VERIFIED CONTENTAuthor: lek. Patryk Jasielski

Drugs have various and not always easy to predict effects on the body. They are used for a specific purpose - to get rid of the disease. Sometimes, however, they can interact in various ways with various types of products, supplements, and even food ingredients. What combinations of drugs with particular products can be dangerous?

Drugs can interact dangerously with various food ingredients and with commonly used dietary supplements. In addition, what we eat may reduce absorption, weaken or, on the contrary, increase the effect of the medications used. It is worth remembering this and always follow the doctor's instructions and read the package leaflet. We can often find there useful information on the method of taking and the interaction of a given medication with other substances.

Anticoagulants - warfarin and acenocoumarol and foods rich in vitamin K

Warfine and acenocoumarol are commonly used drugs that reduce blood clotting. They are used to thin the blood in the treatment of patients with atrial fibrillation or after a stroke.

They work by blocking the production of clotting factors in the liver. The synthesis of these factors, in turn, is stimulated by vitamin K. These drugs act antagonistically towards it.

Excess vitamin, provided in dietary supplements or in food, increases the synthesis of coagulation factors and thus weakens the effect of warfarin and acenocoumarol. This could have serious he alth consequences.

Too little therapeutic effect of drugs increases blood clotting and leads to the formation of blood clots that can block the lumen of arteries, e.g. in the brain.

Foods rich in vitamin K that must be avoided when taking these medications include green vegetables. These are mainly:

  • cucumbers,
  • lettuce,
  • broccoli,
  • kale,
  • arugula,
  • spinach
  • or asparagus.

Other sources include :

  • strawberries,
  • nuts,
  • eggs,
  • liver
  • and milk and its products.

Combining antibiotics with alcohol

The vast majority of us know that you should not drink alcohol while taking antibiotics. There are several reasons for this. Some of the side effects of selected antibiotics may be aggravated by alcohol. These are symptoms such as nausea and dizziness.

Other antibiotics are less effective when taken with alcohol. These include doxycillin. Most antibiotics can be taken with alcohol because there are no interactions, among other things.

There are, however, two that show a strong interaction with alcohol, and you should be absolutely abstinent when taking them. These antibiotics are metronidazole and tinidazole. These are drugs used, among others in intimate, protozoal and anaerobic infections.

When you combine them with alcohol, a strong reaction occurs, the so-called disulfiram-like reaction. It is accompanied by symptoms such as:

  • hot flashes,
  • stomach ache,
  • feeling of general breakdown.

There may also be a rapid heartbeat, headaches and dizziness.

Antibiotics and milk and its products

For antibiotics to work properly in the body, they must be fully absorbed in the digestive tract. Various factors can affect the absorption process. One of the most important is the binding of some of the antibiotics in the intestines by the food you eat. Bound antibiotics become non-absorbable and are excreted instead of being absorbed.

Among those susceptible to such a process are fluoroquinolone antibiotics:

  • ciprofloxacin,
  • levofloxacin, used in more severe infections

and tetracyclines:

  • doxycycline,
  • minocycline, commonly used to treat acne.

These can be bound to calcium, iron and magnesium, which are found in abundance in products such as:

  • milk,
  • yoghurts,
  • cheeses
  • and in dietary supplements.

For this reason, it is recommended to take the above antibiotics 1-2 hours before consuming dairy products or 4 hours after consumption.

Alcohol and NSAIDs

Non-steroidal anti-inflammatory drugs, which include, among others ibuprofen are often used drugs to relieve headache, muscle pain and reduce fever. Although some of them can be purchased without a prescription, they are not indifferent to the body. They irritate the gastric mucosa and damage the liver.

Alcohol has similar properties. Overused, it causes vomiting, damages the stomach and liver. Combining anti-inflammatory drugs with alcohol exacerbates these negative effectsprocesses and can lead to stomach bleeding or to an enlarged and sore liver.

Grapefruit juice and statins and antihypertensive drugs

Grapefruit juice has adverse interactions with various medications. It inhibits the action of liver enzymes, the so-called cytochromes responsible for metabolizing drugs. In this way, it prolongs and intensifies their action. This could lead to overdose and poisoning.

There is a significant interaction between grapefruit juice and statins, drugs used to lower cholesterol and calcium channel blockers to treat high blood pressure.

Combining the juice with these drugs increases their effects. This can lead to symptoms such as:

  • pains,
  • muscle and liver damage,
  • pressure drops too high
  • and arrhythmias.

Monoamine oxidase inhibitors (MAO) and long-matured cheeses

MAO is a group of drugs that inhibit the breakdown of neurotransmitters, such as:

  • serotonin,
  • dopamine
  • and norepinephrine by blocking the enzyme monoamine oxidase.

They are used to treat depression and Parkinson's disease. Food products, such as:

  • wine,
  • beer,
  • long-matured cheeses,
  • bananas,
  • fish subjected to various conservation processes,
  • processed meats
  • and chocolate

contain large amounts of a substance called tyramine.

It is a biogenic amine with specific properties in the body, broken down by monoamine oxidase.

In the case of using MAO inhibitors, the excess of this amine cannot be processed and accumulates in the body. It may then cause a rapid increase in blood pressure, including the hypertensive orifice, which is a direct threat to life.

This manifests itself, among others :

  • severe headache and sternum,
  • elevated body temperature,
  • visual impairment,
  • rapid heartbeat
  • and collapse.

It can also come to:

  • intracranial hemorrhages
  • and heart attacks.

When using drugs from this group, be careful and consult your doctor if you are in doubt as to whether a given food product is dangerous.

Insulin and alcohol

Insulin is used to treat diabetes. It works by lowering blood glucose levels. Alcohol also has a similar effect.

It inhibits the secretion of glucose from its stores in the liver. Combining insulin with alcohol can leadto the dangerous state of hypoglycemia, i.e. reduced blood sugar levels.

This is manifested:

  • pallor,
  • trembling,
  • feeling hungry,
  • anxious,
  • cold sweats appear
  • and a fast heartbeat.

In the absence of help, a person with hypoglycaemia may lose consciousness and fall into a coma. That is why it is so important to maintain an adequate level of glucose in the blood when taking insulin and not to combine it with alcohol.

Levothyroxine and food

Levothyroxine is a synthetic form of thyroid hormone. It is used as a medicine in the treatment of hypothyroidism. Its absorption in the gut is blocked by food.

This may lead to the situation that despite taking the right dose, the drug will not fulfill its function. Therefore, it should be taken on an empty stomach (i.e. after 8-12 hours without a meal) 30-60 minutes before breakfast. This ensures that the drug will be fully absorbed.

St. John's wort and antidepressants

St. John's Wort is a herbal supplement generally available in the form of herbal tea. It is used in low mood, depression and anxiety.

It works by inhibiting the reuptake of serotonin, one of the neurotransmitters in the brain. A similar effect is shown by antidepressants - serotonin reuptake inhibitors (SSRIs).

In the case of using both preparations at the same time, excessive amounts of serotonin may accumulate and the so-called serotonin syndrome.

It manifests itself, among others :

  • tremors and muscle stiffness,
  • fever,
  • sweating
  • and hallucinations.

John's wort should be used with caution and be careful not to take any medications at the same time.

Many medications interact dangerous with food and dietary supplements. You should be aware of this and read the package leaflet before using the medicine.

If in doubt, consult an appropriate specialist. This will help protect against side effects and ensure that the medicine works properly in your body.

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