Food and medication

Food and medication

Posted by AskNurseLinda on Dec 10, 2018 11:00 am

What you take into your body is important for your overall health. Maintaining a healthy diet is critical to the function of your body. Medications can assist in keeping your body at peak performance. Some individuals need supplements to keep the body in shape. Everything that you take into your body can have good and bad effects. Be aware of food and medication combinations that will affect how your body functions.

Reporting what you take in is critical. Tell your health professional about all medications, both prescribed and over the counter, supplemental drugs such as vitamins, herbs and nutrients, as well as recreational drugs. Be sure to note the route of intake, for example if swallowed, inhaled, inserted, rubbed on the skin or any other route. All substances taken into the body will influence medication potency and effectiveness. Some of these will be affected by the foods you eat.
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Be sure to read package inserts provided with prescribed, over the counter medications and supplements to be sure you know why you are taking the drug, what it does, side effects and the section labeled contraindications which will list any foods or drugs that should not be taken in combination with the medication. The package insert will also let you know how to take the medication, for example, if it should be taken with meals or on an empty stomach. Unfortunately, some over the counter products and recreational drugs do not come with these instructions. Therefore, it is imperative that you let your health professional know so they can tell you if there are any interactions.

A pamphlet of medication types and contraindications is available from National Consumers League and U.S. Food and Drug Administration titled: Avoid Food-Drug Interactions. This pamphlet contains a wide variety of drug interactions with food. You can obtain the more information about specific drugs online and from package inserts. A review of some types of medications is listed below but with an emphasis particularly for individuals with spinal cord injury from trauma or disease.

Almost everyone takes medication for temporary pain or fever relief. Some of these medications can upset your stomach such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and aspirin. These drugs can lead to stomach bleeding which can be temporary or erosions in the stomach or bowel as ulcers, a particular problem for slow moving digestive systems. NSAIDS come in both prescription strength and over the counter. Aspirin comes in full strength and low dose which is taken by individuals who need aspirin for heart protection. If these medications upset your stomach, it is usually recommended that it is taken with food or milk as this will help keep the pill from dissolving on the lining of your stomach.

Bronchodilators which are used for asthma or COPD (breathing conditions) can be affected by many types of foods. Be sure to check with your healthcare provider and the package insert to see which affects the type of medication you are using. Inhalants are different from sprinkle medication. Usually drinking water will help flush sprinkles along in your system. Side effects of bronchodilator medication can be increased if taken with caffeine which increases nervousness, excitability and rapid heartbeat. Alcohol increases headache, nausea, vomiting and irritability of these medications.

Some heart medication should be taken an hour prior to meals so the medication is in your system before food competes with absorption. ACE inhibitors have extra potassium which can affect heartbeat so avoid foods high in potassium such as green leafy vegetables, bananas, potatoes and potassium salt substitute. The same dietary restrictions should be followed with diuretics (water pills) which can lead to an overabundance of sodium as potassium is affected.

Digoxin is a medication that helps control the effectiveness of your heart beat. It should be taken an hour before eating or two hours after eating as food can affect the effectiveness of the medication. You should also monitor your pulse as this medication is typically not taken if your pulse is below 60. Your healthcare provider will give you specific information about when you should take your digoxin or not. Do not decide on your own. Individuals with spinal cord injury tend to have slower pulses so knowing if you should take this medicine is important. Fiber supplements can affect the ability of digoxin to work. Take fiber at a different time of day than when you are taking digoxin. St. John’s Wort and licorice affects digoxin. Avoid sweets that might affect this medication. Check your package insert to be sure.

Medications that control cholesterol (statins) usually are taken in the evening as night time is when your body makes the most cholesterol. Even though you might feel fine, you should not stop taking your cholesterol medication unless your healthcare provider tells you to do so.  High cholesterol cannot be felt in the body, so you need to be extremely careful in keeping up with this medication. These are the drugs that are so well known to interact with grapefruit. Check to see if you can eat grapefruit or grapefruit juice with this type of medication. Drinking alcohol with statins can lead to liver failure.

Vasodilators or medication taken for angina can be affected by alcohol. This can lead to low blood pressure. As individuals with spinal cord injury typically have low blood pressure, an even lower blood pressure can lead to extreme complications.

Some individuals with spinal cord injury take anticoagulants or blood thinners. This is to reduce blood clotting which will help avoid a deep vein thrombosis (blood clot(s) in the arms, legs, trunk) or pulmonary embolism (blood clot(s) in the lungs). Vitamin K is the antidote to too much anticoagulant. Therefore, if you take an anticoagulant drug, you should avoid green vegetables which contain Vitamin K. Cranberry juice or pills can change the way anticoagulants work. Over the counter supplements such as garlic, ginger, glucosamine, ginseng, and ginkgo affect the action of anticoagulants and can increase bleeding. Alcohol can affect the dosing of this medication.

