Can consuming caffeine while taking acetaminophen cause liver damage. How does the interaction between these common substances affect your health. What are the potential risks of combining acetaminophen and caffeine in medications. Who may be more vulnerable to the toxic effects of this combination.

The Unexpected Interaction: Acetaminophen and Caffeine

Recent research has uncovered a potentially concerning interaction between two commonly consumed substances: acetaminophen (the active ingredient in Tylenol) and caffeine. This discovery has raised important questions about the safety of combining these widely used compounds.

A preliminary laboratory study, published in the journal Chemical Research in Toxicology, suggests that consuming large amounts of caffeine while taking acetaminophen could potentially lead to liver damage. This finding is particularly significant given the widespread use of acetaminophen as a painkiller in the United States and the ubiquity of caffeine in our daily lives.

The Science Behind the Interaction

The study, conducted by researchers at the University of Washington in Seattle, used E. coli bacteria genetically engineered to express a key human liver enzyme responsible for detoxifying many drugs. The results were startling:

• Caffeine was found to triple the amount of a toxic byproduct called N-acetyl-p-benzoquinone imine (NAPQI) produced when the enzyme breaks down acetaminophen.
• NAPQI is the same toxin responsible for liver damage and failure in toxic alcohol-acetaminophen interactions.
• Previous studies by the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage.

Understanding the Potential Risks

While these findings are concerning, it’s important to note that the study used “megadoses” of both acetaminophen and caffeine, far higher than most individuals would normally consume. However, the exact toxic threshold for this interaction in humans has not yet been determined.

Does this mean you need to completely avoid caffeine when taking acetaminophen? Dr. Sid Nelson, the lead researcher, advises that people don’t necessarily need to stop taking acetaminophen or caffeine products. However, he emphasizes the importance of monitoring intake more carefully when taking them together, especially for those who also consume alcohol.

Who May Be at Higher Risk?

Certain groups may be more vulnerable to the potentially toxic interaction between acetaminophen and caffeine:

1. People taking anti-epileptic medications such as carbamazepine and phenobarbital
2. Individuals using St. John’s Wort, a popular herbal supplement
3. Heavy alcohol drinkers
4. Those who take large amounts of medications combining acetaminophen and caffeine (often used for migraines, arthritis, and other conditions)

The Hidden Dangers in Combination Medications

One of the more surprising aspects of this research is the potential risk associated with medications that intentionally combine caffeine and acetaminophen. These combinations are often used to treat conditions such as migraine headaches and menstrual discomfort.

Why do some medications combine acetaminophen and caffeine? Caffeine is often added to pain relievers because it can enhance their effectiveness. However, this new research suggests that this combination may need to be reevaluated in light of the potential liver risks.

Common Medications Containing Both Acetaminophen and Caffeine

• Excedrin (various formulations)
• Midol Complete
• Anacin
• Some prescription migraine medications

If you regularly use any of these medications, it may be worth discussing alternatives with your healthcare provider, especially if you also consume caffeine from other sources.

Caffeine: More Than Just Coffee

When considering caffeine intake, it’s crucial to remember that coffee isn’t the only source. Caffeine is found in a variety of beverages and foods:

• Tea (including green tea)
• Soft drinks
• Energy drinks
• Chocolate
• Some ice creams and yogurts
• Pre-workout supplements

The cumulative effect of caffeine from multiple sources throughout the day could potentially increase the risk of interaction with acetaminophen.

How Much Caffeine is Too Much?

The FDA recommends that healthy adults consume no more than 400 milligrams of caffeine per day. This is roughly equivalent to:

• 4-5 cups of coffee
• 10 cans of cola
• 2 energy shot drinks

However, when taking acetaminophen, it may be prudent to reduce caffeine intake further, although specific guidelines have not yet been established.

