DRUG FOOD INTERACTIONS

DRUG DRUG-FOOD INTERACTIONS RECOMMENDATIONS for PATIENT

EDUCATION

ANTIHYPERTENSIVES Natural licorice in large amounts can Natural licorice should be avoided with all
aggravate high blood pressure and can lower antihypertensive medications. (Read food ingredient
potassium levels. labels for licorice root or licorice extract.)

CALCIUM CHANNEL BLOCKERS: Supplemental calcium may reduce the Take any vitamin or mineral supplement containing
Norvasc (amlodipine) effectiveness of calcium channel blockers. calcium, two hours before or two hours after taking
Procardia (nifedipine) Norvasc or Procardia.

ACE INHIBITORS: May raise potassium levels. Avoid salt and salty foods.
Vasotec (enalapril) Avoid salt substitutes that contain potassium.
Zestril/Prinivil (lisinopril) Caution with potassium supplements.
Accupril (quinipril) Alcohol should be avoided
Lotensin (benazepril)
Capoten (captopril)

ANTIOTENSIN II RECEPTOR ANTAGONISTS:

May raise potassium levels. Potassium supplements or salt substitutes containing

potassium should not be taken without consent from
Cozaar (losartan) MD.

OTHER CARDIOVASCULAR MEDICATIONS

Digoxin Food high in fiber (such as bran) or pectin Digoxin should be taken a few hours before or after
(such as applesauce) may decrease the eating something high in fiber or pectin. Natural
absorption of digoxin. licorice should be avoided.

Visiting Nurse Service of New York 2010, Reprinted with the permission of Visiting Nurse Service of New York, all rights reserved.
 DRUG FOOD INTERACTIONS
DRUG DRUG-FOOD INTERACTIONS
Coumadin (warfarin sodium) Foods high in Vitamin K may counteract the
blood thinning properties of this drug.
OTHER MEDICATIONS
Aspirin Can be irritating to the stomach
Fosamax (alendronate) Food or beverages other than water may
interfere with absorption of the drug. Tube
feedings or enteral supplements may
interfere with drug absorption.
Dilantin (phenytoin) Dilantin increases the metabolism of vitamins
D and K; may cause folate-deficiency
anemia.
Visiting Nurse Service of New York 2010, Reprinted with the permission of Visiting Nurse Service of New York, all rights reserved.
RECOMMENDATIONS for PATIENT
EDUCATION
Advise patient to maintain consistent diet; patients on
Coumadin should not significantly vary the amount of
Vitamin K rich vegetables/foods in their diet from day
to day. Foods high in Vitamin K should be limited
dark green leafy vegetables, spinach, kale, broccoli,
lettuce, turnips, cabbage, brussel sprouts, soybean
and vegetable oil, beef liver, raw cauliflower. Green
tea is also high in Vitamin K and may need to be
discontinued.
Take with food or milk. Avoid or limit the use of
alcohol.
Fosamax must be taken on an empty stomach at
least 30 minutes before eating or drinking anything
other than water (including other medicines or
vitamins). This medication should be taken with a full
glass (6-8 oz or 180 ml-240 ml) of plain water once
daily unless directed otherwise by MD. Advise patient
to swallow the tablets whole and not to chew or suck
on them. Tell patient not to not lie down for at least 30
minutes after taking this medication to prevent
esophageal irritation.
Dilantin doses should be administered at least two hours
before or two hours after an intermittent tube feeding or
ingestion of an enteral supplement. (If a patient is receiving
continuous enteral feedings, consult with healthcare
provider.). Eating generous amounts of milk, liver, dark
green, leafy vegetables may help replace the vitamins
destroyed by Dilantin.
 DRUG FOOD INTERACTIONS
DRUG DRUG-FOOD INTERACTIONS
Sinemet (levodopa/carbidopa) High protein meals may lead to a decreased
response to levodopa. Pyridoxine (Vitamin
B6) in doses of more than 5 mg/day may
reverse levodopas drug effectiveness.
Iron (ferrous sulfate, ferrous gluconate) Eggs and milk decrease iron absorption.
Coffee and tea that is drunk with a meal or 1
hour after a meal may also decrease iron
absorption.
Synthroid (levothyroxine) Certain foods may decrease absorption of
this medication when taken at the same time.
Some foods may interfere with thyroid
function.
CHOLESTEROL LOWERING Grapefruit or grapefruit juice may increase
MEDICATIONS the serum concentration of these and other
MG-COA reductase inhibitors.
Lipitor (atorvastatin)
ZOCAR (SIMVASTATIN)
POTASSIUM DEPLETING: Increases potassium loss in the urine.
Lasix (furosemide)
Hydrodiuril (hydrochlorothiazide)
Visiting Nurse Service of New York 2010, Reprinted with the permission of Visiting Nurse Service of New York, all rights reserved.
RECOMMENDATIONS for PATIENT
EDUCATION
It is best to be consistent on a daily basis as to when
Sinemet is administered with relationship to meals.
Avoid protein intake swings. Limit foods containing
Vitamin B6: avocado, bacon, beans, beef, liver, dry
skim milk, port, peas, sweet potato, and tuna.
Do not administer with dairy products or eggs
space two hours apart. Foods/beverages high in
Vitamin C may enhance absorption of iron: oranges
and orange juice, broccoli, strawberries, green
peppers, tomatoes, potatoes.
Synthroid should be taken separately from: soybean
flour, walnuts, dietary fiber.
The following should be avoided: soybeans,
cabbage, turnips, brussel sprouts, kale and
rutabagas.
Eating grapefruit or drinking grapefruit juice should be
avoided unless otherwise instructed by MD.
Avoid alcohol to reduce the risk of liver damage.
Maintain consistent consumption of foods high in
potassium such as organ meats, bananas, tomatoes,
cantaloupe, potatoes, spinach. Have potassium
levels checked regularly by healthcare provider.
 DRUG FOOD INTERACTIONS

