Many people need medication of one sort or another to get through their days. What they swallow with their pill and how it reacts on their body is individual but there are some general rules of what not to drink with that pill. For example, most people on routine medication have been told not to drink grapefruit juice with their medication because it alters the effect of the prescription. What can be swallowed with medication to be safe?

Grapefruit and Drugs

Grapefruit inhibits an enzyme CYP3A4 which then interferes with some medication absorption. P-glycoprotein, also affected by grapefruit, prevents gut absorption. Some of these meds affected by grapefruit and grapefruit juice are listed below.

• lipid lowering drugs (cholesterol meds) such as simvastatin or lovastatin, Mevacor
• valium
• some blood pressure medications in the class of: calcium channel blockers (verapamil, cardizem, etc.)

If on a medication where grapefruit is contraindicated, don’t experiment. Everybody is different but all are affected by the enzymes in grapefruit. Neither the juice nor the fruit is recommended.

What about Other Juices and Medication?

Apple and orange juice can reduce the effects of some medication. Keep the following in mind:

• It is possible the absorption of some antibiotics, allergy pills, and atenolol (blood pressure) could be affected. Its not a strong correlation but a simple solution is to wait four hours between drinking Other fruit juices have been implemented as well such as lime or tangelo juice.
• Going further, berry juices such as cranberry or acai berry juice may do this.juice and taking the pills.
• The effect is minimal but if there is concern, take meds with water.

Alcohol and Medication

Is it okay to take a prescription with wine or beer? Sometimes, in moderation, but remember the following:

• All sleeping pills and anti-anxiety medication have warnings about the depressive effects of alcohol. How severe an effect is individual but it can be extreme.
• Alcohol with flagyl (metronidazole), cefobid and cefotan can cause an effect similar to that of an alcoholic taking Antabuse and then drinking. There is facial flushing, dizziness, nausea, shortness of breath, and a drop in blood pressure.
• Some antipsychotic medication can't be combined with red wine due to the presence of tyramine which competes for the same neurons causing the medication effect to be increased.
• Diabetics on oral medications risk sudden drops in blood sugar when drinking.
• Those on daily aspirin or anti-inflmmatories (Motrin, Advil, etc.) can risk internal gastric bleeding if they drink daily with their meds.

Soda, Soft Drinks, and Pills

Wondering about grapefruit-like or citrus drinks such as Fresca or Mountain Dew? There has been no proof there is any problem with soda and pills. Some medications seem to work better with carbonation although this hasn’t been proved scientifically yet.

Coffee and Medication

Coffee (and caffeine) periodically comes in and out of favor, health-wise.

• Caffeine is found in some meds, especially for pain and headaches because it augments the effectiveness of the drug. (Exedrin, Anacin Extra Strength, Midol).
• Coffee may interfere with absorption of thyroid medication and interferes with some asthma medication with a theophylline component.
• Grapefruit and caffeine can cause nervousness and jitteriness.

It is safest to drink water with prescribed and over-the-counter medications. Read the label on the bottle for further warnings. Everyone is different so what worked for a friend may not have the same result for someone else.

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