Avoid high intake of calcium-containing products, such as yogurt, milk, vitamins, or minerals containing iron, or antacids, because these can decrease drug levels in the body (Table 3). QuinolonesAs with several other antibacterial agents, quinolones are taken on an empty stomach, but may be taken with food to reduce stomach upset. Cefuroxime (Ceftin) is an exception, because absorption of the drug is increased when administered with food. Most cephalosporins should be taken on an empty stomach 1 hour before or 2 hours after meals, but may be taken with food to reduce stomach upset. They should not, however, be taken with acidic foods, fruit juices, colas, or other acidic beverages, because increased stomach acid can interfere with their absorption. Table 2 lists foods with a high content of vitamin K.ĭrugs of this class are best absorbed on an empty stomach, but may be taken with food to reduce stomach upset. Nevertheless, it is not necessary to avoid all foods containing vitamin K, but rather to keep a consistent diet to avoid fluctuations in the levels of drug in the body. Certainly, an increased intake of foods high in vitamin K can antagonize the anticoagulant effect and prevent the medication from working. Anticoagulants exert their effect by blocking vitamin K in the production of these clotting factors. Vitamin K is essential for the production of clotting factors that help the blood clot and thus prevent bleeding. Caffeine can interact with ciprofloxacin and theophylline to produce increased stimulant effects.Ĭommon Drug-Nutrient Interactions AnticoagulantsĪnticoagulants (eg, warfarin) help reduce the formation of blood clots. When combined with hypo-glycemic drugs, alcohol can alter blood sugar levels. Alcohol can also affect patients taking beta blockers by causing a drastic decrease in blood pressure. Hypnotics, antidepressants, and antianxiety drugs are greatly affected by alcohol, resulting in enhanced central nervous system side effects. Other drugs, such as aspirin and other anti-inflammatory agents, while best absorbed without food, are so irritating to the stomach that they can cause pain, diarrhea, and nausea (Table 1).Īlcohol, caffeine, and some teas can increase the effect of certain drugs. Many foods can eliminate the benefits of certain medications by interfering with proper absorption. In fact, when taken during the same period of time, some foods and drugs can interfere with the body?s ability to utilize a particular food or drug, which explains why some drugs are prescribed ?with food? or ?on an empty stomach? (empty stomach usually means 1 hour before or 2 hours after a meal). Generally speaking, certain drugs and food do not mix well. Substance that cannot be absorbed by the body. Tetracycline, on the other hand, binds to the calcium in milk to form an insoluble For instance, griseofulvin and saquinavir (antifungal and antiviral agents, respectively) are best absorbed when taken with foods that are high in fat content. Drug-food interactions also can have positive effects that result in a reduction of gastrointestinal irritation and an increase in drug absorption. Many of the foods we eat can substantially interfere with therapeutic goals and lead to interactions that can change the absorption of a medication into the bloodstream, as well as decrease the effect of the drug. There is a dynamic relationship between what we eat and the medications we take. Essentially, drug interactions are extremely complex and linked to phar-macokinetics, which involve drug absorption, distribution, metabolism, and excretion. It is difficult today for a busy physician to take the time to monitor and research every possible drug interaction for each and every patient, so it is common for patients to ultimately rely on the pharmacist for counseling on drug therapy. These interactions are of great concern to all health care providers, especially pharmacists, who are considered experts in the field and, for the most part, are the most accessible health care professionals. Adverse drug interactions represent one of the most important challenges facing pharmacists today, and they can be truly mind-boggling. The medications we take can alleviate our pain, lower our blood pressure and cholesterol, improve our mood disorders, and generally give us a sense of well-being yet they can also cause serious health problems and even death.
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