Acetaminophen: A Closer Look at America’s Go-To Painkiller

Acetaminophen, also known as paracetamol outside the United States, is one of the most widely used over-the-counter pain relievers and fever reducers. It’s the active ingredient in Tylenol and is found in numerous other medications.

Why is Acetaminophen So Popular?

• It’s effective for many types of pain and fever
• It doesn’t cause stomach irritation like some other painkillers
• It’s safe for most people when used as directed

However, the popularity of acetaminophen also means that many people may be consuming it without fully understanding its potential interactions and risks.

The Importance of Proper Dosage

Even without the potential interaction with caffeine, acetaminophen can cause liver damage if taken in excessive amounts. The FDA recommends that adults take no more than 4,000 milligrams of acetaminophen per day.

How can you ensure you’re not exceeding the recommended dose? Always read labels carefully, as acetaminophen is found in many combination medications for colds, flu, and allergies. When in doubt, consult with a pharmacist or healthcare provider.

The Liver: Understanding Its Role and Vulnerability

The liver plays a crucial role in processing both acetaminophen and caffeine, which is why their interaction is of particular concern. This vital organ is responsible for detoxifying numerous substances that enter our bodies.

How Does the Liver Process Acetaminophen?

When you take acetaminophen, your liver breaks it down through several pathways:

1. Most of the drug is converted into harmless substances that are eliminated in urine
2. A small amount is converted into NAPQI, the toxic byproduct mentioned earlier
3. Normally, the liver can quickly neutralize NAPQI with an antioxidant called glutathione

Problems arise when too much NAPQI is produced, overwhelming the liver’s ability to neutralize it. This is what happens in cases of acetaminophen overdose, and potentially when large amounts of caffeine are consumed alongside acetaminophen.

Signs of Liver Damage

If you’re concerned about potential liver damage from acetaminophen and caffeine interaction, be aware of these symptoms:

• Yellowing of the skin or eyes (jaundice)
• Abdominal pain, especially in the upper right area
• Nausea or vomiting
• Loss of appetite
• Fatigue
• Dark urine

If you experience these symptoms, especially after taking acetaminophen and consuming caffeine, seek medical attention immediately.

Alternatives and Precautions: Navigating Pain Relief Safely

Given the potential risks associated with combining acetaminophen and caffeine, what alternatives are available for pain relief? And what precautions can you take if you need to use acetaminophen?

Alternative Pain Relief Options

• Ibuprofen (Advil, Motrin): An effective pain reliever and anti-inflammatory, but can cause stomach irritation in some people
• Naproxen (Aleve): Another non-steroidal anti-inflammatory drug (NSAID) that provides longer-lasting pain relief
• Aspirin: Effective for pain and fever, but can increase bleeding risk
• Topical pain relievers: Creams or gels containing ingredients like menthol or capsaicin can provide localized pain relief
• Non-drug approaches: Heat therapy, cold therapy, massage, or physical therapy can be effective for certain types of pain

Precautions When Using Acetaminophen

If you do need to use acetaminophen, consider these precautions:

1. Limit or avoid alcohol consumption
2. Be cautious with caffeine intake, especially from multiple sources
3. Always follow dosage instructions carefully
4. Be aware of other medications that may contain acetaminophen
5. Consult with a healthcare provider if you need to use acetaminophen regularly

Future Research and Implications

The discovery of the potential interaction between acetaminophen and caffeine opens up several avenues for future research and raises important questions about drug safety and public health.

Ongoing and Future Studies

The researchers who uncovered this interaction are currently studying the mechanism by which it occurs. They are also considering human studies in the future to better understand the real-world implications of their findings.

Some key questions that future research may address include:

• What is the threshold at which the acetaminophen-caffeine interaction becomes dangerous in humans?
• Are there genetic factors that make some individuals more susceptible to this interaction?
• How do other common substances (e.g., herbal supplements, prescription medications) affect this interaction?
• Can the beneficial effects of combining acetaminophen and caffeine in some medications be achieved through safer alternatives?

