Food and Drug Interactions.

Use Interactions! Examples’

Guidelines
ALLERGIES Antihistamine To relieve or FOOD: Take without Diphenhydramine/
prevent the regard to food. BENADRYL
symptoms of Exception: Fexofenadine/ALLEGRA
colds, hay fever Fexofenadine/ALLEGR oratadine/CLARITIN
and allergies. A. Bioavai lability Cetirizine/ZYRTEC
decreases if taken with *
do not take with juice
apple, orange, or
grapefruit juice.
ALCOHOL: Avoid
alcohol because it
increases the sedative
effects of the
medications.
ARTHRITIS Analgesic! To treat mild to FOOD: For rapid relief, AcetaminophenlTYLENOL
and PAIN Antipyretic moderate pain take on empty stomach. TEMPRA
and fever. ALCOHOL: Avoid or
limit the use of alcohol
because chronic alcohol
use can increase the risk
of liver damage or
stomach bleeding.
Non-Steroidal To reduce, pain, FOOD: Take with food AspirinJBAYER, ECOTRW
Anti- fever and or milk because IbuprofenfMOTRlE, ADVIL
Inflammatory inflammation, medications can irritate NaproxenlANAPROX,
Drugs the stomach. ALEVE, NAPROSYN
(NSAIDS) ALCOHOL: Avoid or
limit the use of alcohol
because chronic alcohol
use can increase the risk
of liver damage or
stomach bleeding.
Corticosteroids • To relieve FOOD: Take with food Methyprednisolon! MEDROL
inflamed areas or milk to decrease Prednisone/DELTASONE
of the body. stomach upset. Prednisolone/PEDIAPRED,
• To reduce PRELONE
swelling and Cortisone acetate/CORTEF
itching.
• To help
relieve
allergies,
rheumatoid
arthritis, and
other
conditions.
 ASTHMA To provide ALCOHOL: Avoid Codeine combined with
relief for alcohol because it acetaminophen/TYLENOL
moderate to increases the sedative Morphine/ROXANOL, MS
severe pain, effects of the CONTLN
medication.
Bronchodilators To treat the FOOD: High-fat meals Theophylline/SLO-BID,
symptoms of may increase the amount THEO-DUR, IJNIPHYL
bronchial of theophylline in the Albuterol/VENTOLIN,
asthma, body, while high- PROVENTIL, COMBIVENT
chronic carbohydrate meals may Epinephrine/PRIMATENE
bronchitis decrease it. It is MIST
and important to check with
emphysema. the pharmacist about
which form you are
taking because food can
have different effects
depending on the dose
form.
CAFFEINE: Avoid
eating or drinking large
amounts of foods and
beverages that contain
caffeine.
ALCOHOL: Avoid
alcohol because it can
increase the risk of side
effects such as nausea,
vomiting, headache and
irritability.
CARDIO- Diuretics To help FOOD: Take on an Furosemide/LASIX
VASCULAR eliminate empty stomach or with Triamterene/
DISORDERS water, milk to decrease stomach hydrochlorothiazide/
sodium and upset. Some diuretics DYAZIDE, MAXZIDE
chloride cause loss of potassium, Hydrochlorothiazide/
from the calcium and magnesium. HYDRODIURIL
body. Triamterene is known as Trimterene/DRYENIUM
a “potassium sparing” Bumetamide/BUMEX
diuretic. When taking Metolazone/ZAROXOLYN
triamterene avoid eating
large amounts of
potassium-rich foods
such as bananas, oranges
and green leafy
vegetables or salt
substitutes.
Beta Blockers To decrease FOOD: Take with food Atenolol/TENORMIN
the nerve to increase Metoprolol/LOPRESSOR
 impulses to bioavailability. Take Propranolol/INDERAL
blood atenolol/TENORM1I’4 Nadolol/CORGARD
vessels, separately from orange
juice. Avoid licorice.
ALCOHOL: Avoid
drinking alcohol with
propranolol/INDERAL
because these drugs
lower blood pressure too
much.
Nitrates To relax FOOD: Take on an Isosorbide dinitrate/ ISORDIL,
blood vessels empty stomach. SORBITATE
and lower the ALCOHOL: Avoid NitroglycerinfNlTRO,
demand for alcohol because it may NITRODUR, TRANSDERM
oxygen by add to the blood vessel- NITRO
the heart. relaxing effect of nitrates
and result in dangerously
low blood pressure.
Angiotension To relax FOOD: Take Captopril/CAPOTEN
Converting blood vessels catropil/CAPOTEN or Enalapril/VASOTEC
Enzyme (ACE by moexipril/UNIVASC on Lisinopril/PRINIVIL,
Inhibitors) preventing empty stomach. High fat ZESTRIL
angiotension meals decrease Quinapril/ACCUPRIL
II, a absorption of Moexipril/UNIVASC
vasoconstrict quinapril/ACCUPRIL.
or, from Take others without
being regard to food. Ensure
formed. adequate fluid intake.
Avoid salt substitutes.
HMG-CoA Known as FOOD: Avoid Atorvastatin!LIPITOR
Reductase “statins” grapefruit/related citrus Cerivastatin/BAYCOL
Inhibitors • To lower with Fluvastatin/LESCOL
cholesterol. atorvastatin/LIPITOR, Lovastatin/MEVACOR
• To reduce lovastatinfMEVACOR, PravastatinfPRAVACHOL
the and simvastatinl Simvastatin!ZOCOR
production ZOCOR.
rate of LDL Lovastatin/MEVACOR
(bad) should be taken with the
cholesterol. evening meal to enhance
absorption.

