Food & Medicine Safety
Learn More About the Medicines You Take
Foods can have unwanted—and sometimes unsafe—effects on your medicines. This chart lists common medicine and food interactions. If you have questions, talk to your doctor or pharmacist.
Class
Rx Medicine
Tips
Analgesics (pain relievers)
Percocet (acetaminophen/oxycodone)
Tylenol #3 (acetaminophen/codeine)
Norco, Vicodin (acetaminophen/ hydrocodone)
Avoid drinking alcohol. Take with food to reduce upset stomach. Avoid over-the-counter Tylenol (acetaminophen)-containing products. It’s unsafe to take more than 3,000 mg of acetaminophen in 24 hours.
Anti-arrhythmics (irregular heart beat)
Cordarone, Pacerone (amiodarone)
Avoid eating grapefruit and drinking grapefruit juice. May take with or without food, but take the same time each day.
Antibiotics
Ampicillin
Penicillin
Cipro (ciprofloxacin)
Doxycycline
Tetracycline
Levaquin (levofloxacin)
Flagyl (metronidazole)
Tindamax (tinidazole)
Griseofulvin
Take on an empty stomach for best absorption.
To improve absorption, avoid antacids, iron-containing foods and calcium-rich dairy products.
Avoid alcohol while taking and for 3 days after finishing the medication. Take with food to prevent upset stomach; take probiotics (yogurt or supplements) to prevent diarrhea.
Take with fatty food (ice cream, whole milk or cheese) for better absorption.
Anticoagulants (blood thinners)
Coumadin, Jantoven (warfarin)
Avoid sudden increase or decrease in foods rich in vitamin K (green leafy vegetables, avocados, soybeans, green tea) and multivitamins with vitamin K. Check with your doctor or pharmacist for a complete list. Limit alcohol and cranberry juice.
Antidepressants
Paxil (paroxetine)
Prozac (fluoxetine)
Zoloft (sertraline)
Lexapro (escitalopram)
Celexa (citalopram)
Avoid drinking alcohol; avoid use of nicotine or tobacco products.
Antipsychotics
Clozaril (clozapine)
Abilify (aripiprazole)
Seroquel (quetiapine)
Geodon (ziprasidone)
Avoid drinking alcohol and caffeine.
Avoid drinking alcohol and grapefruit juice.
Take with a meal for best absorption.
Anti-seizure
Dilantin (phenytoin)
Carbatrol, Tegretol (carbamazepine)
Depakote (divalproex)
Lamictal (lamotrigine)
Lyrica (pregabalin)
Topamax (topiramate)
Zarontin (ethosuximide)
Take on an empty stomach at the same time every day. Avoid calcium or antacids within 2 hours of taking medicine.
Avoid eating grapefruit and drinking grapefruit juice.
Avoid drinking alcohol.
Cholesterol
Lipitor (atorvastatin)
Mevacor (lovastatin)
Zocor (simvastatin)
Avoid eating large amounts of grapefruit or grapefruit juice (greater than 1 quart per day). Do not eat oat bran within 2–4 hours of taking medicine. Best if taken in the evening.
Diabetes
Glucophage (metformin)
DiaBeta (glyburide)
Glucotrol (glipizide)
Amaryl (glimepiride)
Avoid drinking alcohol. If diabetes is well controlled, limit alcohol to 1–2 drinks per day consumed with a meal.
Gastrointestinal
Reglan (metoclopramide)
Nexium (esomeprazole)
Prilosec (omeprazole)
Protonix (pantoprazole)
Tagamet
(cimetidine)
Avoid drinking or limit alcohol. Take 30 minutes before meals.
Take at least 1 hour before meals.
Avoid alcohol, caffeine and nicotine.
Gout *
*If you have gout, avoid large amounts of purine-rich foods (anchovies, beef stock gravies, sardines, shellfish, asparagus, lentils and red meat—especially pork). Check with your doctor or pharmacist for a complete list.
Colcrys (colchicine)
Zyloprim (allopurinol)
Avoid eating grapefruit and drinking grapefruit juice.
Take after meals.
High Blood Pressure
ACE Inhibitors
Monopril (fosinopril)
Prinvil, Zestril (lisinopril)
Vasotec (enalapril)
Calcium Channel Blockers
Calan (verapamil)
Cardizem (diltiazem)
Plendil (felodipine)
Procardia (nifedipine)
Beta Blockers
Tenormin (atenolol)
Lopressor (metoprolol tartrate)
Coreg (carvedilol)
Diuretics
Aldactone (spironolactone)
Dyrenium (triamterene)
Midamor
(amiloride)
Avoid potassium-based salt substitutes and eating large amounts of foods high in potassium (almonds, bananas, cantaloupe, kidney beans, oranges/orange juice, potatoes with skin, tomato juice, spinach).
