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Drug Interactions
What the Heck is Hepatotoxicity?
Drug Interactions with "peginterferon alfa-2a"
The following drugs are known to interact with "peginterferon alfa-2a".
Please click on a drug name to check the interaction details.
A red icon denotes a possible severe interaction,
a blue icon denotes a possible moderate interaction,
and a green icon denotes a possible mild interaction.
The following drugs are known to interact with "ribavirin".
Please click on a drug name to check the interaction details.
A red icon denotes a possible severe interaction,
a blue icon denotes a possible moderate interaction,
and a green icon denotes a possible mild interaction.
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Herbs with Drug Interactions - a Partial ListBy popular request, here is a partial list of herbs with drug interactions. It is by no means complete! If you are taking medications, please check with your prescribing physician before taking any supplements.
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| Herb - alphabetical by common name | Possible Drug Interaction | Possible Contraindications |
| Ashwaganda Withania somnifera | None known. (PPP, 601) May potentiate the effects of barbituates (Atal and Schwarting). (BSH, 124) | High dosages of alkaloids from Withania exhibit prolonged hypotensive, bradycardiac and respiratory stimulant actions, may also have depressant effect on higher cerebral centres; sedative effects have also been demonstrated. (CAACH, 138) |
| Bilberry Vaccinium myrtillus | None known. (HM, 18; TGHM, 88) Possible interaction with warfarin and antiplatelet drugs in very high doses. (PPP, 301) | Very high doses should be used cautiously in patients with haemorrhagic disorders and in those taking warfarin or antiplatelet drugs. (PPP, 301) |
| Bladderwrack Fucus vesiculosus | None known. (HM, 213) Caution indicated within iodine-containing drugs. (AEHD, 44) | Therapeutic use is not recommended in hyperthyroidism, long-term therapeutic use is not recommended. (BSH, 54) Contraindicated in hyperthyroidism, cardiac problems. (BHC, 38) In rare cases allergic reactions involving serious overall reactions may occur. (TGHM, 315) |
| Black Cohosh Cimicifuga racemosa | Drugs for iron therapy | Inhibits iron absorption |
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Bugleweed Lycopus virginicus |
None known. (TGHM, 99) Do not take with thyroid medications. (BSH, TGHM, 99) | Contraindicated in thyroid hypofunction, enlargement of the thyroid without functional disorders. (TGHM, 99; BSH, 72) Administration of the herb interferes with diagnostic procedures using radioactive isotopes. (TGHM, 99) |
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Bupleurum
Bupleurum falcatum |
The use of alcohol, sedatives and other central nervous system depressants, in conjunction with this herb, may cause synergistic sedative effects. (WHO, 73) | Bupleurum has a slight sedative effect in some patients and may also increase bowel movements and flatulence (wind). (CAACH, 23; WHO, 73, 74; PPP, 317) May cause nausea and reflux in sensitive patients. (PPP, 317) |
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Californian Poppy Eschscholtzia californica |
May potentiate pharmaceutical MAO-inhibitors. (BSH, 49) | This herb should be restricted in its application to experienced and well-trained practitioners. (PPP, 232) There is a theoretically increased risk of neurotoxicity and other adverse effects (although no known incidence). (PPP, 233) The following cases should be approached with caution: (1) concurrent prescription of powerful analgesics, (2) pain in children, (3) neurological disease, (4) depression and psychosis, (5) liver and kidney disease, and (6) history of allergic or anaphylactic reactions. (PPP, 232) |
| Cascara sagrada Rhamnus purshiana | Most intestinally absorbed drugs; Thiazide-type diuretics | Interferes with absorption of the pharmaceutical agent; Raise blood pressure or deplete potassium |
| Chamomile Matricaria recutita | Drugs for iron therapy | Inhibits iron absorption |
| Coleus Coleus forskohlii | Forskolin has the ability to potentiate many drugs. Use cautiously in patients taking prescribed medication. (CAACH, 106) | Contraindicated in hypotension. (CAACH, 106) |
