Taboo is not only a requirement when taking Chinese medicine, but also applies to western medicine.

There is a cloud in the synopsis of the golden chamber written by Zhang Zhongjing, a medical sage: "If you eat something, it will harm you, but it will harm you." "If you eat something, it will be suitable for your illness, and it will harm you. If you benefit, it will be suitable for your health, and if it hurts you, it will become a disease." Since ancient times, it is well-known that Chinese medicine pays attention to taking medicine and taboos, but in fact, when taking western medicine, it is also necessary to pay attention to dietary taboos.

Taking western medicine still needs to be taboo (Xi Ruonan/People’s Network)

Oral drugs enter the body through absorption (through gastrointestinal tract), distribution (through blood and lymph), metabolism (through liver) and excretion (through kidney and biliary tract). Some foods may affect the absorption, metabolism and other processes of drugs, reduce the efficacy, even make drugs ineffective, and even increase the toxicity of drugs in severe cases. Therefore, according to the condition and treatment needs, patients should follow the doctor’s advice and avoid certain foods when taking medicine, so as not to affect the curative effect of drugs or increase the adverse reactions of drugs. Here are some foods that need to be avoided when taking medicine.

Which drugs should not be taken with grapefruit juice?

Grapefruit juice contains a component that inhibits drug metabolizing enzymes-furan coumarin. It can double the efficacy of drugs entering the blood, thus changing the "therapeutic dose" into "toxic dose". When the situation is serious, users may have adverse reactions such as gastrointestinal bleeding, acute renal failure, respiratory failure and sudden death. In addition, organic anion transport polypeptide OATP1A2 can transport drugs from small intestine to blood, whileNaringin contained in citrus fruits can hinder it. Specifically, the following drugs should not be taken with grapefruit juice:

Antihypertensive drugs (amlodipine, felodipine, nifedipine)

Cholesterol lowering drugs (atorvastatin, lovastatin, simvastatin, fluvastatin, pravastatin)

Hypoglycemic drugs (repaglinide, glibenclamide)

Antiarrhythmic drugs (amiodarone, verapamil)

Antiplatelet drugs (clopidogrel, cilostazol, aspirin, warfarin)

Tetracyclines (erythromycin, clarithromycin)

Antidepressants (trazodone, sertraline)

Antipsychotics (quetiapine, clozapine, haloperidol)

Antiepileptic drugs (carbamazepine)

Sedative hypnotics (triazolam, midazolam, buspirone, diazepam, clonazepam, zolpidem)

Analgesics (methadone, oxycodone, fentanyl)

Medicine for improving cerebral circulation (nimodipine)

Gastrointestinal drugs (cisapride, domperidone)

Cough suppressant (dextromethorphan)

Vasoconstrictor (ergotamine)

Uterine contraction and induced labor drug (mifepristone)

Immunosuppressive drugs after organ transplantation (cyclosporine, tacrolimus)

Antitumor drugs (cyclophosphamide, dasatinib)

Antierectile dysfunction drugs (tadanafil, vardenafil)

Which drugs should not be taken with ethanol?

The combination of ethanol in alcohol and cephalosporins can cause acetaldehyde poisoning. The combination of ethanol and cardiovascular drugs will inhibit the contractility of sympathetic nerve and myocardium, enhance the effect of antihypertensive drugs, reduce blood pressure sharply, and endanger health. The combination of ethanol and hypoglycemic drugs can increase insulin secretion, enhance the effect of hypoglycemic drugs and trigger hypoglycemia shock. The combination of ethanol and sedatives can inhibit the patient’s breathing and lead to coma. The combination of ethanol and anti-gout drugs will weaken the efficacy of drugs in inhibiting uric acid production. The combination of ethanol and antipyretic and analgesic drugs will stimulate gastrointestinal mucosa and cause gastrointestinal bleeding. As an enzyme inducer of liver drugs, ethanol combined with anti-tuberculosis drugs and anti-tumor drugs will accelerate drug metabolism and increase hepatotoxicity. Specifically, the following drugs should not be taken with alcohol:

Antibiotics (cephalosporins, ornidazole, metronidazole, furazolidone, chloramphenicol)

Antihypertensive drugs (reserpine, captopril, nifedipine, hydralazine)

Diuretics (furosemide, spironolactone, hydrochlorothiazide)

Antiangina drugs (nitroglycerin, isosorbide dinitrate)

Cardiotonic drugs (digitalis, digoxin)

Hypoglycemic drugs (gliclazide, glibenclamide, gliquidone, phenformin)

Antiepileptic drugs (carbamazepine, phenytoin sodium)

Sedative hypnotics (diazepam, phenobarbital, chlorzoxazole)

Antidepressants (imipramine, amitriptyline)

Antihistamines (chlorphenamine, cyproheptadine, diphenhydramine)

Antipsychotics (perphenazine, chlorpromazine)

Antigout drugs (allopurinol)

Antipyretic and analgesic drugs (ibuprofen, aspirin, acetaminophen, indomethacin)

Anti-tuberculosis drugs (rifampicin, isoniazid, ethambutol, pyrazinamide)

Gastric acid secretion inhibitor (cimetidine)

Antitumor drugs (fluorouracil, methotrexate)

Which drugs should be taken with milk and yogurt?

