Food for thought—dangerous liaisons with drug combinations
Foodie fanatics, budding masterchefs and wine lovers beware.
Prior to popping your next antibiotic, antidepressant or cholesterol-lowering medication, consider the potential interactions that may occur with certain food and alcohol combinations.
The marriage of food and wine, blended simultaneously with drugs may interact to produce medication toxicity or reduced efficacy of medications. When starting any new drug, always discuss potential interactions between certain foods and alcohol with your doctor or pharmacist to understand the full effects, which to use with caution and those to avoid. Also, always check food labels prior to masticating or slurping sensory delights.
Antibiotics
Antibiotics are widely prescribed to rid the body of bacteria, viruses and fungi that may cause infections. During a course of antibiotics, it is recommended to avoid alcohol consumption to allow the body adequate hydration for aiding immune function. Metronidazole (flagyl) and tinidazole (fasigyn) are particular antibiotics, which strictly require complete abstinence of alcohol. The combination may reduce anti-infectiveness and may cause increased adverse effects such as stomach upsets or headaches, and one of which may potentially induce an irregular heartbeat.
Antihypertensives
Cardiovascular disease is a worldwide epidemic with one of the major risk factors hypertension, contributing to illness and mortality. There are many classes of anti-hypertensives commonly prescribed to lower blood pressure including ACE inhibitors, calcium channel blockers and diuretics. These may all interact with food to produce diverse effects. It is also important to monitor salt intake if taking antihypertensives to maintain optimal blood pressure.
ACE Inhibitors(ACEI )- Potassium is an naturally occurring electrolyte that exists within the body. ACEIs in combination with potassium supplements or potassium rich foods (bananas, liquorice, potassium-based salt substitutes) may cause high levels of potassium in the body and is present with nausea, fatigue, tingling sensations or irregular heartbeats.
Calcium Channel Blockers (CCBs )- Grapefruit and peppermint oil used in combination with CCBs may interact to increase CCBs concentration, which may lead to side effects and toxicity. It is recommended to avoid this combination. Tea and coffee may also reduce the effect of CCBs.
Diuretics- These agents may increase blood glucose levels in diabetic patients, so it is vital to regularly monitor blood glucose levels. Diuretics can cause imbalances or specific electrolytes - namely potassium, due to depletion or loss of the available amount of the electrolytes. Potassium enriched foods such as bananas, liquorice and potatoes can replenish mineral stores.
Cholesterol lowering drugs
Medications like statins (e.g. Lipitor, Crestor, Pravachol) function to lower cholesterol levels within the body. This helps to prevent cardiovascular heart disease. Grapefruit juice sometimes interacts unfavourably resulting with magnification of side effects including muscle pain or liver complications. Omega-3 enriched foods such as salmon, tuna, mackerel or fish supplements have been found to also lower cholesterol levels and may assist if used in combinations with statins.
Anticoagulants
Anticoagulants such as Warfarin and Aspirin are prescribed for the prevention and treatment of different disease states e.g. irregular heartbeat, people who have suffered a heart attack, or lowering the risk of blood clots. Warfarin is very sensitive to many foods and other drugs and allows the blood to clot more freely. Vitamin C supplements, Omega-3, cranberry juice, St. Johns Wort, psyllium husks and vitamin K have been implicated in either reducing or enhancing warfarin’s anticoagulation effects so discuss starting or stopping any of these supplements or foods with a doctor or pharmacist first.
Anti-diabetic Drugs
Diabetes is an autoimmune disease that affects the control of blood glucose. There are two different types of diabetes - Type 1 (insulin dependent) and Type 11 (non-insulin dependent). Strict blood glucose control is essential in combination with drug therapy to prevent complications of the disease. Hypoglycaemia or low blood sugar levels may commonly occur when using antidiabetic drugs and can lead to nausea, headache, faintness and coma. It is important to avoid hypoglycaemia with regular meals and make smart food choices such as low glycaemic index foods. Alcohol limitation and abstinence is favourable as it may also cause hypoglycaemia in combination with antidiabetic medications.
There are many other medications that may be affected by food/alcohol combinations including anticonvulsants, which when taken in combination with alcohol may reduce seizure control and iron supplements can be altered by different iron enhancers (vitamin C) or inhibitors (tannins found in tea and wine). Other classes of drugs altered by certain foods include antidepressants, sedatives, anti-osteoporetic drugs, iron and even specific herbs.
So the next time you entice your senses and invoke your appetite be aware of potential interactions. This may not only prevent unwanted adverse effects but may save your life.