Medications taken for GERD (Gastro Esophageal Reflux Disease) should be taken one hour prior to eating so the medication can begin working before taking in food. Take these drugs as prescribed. Sometimes prescription strength will be needed. Other people will obtain this medication over the counter. If you have severe reflux, you will need to take this medication daily. Others will take it as needed. Be sure you follow your healthcare provider’s instructions for how you should take this medication. You want to be sure to have taken this medication prior to the sensation of ‘heartburn’ to avoid long term complications.

Hypothyroidism is when the thyroid gland does not work enough. Medications of this type are taken in the morning one hour to one and a half hours prior to eating any food. This medication is affected by eating soy products (soy milk or soy ice cream), walnuts or fiber. Since many individuals with spinal cord injury take fiber products, be sure to tell your healthcare professional. Your medication will need to be adjusted to accommodate your fiber intake.

There are many antibiotics and antifungals which means there are many restrictions and contraindications for foods. Be sure to check the package insert to see exactly how to take the specific antibiotic or antifungal you are prescribed.  Some examples include taking the medication on a full or empty stomach, if dairy can be taken with the drug, and if caffeine can be taken. Some antibiotics interact with certain cheeses, meats and as always, alcohol which will modify their effectiveness.

Antipsychotics, antidepressants, sedatives, hypnotics, Monoamine Oxidase Inhibitors, (MAOi), and bipolar medications are taken by individuals who have a chemical imbalance. These issues are developed from medical conditions. This type of medication can help in correcting the imbalance in the brain. It may take several weeks to notice effects of these medications. They should not be stopped unless directed by your healthcare professional. Tapering or slowly withdrawing the medication over time is typically the way these medications are discontinued. Not tapering the medication as directed can lead to significant side effects. These medications can cause drowsiness.

Therefore, you should not take these medications with alcohol which increases the drowsiness. When to take these medications on a full or empty stomach and food restrictions vary with each type of medication. Be sure to read the package insert to find what works best for the medication you have been prescribed.

Foods that contain tyramines affect some antibiotics and MAOi inhibitors.  Tyramine containing foods include some types of cheeses, beef, chicken liver, salt cured meats, tenderizers, avocados, bananas, dried fruits, raspberries, sauerkraut, soy, yeast, fava beans, and chocolate. Caffeine and alcohol affect tyramines. Be sure to check the package insert for any antibiotic and MAOi medications to see if you should be avoiding tyramine in your diet.

Medication for osteoporosis (low bone density) should be taken as soon as you are sitting up in the morning on the days prescribed. A full glass of plain water (not mineral water) should be used with this medicine. Do not take antacids with this medication. You should not eat or lay down for 30-60 minutes. Do not take any supplements or minerals with the medication for at least 60 minutes. This does not mean you just sit in your chair for the hour. You can still read the paper, watch the news, perform pressure releases or other lite activity. You do not want to bend over, recline too far back or exert yourself with too much activity such as therapy in the first 30-60 minutes.

Some medications have sleepiness as a side effect. Eventually, people become tolerant to the sleepiness but if alcohol is added, the sleepiness becomes overpowering especially for use of machinery, cooking or driving. Extreme sleepiness can lead to stopping breathing, coma or death if too much of the drug and alcohol is consumed. Drugs that particularly cause sleepiness include antihistamines which are taken for colds and allergies, pain medications, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), fever reducers, narcotics, antispasmodics, anti-anxiety and panic disorder medications, antidepressants, and other psychiatric medication listed above.

Medications should be taken as prescribed. If needed, tablets can usually be cut or crushed. Coated tables, capsules or gel tablets cannot be altered, cut or crushed. If you cannot swallow a capsule or gel tab, talk to your healthcare professional about a liquid form. Compounding pharmacies are specialty pharmacies that make medications rather than your typical pharmacy that dispenses ready made medications. The compounding pharmacy might be able to create a liquid form for you. This may or may not be paid by your insurance. Check to make sure as this process can be expensive.

Many specific medications have not been covered in this listing. Your healthcare professional, nurse and pharmacist can look up all of your medications, over the counter medicines, supplements, vitamins, and recreational medications for interactions between the medications and food. The route of the medication can also be reviewed. Be sure your medication list of all products is reviewed by your health professional at a minimum of one time per year. Ask for a review at any time to be sure you are not taking a medication that you no longer need, if you would like to try a different medication or if you find your current regimen is not working for you. Also, keep up with the information provided by your pharmacist when you pick up your prescriptions. The exact method for taking your medication will be provided in this information. It is critical to your health that you know how to take your medication for the best results.

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