Implications for Drug Development and Regulation

This research may have far-reaching implications for how drugs are developed, tested, and regulated. It highlights the importance of studying not just individual drugs, but also their interactions with common substances like caffeine.

Regulatory bodies like the FDA may need to reassess guidelines for medications that combine acetaminophen and caffeine, and potentially require additional warning labels or dosage recommendations.

Public Health Education

As more research is conducted, there will likely be a need for increased public health education about the potential risks of combining common substances like acetaminophen and caffeine. This may include:

• Updated guidelines for safe acetaminophen use
• More detailed labeling on medications containing acetaminophen
• Public awareness campaigns about the importance of monitoring caffeine intake when using certain medications
• Enhanced training for healthcare providers to better advise patients on these interactions

The discovery of this potential interaction between acetaminophen and caffeine serves as a reminder of the complex ways in which common substances can interact in our bodies. It underscores the importance of ongoing research and vigilance in the realm of drug safety, even for substances we use every day.

As we await further research and potential regulatory changes, the best approach is to stay informed, use medications as directed, and consult with healthcare providers about any concerns. By understanding the potential risks and taking appropriate precautions, we can continue to benefit from the pain-relieving properties of acetaminophen while minimizing potential harm.

Caffeine and acetaminophen don’t mix well

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Sep 27 2007

Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS’ Chemical Research in Toxicology, a monthly journal.

The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.

Health experts have warned for years that consuming excess alcohol while taking acetaminophen can trigger toxic interactions and cause liver damage and even death. However, this is the first time scientists have reported a potentially harmful interaction while taking the painkiller with caffeine, the researchers say.

While the studies are preliminary findings conducted in bacteria and laboratory animals, they suggest that consumers may want to limit caffeine intake — including energy drinks and strong coffee — while taking acetaminophen.

Chemist Sid Nelson, Ph.D., and colleagues, of the University of Washington in Seattle, tested the effects of acetaminophen and caffeine on E. coli bacteria genetically engineered to express a key human enzyme in the liver that detoxifies many prescription and nonprescription drugs. The researchers found that caffeine triples the amount of a toxic byproduct, N-acetyl-p-benzoquinone imine (NAPQI), that the enzyme produces while breaking down acetaminophen. This same toxin is responsible for liver damage and failure in toxic alcohol-acetaminophen interactions, they say.

In previous studies, the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage, thus supporting the current finding.

“People should be informed about this potentially harmful interaction,” Nelson says. “The bottom line is that you don’t have to stop taking acetaminophen or stop taking caffeine products, but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol.”

Nelson points out that the bacteria used in the study were exposed to ‘megadoses’ of both acetaminophen and caffeine, much higher than most individuals would normally consume on a daily basis. Most people would similarly need to consume unusually high levels of these compounds together to have a dangerous effect, but the toxic threshold has not yet been determined, he says.

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Certain groups may be more vulnerable to the potentially toxic interaction than others, Nelson says. This includes people who take certain anti-epileptic medications, including carbamazepine and phenobarbital, and those who take St. John’s Wort, a popular herbal supplement. These products have been shown to boost levels of the enzyme that produces the toxic liver metabolite NAPQI, an effect that will likely be heightened when taking both acetaminophen and caffeine together, he says.

Likewise, people who drink a lot of alcohol may be at increased risk for the toxic interaction, Nelson says. That’s because alcohol can trigger the production of yet another liver enzyme that produces the liver toxin NAPQI. The risks are also higher for those who take large amounts of medications that combine both acetaminophen and caffeine, which are often used together as a remedy for migraine headaches, arthritis and other conditions.

