House Call: Taking Medicine? Be Aware of Food-Drug Interactions

From OncoLog, December 2008, Vol. 53, No. 12

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Taking Medicine? Be Aware of Food-Drug Interactions

You probably know that certain medications shouldn’t be taken together because of how they interact. But did you know that the food you eat can also interact with your prescription drugs?

While some food-drug interactions may be mild, others can cause serious health effects or prevent you from receiving a drug’s full benefit.

Fortunately, you can avoid food-drug interactions by simply watching what you eat and when you eat it. Elderly patients should be especially careful with their diets because they usually take more than one medication at the same time. However, all patients should know the risks for their prescription drugs.

Below are some commonly prescribed medications listed with foods to avoid while taking them. Keep in mind that this is not a complete list of potentially harmful food-drug combinations. Before taking any medicine for the first time, be sure to ask your physician, pharmacist, nurse, or clinical dietitian about possible side effects, how the medication should be taken, and if what you eat will interact with the drug.

If You Take These Drugs:	You Should Know:
Monoamine oxidase inhibitors (or MAOIs), such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), or selegiline (Eldepryl)—used to treat depression and Parkinson’s disease Isoniazid (INH or Nydrazid)—used to treat or prevent tuberculosis infection Procarbazine (Matulane)—a chemotherapy drug used to treat Hodgkin’s lymphoma and brain tumors	The interaction of these drugs with some foods can cause a dangerous, sudden increase in blood pressure. Patients taking these drugs should not drink alcohol and should not eat soy sauce, canned soups, packaged gravies or sauces, most cheeses, and certain meat products. In addition, avoid eating canned figs, raisins, avocados, bananas, raspberries, red plums, sauerkraut, soybeans, tofu, fava and broad beans, snow peas, and kimchi.
Linezolid (Zyvox)—used to treat bacterial infections	This medication also can cause a sudden increase in blood pressure when combined with caffeine-containing foods. Patients taking this drug should not drink alcohol and should limit their consumption of coffee, cola, tea, and chocolate.
Warfarin (Coumadin)—an anticoagulant used to prevent or decrease blood clots	Suddenly changing the amount of vitamin K in your diet may reduce the drug’s effectiveness. Vitamin K is found in green leafy vegetables, soybean oils, meats, dairy products, egg yolks, and liver. Do not drink alcohol, consume more than one serving a day of caffeine-containing foods or beverages, go on a weight-reduction diet, or consume ginseng, garlic, ginkgo, or vitamin E.
Imatinib (Gleevec)—used to treat certain cancers Statins, such as atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), and simvastatin (Zocor)—used to lower cholesterol Buspirone (BuSpar)—used to treat anxiety Carbamazepine (Tegretol)—used to treat epilepsy and bipolar disorder Nifedipine (Procardia, Adalat) and verapamil (Calan, Isoptin, Verelan)—used to treat high blood pressure	Grapefruit and grapefruit juice can affect the concentration of these drugs in the blood. Patients taking imatinib should avoid eating grapefruit or drinking grapefruit juice and should take the medication with food and a full glass of water. Patients taking the other drugs listed should not make a sudden change in their consumption of grapefruit or grapefruit juice.
Potassium-sparing diuretics, such as amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium); and ACE inhibitors, such as benazepril (Lotensin), captopril (Capoten, Capozide), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik)—used for controlling high blood pressure and treating heart disorders	Patients taking a potassium-sparing diuretic or ACE inhibitor should not use salt substitutes and should limit their consumption of foods high in potassium.

Sources: M. D. Anderson’s Department of Clinical Nutrition and Patient Education Office.

— K. Stuyck

For more information, talk to your physician, visit www.mdanderson.org/departments/nutrition, or call askMDAnderson at 1-877-632-6789.

Other articles in OncoLog, December 2008 issue:

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