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Holiday Food and Drug Interactions - Hazardous to your Health

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Addiction Medicine FYI

Holiday Food and Drug Interactions - Hazardous to your Health

Over the holiday season many people eat larger amounts of food and drink more than usual. There are many opportunities to try new foods.  No matter the holiday, one constant is that food rules.  This change in diet can have harmful effects and adverse reactions if the person is also taking medications.  Approximately 91 million Americans are currently taking prescription medications. This number does not take into account over-the-counter medication use. This change in diet is perceived as a limited event, but it can have a significant impact on health.

Some examples of how foods and drugs can interact include:

  • Food can speed up or slow down the action of a medication.
  • Food can impair absorption of vitamins and minerals in the body.
  • Drugs can stimulate or suppress the appetite.
  • Drugs may alter how nutrients are used in the body.
  • Herbs may interact with anesthesia, beta-blockers and anticoagulants.
  • Food can slow the absorption of some medicines throughout the body.
    • Meals high in carbohydrates can adversely affect the absorption rate of some medications.
  • Some medications need food to help with absorption for the body’s use.

Alcohol-Drug Interactions: Although not technically a food, alcohol is often grouped with foods when considering interactions with medications. The National Institute of Alcohol Abuse and Alcoholism estimates that 25 percent of emergency room admissions may have alcohol-drug interactions as a component of the underlying problem. The elderly are especially at risk for this type of interaction since they consume more than 30 percent of all prescription medications consumed in the United States today.  The risk for alcohol abuse is also significant in the elderly population.

Alcohol intensifies the effect of some medications, such as sedatives or pain medicines. Some medications increase the effects of alcohol causing dizziness, drowsiness, inability to control balance or walk properly. Alcohol can exhaust enzymes needed to metabolize the medication, thereby increasing the level of the medication.

Many physical signs may be attributed to an adverse drug reaction. These include:

  • Fatigue
  • Constipation or Diarrhea
  • Confusion
  • Incontinence
  • Frequent falls
  • Depression
  • Weakness or Tremors
  • Excess drowsiness or Dizziness
  • Agitation or Anxiety
  • Decreased sexual behavior

Some common food and drug interactions:

  • Zoloft® and Alcohol: Consuming alcohol when taking certain medications could potentially lead to decreased drug effectiveness and an increase in side effects. In rare cases, the combination of alcohol and drugs produce a life-threatening reaction. Alcohol will have an effect on most medications that work in the central nervous system. Drinking alcohol while using a Serotonin Selective Reuptake Inhibitor (i.e., Zoloft®, sertraline HCl) could impair mental and motor skills; using alcohol when on a medication that treats insomnia could result in increased sedation.
  • MAOIs and Gravy: Food can decrease or increase the effects of a drug or cause dangerous side effects. For example, eating tyramine rich foods (i.e., spinach, grapes, packaged gravy, aged cheese) while on a Monoamine Oxidase (MAO) Inhibitor (i.e., Parnate®, tranylcypromine sulfate) can increase blood pressure and cause a serious and potentially life-threatening hypertensive crisis. And using Lipitor®, Atorvastatin calcium in conjunction with grapefruit juice can lead to muscle pain and weakness.
  • Pepto-Bismol and Prescription Drugs: Anything from antacids to cold and flu medications can lead to adverse effects when combined with prescription drugs. These over-the-counter remedies can also decrease the effectiveness of prescription medication.
  • Cipro: an antibiotic prescribed to treat bacterial infections, as well as other antibiotics in its class, can bind with dairy products, preventing proper absorption.
  • Sular: a high blood pressure medication, shouldn't be taken with high-fat foods because the interaction increases the amount of the drug in the bloodstream, increasing the side effects.
  • Over-the-Counter Drugs: Tylenol, Midol and cough and cold products, which all contain acetaminophen, can cause liver damage when combined with large amounts of alcohol.
  • Grapefruit Juice: provides many nutrients, including vitamin C, potassium and lycopene. But chemicals in grapefruit juice and grapefruit pulp interfere with the enzymes that break down various drugs in the digestive system - including certain calcium channel blockers and cholesterol-lowering drugs. The result can be excessively high levels of these drugs in the blood and an increased risk of potentially serious side effects. Pomelos and Seville oranges, a type of bitter orange often used to make marmalade and compotes, may have a similar effect. Juices from oranges and other citrus fruits do not interact with medications in the same way. Citrus fruits are good sources of many nutrients, and should be included regularly in a healthy diet.

A sampling of drugs known to have potentially serious interactions with grapefruit products:

Drug name

Type of drug

Amiodarone (Cordarone) A drug used to treat and prevent abnormal heart rhythms (arrhythmias)
Buspirone (BuSpar), sertraline (Zoloft) Antidepressants
Carbamazepine (Carbatrol, Tegretol) An anti-seizure medication
Cyclosporine (Neoral, Sandimmune), tacrolimus (Prograf) Immunosuppressant drugs
Felodipine (Plendil), nifedipine (Procardia), nimodipine (Nimotop), nisoldipine (Sular) Calcium channel blockers used to treat high blood pressure
Saquinavir An HIV medication
Simvastatin (Zocor), lovastatin (Mevacor), atorvastatin (Lipitor) Statins used to treat high cholesterol

What you should remember about food-drug interactions:

  • Read the prescription label on the container. If you do not understand something, or think you need more information, ask your physician or pharmacist.
  • Read directions, warnings, and interaction precautions printed on all medication labels and package inserts. Even over-the-counter medications can cause problems.
  • Take medication with a full glass of water.
  • Do not stir medication into your food or take capsules apart (unless directed by your physician). This may change the way the drug works.
  • Do not take vitamin pills at the same time you take medication - vitamins and minerals can interact with some drugs.
  • Do not mix medications into hot drinks, because the heat from the drink may destroy the effectiveness of the drug.
  • Never take medications with alcoholic drinks.
  • Be sure to tell your physician and pharmacist about all medications you are taking, both prescription and non-prescription.

12/08