Food drug interactions
Below are the ill-advised combinations that Zive believes comprise the top 10 types of drug-nutrient interactions affecting older adults, along with his recommendations for preventing potentially deadly problems. 1.Warfarin and Vitamin K 2.Insulin, Oral Diabetic Agents, and Alcohol 3.Digoxin, High-Fiber Diets, and Herbs 4.Statins and Grapefruit 5.Calcium Channel Blockers and Grapefruit 6.Erectile Dysfunction Drugs and Grapefruit 7.Acetaminophen and Alcohol 8.Antibiotics and Dairy Products 9.MAOIs and Tyramine-Containing Foods 10.Antithyroid Drugs and Iodine-Rich Foods
You've probably heard the warnings not to drink grapefruit juice with cholesterol medication. However, that isn't the only combination of food and drugs to avoid. Grapefruit juice can interact with numerous other medications, both prescription and over-the-counter. And many other foods commonly interact with drugs, too. Steve Plogsted, BS, PharmD, BCNSP, CNSC, clinical pharmacist with Nutrition Support Service of Nationwide Children's Hospital in Columbus, Ohio, fills us in on five foods that most commonly interact with medications. Grapefruit Juice: "Grapefruit juice has the ability to interact with medications in various ways," says Plogsted. One way is by increasing the absorption of certain drugs — as is the case with some, but not all, cholesterol-lowering statins. MedinePlus recommends avoiding grapefruit juice if you are taking statins. Green Leafy Vegetables: Blood-thinning drugs such as Coumadin® (warfarin) interfere with vitamin K-dependent clotting factors. Eating too much green leafy vegetables, which are high in vitamin K, can decrease the ability of blood-thinners to prevent clotting. But you don't have to give up greens altogether. Problems arise from significantly and suddenly increasing or decreasing intake, as it can alter the effectiveness of the medicine. So eat your greens in consistent amounts. Natural Black Licorice (Glycyrrhiza): According to Plogsted, glycyrrhiza — a natural ingredient used to make black licorice — can deplete the body of potassium while causing an increased retention of sodium. When the body is depleted of potassium, the activity of digoxin, a medication used to treat heart failure, can be greatly enhanced, resulting in the heart not beating properly. Salt Substitutes: "There is no real need to avoid salt substitutes, although care should be taken when using the product," say Plogsted. "If the consumer has decreased kidney function they should discuss the use of salt substitutes with their doctor." Tyramine-Containing Foods: High blood levels of the amino acid tyramine can cause an increase in blood pressure. Several medications interfere with the breakdown of tyramine, including monoamine oxidase inhibitors (MAOIs) which treat depression, and drugs used to treat the symptoms of Parkinson's disease. Plogsted advises those taking these drugs to steer clear of tyramine-rich foods. The list is lengthy and includes, but is not limited to: chocolate, aged and mature cheeses, smoked and aged/fermented meats, hot dogs, some processed lunch meats, fermented soy products and draft beers (canned and bottled beers are OK).
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