Food and drugs: 7 possible reactions based on combinations

Medicines and foods interact with each other. We know but maybe not so clearly. The effects of the former can in fact be toughen up or weakened from the intake of food at the same time or at a short distance. Or they can trigger side effects that are completely avoidable with a little attention. The portal of scientific information Univadis has put together some of the key interactions for seven food groups and the active ingredients or in general the drugs with which these combinations can be created and which we summarize below.

Foods containing soccer: milk, derivatives and more (therefore dairy products, calcium-enriched fruit juices and mineral waters rich in the same ion) can interact with thyroid hormones, thus causing typical symptoms of hypothyroidism such as fatigue, weight gain and cold intolerance; with i bisphosphonates – a class of drugs used to counteract the loss of bone mineral density – causing, depending on the area of ​​use, precisely a reduction in bone density and hypercalcaemia; and with the gyrase inhibitors and tetracyclines (for ciprofloxacin and norfloxacin only), causing a reduction in antimicrobial efficacy and therefore treatment failure. This is because the molecules and active ingredients combine with the calcium ions, forming complexes difficult to absorb and therefore intended to hinder the pharmacological action. The same mechanism applies to the magnesium. The advice is therefore to take these foods at least two or three hours from drugs of those categories.

For foods containing caffeine such as coffee, cola and tea, but also mate, the energy drinks very common among young people, and large quantities of dark chocolate. The interaction is possible with the clozapine (a new generation antipsychotic drug) – with possible potentiation of side effects and possible reduction of efficacy with caffeine withdrawal after prolonged caffeine consumption – and with gyrase inhibitors (enoxacin, under certain conditions also ciprofloxacin and norfloxacin). These, combined with caffeine, can cause symptoms such as agitation, restlessness, insomnia, hallucinations.

The grapefruit (Citrus paradisi L.) and the grapefruit juice they can instead cause a strengthening of the effect for i calcium antagonists of the nifedipine type (nifedipine and nitrendipine) and verapamil, drugs cholesterol lowering (atorvastatin, lovavastatin, simvastatin), immunosuppressants (cyclosporine, tacrolimus, everolimus and sirolimus), ivabradine, ivacaftor, lomitapide, ranolazine, colchicine and terfenadine. Or aattenuation of the effect for example with the decrease of the absorption of aliskiren, bilastine, fexofenadine, celiprolol (possibly atenolol) as well as a decrease in the activation of cylophosphamide And ifosfamide. This happens because grapefruit compounds irreversibly inhibit the CYP3A4 enzyme in the intestinal wall. As a result, substances that are substrates of CYP3A4 are not properly metabolised and can increase their plasma concentrations, leading to a variety of side effects. The molecules contained in grapefruit also inhibit i organic anion transporter peptides (OATP) and thus the absorption of some drugs.

There licorice with liquorice root extract (Liquiritiae radix) can interact with the antihypertensives, particularly with thiazide diuretics. An interaction that could generate hypokalaemia (serum concentration <3.5 mmol/l) associated with muscle weakness, hyporeflexia, somnolence and typical electrocardiogram changes with risk of cardiac arrhythmias. Furthermore, an increase in the is also possible blood pressure. The interaction is related to glycyrrhizic acid, which has an indirect mineralocorticoid effect.

THE tanninspresent among other things in coffee and black tea, can interact with iron supplements and this can lead to a reduction in its resorption. In fact, they form poorly soluble complexes with iron salts. It is therefore essential to take iron-based preparations on an empty stomach with tap water or acidic fruit juices containing vitamin C, possibly one hour before breakfast or between meals. It would take at least two hours to drink coffee or tea.

Foods containing vitamin K (leaf lettuce, spinach, broccoli and various cabbages) can interact – in this case without too many surprises – with vitamin K antagonists (coumarins), such as the phenprocoumon and the warfarin. In this case the anticoagulant effect of coumarins can be weakened by the increased consumption of foods containing vitamin K, thus increasing the risk of thromboembolism. Conversely, the anticoagulant effect of coumarins can be increased by a reduced consumption of foods containing vitamin K, leading to an increased risk of bleeding.

L’alcohol, we know, interacts in very different and harmful ways with many drugs. For example by procuring one delayed drug degradation (verapamil, ranitidine, benzodiazepines, barbiturates, phenytoin) and alcohol itself (both due to the double load on the liver) and therefore an intensification of their effects. Or with the enhancement of the liver damaging effect of methotrexate And paracetamolagain due to the burden of liver work.

Alcoholic beverages then cause a reduction in the sensitivity of the central nervous system to drugs, such as antidepressants, hypnotics And benzodiazepinesthe inhibition of CYP2E1aldehyde dehydrogenase ALDH by, for example, metronidazole, chloramphenicol, sulfonamides, griseofulvin and procarbazine. And again, the delay of the gastric emptyingand thus the increased risk of gastric ulcers with nonsteroidal anti-inflammatory drugs and the increased risk of lactic acidosis with metformin.

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