7 Most Dangerous Drug and Food Combinations.
Bacon and chocolate. Chili and peanut butter. Some unlikely
combinations end up working well together. But when it comes to diet and
drugs, the wrong pairing can unwittingly turn into a recipe for
disaster.
You don't need a prescription to face these risks--even some common
over-the-counter treatments should warrant more careful attention to
your menu, says Jen Wolfe, Pharm.D., a D.C.-based pharmacist and
consultant with Comprehensive Pharmacy Consulting. Here are seven
dangerous duos to dodge.
1. Limes and cough medicine.
You may have heard not to drink
grapefruit juice with some prescriptions, including cholesterol-lowering
statins. But limes, pomelos, and Seville oranges--although not the
more-common navel and Valencia varieties--also may block an enzyme that
breaks down statins and other drugs, including the cough suppressant
dextromethorphan. Because the medication then builds up in your
bloodstream, the risk for side effects increases, says Mary Ellen
Gullickson, Pharm.D., a pharmacist at Marshfield Clinic in Wisconsin.
With dextromethorphan, this includes hallucinations and sleepiness; in
statins, you may sustain severe muscle damage. These fruits' effects can
linger for a day or longer, so it's best to avoid them and their juices
altogether while taking these drugs. (That doesn't mean you can't eat
to cure. Try these 5 Fruits That Naturally Fight the Cold & Flu,
instead.) And if you're a citrus fiend? Check in with your pharmacist
about potential drug interactions, Gullickson recommends.
2. Dairy products and antibiotics.
Some antibiotics, including
Cipro, bind to calcium, iron, and other minerals in milk-based foods.
"This prevents the absorption of the antibiotics, ultimately decreasing
their ability to fight infections," Gullickson says. When you get a new
prescription for acne or an infection, ask if the drug falls into a
class known as tetracyclines or flouroquinolones. If so, avoid milk,
yogurt, and cheese 2 hours before and after taking the pills. And talk
with your pharmacist about proper timing if you take multivitamins with
minerals--they can have a similar effect, Gullickson says.
3. Smoked meats and antidepressants.
Check the label on your happy
pills. If they belong to a class called monoamine oxidase inhibitors or
MAOIs--brand names Marplan, Nardil, Emsam, or Parnate--combining them
with foods rich in the amino acid tyramine can cause life-threatening
spikes in blood pressure, says Gullickson. Unfortunately, the list of
no-nos includes not only summer sausage and smoked salmon, but also red
wine, sauerkraut, hot dogs, aged cheeses, soy sauce, and draft or
home-brewed beer. The good news? Canned or bottled beer probably won't
hurt you--and MAOIs have largely been replaced by newer-generation
antidepressants, which don't have the same effect on tyramine levels,
says Nicole Gattas, Pharm.D., B.C.P.S., assistant professor of pharmacy
practice at St. Louis College of Pharmacy.
4. Chocolate and Ritalin.
Besides caffeine, chocolate also
contains a stimulant called theobromine, says Tom Wheeler, Pharm.D.,
B.C.P.S., director of pharmacy and pulmonary services at Advocate
Illinois Masonic Medical Center in Chicago. (It's the reason chocolate
harms dogs--canine bodies can't break it down.) Combining all these
stimulants in humans can potentially lead to erratic behavior and
seizures. As with caffeine alone, the risks are largely individual. Your
best bet: Take note of whether you feel more nervous, irritable, or
wired when you combine Ritalin--especially the extended-release
forms--with chocolate. If so, increase the amount of time between
downing your pill and having dessert. Or, lighten up: "The darker the
chocolate, the more caffeine and theobromine it contains," Wheeler says.
5. Apple juice and allergy meds.
Nix the nectar from apples,
oranges, and grapefruits if you take Allegra (fexofenadine) for hay
fever--at least within 4 hours of swallowing the pill, Gullickson
advises. These juices inhibit a peptide that transports the drug from
your gut to your bloodstream. The resulting lack of absorption makes
Allegra up to 70 percent less effective at stopping your sniffling and
sneezing, Wheeler says. Other medications also travel with the help of
the same peptide; lay off these juices while taking the antibiotics
Cipro or Levaquin, the thyroid medication Synthroid, or the allergy and
asthma treatment Singulair, Gullickson says.
6. Cinnamon and warfarin.
People taking the blood-thinning
medication warfarin--prescribed to prevent or treat clots--have long
been warned to keep their intake of vitamin K steady, says Wolfe. This
means you shouldn't change your weekly intake of foods like leafy greens
or broccoli; because vitamin K plays a key role in clotting, doing so
could affect the thickness of your blood. But there's another risk.
Cassia cinnamon, the kind on most American grocery-store shelves,
contains high levels of a compound called coumarin that can thin blood
and potentially cause liver damage, says Eric Newman, M.D., a resident
at Mercy Medical Center in Baltimore. If you're on warfarin, switch to
Ceylon cinnamon instead, he advises. (Find it at gourmet or spice
retailers like Penzeys, where it's $11.29 for 4 ounces).
7. Alcohol and acetaminophen.
Resist the urge to wash down your
Tylenol with a cold one--your body uses the same enzyme to break down
the two substances. It's generally best to put 6 hours between drinking
booze and taking any medicine containing acetaminophen, including
over-the-counter and prescription pain and cold medicines, Gattas says.
But the bigger risks come with time: "If you drink alcohol every day,
it's probably not a good idea to take Tylenol," Wheeler says. Pairing
them regularly can contribute to kidney and liver disease.
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