ALCOHOL: Avoid
drinking large amounts
of alcohol because it
may increase the risk of
liver damage.
 Anticoagulants To prevent FOOD: Vitamin K WarfrinJCOUMADJN
the formation produces blood-clotting
of blood substances and may
clots, reduce the effectiveness
of anticoagulants. Limit
foods high in Vitamin K
such as broccoli,
spinach, kale, turnip
greens, cauliflower, and
br ussel sprouts. High
doses of vitamin E (400
IU or more) may prolong
clotting time and
increase the
risk of bleeding.
INFECTION Antibiotics and To treat GENERAL
S Antifungals infections GUIDELINES: Tell the
caused by doctor if you experience
bacteria and skin rashes or diarrhea.
fungi. If you are using birth
control, consult with
your health care provider
because some
methods may not work
when taken with
antibiotics. Be sure to
finish all of your
medication even if you
start feeling better. Take
medication with plenty
of water.
Antibacterials/ To treat FOOD: Take on an Penicillin V/VEETIDS
Penicillin infections empty stomach unless it AmoxicillinlTRIMOX,
caused by upsets your stomach, AMOXIL
bacteria and then take with food. AmpicillinJPRINCIPEN,
fungi. OMNIPEN
Quinolones To treat FOOD: Take on empty CiprofloxacinlClPRO
infections stomach one hour before Levofloxacin!LEVAQUIN
caused by or two hours after meals. OfloxacinlFLOX[N
bacteria and If your stomach gets TrovafloxacinlTROVAN
 fungi. upset, take with food,
but not with dairy or
calcium-fortified
products alone.
CAFFEINE: Taking
these medications with
caffeine-containing
products may increase
caffeine levels, leading
to excitability and
nervousness.
Cephalosporins To treat FOOD:Take on an Cefaclor/CECLOR
infections empty stomach one hour CECLOR CD
caused by before or two hours after Cefradroxil/DURICEF
bacteria and meals. If your stomach Cefixime/SUPRAX
fungi. gets upset, take with Cefprozil/CEFZIL
food. CephalexinIKEFLEX,KEFTAB
Macrolides To treat FOOD: May take with AzithromycinJZITHROMAX
infections food if GI distress ClarithromycinlBlAXlN
caused by occurs. Avoid taking ERYTHROMYCIN/E-MYCIN,
bacteria and with citrus foods, citrus ERY-TAB,
fungi. juices, and carbonated ERYCErythromycin
drinks. + sulfisoxazole/PEDIAZOLE

