lanoxin (digoxin)
    -Norvir (AIDS treatment)
  • Antihistamines (allergy medicines)
    -sedatives, tranquilizers, blood pressure or depression medicines

These are only a few examples to point out a much larger problem. A couple more that come to mind are the floxin antibiotics, such as Cipro, don’t absorb well if mixed with calcium-containing foods/supplements, and some antibiotics can weaken the strength of birth-control pills. Use condoms or abstain while on them or you might get a nice little surprise.

The take-home message is talk to your doctor or pharmacist for specific advice before mixing medications.

Have you had experience with interactions?  Feel free to comment on other interactions that come to mind.

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4 Responses to “Drug interactions with food, beverages, supplements, other medicines”

  1. cathy Says:

    Do does eating a grapefruit (as opposed to drinking the juice) cause a similar reaction with those drugs? Or is it just the juice – maybe because the juice is more concentrated?

    cathys last blog post..One of my favorite brands

  2. James Hubbard, M.D., M.P.H. Says:

    Good question, Cathy.

    From what I read it seems eating a grapefruit would do the same as drinking the juice. The juice from the fruit (eaten or drank) interferes with intestinal enzymes needed to break down many medications. This effect can last for as long as 24 hours.

    thanks

  3. Steve Parker, M.D. Says:

    I’m not ashamed to admit it’s very hard to keep up with the interactions of herbal remedies/foods and prescribed medications. New interactions pop ut every month, and it’s often unclear whether they are clinically significant. With drug-drug interactions, I’m much better.

    I’d like to think that pharmacists will catch interactions I overlook. But when you pick up your drug, how often do they ask about you consumption of grapefruit, milk, antacids, etc?

    -Steve

  4. James Hubbard, M.D., M.P.H. Says:

    True Dr. Parker,

    Prescriptions are usually filled by a tech with pharmacy oversight. The only way they will catch it is with the computer if your other meds and allergies are on file. The non-prescription-prescription interactions are up the individual I guess.

    thanks

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