Hazardous Food-Medication Interactions

Did you know that deli meats, milk, and even candy could cause adverse reactions with certain medications? A variety of everyday foods and beverages can weaken the effectiveness of the drugs you’re taking, make them more potent, or spark serious side effects. In rare cases, food-drug interactions can even be lethal: University of Wisconsin Hospital and Clinics reported that a 49-year-old patient died after eating a large amount of chocolate while on antidepressant medication. This mixture triggered a severe spike in blood pressure, followed by a fatal stroke.

The best ways to avoid food-medication interactions: Check the package insert for interaction warnings and ask your doctor and pharmacist if they advise any dietary restrictions. Drugs.com offers an online interaction checker for both interactions with other drugs and with food. Here’s a look at foods that are most likely to react with medications:

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Grapefruit juice. Grapefruit juice can interact with several prescription drugs, because it contains compounds called furanocoumarins which interfere with enzymes that break down the drugs in the gut. That means more of the drug stays in your body, which could cause it to build up to potentially hazardous levels.

Drugs it can interact with: Statins (Zocor, Lipitor), certain medications for anxiety (BuSpar), heart arrhythmias (Cordarone), depression (Zoloft), seizures (Tegretol, Carbatrol), malaria (quinine), insomnia (Halcion) and calcium channel blockers (Procardia, Nimotop, Sular).

Black licorice. Many forms of black licorice (used to flavor foods and candy) contain a sweet substance called glycyrrhizin, which can increase the toxicity of certain drugs or worsen side effects.

Drugs it can interact with: University of Maryland warns that if you’re taking Lanoxin (a treatment for heart failure and irregular heartbeats), licorice can dangerously raise the risk of toxic side effects. It can also lower the effectiveness of ACE inhibitors and diuretics used to regulate blood pressure, may increase adverse effects from insulin, and boosts the potency of corticosteroids. There have also been reports of women on birth control pills developing high blood pressure and low potassium levels after eating licorice.

Leafy green vegetables. Kale, spinach, Brussels sprouts, and cabbage can make medication that combats blood clots less effective. That’s because these foods are high in vitamin K, a crucial nutrient for clot formation, while the goal of anticoagulant therapy is to slow down production of vitamin K to reduce clot risk. In effect, these foods counteract the drug’s desired effect.

Drugs these foods can interact with: Warfarin (Coumadin). If you take this drug, it’s not necessary to avoid leafy greens—instead doctors advise eating a consistent amount week to week, so your dose of warfarin can be calibrated accordingly.

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Milk. Milk and calcium supplements can interfere with absorption of certain infection-fighting drugs, if taken together. The best solution is to wait a few hours after taking these drugs before drinking milk, popping a calcium supplement, or taking antacids (which can also contain calcium).

Drugs it can interact with: Tetracycline and fluoroquinolones (a class of antibiotics that includes Cipro, Levaquin and Avelox).

Alcohol. Mixing alcohol with certain medications—including both Rx and over-the-counter drugs—can have a wide range of harmful effects, from nausea and vomiting to drowsiness (increasing risk for car accidents), internal bleeding, liver damage, sudden changes in blood pressure, impaired breathing, and loss of coordination, warns National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Drugs it can interact with: Painkillers, OTC cold, cough, flu and allergy remedies statins, drugs for angina (Isodil), anxiety and epilepsy (Ativan, Klonopin, Xanax,), arthritis (Celebrex, Voltaren), depression (Celexa, Effexor, Lexapro), diabetes (Glucophage, Orinase), enlarged prostate, high blood pressure, infections and other conditions. NIAAA offers a detailed list of drugs that don’t mix with alcohol.

Aged, cured or pickled foods. Aged cheeses like cheddar or Swiss, cured meats, and sauerkraut contain tyramine, an amino acid that sparks one of the most feared drug-food interactions when combined with certain antidepressants. The mixture can cause facial flushing, sweating, sudden rise in blood pressure, irregular heartbeats and brain hemorrhage. Tyramine is also found in certain types of wine, such as Chianti, sherry and Riesling.

Drugs it can interact with: Monoamine oxidase inhibitors (MAOI) for depression, and the antibiotics Zyvox and isoniazid.

Chocolate. The caffeine in chocolate (and other caffeinated foods) can trigger severe jitters or tremors when combined with certain meds, and packs a double whammy by irritating the stomach lining, amplifying the side effects of drugs likely to cause nausea. Chocolate also contains some tryamine, the culprit in the food-drug interaction that killed a University of Wisconsin Hospital and Clinics patient.

Drugs it can interact with: MAO inhibitors for depression, some antibiotics, narcotic painkillers like Vicodin and Percoset, asthma medications, and stimulants, such as Ritalin.

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