Many common drinks and foods, such as coffee and fruit, can have adverse effects with medications. These effects range from lessening the drug’s effectiveness to serious health complications. Citrus juice has interactions with several classes of drugs. Grapefruit juice is especially counteractive with numerous medications. General guidelines for taking over-the-counter and prescription medications are as follows:
Read all directions and the accompanying literature of medication.
Avoid alcohol when taking medication.
Cigarettes can diminish the effectiveness or cause added hazards with certain medications.
Caffeine from coffee, tea, soft drinks, chocolates and some medications can also have effects with other drugs.
In addition to general guidelines for taking medications, there are several components in common drinks and foods that conflict with many medications.
Fruit juice should not be taken with aspirin because aspirin causes stomach irritation that fruit juice will only compound.
Pomegranate juice has an enzyme that can break down several blood pressure prescriptions.
Cranberries, plums, prunes and citrus fruits and juices should be avoided when taking methenamine for urinary tract infections.
Calcium can interfere with the effectiveness of thyroid medication. Only drink calcium-rich beverages 4 hours after taking thyroid medicine. Avoid dairy with methenamine for urinary tract infections. Dairy products, calcium and iron supplements should not be taken within 4 hours of tetracycline antibiotics.
Caffeine can cause serious health threats when taken with stimulants. This includes appetite suppressants like ephedrine, asthma prescriptions and amphetamines like Adderall. Caffeine is also harmful when taken with bronchodilators because both stimulate the nervous system.
Potassium-rich drinks – fruit juice, vegetable juice, sports drinks, and dairy drinks – can be dangerous when paired with some heart failure or hypertension drugs. Potatoes and bananas are also high in potassium.
Sodium is harmful for the stomach when taken with corticosteroids/cortisone-like drugs, vasodilators (drugs to relax veins and/or arteries to reduce the workload of the heart) and anti-hypertensives.
Wine and energy drinks combined with antidepressants can cause hypertension, headaches, fast heart rate and stroke.
Alcohol is not good to drink with antihistamines because both cause drowsiness and slowed reactions. Aspirin, ibuprofen, corticosteroids/cortison-like drugs, and arthritis medications like indomethacin and piroxicam and alcohol should also be avoided because of stomach irritation. Codeine and narcotics/narcotic-analgesics should never be mixed with alcohol as it will greatly increase codeine’s sedative effect to a dangerous degree. No medication for psychiatric or emotional problems should be taken with alcohol (lithium carbonate has strict dietary and fluid intake instructions to avoid serious toxic reactions). Very dangerous and potentially fatal interactions can occur with alcohol and any other substances with tyramine – wine, hard cheeses, chocolate, beef and chicken livers – and MAO inhibitors prescribed for depression. Anti-infective sulfa drugs can cause nausea when taken with alcohol. Alcohol should especially be avoided with metronidazole, an anti-infective medicine used to treat intestinal and genital infections from bacteria and parasites because the two combined can cause stomach pain, nausea, vomiting, headache and flushing (or redness) of the face. And lastly, do not use alcohol with any sleep medications.
Green Tea can decrease the effect of blood thinners (anticoagulants) such as warfarin. This is due to vitamin K, which is also abundant in broccoli, kale, spinach, cauliflower, Brussels sprouts, potatoes, vegetable oil and egg yolk.
Grapefruit juice alone can negatively interact with more than 50 medications. Furthermore, the effects of citrus juice lasts more than 24 hours, so simply not taking the drug with grapefruit juice will not prevent the interactions. A few of the drug classes that should not be taken with grapefruit juice are:
• benzodiazepines, SSRI antidepressants and azapirone anxiety drugs
• anticonvulsant and mood stabilizing drugs used to treat epilepsy, bipolar disorder and trigeminal neuralgia
• dihydropyridine and other types of hypertension (high blood pressure) drugs
• proton pump inhibitor drugs like omeprazole used to treat gastroesophageal reflux disease (GERD/GORD), peptic ulcer disease (PUD), laryngopharyngeal reflux (LPR), dyspepsia and Zollinger-Ellison syndrome
• thyroid hormone deficiency
• phenylalkylamine calcium channel blocking drugs for hypertension, angina pectoris, cardiac arrhythmia, and cluster headaches.
• erectile dysfunction drugs
• anti-migraine drugs
• anti-diabetic meglitinides
• opioids like oxycodone and hydrocodone
• immunesuppressants used to prevent rejection of organ transplants
• AIDS and HIV antivirals
• eugeroic psychoactive stimulants known as wakefulness-promoting agents
• anthelmintic drugs used to expel parasitic worms from the body (also known as vermifuges and vermicides)
• acetaminophen/paracetamol (Tylenol) blood concentrations increased with both white and pink grapefruit juice, with white juice acting faster, in a mouse study