The drug-diet question

Some foods can interfere with the efficacy of a drug and vice versa. If a drug has been prescribed for long-term use, it is best to check their interaction with food

May 19, 2013 07:20 pm | Updated 07:35 pm IST - Kochi

Did you know that drugs and foods interacted? Certain elements or nutrients in food can make a drug unavailable or increase its potency. Similarly, drugs too can make nutrients go unabsorbed, impair digestion or deplete vitamins and minerals. The elderly, the malnourished, those who are drug-dependant and those in cachexia (emaciation from chronic or terminal illnesses) fall into the risk group. Drug nutrient interaction most often goes unnoticed. Learning about it goes a long way in nutrition and drug treatment efficacy. Should a medication be prescribed to you for long term use, it is prudent to double check their interaction with food or other drugs.

Given here are a few common foods or nutrients that interact with drugs:

Calcium and iron supplements, milk: They reduce the absorption of certain antibiotics. Therefore have a gap of two to four hours between taking antibiotics and these.

Citrus fruits: A compound furanocoumarin present in some fruits like grapefruit, pomelos, lime and Seville oranges increase potency of several prescription medications from hypertensive to cancer drugs causing toxicity. Avoid these fruits. Or ask for an alternative drug because these fruits do not interact with all medications belonging to the same class.

Vitamin A, D, E, K: These are absorbed only in the presence of fat. But cholesterol lowering medications that remove fats from the gastrointestinal tract decreases absorption of these vitamins, leading to deficiencies.

Vitamin K: Foods like broccoli, spinach, cauliflower, Brussels sprouts, liver, turnips, cranberry, strong coffee are high in Vitamin K which is a blood coagulant (helps clotting). Therefore if you are on anti-coagulant (Warfarin) therapy, these foods need to be avoided or eaten in consistent amounts daily. Ginseng and ginkgo on the other hand enhances anti-coagulant medications risking bleeding.

Vitamin B12: Medications given to reduce acid secretions in those with gastric reflux or heart burn decrease. Vitamin B 12 absorption because B12 needs acid medium to facilitate its absorption. Therefore the elderly and long term users of acid blockers may need B12 supplementation.

Calcium and Vitamin D3: The absorption of these is drastically affected leading to osteoporosis and fractures in people taking a class of medications known as proton pump inhibitors given to patients with peptic ulcers.

Minerals: Some diuretics (drugs given to remove fluids from the body) deplete minerals like potassium, magnesium, zinc, sodium. Replacing lost minerals by increasing fruits and vegetable intake is necessary.

Licorice (irattimadhuram/adhimadhuram): These interact with certain cardiac medications causing drug toxicity, irregular heart beat and heart attack.

Alcohol: Last but not the least, a word of caution on the adverse reaction related to alcohol drinking. Alcohol should never be taken with any kind of medication be it prescribed or over the counter since it either enhances the effect of the drug or causes serious side effects.

(The author is a nutritionist)

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