Millions of Americans take prescription drugs to treat diabetes, high blood pressure, heart disease, or other conditions. It also says on many prescriptions labels to “take with meals.” But does that mean you can take any medication with any type of food? We all believe a diet rich in colorful fruits and vegetables, lean proteins, whole grains, and low-fat dairy products is part of healthy eating, but is that always the case? You must beware because the foods you eat and the medications you take could be working against each other. There are many guides out there that give a terrific run-down of food/medication interactions and you can also speak with your primary physician about your specific medications and interactions.

A food/medication interaction can prevent the medicine from working the way it should by not being strong enough or as effective, it could increase the effects of a medication’s side effects, or even create a new side effect. It can also change the way your body uses a food. Medications are affected by many different things such as your age, weight, sex, medical conditions, the dose of the medication, other medications you are also taking including vitamins, herbals, and supplements, plus many other things.

First let’s talk about taking medications on an empty stomach. This only matters with certain medications. Some medications can work faster, slower, better, or worse when you take them on a full or empty stomach. On the other hand, some medicines will upset your stomach, and if there is food in your stomach, that can help reduce the upset. Many medications are instructed to be taken with food for other reasons such as to help increase absorption and reduce the risks of side effects other than just nausea. To stay safe, always speak to your physician about the medication when it is newly prescribed and always read your prescription labels. If you don’t see directions on your medicine label, ask your pharmacist specific questions such as is it best to take your medication on an empty stomach one hour before eating, two hours after eating, with food or after a meal on a full stomach.

Alcohol and caffeine can also affect how your medication works. This includes swallowing your medicine with alcohol, drinking alcohol after you’ve taken medication, or if you take your medication after you’ve been drinking. Alcohol can also add to the side effects caused by medicines. Caffeine can decrease the effectiveness of medications, enhance the effects of medications and even sometimes the medication can decrease the metabolism of caffeine which in turn increases the effects of caffeine. Always speak with your physician about using alcohol or caffeine with medication, but the best rule of thumb is to avoid both. While there are many medication classifications we could cover concerning interactions, this month we’ll be covering a few of the more common ones.

• Antihistamines- These treat or relieve symptoms of colds and allergies, such as sneezing, runny nose, stuffy nose, and itchy eyes. They block the histamine your body releases when a substance (allergen) causes the symptoms of an allergic reaction. Some antihistamines you can buy over-the-counter and some you can buy only with a prescription from your doctor. Some antihistamines can cause drowsiness. A few examples include Cetirizine (Zyrtec) and Diphenhydramine (Benadryl). Avoid alcohol with these because it can add to any drowsiness caused by these medicines.

• Arthritis, Pain, and Fever Analgesics/Antipyretics (Pain relievers/Fever reducers)- Analgesics/antipyretics relieve mild to moderate pain and lower fever. One common example is Acetaminophen. Acetaminophen relieves mild to moderate pain from headaches, muscle aches, toothaches, backaches, menstrual cramps, the common cold, pain of arthritis, and lowers fever. If you drink three or more alcoholic drinks every day, ask your doctor if you should use medicines with Acetaminophen or other pain reliever/fever reducers. Acetaminophen can cause liver damage and the chance for severe liver damage is higher when combined with alcohol.

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)- NSAIDs relieve pain, fever, and inflammation. Some NSAIDs you can buy over-the-counter and some you can buy only with a prescription. The over-the-counter NSAIDs give short term relief from minor aches and pains from headaches, muscle aches, toothaches, backaches, menstrual cramps, and minor aches and pain of arthritis. Common examples Aspirin, Celebrex, Ibuprofen, and Naproxen. Take these medicines with food or milk if they upset your stomach. NSAIDs can cause stomach bleeding and the chance is higher if you drink three or more alcoholic drinks every day.

• Narcotic Analgesics- Narcotic analgesics treat moderate to severe pain. Codeine can also help you cough less. Some of these medicines are mixed with other medicines that aren’t narcotics, such as acetaminophen, aspirin, or cough syrups. You can only buy narcotic analgesics with a prescription. Follow your doctor’s advice carefully because these medicines can be habit forming and can cause serious side effects if not used correctly. Examples include Tylenol/Codeine, Norco, Lorcet, Demerol, Morphine, and Percocet. Don’t drink alcohol while using narcotics. Alcohol can increase the chance of dangerous side effects, coma, or death.

• Bronchodilators- Bronchodilators treat and prevent breathing problems from asthma, chronic bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD). These medicines relax and open the air passages to the lungs to relieve wheezing, shortness of breath, troubled breathing, and chest tightness. Take these medicines only as directed. If your symptoms get worse or you need to take the medicine more often than usual, you should talk to your doctor right away. An example is Albuterol. Food can have different effects on different forms of bronchodilators depending on regular release, sustained release, and sprinkles. Check with your pharmacist to be sure you know which form of the medicine you use and if food can affect your medicine. Follow directions for sprinkle forms of the medicine. You can swallow sprinkle capsules whole or open them and sprinkle them on soft foods, such as applesauce or pudding. Swallow the mixture without chewing, as soon as it is mixed. Follow with a full glass of cool water or juice. Using bronchodilators with foods and drinks that have caffeine can increase the chance of side effects, such as excitability, nervousness, and rapid heart beat. Avoid alcohol because it can increase the chance of side effects, such as nausea, vomiting, headache, and irritability.

Always read the label information carefully before you use the medicine. If you have any questions, don’t hesitate to ask a doctor or pharmacist. Check back for part 2 of food/medication interactions.

Source: https://www.fda.gov/downloads/Drugs/.../.../UCM229033.pdf