properly to ensure that they are safe and
ingredients that interact with the human body
in different ways, and diet and lifestyle can
sometimes have a significant impact on a drugs
ability to work in the body. Certain foods,
beverages, alcohol, caffeine, and even cigarettes
can interact with medicines. This may make
them less effective or may cause dangerous side
When you take medicine, be sure to follow
your doctors instructions carefully to obtain the
maximum benefit with the least risk. Changes
in a medicines effect due to an interaction with
food, alcohol or caffeine can be significant;
however, there are many individual factors that
influence the potential for such variations, like
dose, age, weight, sex, and overall health.
possible interactions between many common
prescription and nonprescription (over-the-
counter) medications with food, alcohol and
caffeine. But this brochure should not replace the
advice from your physician, pharmacist, or other
health care professional. If you have any
questions or concerns about possible drug
Make sure your doctor and pharmacist know
about every drug you are taking, including
supplements such as vitamins, minerals and
herbals. If you have problems or experience side
effects related to medication, call your health care
provider right away. It is also important to
remember that many drugs interact with other
drugs and may cause serious medical conditions.
In this brochure, the generic (nonproprietary)
name for each drug is stated first. Brand names
are in full capital letters and represent only some
ALLERGIES
Antihistamines are used to relieve or prevent the
symptoms of colds, hay fever, and allergies. They
limit or block histamine, which is released by the
body when we are exposed to substances that
cause allergic reactions. Antihistamines are
available with and without a prescription (over-
the-counter). These products vary in their ability
InteractionFood: It is best to take prescription antihistamines
Alcohol: Some antihistamines may increase
ARTHRITIS AND PAIN
ANALGESIC/ANTIPYRETICThey treat mild to moderate pain and fever.
InteractionsFood: For rapid relief, take on an
bodys absorption of acetaminophen.
Alcohol: Avoid or limit the use of alcohol
because chronic alcohol use can increase your
risk of liver damage or stomach bleeding. If you
consume three or more alcoholic drinks per day
talk to your doctor or pharmacist before taking
DRUGS (NSAIDS)NSAIDs reduce pain, fever, and inflammation.
InteractionFood: Because these medications can irritate the
stomach, it is best to take them with food or milk.
Alcohol: Avoid or limit the use of alcohol
because chronic alcohol use can increase your
risk of liver damage or stomach bleeding. If you
consume three or more alcoholic drinks per day
talk to your doctor or pharmacist before taking
these medications. Buffered aspirin or enteric
coated aspirin may be preferable to regular
aspirin to decrease stomach bleeding.
CORTICOSTEROIDSThey are used to provide relief to inflamed areas
of the body. Corticosteroids reduce swelling and
itching, and help relieve allergic, rheumatoid,
InteractionFood: Take with food or milk to decrease stomach
NARCOTIC ANALGESICSNarcotic analgesics are available only with a
prescription. They provide relief for moderate
to severe pain. Codeine can also be used to
suppress cough. Some of these medications can
be found in combination with non-narcotic drugs
such as acetaminophen, aspirin, or cough syrups.
Use caution when taking these medications: take
them only as directed by a doctor or pharmacist
because they may be habit forming and can cause
serious side effects when used improperly.
InteractionAlcohol: Avoid alcohol because it increases the
sedative effects of the medications. Use caution
when motor skills are required, including
BRONCHODILATORSBronchodilators are used to treat the symptoms
of bronchial asthma, chronic bronchitis and
emphysema. These medicines open air passages
to the lungs to relieve wheezing, shortness of
InteractionsFood: The effect of food on theophylline
medications can vary widely. High-fat meals
may increase the amount of theophylline in the
decrease it. It is important to check with your
pharmacist about which form you are taking
depending on the dose form (e.g., regular release,
sustained release or sprinkles) For example, food
has little effect on Theo-Dur and Slo-Bid, but
food increases the absorption of Theo-24 and
Uniphyl which can result in side effects of
nausea, vomiting, headache and irritability.
Food can also decrease absorption of products
like Theo-Dur Sprinkles for children.
