Common Drug-Food Interactions

Background:

Food may affect the action(s) of the drugs you take by:

• Reducing/ delaying drug absorption

• Increasing drug absorption 

• Altering drug metabolism 

Drugs may affect your nutrient intake from food by…

• Changing your appetite

• Modifying the use of nutrients by your body

• Interfering with absorption of nutrients

Be sure to take your medications as directed by your prescriber.

You should plan your diet according to your needs after discharge.

While taking medications, it is advised to avoid alcohol consumption.

Analgesics (Pain Relievers) 

Codeine, Meperidine (Demerol), Morphine, Oxymorphone 

• Avoid alcohol→ increased drowsiness 

• May take with food 
  

Antacids

Maalox, Mylanta, Gaviscon 

• Take after meals with water

Anti-Asthma 

Theophylline (Theo 24)

• Take 30 minutes before meals or 2 hours after meals.

• Avoid food/drinks high in caffeine (coffee, tea, energy drinks)

• Do not change your regular  intake of carbohydrates or protein.

• Avoid charcoal broiled meats.

Zafirlukast (Accolate)

• Take this medication on an empty stomach either 30 minutes before meals or 2 hours after meals.

Antibiotics 

Ciprofloxacin (Cipro), levofloxacin (Levaquin) 

• Avoid calcium containing products (dairy, multivitamins, iron, zinc, and antacids). → May decrease effectiveness of the antibiotic. 

• Can take up to 2 hours before of 6 hours after dose. 

• Avoid use with caffeine containing products→ increase in CNS activity.

Amoxicillin, Penicillin, Ampicillin 

• Take on an empty stomach for best absorption, with food if nausea.

Gastrointestinal Agents

Diphenoxylate (Lomotil), Metoclopramide (Reglan)

• Take 30 minutes before meals

• Avoid alcohol → may cause drowsiness

Cimetidine (Tagamet), Famotidine (Pepcid), Omeprazole (Prilosec), Sucralfate (Carafate)

• Take on an empty stomach to improve absorption

• Avoid alcohol and cigarettes → can worsen GI symptoms.
  

MAO Inhibitors

Selegiline (Eldepryl), Phenelzine (Nardil), Tranylcypromine (Parnate)

• Avoid tyramine-containing foods (tuna, aged cheese, red wine, beer, chocolate, etc.) Limit intake of liver, bananas, avocados, figs, raisins, yogurt, buttermilk, sour cream and soy sauce → may cause a disulfiram reaction. Flushing, increased breathing rate and heart rate can occur. Can be fatal in some patients

Mood Stabilizers

Lithium (Eskalith, Lithobid)

• Take after meals → improves absorption

• Limit intake of caffeine products and alcohol → increases lithium levels, can lead to toxicity

Potassium Supplements

K Dur, Slow K, Klor Con, Ten K

• Avoid extra potassium sources such as large quantities of bananas, citrus fruit juices, salt substitutes, tomatoes, most dark green and orange vegetables and potatoes → will greatly increase potassium levels.

Thyroid Preparations

Levothyroxine (Synthroid, Levoxyl) 

• Avoid milk, dairy products, iron, antacids, cabbage, kale, spinach, broccoli, peas, soybeans, brussels sprouts→ may greatly decrease absorption of Levothyroxine. 

Miscellaneous

Donepezil (Aricept)

• Take constantly either with or without food to avoid change in absorption.

CNS Stimulants: Dextroamphetamine/Amphetamine Salts (Adderall), Lisdexamfetamine (Vyvanse), Methylphenidate (Concerta, Daytrana, Ritalin), Dexmethylphenidate (Focalin)

• Avoid alcohol while taking any prescription stimulant → additive effects can lead to alcohol poisoning, which can be fatal.

• Avoid excess caffeine → can increase heart rate, cause palpitations, anxiety, etc.

References

Lexi-drugs online [database on the Internet]. Hudson (OH): Lexicomp, Inc.; 2021 [cited 25 Feb  2021]. Available from: http://online.lexi.com.

Available as a pamphlet to download on request.