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Leo Galland, M.D.

Leo Galland, M.D.

Posted: December 25, 2010 09:34 AM

Whether you are heading home for the holidays or traveling to a new place, you might wind up eating and drinking all sorts of different food and drink from the usual.

All that eggnog and other treats could throw your medications out of whack, because what you eat can interact with the pills you're taking.

Food and drink can effect how your body absorbs, metabolizes or excretes medications.

The dairy in that eggnog, for example, could decrease how certain drugs are absorbed.

Some foods impact how the liver metabolizes drugs, boosting or decreasing the level of the drug. Think about that when you unwrap that holiday gift carton of grapefruits, because this fruit can interfere with the breakdown of some drugs, causing higher blood levels of those drugs.

So to help get your through the season, I've provided some examples below of holiday food and drug interactions to watch out for. Of course there are many more interactions between food and drugs, and even interactions with sunlight.

To learn more about how food, drugs and supplements interact, try my health application Pill Advised.

Foods With Potential Bad Medication Interactions:

Cranberries

The effect of blood thinner Coumadin (warfarin) is increased by consuming cranberries.
There has been research that indicates cranberry sauce or juice, taken in large quantities can cause a hemorrhage in people who take Coumadin (warfarin).

Chocolate

Is there some dark force lurking in that dark chocolate? The stimulant theobromine, which is also a diuretic.

Theobromine can decrease the effect of sleep medications such as Ambien (zolpidem).

Blood pressure can be boosted by theobromine, interfering with the effects of medication.

It can also boost the effect of stimulants such as those found in cold remedies, for instance pseudoephedrine.

So that innocent hot cocoa, or those chocolate truffles, could end up throwing your medications a curveball.

Dairy Products

Dairy contains calcium, which can interfere with how some antibiotics are absorbed. Two examples are the tetracyclines and quinolones. When you reach for that creamy dip or other dairy treat, consider the medications you are taking. Generally, take antibiotics at least two hours away from eating calcium rich food or drink.

Grapefruit

Grapefruit and grapefruit juice are all-stars when it comes to running interference with medications.

This sweet and tart fruit has chemicals that can interfere with a variety of well-known drugs, for example Valium (diazepam), Zoloft (sertraline), and Prozac (fluoxetine).

Grapefruit also interferes with many cholesterol-lowering drugs, called statins.

Why Mixing Alcohol and Medications Is a Bad Idea

You knew this one was coming. Alcohol and drugs can be a very bad mix. Combining the two can be unhealthy or even dangerous. Here is a quick look at just a few ways alcohol and drugs don't mix.

Alcohol and Acid Suppressing Medications

Mixing alcohol with some acid suppressing drugs is a bad idea. Acid suppressors can block the metabolism of alcohol, boosting blood alcohol levels. This puts the drinker at higher risk of getting drunk, and alcohol poisoning. If you're busy toasting the holidays, skip the acid suppressors such as Zantac or Tagamet.

Alcohol and Tylenol

Mixing alcohol with Tylenol, Midol or cold medicines containing acetaminophen can damage your liver.

Alcohol and Aspirin or NSAID's

Aspirin and popular non-steroidal anti-inflammatory drugs like Advil, Motrin or Aleve, when combined with alcohol use, increase the risk of gastrointestinal bleeding.

Alcohol and Pain Killers

Alcohol boosts the effect of pain medications, sedatives and even antihistamines.

Alcohol and Diabetes Drugs

Medications taken by diabetics for reducing blood sugar such as Metformin interact badly with alcohol.

Supplements can also interact with medications. Here's a video I made about Bad Drug Supplement Interactions:


Wishing You a Happy, Healthy Holiday,

Leo Galland, MD

Important: Share this valuable health information with your friends by forwarding this article to them, and sharing on Facebook.

Leo Galland, MD is a board-certified internist, author and internationally recognized leader in integrated medicine. Dr. Galland is the founder of Pill Advised, a web application for learning about medications, supplements and food. Sign up for FREE to discover how your medications and vitamins interact. Watch his videos on YouTube and join the Pill Advised Facebook page.

References:

Draganov et al, "Alcohol-acetaminophen syndrome." Postgrad Med 2000; 107:189-95.

Kaufman et al, "The risk of acute major upper gastrointestinal bleeding among users of aspirin and ibuprofen at various levels of alcohol consumption." Am J Gastroenterol 1999; 94: 3189-96.

