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properly to ensure that they are safe and ingredients that interact with the human body in different ways, and diet and lifestyle can sometimes have a significant impact on a drug’s ability to work in the body. Certain foods, beverages, alcohol, caffeine, and even cigarettes can interact with medicines. This may make them less effective or may cause dangerous side When you take medicine, be sure to follow your doctor’s instructions carefully to obtain the maximum benefit with the least risk. Changes in a medicine’s effect due to an interaction with food, alcohol or caffeine can be significant; however, there are many individual factors that influence the potential for such variations, like dose, age, weight, sex, and overall health.
possible interactions between many common prescription and nonprescription (over-the- counter) medications with food, alcohol and caffeine. But this brochure should not replace the advice from your physician, pharmacist, or other health care professional. If you have any questions or concerns about possible drug Make sure your doctor and pharmacist know about every drug you are taking, including supplements such as vitamins, minerals and herbals. If you have problems or experience side effects related to medication, call your health care provider right away. It is also important to remember that many drugs interact with other drugs and may cause serious medical conditions.
In this brochure, the generic (nonproprietary) name for each drug is stated first. Brand names are in full capital letters and represent only some ALLERGIES
Antihistamines are used to relieve or prevent the symptoms of colds, hay fever, and allergies. They limit or block histamine, which is released by the body when we are exposed to substances that cause allergic reactions. Antihistamines are available with and without a prescription (over- the-counter). These products vary in their ability InteractionFood: It is best to take prescription antihistamines Alcohol: Some antihistamines may increase ARTHRITIS AND PAIN
ANALGESIC/ANTIPYRETICThey treat mild to moderate pain and fever.
InteractionsFood: For rapid relief, take on an body’s absorption of acetaminophen.
Alcohol: Avoid or limit the use of alcohol because chronic alcohol use can increase your risk of liver damage or stomach bleeding. If you consume three or more alcoholic drinks per day talk to your doctor or pharmacist before taking DRUGS (NSAIDS)NSAIDs reduce pain, fever, and inflammation.
InteractionFood: Because these medications can irritate the stomach, it is best to take them with food or milk.
Alcohol: Avoid or limit the use of alcohol because chronic alcohol use can increase your risk of liver damage or stomach bleeding. If you consume three or more alcoholic drinks per day talk to your doctor or pharmacist before taking these medications. Buffered aspirin or enteric coated aspirin may be preferable to regular aspirin to decrease stomach bleeding.
CORTICOSTEROIDSThey are used to provide relief to inflamed areas of the body. Corticosteroids reduce swelling and itching, and help relieve allergic, rheumatoid, InteractionFood: Take with food or milk to decrease stomach NARCOTIC ANALGESICSNarcotic analgesics are available only with a prescription. They provide relief for moderate to severe pain. Codeine can also be used to suppress cough. Some of these medications can be found in combination with non-narcotic drugs such as acetaminophen, aspirin, or cough syrups.
Use caution when taking these medications: take them only as directed by a doctor or pharmacist because they may be habit forming and can cause serious side effects when used improperly.
InteractionAlcohol: Avoid alcohol because it increases the sedative effects of the medications. Use caution when motor skills are required, including BRONCHODILATORSBronchodilators are used to treat the symptoms of bronchial asthma, chronic bronchitis and emphysema. These medicines open air passages to the lungs to relieve wheezing, shortness of InteractionsFood: The effect of food on theophylline medications can vary widely. High-fat meals may increase the amount of theophylline in the decrease it. It is important to check with your pharmacist about which form you are taking depending on the dose form (e.g., regular release, sustained release or sprinkles) For example, food has little effect on Theo-Dur and Slo-Bid, but food increases the absorption of Theo-24 and Uniphyl which can result in side effects of nausea, vomiting, headache and irritability.
Food can also decrease absorption of products like Theo-Dur Sprinkles for children.
