Top 7 Most Common Food and Drug interactions


The effect of drug on a person may be different than expected because that drug interacts with another drug the person is taking (drug-drug interaction), food, beverages, dietary supplements the person is consuming (drug-nutrient/food interaction) or another disease the person has (drug-disease interaction). Some people have greater risk of food and drug interactions who have a poor diet, have serious health problems, children and pregnant women.

There are some foods that can interact with drugs by increasing or may be decreasing their actions and are capable of producing some serious side effects. Major side-effects of some diet (food) on drugs include alteration in absorption by fatty, high protein and fiber diets. Bioavailability is an important pharmacokinetic parameter which is correlated with the clinical effect of most drugs. However, in order to evaluate the clinical relevance of a food-drug interaction the impact of food intake on the clinical effect of the drug has to be quantified as well.


Certain Antihypertensive and diuretics can cause undesirable effects when taken with bananas. Foods rich in potassium such as bananas, oranges, green leafy vegetables should not be taken with medicines that increase the levels of potassium in body. Ace inhibitors such as captopril, enalapril, lisinopril used to decrease blood pressure and potassium sparing diuretics are not recommended to take with potassium rich foods.

What can happen?

Irregular heartbeats and heart palpitations are most likely to occur in patients taking these medicines with bananas.

2. Milk

The main component of dairy products is calcium found in milk, yogurt, cheese that can interact with certain antibiotics such as tetracyclines, ciprofloxacin, doxycycline. Tetracycline should be taken one hour before or two hours after meals.

What can happen?

Tetracyclines can bind calcium and iron, forming insoluble chelates, and influencing its bioavailability.

3. Green vegetables
Green leafy vegetables such as kale, spinach, broccoli, cabbage are rich in vitamin K, this vitamin is vital for the production of clotting factors that help prevent bleeding, but anticoagulants like warfarin exert their effect by inhibiting vitamin K.

What can happen?

An increased intake of the green vegetables can antagonize the anticoagulant effect and prevent the drug from working.

4. Grapefruit Juice
Patients should avoid eating grapefruit or drinking grapefruit juice while taking some medications, in particular cholesterol lowering agents such as statins e.g. atorvastatin, lovastatin. Compounds in grapefruit called furanocoumarin chemicals cause an increase in medication potency by interacting with enzymes in the small intestine and liver.

What can happen?
Drinking grapefruit juice can raise the level of the drug in your bloodstream and increase the risk of side effects, especially muscular weakness and leg pain.

5. Cheesy foods

Tyramine-containing food (matured cheese, red vine, ripped bananas, yogurt, soy products and salami) or so-called cheese reaction can cause interactions with monoamine oxidase inhibitors (MAOI) such as Phenelzine, Tranylcypromine that are effective in the treatment of depressive disorders

What can happen?

If you eat or drink too much of anything that contains the amino acid tyramine, your blood pressure could spike. Headache is the main symptom associated with heart pounding and palpitations and the complications included cardiac arrhythmias, cardiac failure, pulmonary edema, and death.

6. Licorice

Licorice contains glycyrrhizin and glycyrrhetinic acid. It causes sodium retention and potassium depletion, so it may interfere with various medicines including antihypertensive and antiarrhythmic agents.

What can happen?

A high intake of licorice can cause increased blood pressure, edema, hypermineralocorticoidism, and depression of the renin-angiotensin-aldosterone system this. This system is involved in the regulation of systemic blood pressure, renal blood flow, and glomerular filtration rate.

7. Coca-Cola

The daily dosage and frequency of NSAID’s like ibuprofen must be reduced when administered with Coca-Cola. Food intake did not appear to affect the extent of absorption of oral Diclofenac potassium soft gelatin capsule at doses.

What can happen?

There is a significant increase in plasma concentration when ibuprofen is taken with single and multiple doses of Coca-Cola, thereby indicating increased extent of absorption of ibuprofen.

By Mahum Zulqarnain Pharm.D University Of Central Punjab Pakistan.


· Bushra, R., Aslam, N., & Khan, A. Y. (2011). Food-drug interactions. Oman medical journal, 26(2), 77.

· Schmidt, L. E., & Dalhoff, K. (2002). Food-drug interactions. Drugs, 62(10), 1481-1502.

· Otles, S., & Senturk, A. (2014). Food and drug interactions: a general review. Acta Scientiarum Polonorum Technologia Alimentaria, 13(1), 89-102.

· Yeragani, V. K. (2009). Hypertensive crisis and cheese. Indian journal of psychiatry, 51(1), 65-66.


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