Citrus Memorial Health System	DRUG - FOOD INTERACTIONS (352) 726-1551 Pharmacy Ext. 1311 Registered Dietitian Ext. 6568
DRUG	DRUG TREATMENT		RECOMMENDATIONS
Angiotensin converting enzyme inhibitors (Zestril/Vasotec)	Treats high blood pressure and heart conditions		Follow a low salt diet. Do not take potassium supplements, or use salt substitutes (potassium chloride). Herb/spice mixtures are OK without salt as an ingredient. Avoid alcohol. This drug contains lactose.
Antibiotics –Quinollones (Cipro,Noroxin, Levaquin, Tequin)	Antibacterial agent		Do not take medicine with milk, milk products, or yogurt. If milk cannot be avoided, lengthen the time between taking milk and the antibiotic medication. Milk slows down the medicine ability to work properly.
Cholesterol Lowering Drugs	Helps lower blood cholesterol.		Take with food. Follow a low-fat, low-cholesterol diet. Do not take with grapefruit juice. You may drink grapefruit juice at other times. Heart-Healthy Eating Class is available by calling 344-6504 for registration.
Cholestyramine or Colestipol	Helps lower blood cholesterol		Powder: Take with food or milk. Chewable: Chew each bite well before swallowing. Medication may cause constipation, therefore, eat a low-fat, low cholesterol diet, high in fiber. Drink 8 - 10 cups of water/liquids everyday, unless otherwise directed by your doctor. Avoid alcohol. This drug may deplete some vitamins and minerals. Speak with your doctor for recommended dietary supplements.
Corticosteroids (Prednisone)	Treats asthma, arthritis, or other inflammatory conditions.		This medicine may cause you to gain weight and retain water, so consume healthy diet without sugar or fat added. Limit your salt and salty foods.
Digoxin	Treats heart condition.		Take this medicine one-hour before breakfast. You may take it with food or milk. Avoid high fiber foods for breakfast but it is OK to eat high fiber foods later in the day. Eat at least five servings high potassium foods (fruits & vegetables) per day. May decrease appetite. Report unintentional weight loss greater than 10 lbs. to your doctor. Avoid taking antacids such as: Maalox, and Mylanta at the same time as Digoxin.
Hydralazine	Treats high blood pressure.		Take this medicine with a meal. Follow a low salt diet. Do not drink softened water. Drug contains tartrazine. If sensitive ask your doctor for a different medicine.
Iron	Treats low blood iron: anemia.		Take with full glass water or juice. Take at least one hour before or two hours after a meal for better absorption.
Isoniazid	Treats tuberculosis.		Take one hour before or two hours after meals. May take with food to relieve stomach distress. May need Vitamin B6 and Vitamin D supplements if on medicine for a long time. Avoid alcohol. Not recommended for breast feeding mothers.
Levodopa	Parkinson’s Disease		Take this medicine one-hour before breakfast. Patient may benefit from a low protein diet. Consume protein foods evenly throughout the day.
Loop Diuretics (Lasix)	Prevents fluid retention or treats high blood pressure.		Take this medicine one-hour before breakfast. Eat high potassium foods (fruits, vegetables, and milk) everyday unless your doctor has told you not to eat them. Follow a low-salt diet. Avoid alcohol.
Lithium	Treats manic-depressive illness. Helps with mood changes.		Take with food or milk. Avoid alcohol. Drink 8-10 cups of liquids per day. Do not make major salt intake changes in diet. Limit caffeine beverages to 2 per day. Keep a weekly weight record and review with your doctor.

DRUG	DRUG TREATMENT	RECOMMENDATIONS
Marplan, Matulane, Nardil, Parnate	Treatment for anxiety and depression.	Avoid foods high in tyramine such as processed meat, cheese, and wine. Please call our dietitian at 344-6568 for a diet consult regarding MAO inhibitors.
Methotrexate	Treats cancer, arthritis, or psoriasis.	Take medicine first thing in the morning unless instructed by your doctor to take at a different time. This medicine often causes nausea and vomiting. Do not stop taking medicine. Drink 8 – 10 cups of liquids per day, unless otherwise directed by your doctor. Avoid alcohol.
NSAID (Ibuprofen)	Treats pain or arthritis.	Take with food and 8 fluid ounces water. Do not lie down for 30 minutes after taking medicine. Avoid alcohol. Some drugs contain tartrazine. If you are sensitive discuss with your doctor.
Oral Hypoglycemics	Controls high blood sugar or glucose in diabetes	Take medicine the same time every day. It is important to follow the diabetic meal plan with three meals and snacks. Avoid alcohol. This drug may cause hypoglycemia (low blood sugar) when taken without eating. Learn what to do during your stay and in the Diabetes Management Classes. Call 344-6504 for registration.
Phenytoin (Dilantin)	Treats seizure disorders and prevents seizures.	Take with food to reduce stomach irritation. Avoid alcohol. Drug may cause sore gums. It is very important to brush and floss teeth every day. A vitamin supplement of folic acid and vitamin B12 may be needed.
Potassium Liquids	Maintains electrolyte balance.	Dilute before drinking and take with food.
Potassium Tablets	Maintains electrolyte balance.	Take with food and a full glass of water.
Quinidine	Treats heart condition.	Take this medicine one hour before or two hours after a meal with 8 ounces of water. Do not take with grapefruit juice.
Sulfasalazine	Treats Crohn’s Disease.	Take this medicine after a meal. Drink 8-10 cups of liquids per day unless otherwise directed by your doctor. This medication may increase the need for folic acid supplementation.
Tetracycline	Treats infections and acne.	Take with a full glass of water on an empty stomach or one-hour after meals. Do not take dairy products, antacids, calcium supplements, magnesium-containing laxatives, or iron within 3 hours of taking medicine.
Theophylline	Treats asthma.	Take at least 1 hour before meal. Do not chew slow release medicines and do not take with caffeine containing beverages (coffee, tea, colas, chocolate, Mountain Dew, and Jolt). Water is the best liquid.
Thiazide (HCTZ)	Treats high blood pressure and fluid retention (edema).	Follow a low-salt diet. This medicine may cause your body to lose potassium. Consume high potassium foods every day unless your doctor has instructed you otherwise.
Warfarin (Coumadin)	Helps prevent blood clots.	Eat a healthy, balanced diet maintaining a consistent amount of Vitamin K. Avoid drastic changes in dietary habits. Leafy green vegetables, legumes and vegetable oils contain high amounts of Vitamin K. They are acceptable but in smaller amounts. It is important to check with your doctor before making any major changes to your diet, alcohol, vitamin and nutritional supplements, and/or herbal supplements before you start taking them. Coumadin Educational Packet is available by contacting CMH for additional copies at 344-6504.

This guide contains information about some common interactions that may occur between food and drugs. It does not attempt to discuss all possible food-drug interactions, nor does it list possible drug-drug interactions. If you have additional questions about food-drug interactions, please consult a physician or pharmacist. (OBRA ’90) Source: Micro Medex 2003