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Food-drug interactions

Rohini Diniz

 

Anti fungal medications: These are medicines that treat or prevent fungal infections and work by slowing or stopping the growth of fungi. Griseofluvin, an antifungal works better when taken with fatty food. Other anti fungals can be taken on full or empty stomach.

ACE Inhibitors (Angiotensin Converting Enzyme Inhibitors): ACE inhibitors alone or with other medicines lower blood pressure or treat heart failure. They relax blood vessels so blood flows more smoothly and the heart can pump blood better. ACE Inhibitors can increase the amount of potassium in the body and one need to avoid eating large amounts of foods high in potassium when taking such medications.

Beta Blockers: Beta blockers can be used alone or with other medicines to treat high blood pressure. They are also used to prevent angina (chest pain) and treat heart attacks. They work by slowing the heart rate and relaxing the blood vessels so that the heart does not have to work as hard to pump blood. These medicines should be taken with food to decrease the chance of lowering your blood pressure too much.

Cardiac Glycosides: For example Digoxin are medications used to treat heart failure and abnormal heart rhythms. They help control the heart rate and help the heart work better Digoxin should be taken one hour before or two hours after eating food especially high fibre foods such as whole grain cereals, fruits, vegetables and pulses as foods high in fiber decrease its absorption.  Try to take it at the same time(s) every day and carefully follow your doctor’s instruction. Drink plenty of water while taking this medication.

Avoid taking digoxin with Senna and St John’s wort since they may decrease the amount and action of digoxin in your body, Also avoid black liquorice used in some candies, cakes and other sweets. It contains glycyrrhizin which interacts with digoxin and can cause irregular heartbeats and heart attacks.

Lipid Lowering Drugs: Also known as anti hyper lipemic drugs, this group of medication reduces blood cholesterol levels. Some of these drugs may decrease the absorption of the fat soluble vitamins (A, D, E, and K), vitamin B12, folic acid, and calcium. Hence for long-term use, it may be helpful to take a multivitamin and a calcium supplement.

Psychotherapeutic drugs: These are medications that are used to treat depression, anxiety and other mental health conditions. Some of these drugs increase appetite while others decrease it, both of which impact body weight in a significant way.

Some psychotherapeutic drugs are Monoamine Oxidase (MAO) inhibitors which decrease the body’s use of compounds called monoamines. MAO inhibitors can also react with tyramine, a monoamine found in foods resulting in a sudden increase in blood pressure which can be dangerous if not treated. People taking MAO inhibitors need avoid foods rich in tyramines such as aged cheeses, brewer’s yeast, fava beans smoked and aged/fermented meats, hot dogs, some processed meats, fermented soy products and draft beers

Facts to remember about food-drug interactions

Food may delay or decrease the absorption of medications and this is the reason why some medicines should be taken on an empty stomach (1 hour before eating or 2 hours after eating). On the other hand, some medicines are easier to tolerate when taken with food. Ask your doctor or pharmacist whether it’s okay to take your medicine with a snack or a meal or whether it should be taken on an empty stomach.

It is best to take medicines with cool water unless your doctor tells you differently. Do not take them with hot beverages and soft drinks. Iron supplement should not be taken with tea as the tannins in tea prevent their absorption. They are best taken with a citrus fruit juice.

Do not drink grapefruit juice or eat grapefruit while taking certain medications. Grapefruit juice contains a class of compounds called furanocoumarins, which causes the body to metabolise some medications abnormally, resulting in lower or higher than normal blood levels of the medication. Examples of some types of medications that grapefruit juice interacts with are some statins, some antihypertensives, some anti anxiety drugs, some anti-arrhythmia drugs, antihistamines, such as fexofenadine (Allegra).

Don’t stir your medicine into your food or take capsules apart (unless your doctor tells you to) because this may change the way the drug works.

Don’t take vitamin supplements at the same time you take medicine because vitamins and minerals can cause problems if taken with some drugs.

 

(The writer is a Consultant Nutritionist practising at Panaji and Margao)

 

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