• A Food - Drug interaction occurs when a food interferes with the effects of a drug in the body.
• The content of certain foods interact with some drugs and produce alterations in the Pharmacokinetic (Absorption, Distribution, Metabolism and Elimination) and Pharmacodynamic (Physiologic actions) effects of the drugs.
• Tyramine rich foods (Aged Cheese) may induce Life-threatening hypertensive reaction by interacting with Non-selective MAOIs (tranylcypromine, phenelzine etc.) or MAO-B Inhibitor (Higher dose of Selegeline). Patients taking any of the non-selective MAOIs should not eat foods containing substantial amounts of tyramine.
• Dairy Products (Milk) reduce the absorption and therapeutic efficacy of Fluoroquinolones (Ciprofloxacin, Norfloxacin), Tetracyclines and Bisphosphonates (Alendronate, Risedronate, and Ibandronate).
• Vitamin K Rich Foods (Kale, Collards, Spinach, Turnip greens, Mustard greens, Beet greens, Dandelion greens, Brussels sprouts and Broccoli) may interact with Warfarin and increase the risk of clot formation. Suddenly increasing or decreasing intake of Vitamin K rich foods can alter the effectiveness of the warfarin. So eat greens in consistent amounts.
• Potassium Rich Foods may interact with ACEIs (Lisinopril, etc), ARBs (Losartan, etc), Direct Renin Inhibitors (Aliskiren) or Potassium sparing Diuretics (Spiranolactone, etc) and increase the risk of Hyperkalemia.
• Fiber Rich Foods may interact with Digoxin, Amoxicillin, Levothyroxine or TCAs (Doxepin and Desipramine) and delay their absorption. Avoid ingesting high-fiber foods concomitantly.
• Protein Rich Foods may increase the bioavailability of Propranolol.
• High Fat Meals may elevate the plasma levels of Griseofulvin. Patients should be instructed to take griseofulvin after a high-fat content meal.
• Fruit juices like Grapefruit juice (GFJ), Apple juice or Orange juice may reduce the therapeutic efficacy of Fexofenadine.
• Grapefruit juice (GFJ) may interact with CYP3A4 substrates such as Simvastatin, Amiodarone, Erythromycin, Apixaban, etc. and increase the risk of their toxic effects.
• Seville orange juice may interact with CYP3A4 substrates like Colchicine, etc. and increase the risk of toxic effects.
• Orange juice may interact with drugs like Fexofenadine, Atenolol or Fluoroquinolones and reduce their therapeutic efficacy.
• Apple juice may reduce the therapeutic efficacy of Fexofenadine or Atenolol.
• Licorice may decrease the effectiveness of Antihypertensives such as Amlodipine, Aliskiren, Valsartan, Captopril, Carvedilol, etc. The people with high blood pressure, heart failure, pulmonary hypertension or kidney disease should avoid or limit the consumption of licorice.
• Fish (Omega-3 fatty acids) may increase the risk of Bleeding by interacting with drugs like Anticoagulant / Antiplatelet drugs (Aspirin, Clopidogrel, Ticlopidine, Dipyridamole, Alteplase, Dalteparin, Enoxaparin, Heparin, warfarin and others). It is recommended to consult the physician when the patients experience any unusual bleeding or bruising, swelling, vomiting, blood in your urine or stools, headache, dizziness, or weakness during treatment with these medications.
• Pharmacist or physician should determine the clinical relevance of the interactions of drugs with certain foods or beverages and advise patients appropriately.
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