Food & Meds Mixing
Could Be Dangerous
How to Avoid Common Food & Medication Interactions
February 14, 2025
Prescription medication labels advise how much to take, how often and
for how long. But they often don’t explain how certain foods might
interact with them. “Understanding how certain foods can affect the way medications work
is essential for safety and to ensure maximum benefit,” says Yongjin Chen, MD, PhD,
a family medicine specialist at University Hospitals. “Slower
absorption, reduced effectiveness and an increased risk of side effects
are just some of the potential risks.” He shares more about common
medication and food interactions.
What to Avoid and Why
You may be advised to avoid certain foods and beverages for a
specific timeframe, such as two hours before or after taking the
medication. In other cases, some foods and beverages should be avoided
entirely. Your doctor or pharmacist can provide guidance about how to
take a medication for maximum benefit and minimum risk.
💊
Antibiotics.
You may be advised to avoid or limit
dairy products and antacids with calcium when taking certain
antibiotics. Calcium can bind to antibiotics in the stomach, reducing
absorption and effectiveness. In addition, pineapple and pineapple juice
should be avoided. It contains bromelain, an enzyme that can interact
with certain antibiotics and cause rash, nausea, diarrhea and mouth
tenderness/irritation.
💊
Antidepressants.
Some antidepressant medications
like monoamine oxidase (MAO) inhibitors decrease the production of
enzymes that regulate neurotransmitters in the brain, like serotonin and
dopamine. With less MAO, the breakdown of these “feel-good” chemicals
is slowed and their levels rise, which may improve mood and other
depression symptoms.
You should avoid aged cheeses, cured meats, fermented vegetables,
beer, red wine and soy products when taking MAO inhibitors. These foods
contain high levels of tyramine, an amino acid that also requires MAO
for breakdown. Too much tyramine in the blood can cause a sudden
increase in blood pressure that can be life-threatening.
💊
Blood Pressure Medications.
Common blood pressure
medications like ACE inhibitors and angiotensin receptor blockers (ARBs)
increase potassium levels in the body. High potassium levels can cause
muscle weakness, heart arrhythmias and/or worsening heart failure. You
should avoid or limit high-potassium foods like bananas, avocados,
tomatoes, potatoes and salt substitutes made with potassium.
People taking calcium channel blockers should avoid grapefruit and
grapefruit juice, which can increase drug levels in the body and cause
low blood pressure, reduced heart rate, headaches and dizziness.
💊
Blood Thinners.
When taking blood-thinning
medications like digoxin and warfarin, there are several types of food
to avoid for different reasons:
- Dark green vegetables like kale, broccoli, spinach and chard can counteract the blood-thinning effects and reduce drug effectiveness.
- Grapefruit or grapefruit juice can interfere with absorption and reduce drug effectiveness.
- Liver, eggs, cheese and cranberry juice contain high levels of vitamin K, which promotes blood clotting and counters the effect of blood thinners.
- Alcohol, garlic, ginger, onions and tomatoes can increase bleeding risk.
💊
Immunosuppressants / Steroids.
When taking
immunosuppressants, including steroid medications like prednisone, avoid
eating black licorice, licorice dietary supplements or any desserts
that contain licorice extract. Licorice can slow the breakdown of the
medication, raising levels in the bloodstream while lowering potassium,
which can affect muscle function, nerve conduction and heart rhythms.
Grapefruit and grapefruit juice should also be avoided for similar
reasons.
People taking immunosuppressants should also avoid raw or undercooked
meat, fish and eggs, unpasteurized beverages and soft cheeses. These
foods are more likely to cause illness or food poisoning in those with a
suppressed immune system.
Statins.
Statins inhibit the production of
cholesterol in the liver and promote its removal from the bloodstream.
People taking statins should avoid grapefruit and grapefruit juice as
they can increase drug levels in the system, leading to a greater risk
for side effects like muscle pain, headache and nausea.
