Some Things Don’t Mix Well – Things That Can Affect Your Medication

Allen Lawrence, M.A., M.D., Ph.D.
Advanced Wellness Medical

Some Things Don’t Mix Well – Things That Can Affect Your Medication

 

Many medicines do not work well together. Some medications also do not get along with what you eat and drink. If you are being treated for the first time it is wise to be absolutely sure your doctor or pharmacist know all of the medication you are taking and that you also check up on which foods and drinks may interfere, undermine, sabotage or conflict with any new medications you are about to take. Below is a list of foods, supplements, beverages and other medications which are well known to have negative reactions with common medication many people take.

This is not a comprehensive list rather a place to start, if you are given a new Rx talk with your doctor or pharmacist about your specific dos and don’ts.

 

 

Grapefruit

Grapefruit appears to change the way certain cells within your GI track allow medications to be absorbed. Grapefruit contains substances called furanocoumarins, which selectively inhibit isoenzyme CYP3A4. Grapefruits is known to affect the absorption and hence value of more than 50 different medications. For example, grapefruit negatively affects the following very common medications: Allegra (fexofenadine) used to treat allergies, making it less effective and make it acts to make Lipitor (atorvastatin) and Zocor (simvastatin) too strong.

Other medications which may be negatively affected by grapefruit are:

• High blood pressure medications: Procardia and Adalat CC (both nifedipine)
• HIV medications
• Organ-transplant rejection drugs: Neoral and Sandimmune capsule or oral solution (both are cyclosporines)
• Anti-anxiety drugs: BuSpar (buspirone)
• Corticosteroids that treat Crohn’s disease or ulcerative colitis: Entocort EC and Uceris tablet (both budesonide)
• Abnormal heart rhythms meds: Pacerone and Cordarone tablet (both amiodarone)

 

Dairy Product – Milk, Ice Cream, Yogurt, Cheeses, Kefir and Antacids

Dairy product can make it harder for your body to process certain antibiotics, especially tetracyclines. Minerals in milk like calcium and magnesium are part of the reason, along with the protein casein. If you’re taking antibiotics, make sure to find out about the foods or beverages you should stay away from.

Dairy can also interfere with other medications such as cholesterol-lowering meds, blood thinners, blood pressure drugs, tranquilizers, or antidepressants. It is best if you wait at least two hours before and six hours after taking your antibiotics.

NSAIDs (non-steroidal anti-inflammatory drugs) can irritate your stomach lining, so it is often best to take them with food, here is where a glass of milk is a benefit.

 

Licorice

Some people use licorice to help them with their digestion, and others use it to flavor foods or

simply as a sweet treat. One of the chemicals in licorice, glycyrrhizin, can weaken the effect of certain drugs, including cyclosporine, which are used to keep people who’ve had transplants from rejecting their new organs.

Licorice when taken along with some anti-inflammatory medications can decrease potassium levels in the body. Other anti-inflammatory medications dexamethasone (Decadron), hydrocortisone (Cortef), methylprednisolone (Medrol), prednisone (Deltasone) can also be negatively affected.

Individuals taking fludrocortisone or medications for hypertension, cardiac arrhythmia and myopathy can also deplete potassium and should avoid eating licorice or taking supplements when using these types of medications.

 

Chocolate, Red Wine, and Antidepressants

Dark chocolate is well known to weaken the effects of a number of medications meant to calm you down or help you get to sleep for example zolpidem tartrate (Ambien). Dark chocolate, red wine, and antidepressants can boost the power of some stimulant drugs, for example methylphenidate (Ritalin). If you take an MAO inhibitor (such as selegiline and phenelzine) to treat depression, taking dark chocolate can increase your blood pressure to dangerously high levels.

 

Iodine and Antithyroid drugs, Iron Supplement

Iodine and Antithyroid drugs can lower the effects of levothyroxine (Synthroid), a medicine that gives you thyroid hormone when your body doesn’t make enough (a condition called hypothyroidism). If you take this medication and a multivitamin, check to see if the vitamin has iron in it or if you need an iron supplement, then ask your doctor about taking these medications together, it is likely best to take this medication at different times.

 

Applesauce and Crushed Medications

Many people believe that they can crush their medications (tablets), or open capsules, and then mix them with pudding or applesauce. This is often told to people who have difficulty swallowing. The problem with this is that many medications, including extended-release products and those with propriety delivery systems, are intended to be administered in their original form and crushing them or taking them out of their capsule means they will not work effectively.

In many cases, crushing tablets or opening capsules may completely inactivate drug, significantly impair its absorption or potentiate its toxicity. Ask your doctor or pharmacist if the medications you are prescribed comes in extended-release capsules or has a special delivery system which should not be violated. Altering product can lead to many negative consequences, know what you are doing.

