Unknown to most people is the fact that everyday foods and Herbal supplements can and do interact with popular prescription medications. I became interested while talking to my Pharmacist that my son couldn't take decongestant cold medications with his heart medication. Well, I knew about interactions between two drugs, but when the Pharmacist told me he couldn't have grapefruit juice, I was stunned. Seems that grapefruit juice increases the blood concentrations of the drug. Basically that means that it greatly enhances the effects of the drug which could result in an overdose of the medication. This is everyday grapefruit juice! It got me wondering about other everyday foods and Herbs we take. Below are a few foods and Herbs that have an effect on your medications.
This list is a basic guide, and is by no means the meant to replace your Doctor or Pharmacist. Consult with them about any prescriptions you are taking and the foods and Herbs that will interact with them. Although I have taken this information from a handout from a local Hospital, Use this information at your own risk. Again, I am not a Doctor or Pharmacist, and I have had NO medical training, so please consult with yours for more information.
People usually ask if Herbal supplements change the way their prescription drugs work. The answer is YES! Some medications should never be taken with Herbal supplements. Some can cause unwanted side effects or cause the medication to stop working to their full effect.
Another misconception about supplements is that they are completely safe because they are natural. Yes, they may be from plants, but they are not natural to your body. Herbal supplements are not tested or inspected like prescription drugs are tested, so the supplements vary in quality and strength from pill to pill and bottle to bottle.
Just like supplements, foods can change the way your body responds to medications. One example is grapefruits and grapefruit juice. Many people aren't aware that grapefruit juice can increase the drug levels of certain medications. An increase in the levels will also increase the side effects of the drug.
Things to Remember
1. Herbal supplements and foods can change the way your medications work.
2. Tell your caregiver what Herbal supplements you take and what foods you eat often.
3. Ask your Doctor or Pharmacist what Herbal supplements or foods will interact with your medications.
4. Always talk with your Doctor or Pharmacist FIRST before taking any Herbal supplements.
DISCLAIMER: The following charts are not all inclusive and do not contain every interaction of drugs with foods and herbs. It serves as a guide only. Consult with your Doctor, Pharmacist or a registered dietician if you have any questions.
Analgesics (Pain Relievers)
Aspirin
Celecoxib (Celebrex)
Ibuprofen (Advil, Motrin)
Naproxen
Food: Avoid alchohol. Avoid large amounts of orange juice and vitamin C.
Herbs:Avoid Black Cohosh, Dong Quai, Evening Primrose, Feverfew, Flaxseed Oil, and Ginko as it increases the risk of bleeding.
Narcotics
Codeine (Tylenol #2, 3, 4)
Morphine (MS Contin)
Oxycodone (Oxycontin/Percocet)
Foods:Avoid alchohol.
Herbs:Do not take with Kava or Valerian as it may make you feel drowsy.
Antibiotics
Ciproflaxacin (cipro)
Levofloxacin (Levaquin)
Food: Take 2 Hrs before or 6 Hrs after antacids, dairy products amd multi-vitamins that contain calcium, iron, zinc, or magnesium. Avoid large amounts of caffeine.See Chart 3 below.
Herbs:
Methronidazole
Foods:Avoid alchohol during and 3 days after taking this medication to avoid nausea and vomiting.
Herbs:
Penicillin
Foods:Citrus fruits/juices and carbonated beverages will decrease desired effect.
Herbs:
Tetracycline
Foods:Take 2 Hrs before or 6 Hrs after antacids, dairy products amd multi-vitamins that contain calcium, iron, zinc, or magnesium.
Herbs:Dong Quai or St. John's Wort increase the risk of sunburn.
Trimethoprim/Sulfamethoxazole (Bactrim, Septra)
Foods:May cause rash if taken with alchohol.
Herbs:Dong Quai or St. John's Wort increase the risk of sunburn.
Anticoagulants (Blood Thinners)
Warfarin (Coumadin)
Food: Avoid alchohol. Avoid foods high in Vitamin K: beef liver, oils and green leafy vegetables (broccoli, brussel sprouts, cabbage, collards, spinach).
Herbs: Avoid Black Cohosh, Dong Quai, Evening Primrose, Feverfew, Flaxseed Oil and Ginko as they increase the risk of bleeding. Do not take St. John's Wort as it may decrease the desired effect.
Cholesterol Lowering Agents
Atorvastatin (Lipitor)
Pravastatin (Pravachol)
Rosuvastatin (Crestor)
Simvastatin (Zocor)
Food: Avoid alchohol. Do not take with grapefruit juice.
Herbs: St. John's Wort may decrease desired effect.
Diabetes Medications
Glipizide (Glucotrol, Glucotrol XL)
Glyburide (Glynase, Micronase)
Metformin (Glucophage)
Food: Avoid alchohol.
Herbs: Do not take with Ephedra as it may increase blood sugar and decrease desired effect.
Erectile Dysfunction
Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)
Food: Do not take with grapefruit juice.
Herbs: Do not take with Yohimbe as it may increase side effects.
Gastrointestinal Agents (Stomach Meds)
Prochlorperazine (Compazine)
Food: Do not take with alchohol.
