Drug-Food Interactions

DRUG FOOD INTERACTIONS
DRUG
DRUG-FOOD INTERACTIONS
RECOMMENDATIONS for PATIENT

EDUCATION
Natural licorice in large amounts can

aggravate high blood pressure and can lower
potassium levels.
Natural licorice should be avoided with all

antihypertensive medications. (Read food ingredient
labels for licorice root or licorice extract.)
CALCIUM CHANNEL BLOCKERS:

Norvasc (amlodipine)
Procardia (nifedipine)
Supplemental calcium may reduce the

effectiveness of calcium channel blockers.
Take any vitamin or mineral supplement containing

calcium, two hours before or two hours after taking
Norvasc or Procardia.
ACE INHIBITORS:
Vasotec (enalapril)
Zestril/Prinivil (lisinopril)
Accupril (quinipril)
Lotensin (benazepril)
Capoten (captopril)
May raise potassium levels.
Avoid salt and salty foods.

Avoid salt substitutes that contain potassium.
Caution with potassium supplements.
Alcohol should be avoided
Potassium supplements or salt substitutes containing

potassium should not be taken without consent from
MD.
Food high in fiber (such as bran) or pectin

(such as applesauce) may decrease the
absorption of digoxin.
Digoxin should be taken a few hours before or after

eating something high in fiber or pectin. Natural
licorice should be avoided.
ANTIHYPERTENSIVES
ANTIOTENSIN II RECEPTOR ANTAGONISTS:
Cozaar (losartan)
OTHER CARDIOVASCULAR MEDICATIONS

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

DRUG
Coumadin (warfarin sodium)

EDUCATION
Foods high in Vitamin K may counteract the

blood thinning properties of this drug.
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.
Aspirin
Can be irritating to the stomach
Take with food or milk. Avoid or limit the use of

alcohol.
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.
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 increases the metabolism of vitamins

D and K; may cause folate-deficiency
anemia.
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.
OTHER MEDICATIONS
Dilantin (phenytoin)

DRUG

EDUCATION
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.
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.
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.
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 (levothyroxine)
Certain foods may decrease absorption of

this medication when taken at the same time.
Some foods may interfere with thyroid
function.
Synthroid should be taken separately from: soybean

flour, walnuts, dietary fiber.
The following should be avoided: soybeans,
cabbage, turnips, brussel sprouts, kale and
rutabagas.
Grapefruit or grapefruit juice may increase

the serum concentration of these and other
MG-COA reductase inhibitors.
Eating grapefruit or drinking grapefruit juice should be

avoided unless otherwise instructed by MD.
CHOLESTEROL LOWERING
MEDICATIONS
Lipitor (atorvastatin)
ZOCAR (SIMVASTATIN)
POTASSIUM DEPLETING:
Avoid alcohol to reduce the risk of liver damage.
Increases potassium loss in the urine.
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.
Lasix (furosemide)
Hydrodiuril (hydrochlorothiazide)

DRUG

EDUCATION
DIURETICS
POTASSIUM SPARING:
Foods high in potassium should be avoided as well

as potassium supplements or salt substitutes
containing potassium.
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.
Aldactone, Novo-Spiroton, Aldactazide,

Spiractin, Spirotone, Verospiron,
Berlactone (spironolactone)
Dyrenium (triamterene)
ANTIBIOTICS
Cipro (ciprofloxacin)
Levaquin (levofloxacin)

Drugs Associated with Weight Gain
Antidepressants
Amitriptyline (Elavil)
Mitazapine (Remeron)
Nortriptyline (Aventyl, Pamelor)
OHAs
Pioglitazone (Actos)
Rosiglitazone (Avandia)
Glucocorticoids
Dexamethasone (Cecadron, Dexan)
Methylprednisolone (Medrol, Meprolone)
Prednisone
Prednisolone
Drugs Associated with Weight Loss

SSRI Antidepressants
Citalopram (Celexa)
Fluoxetine (Prozac)
Cardiac Agents
Digoxin (Lanoxin)
Furosemide (Lasix)
Benzodiazepines
Clonazepam (Klonopin)
Lorazepam (Ativan)
OHAs
Metformin (Glucophage)
Antipsychotics
Haloperidol (Haldol)
Olanzapine (Zyprexa)
Risperidone (Risperdal)
Miscellaneous
Cyproheptadine (Periactin)
Lithium (Eskalith, Lithobid)
Omeprazole (Prilosec)

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DRUG FOOD INTERACTIONS

RECOMMENDATIONS for PATIENT

Natural licorice in large amounts can

Natural licorice should be avoided with all

CALCIUM CHANNEL BLOCKERS:

Supplemental calcium may reduce the

Take any vitamin or mineral supplement containing

May raise potassium levels.

Avoid salt and salty foods.

May raise potassium levels.

Potassium supplements or salt substitutes containing

Food high in fiber (such as bran) or pectin

Digoxin should be taken a few hours before or after

ANTIOTENSIN II RECEPTOR ANTAGONISTS:

OTHER CARDIOVASCULAR MEDICATIONS