Major food/drug and drug/nutrient interactions.

  
                                            

 

Table 1: Examples of Food/Drug Interactions
Drug Class	Food that Interacts	Effect of the Food	What to Do
Analgesic acetaminophen (Tylenol)	Alcohol	Increases risk for liver toxicity	Avoid alcohol
Antibiotic tetracyclines amoxicillin, penicillin, zithromax, erythromycin nitrofurantoin (Macrobid)	Dairy products; iron supplements Food Food	Decreases drug absorption Decreases drug absorption Decreases GI distress, slows drug absorption	Do not take with milk. Take 1 hour before or 2 hours after food/milk. Take 1 hour before or 2 hours after meals. Take with food or milk.
Anticoagulant warfarin (Coumadin)	Foods rich in Vitamin K	Decreases drug effectiveness	Limit foods high in Vitamin K: liver, broccoli, spinach, kale, cauliflower, and Brussels sprouts
Anticonvulsant phenobarbital, primidone	Alcohol	Causes increased drowsiness	Avoid alcohol
	Vitamin C	Decrease in drug effectiveness	Avoid excess vitamin C
Antifungal griseofulvin (Fulvicin)	High-fat meal	Increases drug absorption	Take with high-fat meal
Antihistamine diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton)	Alcohol	Increased drowsiness	Avoid alcohol
Antihyperlipemic lovastatin (Mevacor)	Food	Enhances drug absorption	Take with food
Antihypertensive felodipine (Plendil), nifedipine	Grapefruit juice	Increases drug absorption	Consult your physician or Pharmacist before changing diet.
Anti-inflammatory naproxen (Naprosyn), ibuprofen (Motrin)	Food or milk	Decreases GI irritation	Take with food or milk
	Alcohol	Increases risk for liver Damage or stomach bleeding	Avoid alcohol
Diuretic spironolactone (Aldactone)	Food	Decreases GI irritation	Take with food
Psychotherapeutic MAO inhibitors: isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil)	Foods high in tyramine: aged cheeses, Chianti wine, pickled herring, Brewer's yeast, fava beans	Risk for hypertensive crisis	Avoid foods high in tyramine

 

 

Table 2: Examples of Drug/Nutrient Interactions
Drug Class	Food that Interacts	Effect of the Food	What to Do
Acid Blocker ranitidine (Zantac), cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid)	Vitamin B12	Decrease vitamin absorption	Consult your physician regarding B12 supplementation
Antihyperlipemic cholestyramine (Questran), colestipol (Colestid)	Fat soluble vitamins (A, D, E, K)	Decreases vitamin absorption	Include rich sources of these vitamins in the diet
Antineoplastic methotrexate	Folic acid, vitamin B12	Decreases vitamin absorption	Consult your physician regarding supplementation
Diuretic furosemide (Lasix), hydrochlorothiazide (HCTZ)	Many minerals	Increases mineral loss in urine	Include fresh fruits and vegetables in the diet
Laxative fibercon, Mitrolan	Vitamins and minerals	Decreases nutrient absorption	Consult your physician regarding supplementation