Basic Types of Interactions

There are three major types of food and

drug interactions:
• Some drugs interfere with the
absorption, excretion or use in the body
of one or more nutrients.
• Certain foods may affect (increase or
decrease) the absorption of drugs.
• Certain foods may alter the chemical
actions of a drug so that it loses its
therapeutic effect on the body.
• The extent of the effects of any food and
drug interaction can vary.
• Potential effects depend on the dose and
the form in which the drug is taken.
• It also will vary with the individual's age,
sex, body weight, nutritional status, and
specific medical condition.
• Interaction problems most often occur
with the use of diuretics, oral antibiotics,
anticoagulant (blood-thinning) drugs,
anti-hypertensive drugs, thyroid and
sodium com- pounds, and alcohol.
 DRUG EFFECTS ON
NUTRITIONAL STATUS
Drugs can affect nutritional status in a
number of ways:
• by enhancing excretion of certain
nutrients,
• by interfering with nutrient absorption, or
• by decreasing the body's ability to
change nutrients into usable forms.
• These effects are gradual so that the
effects will be greater in persons taking
drugs over a period of time.
EXAMPLES OF DRUG EFFECTS
ON NUTRIENTS
• Abuse of antacids can lead to
phosphate depletion. This can lead to a
vit D deficiency that leads to
osteomalacia ( softening of the bones)
due to loss of calcium.
• The excessive use of diuretics causes
loss of electrolytes, mainly potassium
This leads to heart problems.
• People taking diuretics regularly should
eat foods which are good sources of
potassium: tomatoes,oranges,bananas,
raisins and potatoes.
• Taking oral contraceptives over a
long period of time may develop
folacin and vitamin C
deficiencies.The best sources of
folacin are spinach, asparagus,
broccoli and other greens.
• The antihypertension drug
hydralazine can deplete the body's
supply of vitamin B6. Some good
sources are chicken, fish, liver,
whole grain breads and cereals,
egg yolks, bananas and potatoes.
 The Elderly and Nutrient-Drug
Interactions
• This population often takes the highest
amount of medications, and with the use
of multiple drugs, certain problems may
exist.
• A loss of appetite, a reduced sense of
taste and smell, and swallowing
problems all may result from medication
use in elderly people.
• Elderly people who take many drugs on a
routine basis for long periods of time are
at greatest risk of nutrient depletion and
nutritional deficiencies.
 TELL YOUR PHARMACIST TO
FLAVOR YOUR MEDICINE

• FLAVORx provides a safe, effective and

scientifically-tested flavoring system for over-the-
counter and prescription medications to improve
taste and compliance without affecting the drug’s
efficacy.
• Many patients, especially young children, find
medications easier to swallow when mixed with
food or drink because it masks the existing taste
and/or smell.
 FOOD EFFECTS ON DRUG
ABSORPTION
• We eat food to help our bodies function
normally.
• We take medicine to cure an illness or to be
able to enjoy optimal health.
• It’s hard to imagine but food can actually affect
the ingredients in some medicines preventing
them from working the way they should.
EXAMPLES OF FOOD EFFECTS
ON DRUG ABSORPTION
• The calcium in milk and milk
products decreases the absorption
of certain antibiotics, including
tetracycline.
• Ascorbic acid-containing juices
such as orange and grapefruit
juices enhance absorption of iron
supplements.
GRAPEFRUIT
• It is not recommended that you take
drugs with soda pop or high acid fruit or
vegetable juices.
• These beverages can cause excess
stomach acidity.
• Since drugs are mostly absorbed into the
body in the intestines, this will decrease
the amount of drug that can get into your
body.
• Check with your doctor before taking
drugs with these types of beverages.
• Sometimes certain foods can
speed up absorption of a drug. For
example, fatty foods increase
absorption of griseofulvin, a drug
used to treat fungus infections.
• Some dietary components
increase the risk of side effects.
Theophylline, a medication
administered to treat asthma,
contains xanthines, which are also
found in tea, coffee and
chocolate.
 Strawberries, Raspberries,
Spinach, and Rhubarb:
These contain oxalic acid, which can aggravate kidney
and bladder stones in susceptible people, and reduce
body's ability to absorb iron and calcium.

Raspberries
contain a natural salicylate that can cause an allergic
reaction in aspirin sensitive people.

Seeds from fruits such as Apple,

apricot, and Quinces
contain amygdalin, a compound that turns into
Hydrogen Cyanide in the stomach.
Eating large amount of seeds can result in cyanide
poisoning.
 Potatoes:
Avoid potatoes with a green tint to the skin, and remove
any sprouts; they will taste bitter and may contain solanine,
a toxic substance that can cause diarrhea, cramps, and
fatigue.
Plums, Peaches, Apricots, and Cherries:
These fruits may produce allergic reaction in individuals
with confirmed allergies to apricots, almonds, peaches, and
cherries. The pits of plums, peaches and apricots contain a
compound called amygdalin, breaks down into hydrogen
cyanide, a poison.
Horseradish:
Very high doses of horseradish can cause vomiting or
excessive sweating. Avoid if you have hypothyroidism.
Turmeric:
Should be avoided by persons with symptoms from
gallstones.
 Turnips
contain two goitrogenic substances,
progoitrin and gluconasturtin, which can
interfere with the thyroid gland's ability to
make its hormones.