💊
With or Without Food?
Most medication labels or packages will specify “take with food” or
“take on an empty stomach.” It’s important to follow these
recommendations carefully for effectiveness and to reduce potential side
effects.
Taking medications with food may help to:
- Slow down digestion, allowing more time for the drug to be absorbed and more consistent levels in the blood.
- Reduce side effects like nausea, dizziness, stomach upset or ulcers.
- Protect medications from being destroyed by stomach acid or enzymes before they reach the intestines, where most absorption occurs.
Taking medications on an empty stomach may:
- Allow medications to be absorbed more effectively.
- Allow for faster action of drugs used for acute treatment like some pain relievers or anti-nausea drugs.
Talk to Your Doctor or Pharmacist
All medications have the potential to cause side effects, which is
why it’s important to take them as directed. Those taking multiple
medications should discuss potential interactions with their healthcare
provider and develop a daily schedule.
Related Links:
University Hospitals has a team of primary care physicians
and pharmacists with the advanced training and expertise to advise
patients about the medicines they are taking and how to avoid potential
food interactions.
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Food & Meds Mixing
Could Be Dangerous
Grapefruit 🍊
Licorice 🍬
Chocolate 🍫
Leafy Green 🥬 (Kale 🥗 Collared Green)
Dairy Products 🥛 (Milk & Yogurt)
Black Pepper 🫙
Licorice 🍬
Chocolate 🍫
Leafy Green 🥬 (Kale 🥗 Collared Green)
Dairy Products 🥛 (Milk & Yogurt)
Black Pepper 🫙
🎤 Maybe you've heard that grapefruit can interfere with certain medications but it's worse than you think it turns out.
Grapefruit can cause side effects when combined with about 85 different drugs including things as serious as kidney failure breathing problems and internal bleeding. It’s not just grapefruit other common foods don't play well with some medications including chocolate Licorice and even black pepper. Let’s learn more from CBS medical contributor Dr Holly Phillips
🎤 Dr Holly I'm worried now.
👩⚕️ Nancy yeah it is worrisome. The most important interaction is really between grapefruit and grapefruit juice and medications that bring down your cholesterol. That's the interaction we worry about most because it is the most severe - basically grapefruit has a compound in it that prevents the breakdown of the medication in your intestine so your body absorbs more and you can end up having a toxic overdose just taking your regular pill every day so does this mean you have to give up great food for good if you're on one of these medications well you know what in a word yes and that's not easy to do a lot of my patients say it's part of their morning routine like coffee or cereal or whatever you do.
But there is a new designer grapefruit coming out –it's true some researchers in Florida are working on a hybrid between a red grapefruit and a pomelo fruit (The pomelo is a large, Southeast Asian citrus fruit, often called a shaddock, that is sweeter than its ancestor, the grapefruit. It's a natural, non-hybrid fruit native to Southeast Asia and is considered an ancestor to other citrus fruits like grapefruit, bitter orange, and mandarin) so it's supposed to be sweet and even juicier than other grapefruits but most importantly it doesn't have the compound in it that interacts with medications.
🎤 There are a lot of surprising things on this list including licorice really
👩⚕️ Yep we worry about licorice with the heart and blood pressure medications and it can affect them either way it can decrease the effectiveness of the meds or lead to a toxic overdose when you're not aware of it.
🎤 The next one is really troubling it's chocolate.
👩⚕️ It makes us all very sad. it interacts with a number of medicines the most worrisome are the anti-depressants and stimulant drugs that are used for attention deficit disorder it can actually raise your blood pressure and your heart rate when mixed with those.
🎤 But are we talking about a lot of chocolate like you need to be eating bars and bars or just a little bit?
Just a little bit unfortunately Nancy it just takes a little bit. it has to do also with frequency. The more frequently you have it even if it's a small amount the more likely you are to get the side effect.
