Drug food Interactions

Medications which should be taken on an  EMPTY stomach
Alendronate (Fosamax)	Ampicillin	Astemizole	Bethanechol
Bisacodyl	Captopril (Take 1 hour before meals)	Cefibuten (Cedax)	Cilostazol (Pletal)
Demeclocycline	Dicloxacillin	Didanosine (Videx)	Etidronate (Didronel)
Felodipine (Plendil)	Indinavir (Crixivan)	Lansoprazole (take before eating)	Levothyroxine
loratadine (Claritin)	loracarbef (Lorabid)	Methotrexate	Moexipril (Univasc)
Mycophenolate (Cellcept)	Omeprazole Take before eating	Oxacillin	Penicillamine
Perindopril (Aceon)	Repaglinide (Prandin)	Rifampin	Rifabutin (Mycobutin)
Riluzole (Rilutek)	Roxithromycin (take at least 15 minutes before or after a meal)	Sucralfate (Carafate)	Sulfamethoxazole - trimethoprim (Bactrim)
Sulfadiazine	Tetracycline (Do not take with milk or other dairy products)	Tolcapone (Tasmar)	Zafirlukast (Accolate)
Zalcitabine (Hivid)

 

Medications which should be  Taken with FOOD
Allopurinol (take after meal)	Atovaquone (Mepron)	Augmentin	Aspirin
Amiodarone (Cordarone)	Baclofen (Lioresal)	Bromocriptine (Parlodel)	clofazimine (Lamprene)
Carvedilol (Coreg)	Carbamazepine (Tegretol)	Chloroquine	Cimetidine (Tagamet)
Cefpodoxime (Vantin)	Diclofenac (Voltaren_	Divalproex sodium (Depakote)	Doxycycline
Felbamate (Felbatol)	fenofibrate (TriCor)	Fiorinal	Fludrocortisone
fenoprofen	Griseofulvin	glyburide (take with breakfast)	Hydrocortisone
Hydroxychloroquine (Plaquenil)	Indomethacin	Iron preparations (Take between meals--if GI upset occurs take with food)	Itraconazole capsules
Ketorolac	Lithium	Metronidazole	Misoprostol (Cytotec)
methanamine	mebendazole	methylprednisolone	naltrexone
Naproxen	Nelfinavir (Viracept)	Nitrofurantoin	Niacin
Olsalazine	Perphenazine	Pentoxifylline	Pergolide
Piroxicam	Potassium salts	Prednisone	Procainamide
Ritonavir (Norvir)	Salsalate	Saquinavir	Sevelamer (Renagel)
Spironolactone	Sulfasalazine	Sulfinpyrazone	Sulindac
Ticlopidine	Tolmetin	Trazodone	Troglitazone
Valproic acid

 

Drug - grapefruit interactions:  Drugs which may exhibit increased serum concentrations based on this interaction
amiodarone	astemizole	alprazolam	atorvastatin
benzodiazepines	buspirone	carbamazepine	carvedilol
cerivastatin	cilostazol	clarithromycin	Clomipramine
codeine	cyclosporine	dapsone	dextromethorphan
diazepam	diltiazem	estrogens	erythromycin
felodipine	fentanyl	finasteride	haloperidol
indinavir	lercanidipine	lidocaine	lovastatin
midazolam	methadone	nelfinavir	nifedipine
nicardipine	nimodipine	nisoldipine	nitrendipine
ondansetron	paclitaxel	progestins	progesterone
quinidine	ritonavir	salmeterol	saquinavir
simvastatin	tacrolimus	trazodone	triazolam
vincristine	zaleplon	zolpidem
Note: there may be omissions on this list. Absence of a drug does not necessarily indicate that the drug lacks this potential interaction.

 

Warfarin - food Interactions

Management of Dietary Interactions and Vitamin K: dietary consistency is the key to maintaining a sustained, stable response during warfarin therapy. Patients should be aware of vitamin K content in common foods, particularly foods high in vitamin K (green leafy vegetables (broccoli, Brussel sprouts, turnip greens, kale, spinach, beet greens), Cauliflower , legumes, mayonnaise, canola and soybean oils), and should maintain a consistent amount of these foods in their diet. The following foods should be avoided or limited, since they also can effect warfarin therapy:  caffeinated beverages (cola, coffee, tea, hot chocolate, chocolate milk).