Calcium Channel Blockers: Avoid drinking Seville (sour) orange juice, eating grapefruit, and drinking grapefruit juice.
Limit caffeine when taking Calan.
Tenormin: Avoid drinking orange juice. Do not take calcium products within 2 hours of taking medicine.
Lopressor: Take with or immediately after meals. Do not take calcium products within 2 hours of taking medicine.
Coreg: Take with meals to help reduce side effects.
Diuretics: Avoid potassium-based salt substitutes and eating large amounts of foods high in potassium (bananas, cantaloupe, kidney beans, potatoes with skin, tomato juice, spinach).
Immunosuppressants
Neoral, Sandimmune (cyclosporine)
Prograf (tacrolimus)
Rapamune (sirolimus)
Avoid eating grapefruit and drinking grapefruit juice. Avoid potassium-based salt substitutes and eating large amounts of food high in potassium (almonds, avocados, bananas, cantaloupe, kidney beans, oranges/orange juice, potatoes with skin, spinach).
MAO Inhibitors
Eldepryl, Zelapar, Emsam (selegiline)
Marplan (isocarboxazid)
Nardil (phenelzine)
Parnate (tranylcypromine)
Avoid foods high in tyramine (aged cheese, avocado, banana, bologna, pepperoni, salami, pickled herring, liver, raisins, yeast extracts, red wine, sour cream). Avoid drinking large amounts of alcohol and caffeine (chocolate, coffee, tea).
Osteoporosis
Bisphosphonates
Fosamax (alendronate)
Boniva (ibandronate)
Atelvia, Actonel (risedronate)
Take on an empty stomach with 8 oz. of water in the morning before breakfast. Do not take any other drugs, vitamins or food within 30 minutes (60 minutes for ibandronate) of taking medicine. Remain upright, not reclining or lying down, for 1 hour after taking.
Thyroid Hormones
Levoxyl, Synthroid, Unithroid, Tirosint (levothyroxine)
Take on an empty stomach 30–60 minutes before breakfast with 8 oz. of water. Avoid eating walnuts, soybean flour, dietary fiber, and calcium products within 4 hours of taking medicine.
Class
Analgesics (pain relievers)
Rx Medicine
Percocet (acetaminophen/oxycodone)
Tylenol #3 (acetaminophen/codeine)
Norco, Vicodin (acetaminophen/ hydrocodone)
Tips
Avoid drinking alcohol. Take with food to reduce upset stomach. Avoid over-the-counter Tylenol (acetaminophen)-containing products. It’s unsafe to take more than 4,000 mg of acetaminophen in 24 hours.
Class
Anti-arrhythmics (irregular heart beat)
Rx Medicine
Cordarone, Pacerone (amiodarone)
Tips
Avoid eating grapefruit and drinking grapefruit juice. May take with or without food, but take the same time each day.
Class
Antibiotics
Rx Medicine
Ampicillin
Penicillin
Tips
Take on an empty stomach for best absorption.
Rx Medicine
Cipro (ciprofloxacin)
Doxycycline
Tetracycline
Levaquin (levofloxacin)
Tips
To improve absorption, avoid antacids, iron-containing foods and calcium-rich dairy products.
Rx Medicine
Flagyl (metronidazole)
Tindamax (tinidazole)
Tips
Avoid alcohol while taking and for 3 days after finishing the medication. Take with food to
prevent upset stomach; take probiotics (yogurt or supplements) to prevent diarrhea.
Rx Medicine
Griseofulvin
Tips
Take with fatty food (ice cream, whole milk or cheese) for better absorption.
Class
Anticoagulants (blood thinners)
Rx Medicine
Coumadin, Jantoven (warfarin)
Tips
Avoid sudden increase or decrease in foods rich in vitamin K (green leafy vegetables, avocados, soybeans, green tea) and multivitamins with vitamin K. Check with your doctor or pharmacist for a complete list. Limit alcohol and cranberry juice.
Class
Antidepressants
Rx Medicine
Paxil (paroxetine)
Prozac (fluoxetine)
Zoloft (sertraline)
Lexapro (escitalopram)
Celexa (citalopram)
Tips
Avoid drinking alcohol; avoid use of nicotine or tobacco products.
Class
Antipsychotics
Rx Medicine
Clozaril (clozapine)
Tips
Avoid drinking alcohol and caffeine.
Rx Medicine
Abilify (aripiprazole)
Seroquel (quetiapine)
Tips
Avoid drinking alcohol and grapefruit juice.
Rx Medicine
Geodon (ziprasidone)
Tips
Take with a meal for best absorption.
Class
Anti-seizure
Rx Medicine
Dilantin (phenytoin)
Tips
Take on an empty stomach at the same time every day. Avoid calcium or antacids within 2 hours of taking medicine.
Rx Medicine
Carbatrol, Tegretol (carbamazepine)
Tips
Avoid eating grapefruit and drinking grapefruit juice.