Caffeine: Avoid eating or drinking large amounts of foods and beverages that contain caffeine (e.g., chocolate, colas, coffee, tea) because both oral bronchodilators and caffeine stimulate the theophylline medications because it can increase the risk of side effects such as nausea, vomiting, CARDIOVASCULAR DISORDERS
There are numerous medications used to treat cardiovascular disorders such as high blood pressure, angina, irregular heart beat, and high cholesterol. These drugs are often used in combination to enhance their effectiveness.
conditions. For example, beta blockers can be used to treat high blood pressure, angina, and irregular heart beats. Check with your doctor or pharmacist if you have questions on any of DIURETICSSometimes called “water pills,” diuretics help eliminate water, sodium, and chloride from the body. There are different types of diuretics.
InteractionFood: Diuretics vary in their interactions with food and specific nutrients. Some diuretics cause loss of potassium, calcium, and magnesium.
Triamterene, on the other hand, is known as a“potassium-sparing” diuretic. It blocks the kidneys’ excretion of potassium, which can cause hyperkalemia (increased potassium). Excess potassium may result in irregular heartbeat and heart palpitations. When taking triamterene, avoid eating large amounts of potassium-rich foods such as bananas, oranges and green leafy vegetables, or salt substitutes that contain BETA BLOCKERSBeta blockers decrease the nerve impulses to the heart and blood vessels. This decreases the heart rate and the work load of the heart.
InteractionAlcohol: Avoid drinking alcohol with combination lowers blood pressure too much.
NITRATESNitrates relax blood vessels and lower the InteractionAlcohol: Avoid alcohol because it may add to the blood vessel-relaxing effect of nitrates and result in dangerously low blood pressure.
(ACE) INHIBITORSACE inhibitors relax blood vessels by preventing angiotensin II, a vasoconstrictor, from being InteractionsFood: Food can decrease the absorption of captopril and moexipril. So take captopril and moexipril one hour before or two hours after meals. ACE inhibitors may increase the amount of potassium in your body. Too much potassium can be harmful. Make sure to tell your doctor if diuretics (water pills) that may increase the amount of potassium in your body. Avoid eating large amounts of foods high in potassium such as bananas, green-leafy vegetables, and oranges.
HMG-COA REDUCTASE INHIBITORSOtherwise known as “statins,” these medications are used to lower cholesterol. They work to reduce the rate of production of LDL (bad cholesterol). Some of these drugs also lower triglycerides. Recent studies have shown that pravastatin can reduce the risk of heart attack, stroke, or miniature stroke in certain patient InteractionAlcohol: Avoid drinking large amounts of alcohol because it may increase the risk of liver Food: Lovastatin (Mevacor) should be taken with the evening meal to enhance absorption.
ANTICOAGULANTSAnticoagulants help to prevent the formation of InteractionsFood: Vitamin K produces blood-clotting substances and may reduce the effectiveness of anticoagulants. So limit the amount of foods high in vitamin K (such as broccoli, spinach, kale, turnip greens, cauliflower, and brussel sprouts).
High doses of vitamin E (400 IU or more ) may prolong clotting time and increase the risk of bleeding. Talk to your doctor before taking INFECTIONS
ANTIBIOTICS AND ANTIFUNGALSMany different types of drugs are used to treat infections caused by bacteria and fungi. Some general advice to follow when taking any such • Tell your doctor about any skin rashes you may have had with antibiotics or that you get while taking this medication. A rash can be a symptom of an allergic reaction, and allergic reactions can be very serious.
• Tell your doctor if you experience diarrhea.
