This story is provided by our sponsor, NewYork-Presbyterian Hospital
The Greek physician Hippocrates advised, “Let food be thy medicine and medicine be thy food.” These days, however, we ingest not only food, but any number of drugs taken for one medical condition or another. In most cases, food and drugs can be ingested safely together, but there are times when the combination can have ill effects.
Dr. James Trapasso, a board-certified internist at New York-Presbyterian/Hudson Valley Hospital in Cortlandt Manor, says: “Not all medicines are affected by food, but many can be affected by what you eat — and when you eat it. For example, taking certain medications at the same time that you eat may interfere with the way your stomach and intestines absorb the medicine. The food may delay or decrease the absorption of the drug. This is why some medicines should be taken on an empty stomach, typically one to two hours after eating.”
Being mindful of food and drug interactions can help prevent adverse reactions. Explains Dr. Trapasso: “Medications work at their optimum at certain blood concentration levels. The implications and consequences of not following food instructions can range from an annoying bout of nausea to life threatening toxicity.”
Classes of medications to take with food
- Non-steroidal anti-inflammatory drugs (NSAIDs): These are medications such as aspirins, used to treat a variety of conditions that cause pain and inflammation, including arthritis and tendinitis.
- Most antibiotics: Prescribed to treat a wide variety of bacterial infections.
- Corticosteroids: Used to treat such conditions as arthritis, blood disorders, breathing problems, severe allergies, skin diseases, cancer, eye problems, and immune system disorders.
- Narcotic painkillers: Prescribed only for severe pain that is not helped by other types of painkillers.
- HIV medications: Certain ones require very precise absorption and therefore should be taken with food.
Classes of medications to take on an empty stomach
- Thyroid replacement hormones: These types of medications are generally best taken 30 minutes prior to any other medication or meal.
- Statins to lower cholesterol: Eating grapefruit or pomegranate with certain statin drugs can cause the concentration of these medications to increase to dangerous levels.
- Bisphosphonates: Used to treat osteoporosis, they typically only work on an empty stomach. The medications should be taken along with a large volume of water. (Make sure to sit upright for 30 minutes following a dose).
- Proton Pump Inhibitors (PPI's): The medications in this drug class function by reducing gastric acid volume, and therefore work best when taken on an empty stomach.
- Guanylate cyclase-C agonists: Used to treat intestinal problems such as irritable bowel syndrome or constipation.
- Anticoagulants: used to prevent the formation of blood clots. They are affected not only by eating, but by what is eaten. The concentration of these medications can vary widely with a change in diet. Their benefits may be diminished and bleeding can occur if the drug levels are too high.
5 tips to remember about food/drug interactions
- Read all directions: It’s important to be informed. Read the warnings and interaction precautions printed on medicine labels and packages.
- Take as directed: Typically, take medications with a full glass of water, unless specified otherwise. Do not mix medicine into hot drinks as the heat may prevent the drug from working.
- Do not alter your meds: Don’t stir medicine into your food or take capsules apart (unless permitted by your doctor). It may change the way the drug works.
- Don't mix pills and vitamins: Take them separately, as certain vitamins and minerals, when taken with medications, can cause adverse reactions.
- A cautionary note: Never take medicine with alcoholic drinks.
Finally, Dr. Trapasso advises, “Listen to the directions from your doctor and pharmacist and read the medication inserts with regard to possible food interactions. Never take any medication if you are not clear as to what interaction potential it may have.”
