Q: Aren't you supposed to take medications with food?
A: Many prescription medications are to be taken with food. But some combinations of food and drugs actually can make you more sick. Medicines, such as those prescribed to cardiovascular disease patients, can have powerful ingredients that interact with our bodies in negative ways. Diet often plays a role in a medication's ability to work properly. Certain foods can interact with some medications, making them less effective or causing dangerous side effects.

Q: How will I know whether or not to take my medication with certain foods?
A: Carefully following your doctor's instructions is the best way to maximum your medication's effectiveness and minimize your risk. Although each person's body is different, there are some common food and drug combinations that heart disease patients should avoid. Those include:

  • Diuretics help rid the body of water, sodium and chloride. Diuretics are a little tricky because they vary in their interactions with food and specific nutrients. Some diuretics cause loss of potassium, calcium and magnesium.
  • Contrarily, triamterene (known as Dyazide and Maxzide) is a potassium-sparing diuretic. It blocks the kidneys' excretion of potassium, which can cause increased potassium. Excess potassium can cause irregular heartbeat and heart palpitations. If you take triamterene, avoid eating large amounts of potassium-rich foods such as bananas, oranges and leafy green vegetables, as well as salt substitutes that contain potassium.
  • Beta Blockers decrease the nerve impulses to the heart and blood vessels, which in turn decreases the heart rate and the heart's workload. One beta blocker called propranolol (brand name Inderal) should not be mixed with alcohol. Combining the two can lower blood pressure too much.
  • Nitrates relax blood vessels and lower the heart's demand for oxygen. Anyone taking nitrates should avoid alcohol consumption. Drinking alcohol may add to the blood vessel-relaxing effect of nitrates, resulting in dangerously low blood pressure.
  • Angiotensin Converting Enzyme (ACE) Inhibitors also relax blood vessels. Consuming food with certain ACE inhibitors can decrease the absorption of the drugs. If you take captopril (brand name Capoten) or moexipril (Univasc), take your medication at least one hour before or two hours after meals.
  • ACE inhibitors also may increase the amount of potassium in your body. Too much potassium can be harmful, so avoid eating large amounts of foods high in potassium.
  • Statins are used to lower cholesterol. If you take a statin, avoid drinking large amounts of alcohol because it may increase the risk of liver damage. Lovastatin, also known as Mevacor, should be taken with the evening meal to enhance absorption.
  • Anticoagulants help prevent blood clot formation. Vitamin K may reduce its effectiveness, so limit intake of foods such as broccoli, spinach, kale and cauliflower. Also, high doses of Vitamin E may prolong clotting time and increase the risk of bleeding.

Q: Is it true that drinking grapefruit juice with certain medications can be harmful?
A:
Believe it or not, drinking grapefruit juice can be harmful to your health if you're taking certain medication. Drinking grapefruit juice together with certain medications can increase blood levels of the drug to harmful levels. The juice inhibits a chemical in the liver needed to break down many drugs in the body. The absence of this chemical can lead to high blood level, which can actually make a drug more potent.

This effect has been observed in nearly all calcium channel blockers, a group of drugs used to control blood pressure. Heart patients taking calcium channel blockers or cholesterol-lowering statins should talk to their physician about possible food-drug interactions.

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