| Dong Quai Angelica sinensis | Based on animal studies, caution is advised for patients receiving chronic treatment with anticoagulant drugs such as Coumadin (warfarin). (PPP, 352) | Containdicated in bleeding or very heavy menstruation, first trimester of pregnancy, acute viral infections such as colds or influenza. (CAACH, 5-6; BSH, 11; PPP, 352) Also contraindicated in diarrhea caused by weak digestion and in haemorrhagic disease. (PPP, 352) Cardiovascular side effects include excessive bleeding. (TCPHP, 290) Dong quai has two furanocoumarins (psoralen and bergapten), which are photoreactive and have the potential to cause severe photodermatitis. These furanocoumarins are also photocarcinogenic. However, the risk of phototoxicity in humans from ingestion of Dong quai has not been characterized. (TCPHP, 290-291) |
| Echinacea Echinacea purpurea | None known. (HM, 97; TGHM, 123; WHO, 142; PPP, 360) | Commission E cautioned that the herb should not be used in systemic diseases such as tuberculosis, leukosis, collagenosis, multiple sclerosis, AIDS, HIV infections, and other autoimmune diseases (based on theoretical considerations and not on any reports of adverse findings). (HM, 97; TGHM, 123; WHO, 141-142; PPP, 359) Caution is advised for transplant patients taking immunosuppressive drugs; short-term therapy is suggested. (PPP, 360) Should not be administered to patients with known allergy to any plant of Asteraceae (Compositae). (WHO, 142; PPP, 359; HM, 97) Allergic concern based upon case reports. (TCPHP, 301; PPP, 359; WHO, 142) |
| Evening Primrose Oil Oenothera biennis | Anticonvulsants and tricyclic antidepressants | Lowers the seizure threshold, thus increasing drug dosage requirements |
| Feverfew Tanacetum parthenium | Drugs for iron therapy; Warfarin sodium, heparin, aspirin and other anticoagulants | Inhibits iron absorption; Augments the anticoagulant effect, thus altering clotting or bleeding times |
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Garlic
Allium sativum |
Contains glucose. Use with caution in patients taking anti-platelet drugs. Garlic’s antiplatelet effect might be dangerous in patients taking warfarin or antiplatelet agents such as aspirin, ticlopidine, clopidogrel, or dipyrida-mole. (TCPHP, 118; HM, 115; WHO, 25) | Contraindication with gastrointestinal disturbance; in rare instances, there may be changes to the flora of the intestine, or allergic reactions. (TGHM, 134; HM, 145; BSH, 6; BHC,106) May also cause heartburn, nausea, vomiting, and diarrhea if taken on an empty stomach. (WHO, 26) HM suggests that substantial amounts of garlic should not be consumed prior to surgery. (HM, 145) May increase the risk of postoperative bleeding. (WHO, 25; ESCOPM, 2; AEHD, 229) Allergic and dermatologic concern based upon case reports. (AEHD, 229; WHO, 26; TCPHP, 116-117, 301) Hematologic concern based upon in vitro data and case reports. (TCPHP, 301) |
| Ginger Zingiber officinale | Contraindicated with gallstones; consult a physician first. (HM, 156; BSH, 125; TGHM, 136) May increase the chance of bleeding. (PPP, 401) Overdose may lead to a blood-thinning effect and an increase in gastric secretory activity leading to heartburn. (PPP, 401; ESCOPM, 1996, 1) Topical application may cause contact dermatitis in sensitive patients. (PPP, 401); Warfarin sodium, heparin, aspirin and other anticoagulants | None known. (HM, 156, TGHM, 136) Caution should be used in patients taking anticoagulants and antiplatelet drugs because of its potential antiplatelet effect. (TCPHP, 129; CAACH, 106) May increase the absorption of pharmaceutical drugs. (PPP, 401) Caution indicated with patients taking blood-thinning drugs such as warfarin, or aspirin or who have increased risk of haemorrhage. (PPP, 401) May enhance absorption of sulphaguanidine. (ESCOPM, 1); Augments the anticoagulant effect, thus altering clotting or bleeding times |
| Ginko Ginko biloba | Warfarin sodium, heparin, aspirin and other anticoagulants | Augments the anticoagulant effect, thus altering clotting or bleeding times |
| Ginseng and other herbs that contain cardiac glycosides | Insulin and related drugs for diabetes mellitus; Digoxin; Warfarin soldium, heparin, aspirin and other anticoagulants | Affects glucose levels; compromises dosage potency; alters bleeding or clotting times |
| Golden Seal Hydrastis canadensis | Berberine, an alkaloid constituent of this herb, may reinforce the effects of other drugs which displace the protein binding of bilirubin. (PPP, 295) | Contraindicated in hypertensive conditions. (PPP, 294) Fresh plant may cause irritation to the mucosa. (BSH, 62) Canadian regulations do not allow golden seal as a non-medicinal ingredient for oral use products. (BSH, 62) |
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Hawthorn
Crataegus monogyna |
