How food and drink can affect your medication

Can what I eat affect my medication?

Your doctor should tell you if there are any foods you need to avoid or eat more of while taking the prescribed drugs for your condition. There should also be information in the patient information leaflet included with your drugs.

Complementary treatments, such as supplements or herbal remedies, can also interact with certain medications and could increase the risk of side effects. It’s important to let your doctor know if you take any complementary treatments.

Some drugs prescribed for arthritis do interact with certain foods. These are some of the most common interactions:

Grapefruit

Grapefruit and grapefruit juice contain compounds that can block enzymes in your body. These enzymes are needed to break down certain drugs, but if they’re blocked, this can increase the levels of the drug in your blood. This could then cause new or worse side effects.

This can happen with some drugs to treat arthritis and related conditions, including:

• colchicine for gout
• carbamazepine for long-term pain
• fentanyl for some types of pain
• ciclosporin, a disease-modifying anti-rheumatic drug (DMARD) used to treat conditions such as rheumatoid arthritis
• amitriptyline, originally used as an antidepressant but it can also be used for long-term pain
• warfarin, which can be used to treat antiphospholipid syndrome.

Alcohol

Alcohol can increase some side effects, such as drowsiness, of medications such as strong painkillers and antidepressants used to treat pain. It can also increase the risk of stomach and digestive problems and bleeding, with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and steroid tablets, such as prednisolone.

It used to be thought that people taking the DMARD methotrexate needed to avoid alcohol, but recent research suggests that it’s safe for people taking this drug to drink within the recommended limits for adults in the UK – 14 units a week. Both alcohol and methotrexate can affect the liver, so it’s important that if you do drink, you drink in moderation.

Vitamin K

You may be prescribed blood thinners, such as warfarin, for a number of conditions, including antiphospholipid syndrome. They’re also sometimes prescribed after surgery.

You should try to avoid changing the amount of vitamin K in your diet while taking these drugs, as vitamin K works to prevent your body from bleeding, so could reduce the effects of the drug. Vitamin K is found in leafy greens, such as kale and spinach.

Taking your medication

It’s important that you take any medication you’ve been given as you’ve been told to by your doctor, nurse or pharmacist.

Some drugs need to be taken in a specific way, such as before or after food, or with water – you should be told about this, but the information leaflet included with your medication will also explain this, so make sure to read this carefully.

Taking certain drugs with food or after you’ve eaten can help to reduce the risk of certain side effects – such as indigestion, stomach ulcers, feeling sick or vomiting. It can also help your body to absorb the drug properly and can make sure it’s not washed away by food or drink, for example if you use mouthwashes or gels.

What should I eat if medication is making me feel sick?

Some medications can cause side effects, such as vomiting or feeling sick. However, it’s thought that some foods can reduce nausea or help if your medication has made you unwell.

Some people find taking sips of a cold drink helps. Water can help you stay hydrated, especially if you’ve been sick. Some people find that fizzy drinks work better than flat ones. Ginger or peppermint tea are also good options.

Eating foods containing ginger, even ginger biscuits can also help with feeling sick. It can also be a good idea to eat small, regular meals if you’re feeling unwell, but try not to eat too quickly.

Some people find eating spicy, fried or greasy food, or food that has a strong smell, can upset their stomach more – so try to avoid these if you are experiencing problems. Try and have more dry foods such as crackers and dry toast. Don’t have a large drink with meals either, as this can make nausea worse.

Fasting for religious observances

If you have a type of arthritis, you may have concerns about fasting during religious observances – for example, if medication for your condition needs to be taken with food. Fasting is a personal choice that only you can make, but you may want to speak to your GP, rheumatology team, pharmacist, or religious leader for advice.

Your healthcare team may be able to make suggestions to change the timings or dosages of certain medications, and they’ll also be able to tell you if it’s safe for you to fast. Some people are excused from fasting in different religions, for example if they are children, pregnant, breastfeeding, ill, or if fasting could make their health worse.

Some people believe that medications that aren’t taken by mouth – such as injections, inhalers, creams or eye drops – don’t break the fast. Speak to your doctor or pharmacist for advice on different types of medications. In some faiths, even taking medications by mouth does not count as breaking a fast.

Your religious leader may be able to suggest other ways you can honour your fasts, for example through charity work, or by making up the fast time later in the year, especially when the days are shorter.