Also on this list are leafy greens now what is what what's in that category vegetable spinach what are we talking about you know kale collared green.
The leafy greens are of course high in vitamin K and potassium which is wonderful unless you're uncertain drugs particularly blood thinners.
They block the effect of blood thinners. so you think you're protected and you're not.
The next one I had heard about before dairy products like milk and yogurt that can interfere with certain medications.
🎤 What kinds of medications are we talking about?
The most important are the antibiotics. Dairy products can decrease the effectiveness of your antibiotic and they can also cause stomach problems
Black pepper is on the list too. Black pepper really interacts with allergy meds anti-histamines and of course it's pollen season now so we should pay attention to that it can increase your blood pressure and heart rate on those medicines and also cause nervousness and anxiety.
🎤How are people supposed to know about these interactions? Are they on the labels of these medications?
Right you know some of them are right on the label. In fact you can get some bright orange or yellow labels on your bottle with grapefruit but not every single one of these interactions is on the bottle. Frankly it's hard for doctors to keep track of it.
The best thing to do is read that thick hand out that comes with your meds and also just asks your pharmacist directly. Do any foods interact with what I'm taking?
🎤 Dr Holly I'm worried now.
👩⚕️ Nancy yeah it is worrisome. The most important interaction is really between grapefruit and grapefruit juice and medications that bring down your cholesterol. That's the interaction we worry about most because it is the most severe - basically grapefruit has a compound in it that prevents the breakdown of the medication in your intestine so your body absorbs more and you can end up having a toxic overdose just taking your regular pill every day so does this mean you have to give up great food for good if you're on one of these medications well you know what in a word yes and that's not easy to do a lot of my patients say it's part of their morning routine like coffee or cereal or whatever you do.
But there is a new designer grapefruit coming out –it's true some researchers in Florida are working on a hybrid between a red grapefruit and a pomelo fruit (The pomelo is a large, Southeast Asian citrus fruit, often called a shaddock, that is sweeter than its ancestor, the grapefruit. It's a natural, non-hybrid fruit native to Southeast Asia and is considered an ancestor to other citrus fruits like grapefruit, bitter orange, and mandarin) so it's supposed to be sweet and even juicier than other grapefruits but most importantly it doesn't have the compound in it that interacts with medications.
🎤 There are a lot of surprising things on this list including licorice really
👩⚕️ Yep we worry about licorice with the heart and blood pressure medications and it can affect them either way it can decrease the effectiveness of the meds or lead to a toxic overdose when you're not aware of it.
🎤 The next one is really troubling it's chocolate.
👩⚕️ It makes us all very sad. it interacts with a number of medicines the most worrisome are the anti-depressants and stimulant drugs that are used for attention deficit disorder it can actually raise your blood pressure and your heart rate when mixed with those.
🎤 But are we talking about a lot of chocolate like you need to be eating bars and bars or just a little bit?
Just a little bit unfortunately Nancy it just takes a little bit. it has to do also with frequency. The more frequently you have it even if it's a small amount the more likely you are to get the side effect.
Also on this list are leafy greens now what is what what's in that category vegetable spinach what are we talking about you know kale collared green.
The leafy greens are of course high in vitamin K and potassium which is wonderful unless you're uncertain drugs particularly blood thinners.
They block the effect of blood thinners. so you think you're protected and you're not.
The next one I had heard about before dairy products like milk and yogurt that can interfere with certain medications.
🎤 What kinds of medications are we talking about?
The most important are the antibiotics. Dairy products can decrease the effectiveness of your antibiotic and they can also cause stomach problems
Black pepper is on the list too. Black pepper really interacts with allergy meds anti-histamines and of course it's pollen season now so we should pay attention to that it can increase your blood pressure and heart rate on those medicines and also cause nervousness and anxiety.
🎤How are people supposed to know about these interactions? Are they on the labels of these medications?