 

Alcohol

Alcohol can make certain drugs less effective, even useless. This is especially true of many blood pressure and heart medicines. Alcohol can also make other medications much stronger than they should be, hence lead to dangerous negative side effects. Alcohol can have a negative effect on nonsteroidal anti-inflammatory drugs (NSAIDs), which can increase risk of heart attacks, strokes, ulcers and stomach bleeding; blood-thinners. Alcohol interactions with medications may cause problems such as:

• Nausea and vomiting
• Headaches
• Drowsiness
• Dizziness
• Fainting
• Changes in blood pressure
• Abnormal behavior
• Loss of coordination
• Accidents

Mixing alcohol and medications also may increase the risk of complications such as:

• Liver damage
• Heart problems
• Internal bleeding
• Impaired breathing
• Depression

In some cases, alcohol interactions may decrease the effectiveness of medications or render them useless. In other cases, alcohol interactions may make drugs harmful or even toxic to the body.

 

Coffee (The Caffeine in Coffee)

Coffee can weaken antipsychotic drugs like lithium and clozapine, but boost the effects — and side effects — of others. Those include aspirin, epinephrine (used to treat serious allergic reactions), and albuterol (taken by inhaler for breathing problems). It can also make it harder for your body to take in and use iron. Because of the caffeine in coffee, it is essential to avoid taking stimulant drugs such as diethylpropion (Tenuate), epinephrine, phentermine (Ionamin), pseudoephedrine (Sudafed), and many others along with caffeinated coffee. Decaf coffee does not have these problems.

The tannins and caffeine in coffee can interfere with the absorption of many vitamins and minerals, especially iron. Caffeine also increases urination, which can decrease the concentration of water-soluble vitamins (B-complex and C). So, wait an hour after your morning brew to take supplements.

 

Antihistamines

Antihistamines whether applied to the skin (such as diphenhydramine cream, ointment, spray), or taken orally can make high blood pressure medications (especially guanethidine, methyldopa, beta blockers such as atenolol, or calcium channel blockers such as nifedipine) less effective and raise your heart rate. Talk to your doctor about other ways to manage your allergies if you take blood pressure medicine.

Antidepressants, stomach ulcer or indigestion medications can become problems when taken with antihistamines. You should avoid apples, apple juice, grapefruit, grapefruit juice, oranges and orange juice when taking antihistamines.

 

Anti-Epileptic Drugs (AEDs)

Anti-Epileptic Drugs (AEDs) control seizures in people who have epilepsy. But AEDs can make birth control pills less able to prevent pregnancy, and early research shows they may make other drugs stronger and cause potentially serious side effects.

 

Vitamin K

If you take the drug warfarin — used to treat and prevent blood clots — be aware of how much vitamin K you take in. It can make the blood thinner less effective and put you at higher risk of a dangerous blood clot. Broccoli, Brussels sprouts, kale, parsley, and spinach are some of the most common foods high in vitamin K. Try to eat the same amount of these foods every day so the level of warfarin in your blood stays the same.

 

Ginseng

Ginseng can also lower the effects of warfarin. Ginseng can make you more likely to have internal bleeding if you take the blood thinners heparin or aspirin, as well as nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen. If you take MAO inhibitors, ginseng can cause headaches, sleep problems, hyperactivity, and nervousness.

 

St. John’s Wort

St. John’s Wort is sometimes used to help people with depression. This herbal remedy isn’t a proven treatment for that or any other health condition. It can make your liver release enzymes (things that boost certain chemical reactions in your body) that can weaken some medications. Those include cholesterol drugs like lovastatin (Altoprev and Mevacor), the erectile dysfunction drug sildenafil (Viagra), and digoxin (Lanoxin), used to treat certain heart conditions.

 

Ginkgo Biloba

Many people use Ginkgo Biloba to help with or to prevent high blood pressure, dementia, ringing in the ears (tinnitus), and other conditions, but there’s no research that shows it does any of that. Ginkgo Biloba can weaken the effect of drugs used to control seizures, including carbamazepine (Carbatrol, Equetro, and Tegretol), and valproic acid (Depakene, Depakote, and Stavzor).

 

Take as Directed

Statistic tell us that only about 50% of all medication prescribed are taken as they should be taken, as ordered. Many people often take less medication than they need, they take it medications at random times rather when instructed, they leave big gaps between doses. Not taking medications correctly weakens their overall affect and value. Please, make sure you understand your treatment plan and that follow your doctor’s instructions precisely and correctly.

 

If you have questions and need answers, call your doctor and ask what you need to know. If you have questions for us or wish to set up a consultation, call us at 310-879-9266 or 844-222-577 or email us at info@advancedwellnessmedical.com