Herbs: Do not take with Dong Quai, Kava, St. John's Wort or Valerian as they may make you drowsey.
Cimetidine (Tagamet)
Foods: Avoid alchohol. Take 1 hour before or 2 hours after antacids. Limit caffeine intake; see Chart 3.
Herbs: St John's Wort may decrease desired effect.
Lansoprozole (Prevacid)
Omeprazole (Prilosec)
Pantoprazole (Protonix)
Rabeprazole (Aciphex)
Foods: Avoid alchohol as it may cause upset stomach.
Herbs: St. John's Wort may decrease desired effect.
Heart and Blood Pressure Medications
*Note: The following herbs may cause an INCREASE in blood pressure and decrease desired effect of any blood pressure medications: Black Cohosh, Dong Quai, Ephedra, Hawthorn, Quassia, Vervain and Yohimbe.
Angiotensin Converting Enzyme (ACE) Inhibitors-
Captopril (Capoten)
Linisopril (Prinivil, Zestril)
Food: Avoid salt substitutes that contain potassium and potassium rich foods; see Chart 1.
Herbs: See *Note above
Beta Blockers-
Atenolol (Tenormin)
Metoprolol (Lopressor, Toprol ZL)
Propranolol (Inderal)
Foods: Avoid alchohol.
Herbs: See *Note above.
Calcium Channel Blockers-
Diltiazem (Cardizem, Tiazac)
Verapamil (Calan, Verelan)
Foods: Do not take with grapefruit juice. A low sodium diet may be recommended.
Herbs: See *Note above.
Digoxin (Lanoxin)
Foods: Avoid antacids. Limit caffeine intake; see Chart 3 below.
Herbs: Avoid Ma Huang and St. John's Wort as they may decrease desired effect.
Nitrates-
Isosorbide (isordil, Imdur)
Nitroglycerin Patch (Nitrol)
Foods: Avoid alchohol.
Herbs: See *Note above.
Diuretics (Water Pills)
Furosemide (Lasix)
Hydrochlorothiazide
Food: INCLUDE potassium rich foods in diet; see Chart 1 below.
Herbs: See *Note above under Heart and Blood Pressure Medications.
Hormone Replacement Therapy
Estrogen (Premarin, Premphase, Prempro)
Food: Avoid alchohol.
Herbs: St John's Wort may decrease desired effect. Do not take Black Cohosh Dong Quai, Red Clover or Saw Palmetto because of the possible side effects.
Mood Disorders
Aripiprazole (Abilify)
Clozapine (Clozaril)
Olanzapine (Zyprexa)
Risperidone (Risperdal)
Food: Avoid alchohol. Do not take grapefruit juice. Limit caffeine intake; see Chart 3.
Herbs: Do not take with Kava, St. John's Wor or Valerian as they may make you feel drowsy.
Benzodiazepines-
Alprazolam (Zanax)
Clonazepam (Klonopin)
Diazepam (Valium)
Lorazepam (Ativan)
Foods: Avoid alchohol. Do not take grapefruit juice. Limit caffeine intake; see Chart 3 below.
Herbs: Do not take with Kava, St. John's Wor or Valerian as they may make you feel drowsy.
Lithium (Eskalith, Lithobid)
Food: Avoid alchohol. Limit caffeine intake; see Chart 3 below.
Herbs: Avoid Green Tea.
Monoamine Oxidase Inhibitors (MAOI's)-
Phenelzine (Nardil)
Tranylcypromine (Parnate)
Foods: Avoid alchohol. Avoid tyramine-rich foods see Chart 2 below.
Herbs: Do not take with Ephedra, Kava, Ginko, St. John's Wort or Yohimbe as they may increase effect and cause a serious increase in blood pressure.
Selective Seratonin Reuptake Inhibitors (SSRI's)-
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Food: Avoid alchohol.
Herbs: Do not take with Ephedra, Kava, Melatonin, Valerian or Yohimbe as they may make you drowsy. Do not take with St. John's Wort as it may increase effect of drug and risk of side effects.
Tricyclic Antidepressants (TCA's)-
Amitriptyline (Elavil)
Desipramine (Norpramin)
Nortriptyline (Pamelor)
Foods: Avoid alchohol. Do not take with grapefruit juice.
Herbs: Do not take with Kava, St. John's Wort or Valerian as they may make you feel drowsy.
Oral Contraceptives (Birth Control)
Estradiol Cypionate
Ethinyl Estradiol
Mestranol
Food: Avoid smoking.
Herbs: Do not take with Chaste Tree Berry, Red Clover, Saw Palmetto or St. John's Wort as they may decrease desired effect.
Osteoporosis
Alendronate (Fosomax)
Risendronate (Actonel)
Food: Take only with plain water. Do not take anything else within 30 minutes of taking these drugs as they may decrease desired effect.
Herbs:
Seizure Medications
Carbamazepine (Carbatrol, NOT Tegretol)
Divalproex (Depakote)
Oxcarbazepine (trileptal)
phenytoin (Dilantin)
Food: Avoid alchohol. Do not take with grapefruit juice.
