Manual of Clinical Nutrition

Food and Drug Interactions

Manual of Clinical Nutrition Management II- 30 Copyright © 2013 Compass Group, Inc.

Medication

Classification

Effect of Food

on Medication

Effect of Medication on

Nutritional Status

Patient Guidelines

Cardiovascular
Digoxin (Lanoxin)

Arrhythmia

Specific:

Amiodarone

(Cordarone)

Disopyramide

(Norpace)

Food delays but

does not inhibit

absorption

except for bran,

which may

reduce

absorption. Avoid

Licorice (8). St.

John’s Wort can

reduce the

concentration of

medications in

blood (8)

Grapefruit juice

may increase

medication

availability and

absorption (4-7)

Digitalis may exacerbate metabolic

effects of hyperkalemia, especially

with respect to myocardial activity

May cause GI irritation

Anorexia; weight loss

Diarrhea. Some forms of licorice

may increase risk for toxicity (8).

Take 2 hours after meals to lessen

gastric irritation

Take medication between meals if

meals are high in bran; bran

decreases effects and level of

medication

Diet should provide liberal

potassium, Mg, and Ca intake

Avoid natural licorice (8) (imported)b

and low Na intake

Avoid taking St. John’s Wort (8)

Avoid grapefruit juice (4-7)

Diuretic
Thiazides
(Diuril,
Hydrodiuril)
Furosemide
(Lasix)

Triamterene with
hydrochloro-
thiazide
(Dyazide,
Maxzide)

Food increases

absorption.

Mg supplement

will  absorption

of medication

Licorice may

reduce effects (8),

particularly

hydrodiuruil and

aldactone (8)

Natriuresis may be accompanied by

loss of potassium

Also increases K, Mg, Zn, and B 6

excretion

Will  utilization of folate

Hypokalemia is uncommon, but

hyperkalemia may occur

Do not take with magnesium

supplement

Take with meal or milk

Limit intake of foods high in sodium;

sodium-restricted diet may be

preferred

Increase intake of foods high in

potassium and folate

Limit use of natural licorice (8)

(imported)b^

Avoid use of salt substitutes

Increase potassium intake only

when necessary and then cautiously

GI Stimulant
Cisapride
(Propulsid)

Grapefruit juice

may increase

medication

availability and

absorption (4,5).

Avoid grapefruit juice (4,5).

Laxative
Bisacodyl
(Dulcolax)

Milk can raise pH

of stomach

sufficiently to

dissolve enteric

coating

prematurely

Misuse may cause hypokalemia and

weight loss

Take on empty stomach with 8 oz of

water or juice

Drink plenty of fluids

Bisacodyl
(Dulcolax)

Milk can raise pH

of stomach

sufficiently to

dissolve enteric

coating

prematurely

Misuse may cause hypokalemia and

weight loss

Take on empty stomach with 8 oz of

water or juice

Drink plenty of fluids

aGI indicates gastrointestinal;  , increase; and , decrease