Tomato
contains small quantities of a toxic
substance known as solanine that may
trigger headaches in susceptible people.
They are also a relatively common cause of
allergies.
 Some ways that food and
drugs interact include:
• Food can speed up or slow down
the action of the drug
• Some drugs can delay or prevent
the absorption of nutrients
• Drugs may make you want to eat
more food or suppress your appetite
• Some foods are known to alter the
chemical action of a drug so that it
loses its intended effect on the body
 Food Effects on Drug
Utilization
• Liver and green leafy vegetables can decrease the
effect of anticoagulants (blood-thinning drugs). These
foods contain vitamin K which helps promote blood
clotting.
• Aspirin should only be used on the advice of your
doctor if you are taking anticoagulants.
• One of the most hazardous food and drug inter-
actions is that between monoamine oxidase (MAO)
inhibitors and aged or fermented foods.
• MAO inhibitors are used to treat depression and high
blood pressure. They decrease the metabo- lism in
the body of compounds called monoamines.
• MAO inhibitors can react with a substance called
tyramine (a monoamine) in foods such as aged
cheese, chicken livers, and others.
• As a result blood pressure can rise to dangerous
levels causing severe headaches, brain hemorrhage
and, in extreme cases, death.
 GINKGO

Use:
• For memory enhancement as well as a painful
condition stemming from poor circulation in the legs.

Caution:
• Because it interferes with blood platelets' clot-forming
ability, medical caution when using concurrently anti-
clotting drugs such as Coumadin or blood thinners
such as aspirin, Plavix and Ticlid.
• For related reasons, many experts recommend that
ginkgo not be combined with nonsteroidal anti-
inflammatory drugs such as Advil, Motrin and Aleve.
• The American Herbal Products Assn cautions that
ginkgo may interact with antidepressants called MAO
inhibitors that include Eldepryl, Nardil, and Parnate.
 CAFFEINE
•Some drugs may affect the
absorption of nutrients, while
some foods
•For example, those containing
caffeine-can amplify or modify
the effects of certain drugs.
•Taking drugs with hot
beverages could also make
them less effective.
• Ask a doctor or pharmacist before use
if you are:
• Allergic to milk or milk products if the
product contains more than 5 grams
lactose in a maximum daily dose
• taking a prescription drug
• Ask a doctor before use if you have:
• kidney disease
 Asthma Drugs
• Pseudoephedrine
Avoid caffeine, which increase feelings
of anxiety and nervousness.
• Theophylline
Charbroiled foods and high protein diet
reduce absorption. Caffeine increases the risk
of drug toxicity.
Cholesterol LoweringDrugs
• Cholestyramine
Increases the excretion of folate and vitamins
A, D, E, and K.
 Laxatives
Overuse can cause a deficiency
Mineral Oils of vitamins A, D, E, and K.

Painkillers
Aspirin and Always take with food to lower
stronger non- the risk of gastrointestinal
irritation; avoid taking with
steroidal anti- alcohol.
inflammatory drugs
Increase fiber and water intake
Codeine to avoid constipation.

Sleeping Pills, Tranquilizers

Never take with alcohol.
Benzodiazepines Caffeine increases anxiety and
reduce drug's effectiveness.
 Hormone Preparations

Oral Salty foods increase fluid retention.

Drugs reduce the absorption of folate,
contraceptives vitamin B-6, and other nutrients.

Salty foods increase fluid retention.

Increase intake of foods high in calcium,
Steroids vitamin K, potassium, and protein to
avoid deficiencies.

Iodine-rich foods lower the drug's

Thyroid drugs efficacy.
 Antidepressants

Reduce appetite and can lead to excessive

Fluoxetine weight loss

A low-salt diet increases the risk of lithium

Lithium toxicity.

MAO Foods high in tyramine can bring on a

hypertensive crisis.
Inhibitors

Many foods, especially legumes, meat, fish,

Tricyclics and foods high in Vitamin C, reduce
absorption of the drugs.
Tips for Avoiding Interactions
• Read the label on a prescription medicine.
• Ask a pharmacist or physician if something
is not clear.
• Read all directions, warnings, and any
possible side effects in the package.
• Always take medications with a full glass of
water.
• Do not stir medication into food or take apart
capsules.
• Take vitamin and mineral supplements
before or after medicine.
• Avoid stirring drugs into hot drinks such as
coffee.
• Do not drink alcohol when taking any
medicine.
• Always tell a physician and pharmacist
about all medicines being taken.