2024-11-12 15:50:00
Did you know that certain foods or drinks can go very badly with the treatment(s) you are taking? In most cases, it is recommended to let two to four hours between taking the medication and consuming the food or juice in question. In some cases, medications are incompatible because of an interaction.
By what mechanisms can a food interact with a drug?
For example, by altering the natural capacity of the liver to break down drugs.
Either it increases it, and the concentration of the drug in the blood will be lower than expected, hence a risk that it will not be effective or not effective enough, explains Professor Francesco Salvo, head of the unit. of pharmacovigilance at Bordeaux University Hospital.
« Or, conversely, it reduces itand the drug will then be more concentrated than expected in the blood, which increases its toxicity and its risk of adverse effects.
Foods and medications can also have a antagonistic actionthe effect of some opposing that of others.
Always read the medication instructions
Whether very high or low, the risk of interaction of the drug with certain foods must must be indicated on the instructions. Hence the importance of read it carefully or, if in doubt, seek advice from your doctor or pharmacist.
Why is grapefruit often cited at the top of the risky foods?
Because it increases the toxicity and adverse effects of many medications, whether fresh whole, in the form of juice, or present in preparations (jams, desserts, etc.).
« It should absolutely be avoided when you are on an immunosuppressantmainly due to a risk of serious kidney damage,” specifies Professor Salvo. “As with simvastatin and atorvastatin, prescribed against cholesterol, because their combination can cause severe muscle damage which can be complicated by renal failure.”
Its consumption is also not recommended if taking anti-arrhythmic treatment or against the erectile dysfunction (Spedra, Levitra) or even certain antidepressants. However, as this list is not exhaustive, it is better to read the instructions for the medication you are taking.
Food and drug interactions: what about other citrus fruits?
Better avoid them when taking nonsteroidal anti-inflammatory drugs or NSAIDs (ibuprofen, ketoprofen, diclofenac, etc.). “NSAIDs in fact increase gastric acidity at the same time as they reduce the production of mucus which protects the stomach wall,” explains our expert. “As citrus fruits are also acidic, you increase the risk of heartburn and gastric reflux by associating them.
What foods should you limit when taking an anticoagulant?
Be careful with richest in vitamin K :
Aromatic herbs; Cabbage family including Brussels; Wakamé; Spinach; Watercress; Soya and rapeseed oils…
They can in fact reduce the effectiveness of anticoagulants from the antivitamin K family (Coudamine, Préviscan, etc.), indicated for the prevention or treatment of thromboses and embolisms, and which act by reducing the activity of this vitamin which is very involved in coagulation.
“It is not a question of eliminating these foods, but of consume them occasionally, once or twice a month, in small quantities and without combining them during the same meal,” recalls the doctor.
Before, during, or outside of meals: why does it matter?
“A meal can alter the absorption, therefore the effectiveness, of certain medications which already have low bioavailability, such as certain anticancer drugs or tacrolimus, which must be taken 1 hour before or 2 hours after a meal,” explains Professor Salvo. ” Sometimes, the meal plays a ‘barrier’ role and protects against heartburn, such as that possibly induced by anti-inflammatories. Finally, certain medications are better absorbed if taken before meals, such as iron; or even before breakfast, like levothyroxine.”
Is licorice really not recommended when taking antihypertensive medication?
Yes ! “It contains a compound, glycyrrhizine, Who increases blood pressure and can therefore, if one is under antihypertensive treatmentreduce its effectiveness.
And it’s not just the confectionery which contain licorice: it is also present, as recalled on the Health Insurance website, in:
Bakery products, ice creams and sorbets, savory products… due to its softening properties; Cocoa-based as a flavor enhancer; In certain aperitifs (pastis with or without alcohol, ouzo, raki) or in beers, as a foaming agent, coloring; To reduce bitterness.
What medications should not be combined with foods rich in calcium?
Medications for osteoporosis
To prevent osteoporosis, supplements can strengthen our bones. But be careful with biphosphonatesprescribed after menopause for limit the risk of fracture ! “Combined with the calcium“, by chemical reaction they form heavy precipitates which are no longer absorbable by the body and are directly eliminated via the intestines, which greatly reduces the effectiveness of the drug”, says Alina Moyon, doctor of pharmacy.
Rest assured, dairy products and medications against osteoporosis are not incompatible, you simply need to take bisphosphonates in the morning on an empty stomach, at least 30 minutes before meals and at least two hours away from other medications or food supplements, with a glass of lightly mineralized water (for example tap water).
Antibiotics and dairy products
Calcium in dairy products can harm the body’s ability tocompletely absorb the tetracycline antibiotic. In fact, milk reduces the action of certain antibiotics (tetracycline, ciprofloxacin). It is also suspected of limiting the effectiveness of aspirin by promoting its elimination. In general, tetracycline works best if taken 1 hour before or 2 hours after a meal.