Alcohol intake greater than 3 drinks daily can increase the effect of Coumadin. As long as alcohol intake does not exceed 3 drinks daily, clotting times should not be affected. This amount of alcohol is present in 12 ounces of table wine or three 12  ounce beers. (Acute binges can raise INR. Chronic alcohol ingestion may decrease INR. )

Herbal supplements can affect bleeding time.  Coenzyme Q10 is an herbal supplement whose chemical structure is similar to vitamin K, so it has the potential to affect bleeding time.  Herbal teas: green tea, buckeye, horsechestnut, tonka, bean, meliot, and woodruff.  Other examples include: feverfew, garlic, and ginseng.  Herbal medications should either be avoided or used consistently while on warfarin therapy.

 

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Concise Information on Amimalarials

NAME	MECH. OF ACTION	Elimination half life	ACTION	ADVANTAGE	DISADVANTAGE
Chloroquine	? Inhibits plasmodial heme polymerase Toxic drug-heme complex form n Dg. Intercalation of Pl. DNA Intravacuolar pH alteration	10 days	Schizonticidal for all species Gametocidal for Pv. PO.PM. No action on hypnozoites	Highly potent against sensitive strains Long half life Effective at once a week dose as prophylactic agent	Rapid development of resistance
Quinine	(Same as Chloroquine)	11 hrs.	Primary blood schizonticide Little effect on sporozoite Gametocidal to PV and PM	Rapid development of resistance not yet seen	Higher toxicity
Artesunate /   Artemether /   Arteether	Activated by heme/ molecular iron to produce carbon centered free radicals Membrane damage by free radical	< 1 hr.   3-11 hrs   > 20 hrs.	Blood schizonticide Gametocidal action recently described	Broader window period of effectiveness Little/ no cross resistance Resistance not yet recorded	High recrudescence rate when used as monotherapy (10-50%) when used for <5 days="" o:p="">

 

NAME	MECH. OF ACTION	T ½	ACTION	ADVANTAGE	DISADVANTAGE
Mefloquine	Formation of toxic subs. with heme Damages membrane and other comp. Causes swelling of food vacuole	20 days	Strong schnizonticidal action against all species. Gametocidal l against PV, PM, PO Sporonticidal act	Useful as prophylactic agent for non-immune travellers Single dose sufficient Good alt. To quinine in MDR Pf.	Only oral prep. available.  So cannot be used in sev. Pf malaria High chances of cross-resistance, might lead to quinine resistance as well
Halofantrine	Concentrates and combines with ferri protop orphyrin IX, leading to memb. Damage1	10-90 hrs.	Schizonticidal to all species No action on latent tissue form of PV and gametocytes	Good alternative to mefloquine/ quinine in chloroquine/ MDR Pf.	Oral absorption erratic High chances of cross resistance with mefloquine Cardiotoxicity
Atovaquone	Inhibits parasite mitochondrial electron transport chain (complex III )(	70 hrs.	Blood schizonticide (used primarily for MDR Pf.)_		Erratic absorption High recrudescence rate when used alone
Pyronaridine	Inhibits vacuolar degradation, leading tot impaired Hb degradation	60 hrs.	Schizonticide for PF,PV, MDR, PF	Good oral absorption Cross resistance not yet documented Well tolerated

 

NAME	MECH. OF ACTION	T ½	ACTION	ADVANTAGE	DISADVANTAGE
Sulfadoxine - Pyrimethamine	Acts against the parasite dihydrofolate reductase enzyme	Sulfadoxine – 180 hrs. Pyrimethamine – 95 hrs	Active against blood schizonts of P.falciparum.  Less active against other species	Can be used against chloroquine resistant P.falciparum. No cross resistance with the 4 aminoquinolines, mefloquine, quinine, artemisinin derivatives	Risk of severe skin reactions
Primaquine	May get converted to electrophiles that act as redox mediators	6 hrs.	Destroys late hepatic stage and latent forms of PV and PO Gametocidal to all sp., mainly Pf. No action on erythrocyte stage of Pf., though active against the hepatic stage	Useful for the terminal prophylaxis and radical cure of PV and PO	Cannot be used in patient with G-6PD deficiency.
Proguanil	Selective inhibition of the bi-functional dihydrofolate reductase-thymidylate synthetase of Pl.	16 hrs.	Weak schizonticidal action against all species.	Good prophylactic agent for Pf or mixed infection, when used with chloroquine	Can not be used alone in treatment of malaria