General rules

• If you are starting a new medication, be sure to read the directions and all drug information before taking the medication. You may also want to consult your doctor.
• Avoid consuming alcohol while taking any drug unless a physician or pharmacist indicates that the combination is acceptable.
• Cigarettes can also diminish the effectiveness of medication or create added hazards with certain medications.
• Caffeine, which is found in coffee, tea, soft drinks, chocolate, and some medications, can also affect the action of some drugs.
• If you are pregnant or breastfeeding, consult your doctor before taking medication.

Allergies, asthma, colds and coughs
Antihistamines
Antihistamines are used to relieve or prevent the symptoms of colds and hay fever and other types of allergies. They act to limit or block histamine, which is released by the body when it is exposed to substances that cause allergic reactions.

Interaction: Avoid drinking alcoholic beverages because antihistamines combined with alcohol may cause drowsiness and slow your reactions.

Bronchodilators
Bronchodilators are used to treat the symptoms of bronchial asthma, chronic bronchitis, and emphysema. These medicines relieve wheezing, shortness of breath, and troubled breathing. They work by opening the air passages of the lungs.

Interaction: Avoid eating or drinking large amounts of foods or beverages that contain caffeine because both bronchodilators and caffeine stimulate the central nervous system.

Arthritis and gout
Aspirin
Aspirin reduces pain, fever, and inflammation. Aspirin is available in many brands. Many over-the-counter cold remedies contain aspirin in combination with other active ingredients.

Interaction: Aspirin can cause stomach irritation, so avoid alcohol. Take with food to prevent stomach upset. Do not take with fruit juice.

Corticosteroids
Corticosteroids are cortisone-like drugs that are used to provide relief to inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions.

Interaction: Avoid alcohol because both alcohol and corticosteroids can cause stomach irritation. Also avoid foods high in sodium (salt). Check labels on food packages for sodium content. Take with food to prevent stomach upset.

Ibuprofen and other anti-inflammatory agents
Ibuprofen relieves pain and reduces inflammation and fever.

Interaction: These drugs can irritate your stomach so take them with food or milk. Avoid taking the medication with alcoholic beverages or foods that tend to bother your stomach.

Indomethacin
This medication is used to treat the painful symptoms of certain types of arthritis and gout by reducing inflammation, swelling, stiffness, joint pain, and fever.

Interaction: This drug can irritate your stomach, so take it with food. Avoid taking this medication with alcoholic beverages or foods that tend to irritate your stomach.

Piroxicam
This medication is used to treat pain, inflammation, redness, swelling, and stiffness caused by certain types of arthritis.

Interaction: This medication can cause stomach irritation so take it with food. Avoid alcohol because it can add to the possibility of stomach upset.

Heart and circulatory diseases
Diuretics
Diuretics increase the elimination of water, sodium, and chloride from the body.

Interaction: Diuretics vary in their interactions with nutrients. Loss of potassium, calcium, and magnesium occurs with some diuretics. If necessary, your doctor may prescribe a potassium supplement. Consult your doctor or pharmacist.

Vasodilators
Vasodilators are used to relax veins and/or arteries to reduce the workload of the heart.

Interaction: Restrict the use of sodium (salt) for this medication to work effectively. Check labels on food packages for sodium content.

Anti-Hypertensives
Anti-hypertensives relax blood vessels, increase the supply of blood and oxygen to the heart, and lessen its workload. Some anti-hypertensives also regulate heart beat.

Interaction: Restrict the use of sodium (salt) for medication to work effectively. Check labels on food packages for sodium content.

Anticoagulants
Anticoagulants are used to reduce clotting of the blood.

Interaction: Consume foods high in vitamin K in moderation because vitamin K produces blood-clotting substances. These foods include spinach, cauliflower, Brussels sprouts, potatoes, vegetable oil, and egg yolk.

Antibiotics
Erythromycin
Erythromycin is an antibiotic used to treat a wide variety of infections, including throat, ears, and skin infections.

Interaction: Erythromycins vary in their reactions with food; consult your doctor or pharmacist for instructions.

Methenamine
Methenamine is used to treat urinary tract infections.

Interaction: Cranberries, plums, and prunes as well as their juices help the action of this drug. Avoid citrus fruits and citrus juices. Eat foods with protein, but avoid dairy products.

Metronidazole
This agent is an anti-infective used to treat intestinal and genital infections due to bacteria and parasites.

Interaction: Do not drink alcohol while using this drug, because it may cause a severe reaction that includes stomach pain, nausea, vomiting, headache, and flushing or redness of the face.

Penicillins
Penicillins are antibiotics used to treat a wide variety of infections.

Interaction: Amoxicillin may be taken with food; however, absorption of other types of penicillins is reduced when you take them with food. Consult your doctor or pharmacist for instructions.

Sulfa Drugs
Sulfa drugs are anti-infectives which are used to treat stomach and urinary infections.

Interaction: Avoid alcohol; the combination of sulfa drugs and alcohol may cause nausea.

Tetracyclines
Tetracyclines are antibiotics used to treat a wide variety of infections.

Interaction: These drugs should be taken 1 hour before or 2 hours after eating dairy products such as milk, yogurt or cheese Calcium or iron supplements should not be taken within 4 hours of tetracycline.

Pain
Aspirin
Aspirin reduces pain, fever, and inflammation. Aspirin is available in many brands.

Interaction: To avoid stomach upset, take with food. Do not take with fruit juice. Do not drink alcohol when you are taking aspirin as it can cause stomach irritation.

Codeine
Codeine is a narcotic used in many cough and pain relief medicines. Codeine suppresses coughs and relieves pain, and it is often combined with aspirin or acetaminophen in medications.

Interaction: Do not drink alcohol with this medication because it could increase the medication’s sedative effect. Take with meals, small snacks, or milk because this medication may cause stomach upset.

Other Narcotic Analgesics
Narcotics are used for the relief of pain.

Interaction: Do not drink alcohol because it increases sedative effect of the medications. Take these medications with food because they can upset the stomach.

Psychiatric or emotional problems
Most medications for psychiatric or emotional disturbances interact dangerously with alcohol.

Lithium Carbonate
Lithium regulates changes in hormone levels in the brain, balancing excitement and depression.

Interaction: Follow the dietary and fluid intake instructions of your physician to avoid very serious toxic reactions.

MAO Inhibitors
MAO Inhibitors are used primarily to treat depression.

Interaction: A very dangerous, potentially fatal interaction can occur with foods containing tyramine, a chemical in alcoholic beverages, particularly wine, and in many foods such as hard cheeses, chocolate, beef, and chicken livers. Be sure to follow your physician's instructions.

Sleep disturbances
Do not use alcohol with any sleep medications.

Food and Drug Administration Reproduced from the Office on Women's Health; Department of Health and Human Services.