Sulfonamides To treat FOOD: Take with food Sulfamethoxazole +

infections and at least 8 ounces of trimethoprimlBACTRlM,
caused by water. SEPTRA
bacteria and
fungi.
Tetracyclines To treat FOOD:Take on an Tetracycline! ACHROMYCIN,
infections empty stomach with 8 SUMYCIN
caused by ounces of water. Avoid Doxycycline/VIBRMYCIN
bacteria and taking tetracycline with Minocycline/MINOCJN
fungi. dairy products, antacids,
and vitamin supplements
containing iron because
they can interfere with
the medication’s
effectiveness.
Nitromidazole To treat FOOD: May take with Metronidazole/FLAGYL
infections food to decrease GI
caused by distress, but food
bacteria and decreases bioavailability.
fungi. ALCOHOL: Avoid
drinking alcohol and
taking medications that
contain alcohol while
taking metronidazole
 and for at least three
days after you finish the
medication. Alcohol may
cause nausea, abdominal
cramps, vomiting,
headaches, and flushing.
Antifungals FOOD: Take with food Fluconazole/DIFLUCAN
to increase absorption. Griseofulvin/GRIFULVIN
Do not take Ketoconazole/NIZORAL
itraconazole/SPORANO Itraconazole/SPORANOX
X with grapefruit/related
citrus.
ALCOHOL: Avoid
drinking alcohol and
taking medications that
contain alcohol while
taking keroconzole and
for at least three days
after you finish the
medication. Alcohol may
cause nausea, abdominal
cramps, vomiting,
headaches, and flushing.
MOOD Monoamine To treat FOOD: These Phenelsine/NARDIL
DISORDERS Oxidase (MAO) depression, medications have many Tranycypromine/PARNATE
Inhibitors emotional dietary restrictions and
and anxiety people taking them need
disorders. to follow the dietary
guidelines and
physician’s instructions
very carefully.
A rapid, potentially fatal
increase in blood
pressure can occur if
foods or alcoholic
beverages containing
tyramine are consumed
while taking MAO
inhibitors. Avoid foods
high in tyramine and
other pressor amines
during drug use and for
two weeks after
discontinuation. These
include aged cheeses,
aged meats, soy sauce,
tofu, miso, fava beans,
snowpeas, sauerkraut,
 avocadoes, bananas,
yeast extracts, raisins,
ginseng, licorice, and
caffeine.
ALCOHOL: Do not
drink beer, red wine,
other alcoholic
beverages, non-alcoholic
and reduced alcohol beer
and red-wine products.
Anti-Anxiety To treat FOOD: May take with Lorasepan/ATIVAN
Drugs depression, food if GI distress Diazepam/VALIUM
emotional occurs. AlprazolamJXANAX
and anxiety CAFFEINE: May cause
disorders. excitability, nervousness
and hyperactivity and
lessen the anti-anxiety
effects of the drugs.
ALCOHOL: May
impair mental and motor
performance.
Antidepressant To treat FOOD: These Paroxetine/PAXIL
Drugs depression, medications can be taken Sertraline/ZOLOFT
emotional with or without food. Fluoxetine/PROZAC
and anxiety ALCOHOL: Avoid
disorders. alcohol.
STOMACH Histamine To relieve FOOD: These Cimetidine/TAGAMET
CONDITION Blockers pain, mediations can be taken Famotidine/PEPCID
S promote with or without food. Ranitidine/ZANTAC
healing and CAFFEINE: Caffeine Nizatadine/AXID
prevent products may irritate the
irritation stomach.
from ALCOHOL: Avoid
returning. alcohol while
takingthese products.
Alcohol may irriate the
stomach and make it
more difficult for the
stomach to heal.
‘The generic name for each drug is stated first. Brand names are in all capital letters and represent only
some examples of those medications.
References: Food and Drug Interactions, 1998, U.S. Food and Drug Administration, National Consumers
League.

Table 2: Aspirin vs. Acetaminophen vs. Ibuprofen

Aspirin Acetaminophen Ibuprofen
Classification NSAID, ANALGESIC,
ANTIPYRETIC,
ANTIARTHRITIC
Use • pain relief and fever • mild pain relief
reduction in adults-relieves • reduces fever
mild itching
• reduces swelling and
inflammation
• used to treat arthritis,
many
other conditions and
injuries
• used to reduce risk of
heart attack and stroke
Cautions Caution is advised if you:
• get stomach irritation
when taking aspirin-or are
allergic to aspirin
• are taking blood thinning
medication
• have a hang-over
A person should not take
aspirin if he/she has:
ulcers, gout, asthma,
hearing loss.
Dietary • Insure adequate fluid
Recommendations intake/hydration
• Increase foods high in
vitamin C and
folic acid with long-term,
high dosage use
• Avoid or limit garlic,
ginger and Gingko, or
horse chestnut
• Limit caffeine
• Avoid alcohol
Remarks Children and teenagers
should not take aspirin
because it is associated
with a rare disorder called
Reye’s Syndrome in these
age groups.
ANALGESIC,
ANTIPYRETIC
• High doses or regular,
long-term use can cause
liver damage, especially if
used with alcohol.
• Should not be used to
treat fever over 103.10 F
for more than three days.
• Should not be used to
treat fevers that keep
coming back.
• Should not be used on a
regular basis by people
who suffer from: anemia or
liver or kidney disease
Avoid alcohol or limit to
less than 3 drinks per day.
Works will for people who
can’t take aspirin because
of aspirin-related allergic
reactions, stomach
irritation, or ringing in the
ears.
N SAID, ANALGESIC,
ANTIARTHRITIC
• pain relief
• reduces fever
• reduces inflammation
Caution is advised if you
have:
• asthma and nasal polyps
• a stomach or intestinal
disorder
• a skin condition called
“angioedema”
• an allergic reaction to other
antiinflammatory
medications
• liver or kidney disease
• a blood clotting disorder
• heart failure
• Not to be used with aspirin,
alcohol or steroids.
• HT hypertension
• Take with meals or milk.
• Avoid or limit garlic, ginko,
or horse chestnut.
• Limit caffeine.
•Avoid alcohol.
• Less irritating to the
stomach than aspirin for
some.
• Does not cause ringing in
the ears like aspirin.
• Does not cause liver
 damage like acetaminophen.
Known Brands Aspirin, Ascriptin, Aspirin Free Anacin, Advil, Midol IB, Motrin
Bufferin, Ecotrin Aspirin Free Excedrin,
Tylenol, Panadol, Tempra.