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Risky Holiday Food and Drug Interactions

If you're on medication, check this list twice before indulging in the season's goodies

Eggnog, spiked punch and high-fat meals are traditional parts of ringing in the holidays. But attacking the cheese tray or reaching for a third glass of wine can have dangerous consequences if you're on certain medications. "Alcohol, especially, plays a role in altering the effects of just about all medications," says pharmacist and activist Armon Neel Jr., co-author of Are Your Prescriptions Killing You? (Simon & Schuster, 2012).

(MORE: 7 Questions to Ask About Every New Prescription)

But other foods and drinks that aren't part of your regular diet may also cause unexpected interactions with your prescription drugs. "Plan ahead and talk to your pharmacist or physician before putting yourself at risk," says Jill Sailors, assistant professor of pharmacy practice at the St. Louis College of Pharmacy.
Here are some of the potentially dangerous medication and food combinations you or your loved ones will want to avoid this holiday season. When planning your meals, of course, it's the foods or drinks that should be avoided; don't stop taking any medication to accommodate holiday eating or drinking plans without consulting your doctor.

If you take: Antidepressants or tranquilizers
Avoid: Alcohol

Many of us drink more during the holidays than we might at other times of the year, but combining "alcohol and these medications should be avoided altogether," Neel says. Fundamentally, alcohol can make some people feel more depressed, counteracting the antidepressant. Drinking while taking antidepressants or tranquilizers can also make you sleepy, and impair your alertness and focus. It may also lower your breathing rate and heart rate.
If you take: Monoamine oxidase inhibitors (MAOIs)
Avoid: Alcohol and foods with tyramine

MAOIs are not prescribed to treat depression as often as they once were, says Sybil Thomas, lead pharmacist at Loyola University Medical Center in Chicago. If you do take this medication, be leery of foods high in tyramine, which can increase blood pressure to dangerous, potentially life-threatening levels. Tyramine is found all over the holiday buffet table, in cured meats, like salami; chocolate; red wine; aged cheese; soy sauce; packaged gravy; licorice; yeast extracts; and, yes, alcohol.

If you take: Statins
Avoid: Grapefruit juice

Cholesterol-lowering statins, like Lipitor, are among the most widely prescribed drugs in the United States, and many users are aware that they mesh poorly with grapefruit juice, which can cause a dangerous buildup of the medication in the bloodstream. "The interaction can last for several days," Sailors says, "and can be potentially life threatening." The particular holiday risk is that many seasonal mixed drinks, including a variety of fruit punches and cocktails, are made with grapefruit juice. If there's punch on the table at your gathering, ask the host what's in it before trying a cup.

If you take: Antihistamines
Avoid: Fruit juices

Apple, orange and grapefruit juice can all decrease the effectiveness of antihistamines, like Allegra, Thomas says. Again, if you're not sure what's in a punch or cocktail, be safe: ask.

(MORE: The Risk of Becoming an 'Almost' Alcoholic)

If you take: Blood thinners
Avoid: Vegetables high in vitamin K

Blood-thinning medications like Coumadin are often prescribed to people who have irregular heartbeats, have suffered a heart attack or are prone to blood clots. But vegetables high in vitamin K can block the effectiveness of warfarin, the active ingredient in such drugs, Neel says, and as a result increase the risk of blood clots. If you're on a blood thinner, steer clear of green tea, Brussels sprouts, avocado, spinach and asparagus.

If you take: Diabetes medication
Avoid: Alcohol

Consuming alcohol while taking oral diabetic medications, like Metformin, can result in low blood sugar, Thomas says. Drinking while taking such drugs can also result in a potentially fatal condition called lactic acidosis, in which lactic acid builds up in the bloodstream faster than it can be removed. If you're taking any of these drugs, she says, limit your alcohol intake to no more than one or two drinks — and be sure to drink with a meal or snack to lessen the impact.
If you take: Antibiotics
Avoid: Dairy

The cheese tray may be tempting, but the calcium in dairy foods, yogurt and milk binds with some types of antibiotic medication and prevents their absorption in the body. (Ask your doctor or pharmacist if the antibiotic you're taking puts you at risk.) To avoid the problem, Thomas suggests, stop consuming dairy products one hour before taking an antibiotic and wait at least two hours afterward before nibbling more Jarlsberg.
(MORE: Get Your Pharmacist on Your Health Team)
If you take: Any prescriptions
Avoid: High-fat meals

Heavy, high-fat meals should be avoided in general. "They lead to delayed absorption of medications because they slow down your gastrointestinal tract," Thomas says.

If you're on prescription medication this season, Neel suggests, try to limit yourself to one drink at gatherings and eat as close to the usual amount and type of food you normally consume.

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