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Time it right and you’ll be just fine

Photo: M. Vedhan

Food wise Iron supplements are best taken on empty stomach with lime juice

Prof. V.R. Srinivasan, a leading haematologist in Hyderabad, makes sure all his patients on oral blood-thinners get a drug-information pamphlet detailing, among other things, the foods to avoid while using such drugs. His obsession in this matter appears odd even to some doctors, but there is no doubt it saves lives. Vitamin K–rich foods such as leafy vegetables, cabbage and cauliflower, which are otherwise healthful, will nullify the blood-thinning effect of warfarin and nicoumalone (“Acitrom”). In a patient with an artificial heart valve or a clotting tendency, this can lead to a stroke or an embolism. On the other hand, research shows that an excess of onions, garlic and vitamin E will add to the blood-thinning effect.

Although not every food-drug interaction puts lives at risk, it is amazing how often they occur, especially with the commonest of drugs. The following are some common food-drug pitfalls.

Iron: Best to take on an empty stomach with a glass of Vitamin C-rich orange juice or lime juice. Leafy vegetables, milk and dairy products, tea, coffee, beans, eggs, and calcium supplements interfere with its absorption. Taking iron with food is an inferior option: Use it only if iron causes gastritis on empty stomach. Bisphosphonates, proton pump inhibitors such as pantoprazole, and thyroxine should also go down the hatch into an empty stomach.

Calcium supplements: Whole grains and other high-fibre foods, leafy vegetables, tea, coffee, beans, sweet potatoes decrease absorption, but leaving them out is not practical.

Antibiotics: Acidic foods such as oranges, limes, tomatoes, and coffee will hinder the absorption of erythromycin, ampicillin and cloxacillin. Dairy products will prevent the ingress of tetracyclines.

Non-steroidal anti-inflammatory drugs (NSAIDS): These drugs, which include aspirin, ibuprofen, diclofenac and naproxen, can cause gastritis. Taking them with food is safer.

Diuretics: Commonly used in hypertension, heart failure and renal failure. They affect the salt profile of the blood.

Potassium-sparing diuretics like spironolactone can increase potassium levels; one should avoid high-potassium foods when using such drugs. A high-sodium diet will nullify the action of diuretics.

Antidepressants: Avoid banana, cheese, beer, soy sauce and avocados when using antidepressants such as phenelzine and tranylcypromine, which belong to a class called monoamine oxidase inhibitors. The combination of such foods and drugs can cause headache, chest pain, sweating, hypertension, heart attack and stroke.

Avoid alcohol when using metformin, antidepressants, sleeping pills, and NSAIDS. For any other medicine and alcohol, always consult your doctor first.

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