digitalis glycosides, beta-blockers and other hypotensive drugs | May potentate the actions of digitalis, though this action has not been confirmed. (HM, 186-188) Hawthorn may act in synergy with digitalis glycosides, beta-blockers and other hypotensive drugs. Modification of drug dosage may be required. (PPP, 446) Drug interactions are also theoretically possible with cardioactive medications. (TCPHP, 257) |
| Kava Kava Piper methysticum | Potentiation of effectiveness is possible for substances on the central nervous system, such as alcohol, barbituates and psychopharmacological agents. (TGHM, 156; PPP, 462) Caution indicated with medications for insomnia or anxiety such as benzodiazepine. (PPP, 463; TCPHP, 33) There is a risk of sudden abnormal movements (a dystonic reaction) when combined with antipsychotic drugs. (TCPHP, 37) May reduce the efficacy of Levodopa, a medication for Parkinson’s disease; may interact with antiplatelet drugs or anticoagulants (e.g., warfarin, heparin) however there are no case reports of such interactions. (TCPHP, 36) | Extended use can cause discoloration of the skin, nails, and hair. (TGHM, 156; PPP, 462) In rare cases, contact type dermatitis can occur. (PPP, 462) Also accommodative disturbances, such as enlargement of the pupils and disturbances of the oculomotor equilibrium, have been reported. (TGHM, 156; TCPHP, 35) Contraindicated in endogenous depression. (HM, 223) Chronic usage may result in skin rash, shortness of breath, liver damage and neurological manifestations may occur. (PPP, 463) dermatologic and neurologic concern based upon case reports. (TCPHP, 301) Do not exceed recommended dose. (BSH, 86) |
| Korean Ginseng Panax ginseng | May interact with monoamine oxidase inhibitor phenelzine and also with warfarin. (PPP, 429; WHO, 176). Do not use with stimulants, including excessive use of caffeine. (HM, 174, PPP, 429) | Contraindicated for hypertension. (BSH, 81; HM, 174) Contraindicated with signs of heat, acute infections, acute asthma, hypertension, excessive menstruation or nose bleeds. (PPP, 429; CAACH, 41) Consuming caffeine with ginseng increases the risk of overstimulation and gastro-intestinal upset. (BSH, 81; BHC, 116) Higher doses can over-stimulate and aggravate insomnia, irritability, depression, headache, palpitation, hypertension, and can cause tremor, euphoria, skin eruptions, menstrual abnormalities, diminished sexual function and weight loss. (BSH, 81; CAACH, 40). May reduce blood glucose levels, diabetic patients should consult with physician. (WHO, 176) |
| Licorice Glycyrrhiza glabra | Should not be taken concurrently with corticosteroid treatment. (WHO, 190; AEHD, 77) Concurrent use of furosemide may potentiate development of acute renal failure. (AEHD, 77) Potassium loss due to other drugs, e.g. thiazide diuretics, can be increased. With potassium loss, sensitivity to digitalis glycosides increases. (HM, 237; TGHM, 161; WHO, 190) Should not be administered in conjunction with spironolactone or amiloride. (WHO, 190) Insulin may be synergistic with glycyrrhizin in causing electrolyte disturbances and suppression of renin and aldosterone. (AEHD, 77) | It is recommended that patients with cardiovascular or renal disease use licorice only under care of physician. (TCPHP, 232; PPP, 474) Patients prone to potassium deficiency are also advised not to use licorice. (TCPHP, 232; TGHM, 161) Treatment not to exceed six weeks. (TCPHP, 232; BSH, 58; TGHM, 162) Contraindications: cholestatic liver disorders, liver cirrhosis, hypertonia, hypokalemia, and severe kidney insufficiency. (HM, 236; BSH, 58; BHC,146; TGHM, 161; WHO, 190; AEHD, 72) Also contraindicated if there is edema or congestive heart failure. (PPP, 474) Ingestion of large amount can lead to severe hypertension, cardiac arrhythmias, cardiomyopathy, and cardiac arrest. (AEHD, 73; BSH, 58; BHC, 146; AEHD, 72) |
| Marshmallow Althaea officinalis | Absorption of other drugs taken simultaneously may be delayed. (BSH, 9; HM, 245, 247; ESCOPM, 1; TGHM, 166, 167) | As a mucilage or respiratory demulcent, contraindicated or at least inappropriate in congestive bronchial, catarrhal and congestive conditions of the mucosa. (PPP, 169, 211) |
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Oregon Grape
Berberis aquifolium |
Berberine, an alkaloid constituent of this herb, may potentiate other drugs which displace the protein binding of bilirubin. (PPP, 295) | This herb is classified as a choleretic and cholagogue. It is either contraindicated or at least inappropriate in the following: (1) obstructed bile ducts, (2) unconjugated hyperbilirubinaemia, (3) acute or severe hepatocellular disease, (4) septic cholecystitis (where there is risk of peritonitis), (5) intestinal spasm or ileus, and (6) liver cancer. (PPP, 187) As an alterative, this herb may be provocative to skin disease, and care needs to be taken to reduce the prospects of exacerbations. (PPP, 254) |