Caffeine: Avoid eating or drinking large amounts
of foods and beverages that contain caffeine (e.g.,
chocolate, colas, coffee, tea) because both oral
bronchodilators and caffeine stimulate the
theophylline medications because it can increase
the risk of side effects such as nausea, vomiting,
CARDIOVASCULAR DISORDERS
There are numerous medications used to treat
cardiovascular disorders such as high blood
pressure, angina, irregular heart beat, and high
cholesterol. These drugs are often used in
combination to enhance their effectiveness.
conditions. For example, beta blockers can be
used to treat high blood pressure, angina, and
irregular heart beats. Check with your doctor
or pharmacist if you have questions on any of
DIURETICSSometimes called “water pills,” diuretics help
eliminate water, sodium, and chloride from the
body. There are different types of diuretics.
InteractionFood: Diuretics vary in their interactions with
food and specific nutrients. Some diuretics cause
loss of potassium, calcium, and magnesium.
Triamterene, on the other hand, is known as a“potassium-sparing” diuretic. It blocks the
kidneys’ excretion of potassium, which can cause
hyperkalemia (increased potassium). Excess
potassium may result in irregular heartbeat and
heart palpitations. When taking triamterene,
avoid eating large amounts of potassium-rich
foods such as bananas, oranges and green leafy
vegetables, or salt substitutes that contain
BETA BLOCKERSBeta blockers decrease the nerve impulses to the
heart and blood vessels. This decreases the heart
rate and the work load of the heart.
InteractionAlcohol: Avoid drinking alcohol with
combination lowers blood pressure too much.
NITRATESNitrates relax blood vessels and lower the
InteractionAlcohol: Avoid alcohol because it may add to
the blood vessel-relaxing effect of nitrates and
result in dangerously low blood pressure.
(ACE) INHIBITORSACE inhibitors relax blood vessels by preventing
angiotensin II, a vasoconstrictor, from being
InteractionsFood: Food can decrease the absorption of
captopril and moexipril. So take captopril and
moexipril one hour before or two hours after
meals. ACE inhibitors may increase the amount
of potassium in your body. Too much potassium
can be harmful. Make sure to tell your doctor if
diuretics (water pills) that may increase the
amount of potassium in your body. Avoid eating
large amounts of foods high in potassium such
as bananas, green-leafy vegetables, and oranges.
HMG-COA REDUCTASE INHIBITORSOtherwise known as “statins,” these medications
are used to lower cholesterol. They work to
reduce the rate of production of LDL (bad
cholesterol). Some of these drugs also lower
triglycerides. Recent studies have shown that
pravastatin can reduce the risk of heart attack,
stroke, or miniature stroke in certain patient
InteractionAlcohol: Avoid drinking large amounts of
alcohol because it may increase the risk of liver
Food: Lovastatin (Mevacor) should be taken
with the evening meal to enhance absorption.
ANTICOAGULANTSAnticoagulants help to prevent the formation of
InteractionsFood: Vitamin K produces blood-clotting
substances and may reduce the effectiveness of
anticoagulants. So limit the amount of foods
high in vitamin K (such as broccoli, spinach, kale,
turnip greens, cauliflower, and brussel sprouts).
High doses of vitamin E (400 IU or more ) may
prolong clotting time and increase the risk of
bleeding. Talk to your doctor before taking
INFECTIONS
ANTIBIOTICS AND ANTIFUNGALSMany different types of drugs are used to treat
infections caused by bacteria and fungi. Some
general advice to follow when taking any such
Tell your doctor about any skin rashes you
may have had with antibiotics or that you
get while taking this medication. A rash can
be a symptom of an allergic reaction, and
allergic reactions can be very serious.
Tell your doctor if you experience diarrhea.