The researchers are currently studying the mechanism by which this toxic interaction occurs and are considering human studies in the future, they say. The National Institutes of Health funded the initial animal and bacterial studies.

http://www.acs.org/

Posted in: Drug Trial News

Tags: Acetaminophen, Alcohol, Anti-Epileptic Drug, Arthritis, Bacteria, Caffeine, Coffee, Drugs, E. coli, Enzyme, Laboratory, Liver, Metabolite, Migraine, OCT, Painkiller, Research, Toxicology, Toxin

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Mixing large doses of both acetaminophen painkiller and caffeine may increase risk of liver damage

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• Mixing large doses of both acetaminophen painkiller and caffeine may increase risk of liver damage

FOR IMMEDIATE RELEASE | September 26, 2007

WASHINGTON, Sept. 26 2007 — Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS’ Chemical Research in Toxicology, a monthly journal. The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.

Health experts have warned for years that consuming excess alcohol while taking acetaminophen can trigger toxic interactions and cause liver damage and even death. However, this is the first time scientists have reported a potentially harmful interaction while taking the painkiller with caffeine, the researchers say.

While the studies are preliminary findings conducted in bacteria and laboratory animals, they suggest that consumers may want to limit caffeine intake — including energy drinks and strong coffee — while taking acetaminophen.

Chemist Sid Nelson, Ph.D., and colleagues, of the University of Washington in Seattle, tested the effects of acetaminophen and caffeine on E. coli bacteria genetically engineered to express a key human enzyme in the liver that detoxifies many prescription and nonprescription drugs. The researchers found that caffeine triples the amount of a toxic byproduct, N-acetyl-p-benzoquinone imine (NAPQI), that the enzyme produces while breaking down acetaminophen. This same toxin is responsible for liver damage and failure in toxic alcohol-acetaminophen interactions, they say.

In previous studies, the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage, thus supporting the current finding.

“People should be informed about this potentially harmful interaction,” Nelson says. “The bottom line is that you don’t have to stop taking acetaminophen or stop taking caffeine products, but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol. ”

Nelson points out that the bacteria used in the study were exposed to ‘megadoses’ of both acetaminophen and caffeine, much higher than most individuals would normally consume on a daily basis. Most people would similarly need to consume unusually high levels of these compounds together to have a dangerous effect, but the toxic threshold has not yet been determined, he says.

Certain groups may be more vulnerable to the potentially toxic interaction than others, Nelson says. This includes people who take certain anti-epileptic medications, including carbamazepine and phenobarbital, and those who take St. John’s Wort, a popular herbal supplement. These products have been shown to boost levels of the enzyme that produces the toxic liver metabolite NAPQI, an effect that will likely be heightened when taking both acetaminophen and caffeine together, he says.

Likewise, people who drink a lot of alcohol may be at increased risk for the toxic interaction, Nelson says. That’s because alcohol can trigger the production of yet another liver enzyme that produces the liver toxin NAPQI. The risks are also higher for those who take large amounts of medications that combine both acetaminophen and caffeine, which are often used together as a remedy for migraine headaches, arthritis and other conditions.

The researchers are currently studying the mechanism by which this toxic interaction occurs and are considering human studies in the future, they say. The National Institutes of Health funded the initial animal and bacterial studies.

— Mark T. Sampson

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Hangover – Alkoinfo.ee

Advise

One of the causes of a hangover, that is, alcohol withdrawal syndrome, is the substance acetaldehyde, which is formed in the body as a result of the conversion of ethanol.

A hangover signals that the body is fighting poison – it is, in fact, a mild form of alcohol poisoning.

Hangover symptoms appear when the blood alcohol level begins to drop to the body’s natural level, close to zero.

Why does a hangover occur?