| Pau D'Arco Tabebuia avellanedae | Patients on anticoagulant therapy should not be prescribed Pau D’Arco due to the warfarin-like action of naphthoquinones at high doses. (PPP, 504) | Contraindicated with anticoagulants. (PPP, 504) Adverse effects are not expected when consumed with the recommended dosage. (PPP, 500) |
| St. John's Wort Hypericum perforatum | None known. (ESCOPM, 2; TGHM, 215; HM, 363) May potentiate pharmaceutical MAO-inhibitors. (BSH, 62, 173) Recommend physician consultation when taken with MAO inhibitors, SSRIs, and tricyclics. (PPP, 549); Drugs for iron therapy | Contraindicated in the treatment of serious depression with psychotic symptoms, suicidal risk or signs and symptoms that are so severe that they do not allow the patient’s family or work involvements to continue. (PPP, 549) May cause mild stomach discomfort, skin rash, tiredness, fatigue, sleep disturbances, photosensitization is possible, especially in fair skinned individuals. (BSH, 62; TGHM, 215; HM, 363; PPP, 548; ESCOPM, 1996, 1) Caution advised in very severe debility, especially if associated with immune or digestive collapse, renal or hepatic failure, rampant cancer or strong regimes of chemotherapy. (PPP, 155) dermatologic and neurologic concern based upon case reports. (TCPHP, 301); Inhibits iron absorption |
| Sarsaparilla Smilax ornata | Commission E advises of potential drug interactions with hypnotics, digitalis glycosides, and bismuth. However, no other reference substantiates these concerns. (BSH, 108) | Risks: taking the herb may lead to gastric irritation and temporary kidney impairment [diuresis]. The absorption of simultaneously administered substances may be increased. The elimination of other substances (e.g., hypnotics) is accelerated. This can cause an uncontrolled condition of increased or decreased action of herbs taken simultaneously. (TGHM, 372) |
| Tribulus Tribulus terrestris | This herb may increase FSH in women, which in turn increases levels of oestrogen. (PPP, 46) | Due to the presence of saponins, this herb may be a gastrointestinal irritant. (PPP, 46) |
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Turmeric
Curcuma longa |
None known. (HM, 382; TGHM, 222) High doses should not be given to patients taking antiplatelet or anticoagulant drugs. (PPP, 578) | Contraindicated in obstruction of bile passages; in case of gallstones, use only after consulting with a physician. (TGHM, 222; HM, 382; WHO, 121; PPP, 578) The herb should not be administered to patients who suffer from stomach ulcers or hyperacidity. (BSH, 39; HM, 382) Occasional cases of allergic dermatitis reported. (WHO, 121; PPP, 578) Patients applying topical doses should be cautioned against excessive exposure to sunlight. (PPP, 578) |
| Valerian Valeriana officinalis | None known. (TGHM, 226; ESCOPM, 2; HM, 397) May increase the effects of CNS depressants or alcohol when taken together. (PPP, 587; AEHD, 172; WHO, 273) The herb may be expected to have at least an additive effect with barbiturates, alcohol, benzodiazepines, and other CNS depressants. (TCPHP, 64); diphenlydramine | Can aggravate a sensation of tiredness or drowsiness, particularly in higher doses. (PPP, 587; WHO, 273) Overdose can result in blurred vision, erratic heart beat, headache, nausea, restlessness, visual illusions, even spasmodic movements. (PPP, 588; BSH, 120) Very large doses may cause bradycardia and arrhythmias, and decrease intestinal motility. (WHO, 274) Canada allows products containing valerian for use as sleeping aids and sedatives. (TCPHP, 64) Hepatic and neurologic concern based upon case reports, although in the case of alleged hepatotoxicity coingestants were involved. (TCPHP, 301) |
| Yohimbe Pausinystalia yohimbe | Monoaminoxidase inhibitors | Causes hypertension, insomnia, headache, and tremulousness |
AASLD: Smoking Marijuana Raises Fibrosis Risk in Patients With Chronic Hepatitis C InfectionBy Mark L. Fuerst 5256F40005204E7?OpenDocument&id=48DDE4A73E09A96985256888007
8C249&c=Hepa%2fBiliary%20Other&count=10
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http://www.hcvadvocate.org/news/newsLetter/2005/advocate0105.html#3 |
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Medicines can treat and cure many health problems.