Rx Medicine
Depakote (divalproex)
Lamictal (lamotrigine)
Lyrica (pregabalin)
Topamax (topiramate)
Zarontin (ethosuximide
Tips
Avoid drinking alcohol.
Class
Cholesterol
Rx Medicine
Lipitor (atorvastatin)
Mevacor (lovastatin)
Zocor (simvastatin)
Tips
Avoid eating large amounts of grapefruit or grapefruit juice (greater than 1 quart per day). Do not eat oat bran within 2–4 hours of taking medicine. Best if taken in the evening.
Class
Diabetes
Rx Medicine
Glucophage (metformin)
DiaBeta (glyburide)
Glucotrol (glipizide)
Amaryl (glimepiride)
Tips
Avoid drinking alcohol. If diabetes is well controlled, limit alcohol to 1–2 drinks per day consumed with a meal.
Class
Gastrointestinal
Rx Medicine
Reglan (metoclopramide)
Tips
Avoid drinking or limit alcohol. Take 30 minutes before meals.
Rx Medicine
Nexium (esomeprazole)
Prilosec (omeprazole)
Protonix (pantoprazole)
Tips
Take at least 1 hour before meals.
Rx Medicine
Tagamet (cimetidine)
Tips
Avoid drinking alcohol, caffeine and nicotine.
Class
Gout*
*If you have gout, avoid large amounts of purine-rich foods (anchovies, beef stock gravies, sardines, shellfish, asparagus, lentils and red meat—especially pork). Check with your doctor or pharmacist for a complete list.
Rx Medicine
Colcrys (colchicine)
Tips
Avoid eating grapefruit and drinking grapefruit juice.
Rx Medicine
Zyloprim (allopurinol)
Tips
Take after meals.
Class
High Blood Pressure
Rx Medicine
ACE Inhibitors
Monopril (fosinopril)
Prinvil, Zestril (lisinopril)
Vasotec (enalapril)
Tips
Avoid potassium-based salt substitutes and eating large amounts of foods high in potassium (almonds, bananas, cantaloupe, kidney beans, oranges/orange juice, potatoes with skin, tomato juice, spinach).
Rx Medicine
Calcium Channel Blockers
Calan (verapamil)
Cardizem (diltiazem)
Plendil (felodipine)
Procardia (nifedipine)
Tips
Avoid drinking Seville (sour) orange juice, eating grapefruit, and drinking grapefruit juice. Limit caffeine when taking Calan.
Rx Medicine
Beta Blockers
Tenormin (atenolol)
Tips
Avoid drinking orange juice. Do not take calcium products within 2 hours of taking medicine.
Rx Medicine
Lopressor (metoprolol tartrate)
Tips
Take with or immediately after meals. Do not take calcium products within 2 hours of taking medicine.
Rx Medicine
Coreg (carvedilol)
Tips
Take with meals to help reduce side effects.
RX Medicine
Diuretics
Aldactone (spironolactone)
Dyrenium (triamterene)
Midamor (amiloride)
Tips
Avoid potassium-based salt substitutes and eating large amounts of foods high in potassium (bananas, cantaloupe, kidney beans, potatoes with skin, tomato juice, spinach).
Class
Immunosuppressants
Rx Medicine
Neoral, Sandimmune (cyclosporine)
Prograf (tacrolimus)
Rapamune (sirolimus)
Tips
Avoid eating grapefruit and drinking grapefruit juice. Avoid potassium-based salt substitutes and eating large amounts of food high in potassium (almonds, avocados, bananas, cantaloupe, kidney beans, oranges/orange juice, potatoes with skin, spinach).
Class
MAO Inhibitors
Rx Medicine
Eldepryl, Zelapar, Emsam (selegiline)
Marplan (isocarboxazid)
Nardil (phenelzine)
Parnate (tranylcypromine)
Tips
Avoid foods high in tyramine (aged cheese, avocado, banana, bologna, pepperoni, salami, pickled herring, liver, raisins, yeast extracts, red wine, sour cream). Avoid drinking large amounts of alcohol and caffeine (chocolate, coffee, tea).
Class
Osteoporosis
Rx Medicine
Bisphosphonates
Fosamax (alendronate)
Boniva (ibandronate)
Atelvia, Actonel (risedronate)
Tips
Take on an empty stomach with 8 oz. of water in the morning before breakfast. Do not take any other drugs, vitamins or food within 30 minutes (60 minutes for ibandronate) of taking medicine. Remain upright, not reclining or lying down, for 1 hour after taking.
Class
Thyroid Hormones
Rx Medicine
Levoxyl, Synthroid, Unithroid, Tirosint (levothyroxine)
Tips
Take on an empty stomach 30–60 minutes before breakfast with 8 oz. of water. Avoid eating walnuts, soybean flour, dietary fiber, and calcium products within 4 hours of taking medicine.
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