Interactions between food and drugs: what about drinks?
Tea, especially black because it is rich in tannins, can hinder iron absorption.
Thus, as a precautionary principle, we advise people supplemented with iron to favor green or white tea, and to drink it 2 or 3 hours after their treatment. Professor Francesco Salvo, head of the pharmacovigilance unit at Bordeaux University Hospital
As for the‘alcohol, it can interact with many medications: sleeping pills, antidepressants, antihistamines, opiate analgesics, non-steroidal anti-inflammatories, paracetamol, hypoglycemics, etc. to name just a few. “Reason why better to avoid it when you are under treatment, whatever it is ».
Why are coffee and certain medications a bad combination?
Caffeine consumption should be avoided if you take certain antibiotics of the fluoroquinolone family (enoxacin, ciprofloxacin, norfloxacin). “This family slows down the metabolism of caffeine, increasing its concentration and its effects in the body,” explains Dr. Marie Miremont-Salamé, pharmacologist at the Bordeaux Regional Pharmacovigilance Center. Depending on your sensitivity to caffeine, you may experience palpitations, tremors, sweating, etc. These types of antibiotics are most often prescribed to treat cystitis.
You also need to be careful when taking paracetamol. Whether from coffee, tea (theine) or cola drinks, caffeine increases the absorption of this medication and overdose can cause hepatitis.
Finally, it also goes very poorly with asthma medications that contain theophylline. Sweating and palpitations may appear if you combine the two.
Better to reduce your usual consumption of café during treatment, especially if you notice these effects.
Sources
Interviews with Professor Francesco Salvo, head of the pharmacovigilance unit at Bordeaux University Hospital, with Alina Moyon, doctor of pharmacy, and with Dr Marie Miremont-Salamé, pharmacologist at the Bordeaux Regional Pharmacovigilance Center.
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#Foods #medications #interactions #aware
**Interview with Professor Francesco Salvo: Understanding Food and Medication Interactions**
*Date: November 12, 2024*
*Location: Bordeaux University Hospital*
**Interviewer:** Thank you for joining us today, Professor Salvo. Let’s start with a fundamental question: Why is it important to be aware of food and medication interactions?
**Professor Salvo:** It’s essential because certain foods or drinks can significantly alter how our bodies process medications. As just one example, consuming grapefruit can increase the toxicity of various drugs, potentially leading to serious side effects. Therefore, understanding these interactions can ensure the effectiveness of treatment regimens and safeguard patients’ health.
**Interviewer:** You mentioned grapefruit specifically. What makes it particularly dangerous when taking medications?
**Professor Salvo:** Grapefruit contains compounds that affect liver enzymes responsible for drug metabolism. When you consume it, these enzymes are inhibited, leading to higher drug concentrations in the blood, which can increase the risk of adverse effects. It’s particularly problematic with immunosuppressants and cholesterol medications.
**Interviewer:** What about other citrus fruits? Are they just as risky?
**Professor Salvo:** Other citrus fruits can also pose risks, particularly when taken with NSAIDs like ibuprofen. These drugs increase stomach acidity, and combining them with acidic foods can exacerbate issues like heartburn and gastric reflux.
**Interviewer:** That’s insightful. Are there any specific dietary considerations for patients taking anticoagulants?
**Professor Salvo:** Yes, patients should be cautious with foods rich in vitamin K, like leafy greens and certain oils, as they can interfere with the effectiveness of anticoagulants. It’s not about elimination; rather, it’s about moderation and timing their consumption to minimize impact.
**Interviewer:** Many people might not consider how the timing of medication and meals affects absorption. Can you elaborate on this?
**Professor Salvo:** Certainly! Some medications, particularly those that are poorly absorbed, should be taken on an empty stomach or at specific times relative to meals to enhance their effectiveness. For example, medications like iron supplements tend to be better absorbed when taken before meals.
**Interviewer:** Lastly, what should patients know about drinks, like tea or alcohol, in relation to their medications?
**Professor Salvo:** Tea, particularly black tea, can hinder iron absorption, so it’s good practice to wait a couple of hours after taking iron supplements before drinking it. As for alcohol, it can interact with various medications, including sleeping pills and antidepressants, often amplifying side effects, so caution is paramount.
**Interviewer:** Thank you for shedding light on this critical topic, Professor Salvo. It’s clear that awareness of food and medication interactions is crucial for everyone taking prescribed treatments.
**Professor Salvo:** Thank you for having me. Always read medication instructions thoroughly and consult with healthcare providers whenever uncertain. It’s a simple but vital step toward effective treatment.