Right you know some of them are right on the label. In fact you can get some bright orange or yellow labels on your bottle with grapefruit but not every single one of these interactions is on the bottle. Frankly it's hard for doctors to keep track of it.
The best thing to do is read that thick hand out that comes with your meds and also just asks your pharmacist directly. Do any foods interact with what I'm taking?
🎤 Advice very Eye opening Dr Holly Phillips. Thanks you so much great to be here.
****************************
Food Drug Interactions:
What Should You Look Out For?
Most people know that medicines can interact with other drugs that you’re taking. But did you know the food you eat can interact with your medicines as well? Food-drug interactions can increase the risk of side effects or block the absorption of the drug into your body.
In this video, we talk about 4 different food & drug interactions:
1) High blood pressure/heart disease meds and potassium-rich foods like bananas, potatoes and licorice
2) Antibiotics and dairy products
3) Statins and grapefruit
4) Warfarin & vitamin K leafy greens
When taking the medicines listed above, it's essential that you avoid the foods that could cause food and drug interactions.
For more information on foods that can mess with your medicines and other medication side effects, go to www.medShadow.org where we help you balance the risks and benefits of medicines. We’re a non-profit, and since we don’t accept support or money from pharmaceutical companies, we can give you health information independent from big pharma’s influence
In this video, we talk about 4 different food & drug interactions:
1) High blood pressure/heart disease meds and potassium-rich foods like bananas, potatoes and licorice
2) Antibiotics and dairy products
3) Statins and grapefruit
4) Warfarin & vitamin K leafy greens
When taking the medicines listed above, it's essential that you avoid the foods that could cause food and drug interactions.
For more information on foods that can mess with your medicines and other medication side effects, go to www.medShadow.org where we help you balance the risks and benefits of medicines. We’re a non-profit, and since we don’t accept support or money from pharmaceutical companies, we can give you health information independent from big pharma’s influence
👇 💻 👇
Transcript
Most people know that medicines can interact with other drugs that you’re taking. But did you know the food you eat can interact with your medicines as well?
Specific foods can interact with your medicine to increase the risk of side effects or block the absorption of the drug into your body. You should talk to your doctor as soon as the drug is recommended. In the meantime, here are four common drugs that are affected by the foods you eat.
ACE inhibitors and ARBs -- angiotensin II receptor blockers -- are used to treat high blood pressure and heart disease.
ACE inhibitors and ARBs can cause your body to store potassium, keeping it there longer and causing it to accumulate in your body.
Did you know that High potassium can cause an irregular heartbeat?
A little potassium is your food fine, but avoid eating large amounts of bananas, oranges, avocados, tomatoes, white and sweet potatoes and dried fruits — especially apricots.
On the flip side, licorice candy, licorice tea, and licorice root can all dangerously lower your potassium.
So while you’re on ACE inhibitors or ARBs, avoid these foods. And stay away from salt substitutes! Many have replaced the sodium with potassium.
If you’re taking an antibiotic like Ciprofloxacin, levofloxacin and moxifloxacin or if you are taking a tetracycline like doxycycline and minocycline don’t eat any dairy-rich foods. Milk, cheese, ice cream, yogurt and butter can lower the absorption of antibiotics in your gut and keep them from being effective.
Additionally, watch out for calcium-fortified foods such as some juices and cereals which will cause the same problems with absorbing antibiotics.
Your body can only absorb a portion of the drug in a pill or liquid, the rest gets flushed away.
This is calculated into how much of a drug you get prescribed.
In the case of statins, grapefruit increases the amount of the statin drug that your body absorbs. So eating grapefruit while you’re taking statins can increase the likelihood of worsened side effects. You may experience dizziness, muscle pain, kidney failure and other dangerous side effects.
Warfarin’s brand name is Coumadin. It’s a blood-thinner and slows your body’s ability to clot. This is very helpful if you are at risk for strokes or other heart conditions.