However, they must be taken properly to ensure that they are safe
and effective.
Many medicines have powerful ingredients that interact with the
human body in different ways, and diet and lifestyle can sometimes
have a significant impact on a drug's ability to work in the body.
Certain foods, beverages, alcohol, caffeine, and even cigarettes can
interact with medicines. This may make them less effective or may
cause dangerous side effects or other problems.
When you take medicine,
be sure to follow your doctor's instructions carefully to obtain the
maximum benefit with the least risk.
Changes in a medicine's effect due to an interaction with food,
alcohol or caffeine can be significant; however, there are many
individual factors that influence the potential for such variations,
like dose, age, weight, sex, and overall health.
This article has
information about possible interactions between many common
prescription and nonprescription (over-the-counter) medications with
food, alcohol and caffeine, but should not replace the advice from
your physician, pharmacist, or other health care professional.
If you have any questions or concerns about possible drug
interactions, consult your health care professional.
Make sure your doctor
and pharmacist know about every drug you are taking, including
nonprescription drugs and any dietary supplements such as vitamins,
minerals and herbals.
If you have problems or experience side effects related to
medication, call your health care provider right away.
It is also important to remember that many drugs interact with other
drugs and may cause serious medical conditions.
In this article, the
generic (nonproprietary) name for each drug is stated first. Brand
names are in full capital letters and represent only some examples
of those medications.
Medications for Allergies
Antihistamines are used
to relieve or prevent the symptoms of colds, hay fever, and
allergies.
They limit or block histamine, which is released by the body when we
are exposed to substances that cause allergic reactions.
Antihistamines are available with and without a prescription (over-
the-counter).
These products vary in their ability to cause drowsiness and
sleepiness.
Antihistamines (over the counter)
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brompheniramine / DIMETANE, BROMPHEN
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chlorpheniramine / CHLOR-TRIMETON
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diphenhydramine / BENADRYL
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clemastine/TAVIST
Antihistamines (prescriptions)
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fexofenadine / ALLEGRA
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loratadine / CLARITIN
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cetirizine / ZYRTEC
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astemizole/HISMANAL
Interaction
Food: It is best to take prescription antihistamines on an empty stomach to increase their effectiveness.
Alcohol:
Some antihistamines may increase drowsiness and slow mental and
motor performance. Use caution when operating machinery or driving.
Medications for Arthritis / Pain
Analgesic / Antipyretic
These medications are used to treat mild to moderate pain and
fever. One example is:
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acetaminophen/TYLENOL, TEMPRA
Interactions
Food: For rapid relief, take on an empty stomach because food may slow the body's absorption of acetaminophen.
Alcohol:
Avoid or limit the use of alcohol because chronic alcohol use can
increase your risk of liver damage or stomach bleeding.
If you consume three or more alcoholic drinks per day talk to your
doctor or pharmacist before taking these medications.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
NSAIDs reduce pain, fever, and inflammation. Some examples are:
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aspirin/BAYER, ECOTRIN
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ibuprofen/MOTRIN, ADVIL
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naproxen/ANAPROX, ALEVE, NAPROSYN
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ketoprofen/ORUDIS
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nabumetone/RELAFEN
Interaction
Food: Because these medications can irritate the stomach, it is best to take them with food or milk.
Alcohol:
Avoid or limit the use of alcohol because chronic alcohol use can
increase your risk of liver damage or stomach bleeding.
If you consume three or more alcoholic drinks per day talk to your
doctor or pharmacist before taking these medications.
Buffered aspirin or enteric coated aspirin may be preferable to
regular aspirin to decrease stomach bleeding.
Corticosteroids
They are used to provide relief to inflamed areas of the body. Corticosteroids reduce swelling and itching, and help relieve allergic, rheumatoid, and other conditions. Some examples are:
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methylprednisolone / MEDROL
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prednisone / DELTASONE
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prednisolone / PEDIAPRED, PRELONE
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cortisone acetate / CORTEF
Interaction
Food: Take with food or milk to decrease stomach upset.
Narcotic Analgesics
Narcotic analgesics are
available only with a prescription.
They provide relief for moderate to severe pain. Codeine can also be
used to suppress cough.
Some of these medications can be found in combination with
non-narcotic drugs such as acetaminophen, aspirin, or cough syrups.
