DRUG – FOOD INTERACTIONS

DRUG ¨C 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

May raise potassium levels.

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 ¨C FOOD INTERACTIONS

DRUG

Coumadin (warfarin sodium)

DRUG-FOOD INTERACTIONS

RECOMMENDATIONS for PATIENT

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 ¨C

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)

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

DRUG ¨C FOOD INTERACTIONS

DRUG

DRUG-FOOD INTERACTIONS

RECOMMENDATIONS for PATIENT

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 levodopa¡¯s 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 ¨C

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)

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

DRUG ¨C FOOD INTERACTIONS

DRUG

DRUG-FOOD INTERACTIONS

RECOMMENDATIONS for PATIENT

EDUCATION

DIURETICS

POTASSIUM SPARING:

May raise potassium levels.

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)

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

DRUG ¨C FOOD INTERACTIONS

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)

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

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