Milk and yogurt contain more calcium, protein, amino acids, tyramine and other ingredients. Calcium ions can form insoluble complexes with antibiotics, iron agents, metal ions and other drugs in the intestine, which will affect the absorption of drugs and lead to weakened curative effect. Aromatic amino acids in milk will significantly reduce the absorption of anti-Parkinson’s drugs. Monoamine oxidase inhibitors can accumulate.Tyramine in milk causes adverse reactions such as sudden rise of blood pressure and arrhythmia. Protein in milk can reduce the efficacy of theophylline drugs. Specifically, the following drugs should not be taken with milk and yogurt:

Antibiotics (tetracycline, doxycycline, minocycline, moxifloxacin, levofloxacin)

Gastric mucosal protective drugs (aluminum hydroxide, magnesium aluminum carbonate, colloidal bismuth pectin)

Osteoporosis drugs (alendronate sodium, ibandronate sodium)

Anti-Parkinson drugs (levodopa, carbidopa)

Antihypothyroid drug (levothyroxine sodium)

Iron supplement (ferrous succinate)

Antiasthmatic drugs (theophylline, aminophylline)

Medicine for treat constipation (bisacodyl)

Monoamine oxidase inhibitors (selegiline, isoniazid)

Which drugs should not be taken with tea and coffee?

Tea and coffee contain caffeine, theophylline and other alkaloids, which can excite the central nervous system and reduce the sleeping effect of sedative and hypnotic drugs. Tannin contained in tea can combine with protein to form tannic acid protein, which inactivates probiotics with enzyme activity, weakens the effect of digestive aid or invalidates the drug. Tannin combined with antibiotics will affect antibacterial activity, and antibiotics can inhibit theophylline metabolism, increase theophylline toxicity, and lead to adverse reactions such as nausea and vomiting. Tannin can also precipitate with metal ions, reducing the efficacy of drugs such as iron and calcium. Tannin combined with cardiac glycosides and alkaloids will form insoluble precipitate, which will hinder gastrointestinal absorption and affect the efficacy of drugs. Specifically, the following drugs should not be taken with tea and coffee:

Digestive AIDS (multi-enzyme tablets, pancreatin tablets, mother-feeding students, lactase students)

Cardiotonic (digoxin)

Iron supplement (ferrous succinate)

Calcium supplements (calcium carbonate, calcium gluconate)

Sedative hypnotics (diazepam, phenobarbital, zopiclone)

Gastric mucosal protective drugs (bismuth potassium citrate, sucralfate)

Antibiotics (minocycline, doxycycline, roxithromycin, azithromycin)

Alkaloids (codeine, atropine, ephedrine)

Which drugs should not be taken with polycyclic aromatic hydrocarbons (nicotine)?

Nicotine, nicotine and other components contained in tobacco can affect the metabolism of antiasthmatic drugs, hypoglycemic drugs, diuretics, anti-angina drugs and other drugs, leading to the decrease of drug concentration in blood and the increase of excretion rate, thus affecting the curative effect of drugs. Nicotine in tobacco can excite the central nervous system, reduce the sensitivity of the body to sedative and analgesic drugs, and make the efficacy of drugs worse. Smoking will increase the secretion of gastric acid and pepsin, stimulate vasoconstriction, delay gastric emptying, and affect the protective effect of gastric mucosa on drugs. Long-term smokers will form a layer of smoke tar on the inner membrane of trachea. If patients need to use aerosol for treatment, smoke tar will affect the effect of aerosol in treatment. In addition, smoking will also weaken the role of local anesthetics and increase the chance of pain after anesthesia. Specifically, the following drugs should not be taken with polycyclic aromatic hydrocarbons (nicotine):

Antiasthmatic drugs (theophylline, aminophylline)

Hypoglycemic drugs (insulin, tolbutamide, phenformin)

Antiangina drugs (nifedipine, atenolol)

Gastric acid secretion inhibitors (cimetidine, ranitidine)

Diuretics (furosemide)

Antipyretic analgesic (acetaminophen)

Antipsychotics (clozapine)

Sedative hypnotics (diazepam, azone)

Local anesthetic (lidocaine)

All kinds of aerosols (salbutamol)

Which drugs should not be taken with foods containing potassium?

Banana, citrus, coriander, laver, spinach and other foods with high potassium content should not be combined with drugs such as spironolactone, triamcinolone acetonide and potassium chloride to avoid hyperkalemia.

Which drugs should not be taken with pickled food?

Drugs containing aminopyrine, such as acetaminophen, aminopyrine caffeine and compound amantadine aminopyrine, and sodium nitrite in pickled food can form carcinogenic nitroso compounds in gastric acid. Therefore, drugs containing aminopyrine can not be eaten with pickled food.

Which drugs should not be taken with high-protein foods?

When high-protein food is combined with levodopa, it will produce a large number of amino acids in the intestine that hinder the absorption of drugs, which will reduce the efficacy of drugs. In addition, when high-protein food is combined with isoniazid, tyramine, an intermediate product of protein decomposition, can accumulate in the body, causing patients to have symptoms such as headache, palpitation, limb swelling and numbness. (Jin Tang)

This article is scientifically checked by Zhang Jianping, deputy director of Pharmacy Department of the Sixth People’s Hospital affiliated to Shanghai Jiaotong University.

Contributed by "reaching the doctor and caring for him"