Use caution when taking these medications: take them only as
directed by a doctor or pharmacist because they may be habit forming
and can cause serious side effects when used improperly.
Some examples are:
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codeine combined with acetaminophen / TYLENOL #2,#3,& #4
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morphine / ROXANOL, MS CONTIN
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oxycodone combined with acetaminophen / PERCOCET, ROXICET
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meperidine / DEMEROL
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hydrocodone with acetaminophen / VICODIN, LORCET
Interaction
Alcohol: Avoid alcohol because it increases the sedative effects of the medications. Use caution when motor skills are required, including operating machinery and driving.
Medications for Asthma
Bronchodilators
Bronchodilators are
used to treat the symptoms of bronchial asthma, chronic bronchitis
and emphysema.
These medicines open air passages to the lungs to relieve wheezing,
shortness of breath and troubled breathing.
Some examples are:
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theophylline / SLO-BID, THEO-DUR,THEO-DUR 24, UNIPHYL
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albuterol / VENTOLIN, PROVENTIL,COMBIVENT
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epinephrine / PRIMATENE MIST
Interactions
Food:
The effect of food on theophylline medications can vary widely.
High-fat meals may increase the amount of theophylline in the body,
while high-carbohydrate meals may decrease it.
It is important to check with your pharmacist about which form you
are taking because food can have different effects depending on the
dose form (e.g., regular release, sustained release or sprinkles).
For example, food has
little effect on Theo-Dur and Slo-Bid, but food increases the
absorption of Theo-24 and Uniphyl which can result in side effects
of nausea, vomiting, headache and irritability.
Food can also decrease absorption of products like Theo-Dur
Sprinkles for children.
Caffeine: Avoid eating or drinking large amounts of foods and beverages that contain caffeine (e.g., chocolate, colas, coffee, tea) because both oral bronchodilators and caffeine stimulate the central nervous system.
Alcohol:
Avoid alcohol if you're taking theophylline medications because it
can increase the risk of side effects such as nausea, vomiting,
headache and irritability.
Medications for Cardiovascular Disorders
There are numerous medications used to treat cardiovascular
disorders such as high blood pressure, angina, irregular heart beat,
and high cholesterol.
These drugs are often used in combination to enhance their
effectiveness. Some classes of drugs can treat several conditions.
For example, beta blockers can be used to treat high blood pressure,
angina, and irregular heart beats. Check with your doctor or
pharmacist if you have questions on any of your medications.
Diuretics
Sometimes called "water pills," diuretics help eliminate water, sodium, and chloride from the body. There are different types of diuretics. Some examples are:
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furosemide / LASIX
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triamterene / hydrochlorothiazide / DYAZIDE, MAXZIDE
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hydrochlorothiazide / HYDRODIURIL
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triamterene / DYRENIUM
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bumetamide / BUMEX
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metolazone / ZAROXOLYN
Interaction
Food:
Diuretics vary in their interactions with food and specific
nutrients.
Some diuretics cause loss of potassium, calcium, and magnesium.
Triamterene, on the other hand, is known as a "potassium-sparing"
diuretic.
It 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
Beta blockers decrease
the nerve impulses to the heart and blood vessels. This decreases
the heart rate and the work load of the heart.
Some examples are:
-
atenolol / TENORMIN
-
metoprolol / LOPRESSOR
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propranolol / INDERAL
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nadolol / CORGARD
Interaction
Alcohol: Avoid drinking alcohol with propranolol / INDERAL because the combination lowers blood pressure too much.
Nitrates
Nitrates relax blood vessels and lower the demand for oxygen by the heart. Some examples are:
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isosorbide dinitrate / ISORDIL,SORBITRATE
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nitroglycerin / NITRO, NITRO-DUR,TRANSDERM-NITRO.
Interaction
Alcohol: Avoid alcohol because it may add to the blood vessel-relaxing effect of nitrates and result in dangerously low blood pressure.
Angiotensin Converting Enzyme (ACE) Inhibitors
ACE inhibitors relax blood vessels by preventing angiotensin II, a vasoconstrictor, from being formed. Some examples are:
-
captopril / CAPOTEN
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nalapril / VASOTEC
-
lisinopril / PRINIVIL, ZESTRIL
-
quinapril / ACCUPRIL
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moexipril / UNIVASC
Interactions
Food: Food can decrease the absorption of captopril and moexipril. So take captopril and moexipril one hour before or two hours after meals. ACE inhibitors may increase the amount of potassium in your body.
Too much potassium can
be harmful.