• If you are using birth control, consult with • Be sure to finish all your medication even if InteractionFood: Take on an empty stomach, but if it upsets InteractionsFood: Take on an empty stomach one hour before or two hours after meals. If your stomach gets upset, take it with food. However, avoid calcium-containing products like milk, yogurt, vitamins or minerals containing iron, and antacids because they significantly decrease Caffeine: Taking these medications with caffeine- containing products (e.g., coffee, colas, tea, and chocolate) may increase caffeine levels, leading InteractionFood: Take on an empty stomach one hour before or two hours after meals. If your stomach InteractionFood: Take on an empty stomach one hour before or two hours after meals. If your stomach InteractionFood: Take on an empty stomach one hour before or two hours after meals. If your stomach InteractionFood: Take on an empty stomach one hour before or two hours after meals. If your stomach gets upset, take with food. However, it is products, antacids and vitamins containing iron because these can interfere with the medication’s InteractionAlcohol: Avoid drinking alcohol or using medications that contain alcohol or eating foods prepared with alcohol while you are taking metronidazole and for at least three days after you finish the medication. Alcohol may cause InteractionFood: It is important to avoid taking these medications with dairy products (milk, cheeses, medications that contain alcohol, or eating foods prepared with alcohol while you are taking ketoconazole/NIZORAL and for at least three days after you finish the medication. Alcohol may cause nausea, abdominal cramps, vomiting, MOOD DISORDERS
Depression, Emotional, and AnxietyDisordersDepression, panic disorder and anxiety are a few examples of mood disorders -- complex medical conditions with varying degrees of severity.
When using medications to treat mood disorders instructions. Remember to take your dose as directed even if you are feeling better, and do not stop unless you consult your doctor. In some cases it may take several weeks to see an MONOAMINE OXIDASE (MAO) INHIBITORSSome examples are: InteractionsMAO Inhibitors have many dietary restrictions, and people taking them need to follow the dietary guidelines and physician’s instructions very carefully. A rapid, potentially fatal increase in blood pressure can occur if foods or alcoholic beverages containing tyramine are consumed Alcohol: Do not drink beer, red wine, other alcoholic beverages, non-alcoholic and reduced Food: Foods high in tyramine that should be • American processed, cheddar, blue, brie, • Beef or chicken liver; cured meats such as • Avocados, bananas, yeast extracts, raisins, • Broad (fava) beans, ginseng, caffeine-con- taining products (colas, chocolate, coffee InteractionsAlcohol: May impair mental and motor Caffeine: May cause excitability, nervousness, and hyperactivity and lessen the anti-anxiety InteractionsAlcohol: Although alcohol may not significantly interact with these drugs to affect mental or motor skills, people who are depressed should Food: These medications can be taken with or STOMACH CONDITIONS
Conditions like acid reflux, heartburn, acid indigestion, sour stomach, and gas are very common ailments. The goal of treatment is to relieve pain, promote healing and prevent the irritation from returning. This is achieved by either reducing the acid the body creates or protecting the stomach from the acid. Lifestyle and dietary habits can play a large role in the symptoms of these conditions. For example, smoking cigarettes and consuming products that contain caffeine may make symptoms return.
InteractionsAlcohol: Avoid alcohol while taking these products. Alcohol may irritate the stomach and make it more difficult for the stomach to heal.
Food: Can be taken with or without regard to Caffeine: Caffeine products (e.g., cola, chocolate, tea and coffee) may irritate the stomach.
DRUG-TO-DRUG INTERACTIONS
Not only can drugs interact with food and alcohol, they can also interact with each other.
Some drugs are given together on purpose for an added effect, like codeine and acetaminophen interactions may be unintended and harmful.
Prescription drugs can interact with each other or with over-the-counter (OTC) drugs, such as acetaminophen, aspirin, and cold medicine.
Likewise, OTC drugs can interact with each increased or decreased. For example, tricyclic antidepressants such as amitriptyline (ELAVIL), or nortriptyline (PAMELOR) can decrease the ability of clonidine (CATAPRES) to lower blood pressure. In other cases, the effects of a drug can increase the risk of serious side effects. For example, some antifungal medications such as (NIZORAL) can interfere with the way some cholesterol-lowering medications are broken down by the body. This can increase the risk of a medications to reduce the risk of drug-drug interactions. For example, two cholesterol- and fluvastatin (LESCOL), are less likely to interact with antifungal medications. Be sure to prescription and OTC— that you are taking.
This brochure was produced in cooperation with the U.S. Food and Drug Administration.
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