If you are using birth control, consult with
Be sure to finish all your medication even if
InteractionFood: Take on an empty stomach, but if it upsets
InteractionsFood: Take on an empty stomach one hour
before or two hours after meals. If your stomach
gets upset, take it with food. However, avoid
calcium-containing products like milk, yogurt,
vitamins or minerals containing iron, and
antacids because they significantly decrease
Caffeine: Taking these medications with caffeine-
containing products (e.g., coffee, colas, tea, and
chocolate) may increase caffeine levels, leading
InteractionFood: Take on an empty stomach one hour
before or two hours after meals. If your stomach
InteractionFood: Take on an empty stomach one hour
before or two hours after meals. If your stomach
InteractionFood: Take on an empty stomach one hour
before or two hours after meals. If your stomach
InteractionFood: Take on an empty stomach one hour
before or two hours after meals. If your stomach
gets upset, take with food. However, it is
products, antacids and vitamins containing iron
because these can interfere with the medications
InteractionAlcohol: Avoid drinking alcohol or using
medications that contain alcohol or eating foods
prepared with alcohol while you are taking
metronidazole and for at least three days after
you finish the medication. Alcohol may cause
InteractionFood: It is important to avoid taking these
medications with dairy products (milk, cheeses,
medications that contain alcohol, or eating foods
prepared with alcohol while you are taking
ketoconazole/NIZORAL and for at least three
days after you finish the medication. Alcohol
may cause nausea, abdominal cramps, vomiting,
MOOD DISORDERS
Depression, Emotional, and AnxietyDisordersDepression, panic disorder and anxiety are a few
examples of mood disorders -- complex medical
conditions with varying degrees of severity.
When using medications to treat mood disorders
instructions. Remember to take your dose as
directed even if you are feeling better, and do
not stop unless you consult your doctor. In some
cases it may take several weeks to see an
MONOAMINE OXIDASE (MAO) INHIBITORSSome examples are:
InteractionsMAO Inhibitors have many dietary restrictions,
and people taking them need to follow the
dietary guidelines and physicians instructions
very carefully. A rapid, potentially fatal increase
in blood pressure can occur if foods or alcoholic
beverages containing tyramine are consumed
Alcohol: Do not drink beer, red wine, other
alcoholic beverages, non-alcoholic and reduced
Food: Foods high in tyramine that should be
American processed, cheddar, blue, brie,
Beef or chicken liver; cured meats such as
Avocados, bananas, yeast extracts, raisins,
Broad (fava) beans, ginseng, caffeine-con-
taining products (colas, chocolate, coffee
InteractionsAlcohol: May impair mental and motor
Caffeine: May cause excitability, nervousness,
and hyperactivity and lessen the anti-anxiety
InteractionsAlcohol: Although alcohol may not significantly
interact with these drugs to affect mental or
motor skills, people who are depressed should
Food: These medications can be taken with or
STOMACH CONDITIONS
Conditions like acid reflux, heartburn, acid
indigestion, sour stomach, and gas are very
common ailments. The goal of treatment is to
relieve pain, promote healing and prevent the
irritation from returning. This is achieved by
either reducing the acid the body creates or
protecting the stomach from the acid. Lifestyle
and dietary habits can play a large role in the
symptoms of these conditions. For example,
smoking cigarettes and consuming products that
contain caffeine may make symptoms return.
InteractionsAlcohol: Avoid alcohol while taking these
products. Alcohol may irritate the stomach and
make it more difficult for the stomach to heal.
Food: Can be taken with or without regard to
Caffeine: Caffeine products (e.g., cola, chocolate,
tea and coffee) may irritate the stomach. DRUG-TO-DRUG INTERACTIONS
Not only can drugs interact with food and
alcohol, they can also interact with each other.
Some drugs are given together on purpose for
an added effect, like codeine and acetaminophen
interactions may be unintended and harmful.
Prescription drugs can interact with each other
or with over-the-counter (OTC) drugs, such as
acetaminophen, aspirin, and cold medicine.
Likewise, OTC drugs can interact with each
increased or decreased. For example, tricyclic
antidepressants such as amitriptyline (ELAVIL),
or nortriptyline (PAMELOR) can decrease the
ability of clonidine (CATAPRES) to lower blood
pressure. In other cases, the effects of a drug can
increase the risk of serious side effects. For
example, some antifungal medications such as
(NIZORAL) can interfere with the way some
cholesterol-lowering medications are broken
down by the body. This can increase the risk of a
medications to reduce the risk of drug-drug
interactions. For example, two cholesterol-
and fluvastatin (LESCOL), are less likely to
interact with antifungal medications. Be sure to
prescription and OTC that you are taking.
This brochure was produced in cooperation with
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Comunicación dirigida a los profesionales sanitarios sobre la asociación de clopidogrel con la hemofilia adquirida. Los laboratorios farmacéuticos titulares de medicamentos con clopidogrel actualmente comercializados, deseamos comunicarle una información de seguridad importante en relación con el uso de este medicamento. Se han notificado un número reducido de casos de hemofilia adquir