Make sure to tell your doctor if you are taking potassium
supplements or diuretics (water pills) that may increase the amount
of potassium in your body.
Avoid eating large amounts of foods high in potassium such as
bananas, green-leafy vegetables, and oranges.
HMG-CoA Reductase Inhibitors
Otherwise known as
"statins," these medications are used to lower cholesterol.
They work to reduce the rate of production of LDL (bad cholesterol).
Some of these drugs also lower triglycerides.
Recent studies have shown that pravastatin can reduce the risk of
heart attack, stroke, or miniature stroke in certain patient
populations.
Some examples are:
-
atorvastatin / LIPITOR
-
cerivastatin / BAYCOL
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fluvastatin / LESCOL
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lovastatin / MEVACOR
-
pravastatin / PRAVACHOL
-
simvastatin / ZOCOR
Interaction
Alcohol: Avoid drinking large amounts of alcohol because it may increase the risk of liver damage.
Food: Lovastatin (Mevacor) should be taken with the evening meal to enhance absorption.
Anticoagulants
Anticoagulants help to prevent the formation of blood clots. An example is:
-
warfarin / COUMADIN
Interactions
Food:
Vitamin K produces blood-clotting substances and may reduce the
effectiveness of anticoagulants.
So limit the amount of foods high in vitamin K (such as broccoli,
spinach, kale, 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.
Medications to Treat Infections
Antibiotics and Antifungals
Many different types of drugs are used to treat infections caused by
bacteria and fungi. Some general advice to follow when taking any
such product is:
-
Tell your doctor about any skin rashes you may 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.
-
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.
-
Be sure to finish all your medication even if you are feeling better.
-
Take with plenty of water.
Antibacterial: Penicillin
Some examples are:
-
penicillin V / VEETIDS
-
amoxicillin / TRIMOX, AMOXIL
-
ampicillin / PRINCIPEN, OMNIPEN
Interaction
Food: Take on an empty stomach, but if it upsets your stomach, take it with food.
Antibacterial: Quinolones
Some examples are:
-
ciprofloxacin / CIPRO
-
levofloxacin / LEVAQUIN
-
ofloxacin / FLOXIN
-
trovafloxacin / TROVAN
Interactions
Food:
Take on an empty stomach one hour before or two hours after meals.
If your stomach gets upset, take it with food.
However, avoid calcium-containing products like milk, yogurt,
vitamins or minerals containing iron, and antacids because they
significantly decrease drug concentration.
Caffeine: Taking these medications with caffeine- containing products (e.g., coffee, colas, tea, and chocolate) may increase caffeine levels, leading to excitability and nervousness.
Antibacterial: Cephalosporins
Some examples are:
-
cefaclor / CECLOR, CECLOR CD
-
cefadroxil / DURICEF
-
cefixime / SUPRAX
-
cefprozil / CEFZIL
-
cephalexin / KEFLEX, KEFTAB
Interaction
Food: Take on an empty stomach one hour before or two hours after meals. If your stomach gets upset, take with food.
Antibacterial: Macrolides
Some examples are:
-
azithromycin / ZITHROMAX
-
clarithromycin / BIAXIN
-
erythromycin / E-MYCIN, ERY-TAB, ERYC
-
erythromycin + sulfisoxazole / PEDIAZOLE
Interaction
Food: Take on an empty stomach one hour before or two hours after meals. If your stomach gets upset, take with food.
Antibacterial: Sulfonamides
An example is:
-
sulfamethoxazole + trimethoprim /BACTRIM, SEPTRA
Interaction
Food: Take on an empty stomach one hour before or two hours after meals. If your stomach gets upset, take with food.
Antibacterial: Tetracyclines
Some examples are:
-
tetracycline / ACHROMYCIN, SUMYCIN
-
doxycycline / VIBRAMYCIN
-
minocycline / MINOCIN
Interaction
Food:
Take on an empty stomach one hour before or two hours after meals.
If your stomach gets upset, take with food.
However, it is important to avoid taking tetracycline / ACHROMYCIN,
SUMYCIN with dairy products, antacids and vitamins containing iron
because these can interfere with the medication's effectiveness.
Antibacterial: Nitroimidazole
An example is:
-
metronidazole / FLAGYL
Interaction
Alcohol:
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
Some examples are:
-
fluconazole / DIFLUCAN
-
griseofulvin / GRIFULVIN
-
ketoconazole / NIZORAL
-
itraconazole / SPORANOX
Interaction
Food: It is important to avoid taking these medications with dairy products (milk, cheeses, yogurt, ice cream), or antacids.