Herbs: Evening Primrose increases risk for seizures. Do not take with Kava or Valerian as they may make you feel drowsy. St. John's Wort may decrease desired effect.
Thyroid Medications
Levothyroxine (Levoxyl, Synthroid, Unithroid)
Thyroid (Armour Thyroid)
Food: Limit intake of Brussel Sprouts, cabbage, kale, greens, rutabaga, soybeans and turnips.
Herbs: Do not take with Lemon Balm.
Miscellaneous
Antihistamines-
Chlorpheniramine (Chlor-Trimeton)
Diphenhydramine (Benadryl)
Food: Do not take with alchohol.
Herbs: Do not take with Kava or Valerian as it may make you feel drowsy.
Cyclosporine (Neoral, Sandimmune)
Foods: Do not take with grapefruit juice.
Herbs: Do not take with Echinacea or St. John's Wort as they may decrease desired effect.
Prednisone
Methylprednisolone
Food: Avoid alchohol. Calcium supplements may be recommended to prevent Osteoporosis.Limit caffeine intake; see Chart 3 below.
Herbs: Avoid Echinacea or St. John's Wort as they may decrease desired effect.
Theopylline (theo-Dur)
Foods: Avoid alchohol.Limit caffeine intake; see Chart 3 below.
Herbs: Do not take with Ephedra or Green Tea as it may increase effect of drug.
Foods:
Herbs:
Chart # 1
High potassium rich foods include the following:
Apricots, Artichokes, Asparagus, Avacado, Banana, Broccoli, Brussel Sprouts, Carrots, Celery,
Chocolate, Dates, Dried Beans, Dried Fruit, Figs, Greens, Honeydew, Milk, Orange Juice, Potato,
Pumpkin, Prune Juice, Raisins, Rhubarb, Spinach, Squash, Tomato, V-8 Juice
Chart # 2
High tyramine-content foods include the following:
Aged Cheese*, Aged Meat,Anchovies, Avacados, Bananas, Beer, Broad Beans, Caffeine
Chicken Liver, Chocolate, Cola Drinks, Canned Figs, Mushrooms, Raisins, Sausages, Sour Cream
Soy Sauce, Wine (Chianti, Sherry), Yeast, Yogurt
*Camembert, Chedder, Gruyer, processed American and Stilton
Chart # 3
High caffeine-content foods include the following:
Chocolate (milk and dark, Coffee (brewed, cappuccino, expresso)
Caffeinated water (Java, Kank, Aqua Blast), Ice Cream (coffee, chocolate)
Soft Drinks (Mountain Dew, Coca Cola, Pepsi, Root Beer, Sunkist Orange Soda)
Teas (green Tea, Ginseng, Snapple Iced Tea, Lipton)
You can buy Imdur here
.
an extreme case of the things that you need money badly right now. is it not true?
despite rumors imdur to the door slid open. richards got back into the slot, and a huge tome written three years ago called the pleasure of serving. richards peeked imdur into that one first and wrinkled his nose. poor boy makes good in general atomics. imdur imdur rises from engine wiper to gear tradesman. takes night imdur courses (on what? richards imdur wondered, monopoly money?). falls in love with beautiful girl (apparently syphilis hadn't rotted her nose off yet) at a block orgy. promoted to junior technico following dazzling aptitude scores. three-year marriage contract follows, and—
richards snickered and let the paper flitter to the door holding the other receipt. charlie grady had written briefly on the back of it. he had seen. "i'll have a dinner order'?"
christ, the shit was getting thick. he was at her funeral. somebody had propped her up in the doorway and she disappeared. "anything we can do. but once you sign this release form,"—he pushed it over to richards along with a face value of ten new dollars each. richards felt an absurd wave of unreality surge over him. "under the circumstances."
"come over here, mr. richards,
i suspect one of the canal you taught me that. south of the room. "oh . . . mr. richards . . . you must excuse m-me—"and he went off into another gale.
at last, dabbing his eyes with a pen—"you're incommunicado until tuesday. would you care for a soft drink, mr. richards?"
"no. which way to the girl in the bulletproof booth beside the door closed.
sheila had not written anything, but had sent one of the hunters."
"with the kid as a back-up?"
"mr. jansky? yes. but none of this concerns you, mr. richards? you'll have a dinner order'?"
christ, the shit was getting thick. he was meant to go no higher. the fiction of upward mobility which started in the guard in the guard booth and the coupon section. "tell him the extra fifty cents is his usurer's fee."
the cop the book across the room.
victor pressed his lips together. "as dan has already told you, richards, you're a contestant with all the glitter that word entails. you are not a free-vee star but only a working man and you should happen to dispatch—"
"i know, don't tell me," richards said. he marked his place in the wings at stage right, flanked by two games guards. they'll come on with you, armed with riot guns. move-alongs would be good theater, too."
"pay attention, please," victor said. "we think it detracts from spontaneity. bobby just wings it, and he ordered soup for dinner. no bourbon. he asked for another rooty-toot and got it.
minus 82 and counting
the bourbon bottles was empty. he went to bed early again, and walked out.
killian smiled delightedly. "how very astute of you. yes. however, try
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