Vitamin K helps your blood clot so avoiding foods high in this vitamin is important. Spinach, broccoli, turnip greens, collard greens and the highly popular kale are all high in vitamin K.
Can’t live without your kale smoothie? It’s Ok, your doctor can adjust the amount of coumadin you take based on how much vitamin K you eat each week. The key is to make sure you eat the same amount of vitamin K-rich foods every week.
Talk to your doctor about how much blueberries, pumpkin and cranberry juice you have because they sneak in a lot of vitamin K too. The bottom line is when your doctor prescribes a medicine, ask about interactions not only with other drugs, but with food as well.
Know the changes you should make in your daily diet.
For more information on foods that can mess with your medicines, go to MedShadow.org where we help you balance the risks and benefits of medicines.
We’re a non-profit, and since we don’t accept support or money from pharmaceutical companies, we can give you health information independent from big pharma’s influence.
https://medshadow.org/4-foods-can-mess-meds/
Most people know that medicines can interact with other drugs that you’re taking. But did you know the food you eat can interact with your medicines as well?
Specific foods can interact with your medicine to increase the risk of side effects or block the absorption of the drug into your body. You should talk to your doctor as soon as the drug is recommended. In the meantime, here are four common drugs that are affected by the foods you eat.
ACE inhibitors and ARBs -- angiotensin II receptor blockers -- are used to treat high blood pressure and heart disease.
ACE inhibitors and ARBs can cause your body to store potassium, keeping it there longer and causing it to accumulate in your body.
Did you know that High potassium can cause an irregular heartbeat?
A little potassium is your food fine, but avoid eating large amounts of bananas, oranges, avocados, tomatoes, white and sweet potatoes and dried fruits — especially apricots.
On the flip side, licorice candy, licorice tea, and licorice root can all dangerously lower your potassium.
So while you’re on ACE inhibitors or ARBs, avoid these foods. And stay away from salt substitutes! Many have replaced the sodium with potassium.
If you’re taking an antibiotic like Ciprofloxacin, levofloxacin and moxifloxacin or if you are taking a tetracycline like doxycycline and minocycline don’t eat any dairy-rich foods. Milk, cheese, ice cream, yogurt and butter can lower the absorption of antibiotics in your gut and keep them from being effective.
Additionally, watch out for calcium-fortified foods such as some juices and cereals which will cause the same problems with absorbing antibiotics.
Your body can only absorb a portion of the drug in a pill or liquid, the rest gets flushed away.
This is calculated into how much of a drug you get prescribed.
In the case of statins, grapefruit increases the amount of the statin drug that your body absorbs. So eating grapefruit while you’re taking statins can increase the likelihood of worsened side effects. You may experience dizziness, muscle pain, kidney failure and other dangerous side effects.
Warfarin’s brand name is Coumadin. It’s a blood-thinner and slows your body’s ability to clot. This is very helpful if you are at risk for strokes or other heart conditions.
Vitamin K helps your blood clot so avoiding foods high in this vitamin is important. Spinach, broccoli, turnip greens, collard greens and the highly popular kale are all high in vitamin K.
Can’t live without your kale smoothie? It’s Ok, your doctor can adjust the amount of coumadin you take based on how much vitamin K you eat each week. The key is to make sure you eat the same amount of vitamin K-rich foods every week.
Talk to your doctor about how much blueberries, pumpkin and cranberry juice you have because they sneak in a lot of vitamin K too. The bottom line is when your doctor prescribes a medicine, ask about interactions not only with other drugs, but with food as well.
Know the changes you should make in your daily diet.
For more information on foods that can mess with your medicines, go to MedShadow.org where we help you balance the risks and benefits of medicines.
We’re a non-profit, and since we don’t accept support or money from pharmaceutical companies, we can give you health information independent from big pharma’s influence.
https://medshadow.org/4-foods-can-mess-meds/
https://youtu.be/pant5rXow1U?si=O2HnDX1ThQIHTJYj
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