DRUG DRUG-FOOD INTERACTIONS RECOMMENDATIONS for PATIENT

EDUCATION

DIURETICS

POTASSIUM SPARING: May raise potassium levels. Foods high in potassium should be avoided as well
as potassium supplements or salt substitutes
containing potassium.
Aldactone, Novo-Spiroton, Aldactazide,
Spiractin, Spirotone, Verospiron,
Berlactone (spironolactone)
Dyrenium (triamterene)

ANTIBIOTICS
Cipro (ciprofloxacin)
Levaquin (levofloxacin)
Calcium and other minerals may decrease
absorption of Cipro and other
fluoroquinolones.
Take medication on an empty stomach or at least one
to two hours before or after a meal. Take antacids,
magnesium, calcium, iron or zinc supplements two
hours before or two hours after medication
administration.

Visiting Nurse Service of New York 2010, Reprinted with the permission of Visiting Nurse Service of New York, all rights reserved.
 DRUG FOOD INTERACTIONS

Drugs Associated with Weight Gain Drugs Associated with Weight Loss

Antidepressants SSRI Antidepressants

Amitriptyline (Elavil) Citalopram (Celexa)
Mitazapine (Remeron) Fluoxetine (Prozac)
Nortriptyline (Aventyl, Pamelor)
Cardiac Agents
OHAs Digoxin (Lanoxin)
Pioglitazone (Actos) Furosemide (Lasix)
Rosiglitazone (Avandia)
Benzodiazepines
Glucocorticoids Clonazepam (Klonopin)
Dexamethasone (Cecadron, Dexan) Lorazepam (Ativan)
Methylprednisolone (Medrol, Meprolone)
Prednisone OHAs
Prednisolone Metformin (Glucophage)

Antipsychotics
Haloperidol (Haldol)
Olanzapine (Zyprexa)
Risperidone (Risperdal)

Miscellaneous
Cyproheptadine (Periactin)
Lithium (Eskalith, Lithobid)
Omeprazole (Prilosec)

Visiting Nurse Service of New York 2010, Reprinted with the permission of Visiting Nurse Service of New York, all rights reserved.