When taking medications, what they are taken with matters a lot. Paracetamol, for example, takes effect much faster on an empty stomach and, if taken with food, it is key that they are not rich in carbohydrates or pepsin like apples or pears. It is explained by Carmen del Campo Arroyo, pharmacist, nutritionist and co-author of the manual Interactions between Foods and Medicines prepared by the General Council of Pharmaceutical Colleges of Spain.
Because, he emphasizes, there are foods that, due to their components, can change the therapeutic effect of a medication, increase or decrease it, but drugs also modify the way in which the body uses nutrients and can compromise the nutritional status of the person.
For example, taking some iron capsules or drops if you have kiwi for breakfast is not the same as if you eat yogurt. “In the case of iron, we help its absorption and its effect if we take it with a fruit or vegetable with vitamin C, but we will do the opposite if we take it with a source of calcium; So instead of recommending taking it with breakfast (which usually includes dairy), it should be recommended with the midday meal, when it is easy to eat products with vitamin C such as tomatoes, peppers, kiwi or strawberries,” says Del Campo.
The authors of the guide comment that food-drug interactions are not detected as easily as interactions between medications, but their frequency is much higher because the habit of taking drugs with meals is well established.
And this habit is not always advisable. “If you have a thyroid hormone deficiency and are one of those who start the day with levothyroxine, always do it on an empty stomach, as food reduces its absorption and, therefore, its effect,” notes one of the recommendations.
And the effect of antibiotics can also be compromised when taken with food. “Certain components of food – such as fiber, calcium, iron… – can trap the medication throughout the digestive system” and inactivate its effect.
The information campaign launched by the Pharmacists Council makes it clear that interference with drugs can also occur with foods considered healthy. Green leafy vegetables such as spinach, kale, cabbage or lettuce are not suitable for those who take acenocoumarol, because they contain vitamin K, which can modify their anticoagulant effect.
On the other hand, Del Campo emphasizes that, although doctors often advise taking the medication with breakfast, lunch and dinner so that the patient does not forget, “the recommendation on when to do it, whether with food or not, and with Which ones should be individualized because the severity of the effects of the drug-nutrient interaction depends on the habits, genetics, and the health and nutritional status of the person.
