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Analgesic/antipyretic drugs (Tylenol, other acetaminophen products): For fastest relief, take on empty stomach. Avoid or limit the use of alcohol. If you consume three or more alcoholic drinks per day, talk to your doctor or pharmacist before taking.
Non-steroidal anti-inflammatory drugs (products with aspirin, ibuprofen, naproxen, ketoprofen or nabumetone): NSAIDs can irritate the stomach; best taken with food or milk. Avoid or limit the use of alcohol. Buffered aspirin or enteric-coated aspirin can help decrease stomach bleeding.
Corticosteroids (prednisone, etc.): Take with food or milk to decrease stomach upset.
Narcotic analgesics (Prescription codeine, morphine, oxycodone, hydrocodone, etc.): Some used in combination with non-narcotic drugs, such as acetaminophen, aspirin or cough syrups. May be habit-forming, and can cause serious side effects when used improperly. Avoid alcohol, because it increases the sedative effects of the medications. Use caution when operating machinery or driving.
Bronchodilators (theophylline, albuterol, epinephrine): High-fat meals may increase theophylline in the body, while high-carbohydrate meals may decrease it. Food can have different effects, depending on the dose form (e.g., regular release, sustained release or sprinkles). Food has little effect on Theo-Dur and Slo-Bid, but food increases the absorption of Theo-24 and Uniphyl, which can cause side effects of nausea, vomiting, headache and irritability. Food can decrease absorption of products like Theo-Dur Sprinkles for children. Avoid consuming large amounts of caffeine, because both oral bronchodilators and caffeine stimulate the central nervous system. Avoid alcohol if on theophylline medications, because of increased risk of side effects, such as nausea, vomiting, headache and irritability.
Diuretics (furosemide, triamterene/hydrochlorothiazide, etc.): Some diuretics cause loss of potassium, calcium, and magnesium. However, triamterene blocks the kidneys' excretion of potassium, which can cause hyperkalemia (increased potassium). Excess potassium may result in irregular heartbeat and heart palpitations. When taking triamterene, avoid eating large amounts of potassium-rich foods such as bananas, oranges and green leafy vegetables, or salt substitutes that contain potassium.
Beta blockers (atenolol, metoprolol, propranolol, etc.): Avoid drinking alcohol with propranolol, sold as Inderal, because the combination lowers blood pressure too much.
Nitrates (nitroglycerin, etc.): Avoid alcohol, because it may add to the blood vessel-relaxing effect of nitrates and result in dangerously low blood pressure.
Angiotensin Converting Enzyme Inhibitors (captopril, enalapril, etc.): Food can decrease absorption. Take one hour before or two hours after meals. ACE inhibitors may increase potassium in your body, and too much can be harmful. Tell your doctor if you are taking potassium supplements or diuretics that may increase the amount of potassium in your body. Avoid eating large amounts of potassium-rich foods, such as bananas, green-leafy vegetables, and oranges.
HMG-CoA Reductase Inhibitors (atorvastatin, lovastatin, pravastatin, simvastatin): Lovastatin (Mevacor) should be taken with the evening meal to enhance absorption. Avoid drinking large amounts of alcohol with statins, because it may increase the risk of liver damage.
Anticoagulants (warfarin, sold as Coumadin): Vitamin K produces blood-clotting substances and may reduce the effectiveness of anticoagulants. Limit foods high in vitamin K (such as broccoli, spinach, turnip greens, cauliflower, and brussel sprouts). High doses of vitamin E (400 IU or more) may prolong clotting time and increase the risk of bleeding. Talk to your doctor before taking vitamin E supplements.
Antibacterials
Penicillin (penicillin V, amoxicillin and ampicillin), Cephalosporins (cefaclor, cefadroxil, etc.), Macrolides (azithromycin, clarithromycin and erythromycin), Sulfonamides (sulfamethoxazole and trimethoprim)
Best taken on an empty stomach one hour before or two hours after meals. If your stomach gets upset, take with food. Finish medication, even if you are feeling better. Take with plenty of water. Tell doctor about any skin rashes you have had with antibiotics or that you get while taking this medication. A rash can be a symptom of an allergic reaction, and allergic reactions can be very serious. Also, tell your doctor if you experience diarrhea. If you are using birth control, consult with your health care provider, because some methods may not work when taken with antibiotics.
Tetracyclines (tetracycline, doxycycline and minocycline): Avoid taking tetracycline with dairy products, antacids and vitamins containing iron, because these can interfere with the medication's effectiveness.
Quinolones ciprofloxacin, levofloxacin, etc.): Avoid calcium-containing products like milk, yogurt, vitamins or minerals containing iron, and antacids, because they significantly decrease drug concentration. Taking these medications with caffeine products may lead to excitability and nervousness.
Nitroimidazole (metronidazole, sold as Flagyl): Avoid drinking alcohol or using medications that contain alcohol or eating foods prepared with alcohol while you are taking metronidazole and for at least three days after you finish the medication. Alcohol may cause nausea, abdominal cramps, vomiting, headaches, and flushing.
Antifungals (fluconazole, itraconazole, etc.): Avoid taking with dairy products or antacids. Avoid drinking alcohol, using medications that contain alcohol, or eating foods prepared with alcohol while you are taking ketoconazole, sold as Nizoral, and for at least three days after you finish the medication. Alcohol may cause nausea, abdominal cramps, vomiting, headaches and flushing.
Mood disorders
Follow instructions carefully. Take dose as directed, even if you are feeling better, and do not stop without consulting doctor. May take several weeks to reduce symptoms.
Monoamine oxidase inhibitors (phenelzine, tranylcypromine, etc.): Rapid, potentially fatal increase in blood pressure can occur if foods or alcoholic beverages containing tyramine are consumed while on MAO Inhibitors. Do not drink beer, red wine, other alcoholic beverages, non-alcoholic and reduced-alcohol beer and red-wine products. Avoid American processed, cheddar, blue, brie, mozzarella and Parmesan cheese; yogurt, sour cream; beef or chicken liver; cured meats such as sausage and salami; game meat; caviar; dried fish; avocados, bananas, yeast extracts, raisins, sauerkraut, soy sauce, ginseng and caffeine.
Anti-anxiety drugs (lorazepam, diazepam or Valium and alprazolam): Can interact with alcohol and impair mental and motor performance (e.g., driving, operating machinery). May interact with caffeine and cause excitability, nervousness, and hyperactivity and lessen the anti-anxiety effects of the drugs.
Antidepressants (paroxetine or Paxil, sertraline or Zoloft, fluoxetine or Prozac): Although alcohol may not significantly interact with these drugs to affect mental or motor skills, people who are depressed should not drink alcohol. These medications can be taken with or without food.
Histamine blockers (cimetidine or Tagamet, famotidine or Pepcid AC, ranitidine or Zantac, etc.): Avoid alcohol while taking these products, as it may irritate stomach and make it more difficult for stomach to heal. Can be taken with or without meals. Caffeine products may irritate stomach.
- National Consumers League and Food and Drug Administration. For more information on the NCL, call (202) 835-3323 or go to www.nclnet.org.