Alcohol:
Avoid drinking alcohol, using medications that contain alcohol, or
eating foods prepared with alcohol while you are taking
ketoconazole/NIZORAL and for at least three days after you finish
the medication.
Alcohol may cause nausea, abdominal cramps, vomiting, headaches and
flushing.
Medications for Mood Disorders
Depression, panic
disorder and anxiety are a few examples of mood disorders — complex
medical conditions with varying degrees of severity.
When using medications to treat mood disorders it is important to
follow your doctor's instructions.
Remember to take your dose as directed even if you are feeling
better, and do not stop unless you consult your doctor. In some
cases it may take several weeks to see an improvement in symptoms.
Monoamine Oxidase (MAO) Inhibitors
Some examples are:
-
phenelzine / NARDIL
-
tranylcypromine / PARNATE
Interactions
MAO Inhibitors have
many dietary restrictions, and people taking them need to follow the
dietary guidelines and physician's instructions very carefully.
A rapid, potentially fatal increase in blood pressure can occur if
foods or alcoholic beverages containing tyramine are consumed while
taking MAO Inhibitors.
Alcohol: Do not drink beer, red wine, other alcoholic beverages, non-alcoholic and reduced alcohol-beer and red-wine products.
Food: Foods high in tyramine that should be avoided include:
-
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, miso soup.
-
Broad (fava) beans, ginseng, caffeine-con- taining products (colas, chocolate, coffee and tea).
Anti-Anxiety Drugs
Some examples are:
-
lorazepam / ATIVAN
-
diazepam / VALIUM
-
alprazolam / XANAX
Interaction
Alcohol: May impair mental and motor performance (e.g., driving, operating machinery).
Caffeine: May cause excitability, nervousness, and hyperactivity and lessen the anti-anxiety effects of the drugs.
Antidepressant Drugs
Some examples are:
-
paroxetine / PAXIL
-
sertraline / ZOLOFT
-
fluoxetine / PROZAC
Interactions
Alcohol: Although alcohol may not significantly interact with these drugs to affect mental or motor skills, people who are depressed should not drink alcohol.
Food: These medications can be taken with or without food.
Medications for
Stomach Conditions
Conditions like acid
reflux, heartburn, acid indigestion, sour stomach, and gas are very
common ailments.
The goal of treatment is to relieve pain, promote healing and
prevent the irritation from returning. This is achieved by either
reducing the acid the body creates or protecting the stomach from
the acid.
Lifestyle and dietary habits can play a large role in the symptoms
of these conditions.
For example, smoking cigarettes and consuming products that contain
caffeine may make symptoms return.
Histamine Blockers
Some examples are:
-
cimetidine / TAGAMET or TAGAMET HB
-
famotidine / PEPCID or PEPCID AC
-
ranitidine / ZANTAC or ZANTAC 75
-
nizatadine / AXID OR AXID AR
Interactions
Alcohol: Avoid alcohol while taking these products. Alcohol may irritate the stomach and make it more difficult for the stomach to heal.
Food: Can be taken with or without regard to meals.
Caffeine: Caffeine products (e.g., cola, chocolate, tea and coffee) may irritate the stomach.
Drug to Drug
Interactions
Not only can drugs interact with food and alcohol, they can also
interact with each other.
Some drugs are given together on purpose for an added effect, like
codeine and acetaminophen for pain relief. But other drug-to-drug
interactions may be unintended and harmful.
Prescription drugs can interact with each other or with
over-the-counter (OTC) drugs, such as acetaminophen, aspirin, and
cold medicine. Likewise, OTC drugs can interact with each other.
Sometimes the effect of
one drug may be increased or decreased.
For example, tricyclic antidepressants such as amitriptyline (ELAVIL),
or nortriptyline (PAMELOR) can decrease the ability of clonidine (CATAPRES)
to lower blood pressure.
In other cases, the effects of a drug can increase the risk of
serious side effects.
For example, some antifungal medications such as itraconazole (SPORANOX)
and ketoconazole (NIZORAL) can interfere with the way some
cholesterol-lowering medications are broken down by the body.
This can increase the risk of a serious side effect.
Doctors can often
prescribe other medications to reduce the risk of drug-drug
interactions.
For example, two cholesterol- lowering drugs — pravastatin (PRAVACHOL)
and fluvastatin (LESCOL), are less likely to interact with
antifungal medications.
Be sure to tell your doctor about all medications — prescription and
OTC— that you are taking.
Source
Food & Drug Interactions. U.S. Food and Drug Administration / National Consumers League.