Zimatkin & Anichtchik, "Alcohol-histamine interactions." Alcohol 1999; 34: 141-47.

Bailey et al, "Grapefruit juice-drug interactions." Br J Clin Pharmacol 1998; 46: 101-10.

Jelski W, Orywal K, Szmitkowski M. Pol Merkur Lekarski. 2008 Dec;25(150):531-3. "Effects of H2-blockers on alcohol dehydrogenase (ADH) activity"

This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine or the provision of health care diagnosis or treatment, (iii) or the creation of a physician--patient relationship. If you have or suspect that you have a medical problem, contact your doctor promptly.

 
 
 

Follow Leo Galland, M.D. on Twitter: www.twitter.com/Pilladvised/

 
 
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05:26 PM on 12/27/2010
Mixing alcohol and any medication, including over-the-counter ones, is extremely dangerous. Acetaminophen, the active ingredient in Tylenol, has been linked to liver failure and death when mixed with alcohol. Education is the best method of prevention, great article. Regards, TM http://www.liverfailurefromtylenol.com/
justobserve
Not left nor right or center. Just a free thinker!
10:45 AM on 12/27/2010
Help: Does goji berry interact with any medicaiton?
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DSevere
Deviant mind
01:26 AM on 12/27/2010
The punchline is, really examine the drugs you're taking. There are so many drugs where I hear the side effects on TV commercials and think w t f? "this will improve your depression but you might have seizures, impotence, delusional thoughts, heart attack and cancer..." that kind of thing. Where the only rational answer is, "thanks, but I'll just deal with being depressed!"
10:38 PM on 12/27/2010
Seriously, I always think that too! I saw a Lunesta commercial before, where one of the side effects could be suicidal thoughts. I'd rather be awake than suicidal.
01:29 PM on 12/29/2010
My husband and I make a game out of counting how many side effects are listed in those commercials. So far, the winner hands down is the medication for dry eye. Seriously!

The pharma industry is poisoning us with a smile and catchy commercials, and laughing all the way to the bank. I still get a kick out of the ones that say "ask your doctor if you need ______". As if doctors are just drug dealers with pretty offices.
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DSevere
Deviant mind
02:40 PM on 12/29/2010
The one that gets me is Accutane, which was pulled off the market. You don't have acne any more, but you might have Crohn's (sp?) disease or another major-league chronic gastric problem.

There's also an anti-arthritis drug where one of the side effects is possible sudden d eath...
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Mik McAllister
05:40 PM on 12/26/2010
There are a lot of food and drug interactions. One of my ex-roommates could not eat broccoli because it interfered with one of his medications.

Another thing to be wary of is similarities between certain foods and drugs. For example, if you are allergic to rye grain, do not take migraine medication. Migraine medication uses synthesized ergot. Ergot is a fungus/mold that occurs on rye.

I had a roommate who was allergic to rye, and had bad migraines. Very scary to see that kind of allergic reaction in progress.
08:50 PM on 12/25/2010
Pro tip: METRONIDAZOLE (Flagyl) + alcohol, HUGE no-no. I know they say "no alcohol" with many things because of increased sedation and whatnot, but just research what this particular interaction will do. No fun for patients not heeding this.
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ljkcan
I don't let geographical borders limit my thinking
11:07 PM on 12/25/2010
Flagyl is the most vile drug I have ever taken, gives a whole new meaning to "the cure is worse than the ailment".
07:19 PM on 12/25/2010
Don't take the drugs then.
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02:07 PM on 12/25/2010
A friend of mine died of liver failure within hours after taking Tylenol when drinking beer. He was only 42. It's a deadly risk. That happened just before the warnings about mixing Tylenol with booze came out.
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VanessaFas
01:43 PM on 12/25/2010
Good to know. The grapefruit interaction is actually for many medications, which is strange, but necessary to heed.
08:48 PM on 12/25/2010
It's not that strange. The body has metabolizing enzymes called CYPs. Some of them are very concentrated in the liver, other elsewhere. CYP 3A4 happens to metabolize (meaning, changing them chemically to make them more excretable from the body) a lot of drugs, which is why it's involved in so many drug interactions.
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Margie Kronewitter
11:26 AM on 12/25/2010
Dr. Galland is a deep, "out of the box" thinker. His books are also SUPER. Happy Hollidays, Doc.
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