Food & Medication Interactions Part 3

Last week, we began educating about the importance of knowing your medications and the possibilities of food/medication interactions. Medications can be affected by many different things such as age, weight, medical conditions, other medications, as well as food and drinks. The best way to understand your medications is to ask your physician at the time they are prescribed or your local pharmacist for over-the-counter medications. We are only providing a general list of interactions, but there are many more and the effects can be different for different people. We have already touched on antihistamines, arthritis, pain, and fever analgesics/antipyretics, NSAIDS, narcotics, bronchodilators, and cardiovascular medications such as ACE Inhibitors, Beta Blockers, Diuretics, Glycosides, Lipid-Altering agents, Vasodilators/ Nitrates, and Vitamin K Agonists/ Anticoagulants, but let’s take a look at a few more.

Depression, bipolar disorder, general anxiety disorder, social phobia, panic disorder, and schizophrenia are a few examples of common psychiatric (mental) disorders. Use the amount of medicine that your doctor tells you to use, even if you are feeling better. In some cases it can take several weeks before you see your symptoms get better. Don’t stop these medicines until you talk to your doctor. You may need to stop your medicine gradually to avoid getting side effects. Some of these medicines can affect your thinking, judgment, or physical skills. Some may cause drowsiness and can affect how alert you are and how you respond. Don’t do activities like operating machinery or driving a car, until you know how your medicine affects you.

Anti-Anxiety and Panic Disorder Medicines- Examples of these include Alprazolam (Xanax), Clonazepam (Klonopin), Diazepam (Valium), and Lorazepam (Ativan). Avoid alcohol. These medications act as sedatives, binding with the brain’s natural tranquilizers to calm you down. But when you mix these drugs with alcohol, the side effects intensify, and can cause you to feel lightheaded, sleepy, and forgetful.
Antidepressants- Antidepressants treat depression, general anxiety disorder, social phobia, obsessive-compulsive disorder, some eating disorders, and panic attacks. The medicines below work by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. Never stop an antidepressant medicine without first talking to a doctor. You may need to stop your medicine gradually to avoid getting side effects. Examples include Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft). You can take these medicines on a full or empty stomach. Swallow Paxil whole; don’t chew or crush it. Avoid alcohol. Alcohol can add to the side effects caused by these medicines, such as drowsiness.
Monoamine Oxidase Inhibitors (MAOIs)- MAOIs treat depression in people who haven’t been helped by other medicines. They work by increasing the amounts of certain natural substances that are needed for mental balance. Examples include Phenelzine (Nardil) and Tranylcypromine (Parnate). Avoid foods and drinks that contain tyramine such as aged cheeses, chocolate, cured meats and alcoholic drinks. Normally, the body controls tyramine levels with an enzyme called monoamine oxidase, but the MAOI antidepressant blocks that enzyme. Tyramine levels then increase and can cause a sudden, dangerous increase in your blood pressure. Follow your doctor’s directions very carefully. Many drinks with caffeine also contain tyramine. Ask your doctor if you should avoid or limit caffeine. Don’t drink alcohol while using these medicines. Many alcoholic drinks contain tyramine, including tap beer, red wine, sherry, and liqueurs. Tyramine also can be in alcohol-free and reduced alcohol beer. Alcohol also can add to the side effects caused by these medicines.
Antipsychotics- Antipsychotics treat the symptoms of schizophrenia and acute manic or episodes from bipolar disorder. People with schizophrenia may believe things that are not real (delusions) or see, hear, feel, or smell things that are not real (hallucinations). They can also have disturbed or unusual thinking and strong or inappropriate emotions. These medicines work by changing the activity of certain natural substances in the brain. Examples include Aripiprazole (Abilify), Olanzapine (Zyprexa), Quetiapine (Seroquel), and Risperidone (Risperdal). Some of these medications can be taken with food and caffeine while others cannot. Ask your physician for details. Avoid alcohol. Alcohol can add to the side effects caused by these medicines, such as drowsiness.
Sedatives and Hypnotics (Sleep Medicines)- Sedative and hypnotic medicines treat people who have problems falling asleep or staying asleep. They work by slowing activity in the brain to allow sleep. Some of these medicines you can buy over-the-counter and some you can only buy with a prescription. Tell your doctor if you have ever abused or have been dependent on alcohol, prescription medicines, or street drugs before starting any sleep medicine. You could have a greater chance of becoming addicted to sleep medicines. Examples include Eszopiclone (Lunesta) and Zolpidem (Ambien). To get to sleep faster, don’t take these medicines with a meal or right after a meal. Don’t drink alcohol while using these medicines. Alcohol can add to the side effects caused by these medicines.
Bipolar Disorder Medicines- People with bipolar disorder experience mania (abnormally excited mood, racing thoughts, more talkative than usual, and decreased need for sleep) and depression at different times during their lives. Bipolar disorder medicines help people who have mood swings by helping to balance their moods. Examples include Carbamazepine (Tegretol), Divalproex sodium (Depakote), Lamotrigine (Lamictal), Lithium (Lithobid). Take Depakote with food if it upsets your stomach. Take Lithobid immediately after meal or with food or milk to avoid stomach upset. Lithobid can cause you to lose sodium, so maintain a normal diet, including salt; drink plenty of fluids (eight to 12 glasses a day) while on the medicine. Avoid alcohol. Alcohol can add to the side effects caused by these medicines, such as drowsiness.

Always read the label information carefully before you use medications. If you have any questions, don’t hesitate to ask a doctor or pharmacist. Check back for part 4 of food/medication interactions.

Source: https://www.fda.gov/downloads/Drugs/.../.../UCM229033.pdf