Medicine-Food Interactions : Hidden Dangers

Most people know that certain drugs don't mix with each other; but there are many foods that interact with medicines too-sometimes with deadly results.

Any medication that is taken by mouth travels through the digestive system in much the same way as food does. So it stands to reason that when a drug is mixed with a food, each can alter the way the body metabolizes the other. Some drugs interfere with the body's ability to absorb nutrients; similarly, foods can lessen or increase the impact of a drug. Medications may affect the digestive system itself; for example, aspirin and antibiotics are among the many that irritate the stomach and intestines. Others, such as insulin and similar protein-based hormones, are destroyed if they pass through the digestive system; therefore, they must be injected directly into the bloodstream. Still others are given by injection or absorbed into the bloodstream through a skin patch to bypass being metabolized by the liver, thereby reducing the risk of some side effects.

Mixing monoamine oxidase (MAO) inhibitors-a class of medications used to treat depression-with foods high in tyramine, an amino acid, produces one of the most dramatic and dangerous food-drug interactions. Symptoms, which can occur within minutes of ingesting such foods while taking an MAO inhibitor, include a rapid rise in blood pressure, a severe headache, and perhaps collapse and even death. (Foods high in tyramine include aged cheese, chicken liver, Chianti and certain other red wines, yeast extracts, bologna and other processed meats, dried or pickled fish, legumes, soy sauce, ale, and beer.)

While some drugs should be taken between meals when the stomach is empty, many others should be con-sumed with foods. The composition of the meal, however, may affect the speed with which the medication is absorbed into the body. Griseofulvin, a common antifungal medication, is better absorbed if it's consumed with fatty foods.

In contrast, an antibiotic should not be taken with fat, which increases the time the drug is in the stomach and exposed to stomach acids that can reduce its efficacy. Most antibiotics should be taken between meals; for those that are ingested with food, lean meat and poultry are generally good food selections, because protein appears to speed up the metabolism of these medications.

Dietary fiber also affects drug absorption. Pectin and other soluble fibers slow down absorption of the painkiller acetaminophen; bran and other insoluble fibers have a similar effect on digoxin, a major heart medication.

The effectiveness of antihy-pertensive drugs is reduced by eating large amounts of natural licorice or salty foods, both of which promote fluid retention, thereby raising blood pressure. Certain vitamins and miner-als impact on medications too.

Large amounts of broccoli, spinach, and other green leafy vegetables high in vitamin K, which promotes the formation of blood clots, can counteract the effects of heparin, warfarin, and other drugs given to prevent clotting.

Another situation to consider is that some dietary components increase the risk of side effects. Theophylline. a medication administered to trear asthma, contains xanthines, which are also found in tea, coffee, chocolate, and other sources of caffeine. Consuming large amounts of these substances while taking theophylline increases the risk of drug toxicity.

Alcohol is a drug that interacts with almost every medication, especially antidepressants and other drugs that affect the brain and nervous system. Doctors generally advise that patients abstain from alcohol while taking any medication; this recommendation includes over the counter (OTC) drugs.

Beneficial Foods

Some foods help prevent unwanted drug side effects. Many antihyperten-sive drugs, for example, deplete the body's reserves of potassium, an electrolyte that maintains the body's fluid balance and is also essential for nerve and muscle function. Thus, people taking diuretics to treat high blood pressure should eat extra bananas citrus and dried fruits, tomatoes, and other potassium rich foods to prevent the diuretic from depleting the body's reserves of this essential mineral.

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