• Drinking alcohol increases urine output and causes fluid loss. Drinking alcohol is often associated with sweating, vomiting, and diarrhea, which in turn remove water and electrolytes from the body. Fluid loss leads to thirst, weakness and dizziness.
• Alcohol is irritating to the stomach and intestines. The resulting inflammatory process can lead to abdominal pain, nausea, and vomiting.
• Alcohol also depletes the body of vitamins and minerals and lowers blood sugar, which in turn causes fatigue, weakness and mood swings.
• Acetaldehyde, formed as an intermediate in the breakdown of alcohol, can speed up the pulse and cause palpitations, as well as sweating, nausea, and vomiting.
• Alcohol, of course, can induce deep sleep, although in fact, with excessive use, the first phases of sleep, which should precede deep sleep, fall out. In addition, the phase of REM sleep is reduced. In the phase of REM sleep, among other things, there is a consolidation of what has been learned, the ordering of thoughts and memories, and when it is present, a person feels fresh and rested after waking up. Therefore, a person with a hangover feels tired, not getting enough sleep.
• Although no clear explanation for hangover headaches has been found, it has been linked to brain chemistry and hormone imbalances, as well as vasodilation.

How to prevent a hangover?

The less you drink, the less chance of a hangover. The best way to completely avoid a hangover is to not drink at all. Other methods do not give any guarantee that there will be no torment the next day.

Never cross the low-risk limits when drinking. The Alcocalculator will help you keep track of your drinks. See also tips on how to stay within the limits of moderation when drinking alcohol at home or outside.

Be sure to eat your fill before drinking. Then alcohol will be absorbed more slowly, and you will get less drunk.

In order to feel better the next day, it is important to drink enough water in addition to alcohol. When you drink water, you drink less alcohol, and water helps reduce fluid loss. Drink a few large glasses of water before going to bed.

Drinks containing more impurities, usually dark in color – such as red wine, brandy and port – cause more severe hangovers.

Do not mix drinks of different types. This irritates the stomach and guarantees future torment.

How to relieve a hangover?

• To compensate for lost fluids, drink plenty of fluids, preferably non-carbonated drinks. Fresh juice will help replace lost vitamins.
• If you really need it, you can take painkillers, and in case of digestive problems, drugs that reduce the acidity of the stomach. There is an over-the-counter powder in pharmacies that is taken dissolved in water to restore electrolytes and fluids in the body.
• Eat something: for example, bananas and kiwis help fight potassium loss that accompanies fluid loss.
• Don’t get drunk – it will only delay problems. Take a break from alcohol. Wanting to drink in the morning to relieve a hangover means you’re having withdrawal symptoms, which could indicate excessive drinking or an alcohol use disorder (abuse or addiction).
• Take a multivitamin to replace the body’s essentials lost through alcohol.

Ten myths about hangovers

1. Hangovers are caused by dehydration

Dehydration is one of the hangover causes, but not the only one. In fact, with each unit of alcohol from the body, in addition to the amount drunk, an additional 100 ml of liquid is excreted. For example, if you drink five servings of beer, the body will lose another liter of fluid.

However, will two liters of water save you from a hangover? Obviously not. Coincident symptoms of dehydration and hangovers are thirst, weakness, and headache. Have you ever had such a hangover that you could not eat and spent the whole day on your knees in front of the toilet? Daylight is deadly harsh, and it is almost impossible to express at least one thought coherently? These symptoms are not related to dehydration, but to the toxic effects of alcohol.

2. Coffee or a cold shower helps with a hangover

Last night you had a little too much to drink. In the morning, you put coffee on and jump into a cold shower to cheer yourself up. Both of these can give you the slightest boost, but they won’t cure a hangover. In fact, coffee can increase it, as it also removes fluid from the body. So replace your coffee with water – and especially if you’ve been throwing up, causing you to lose even more fluid.

3. Hangover helps

It is believed that the morning hangover relieves the hangover. But this is not true. Hangovers begin to form as the blood alcohol level drops, and symptoms peak when the blood alcohol level approaches zero. Getting drunk is just delaying the hangover. At some point, you willy-nilly have to sober up, and the hangover will still come. Instead of alcohol, drink water or a sports drink instead to restore fluid levels, electrolytes, and vitamins.

Morning hangovers are often a sign that you are at serious risk of having problems with excessive drinking. It is also one of the symptoms of alcohol addiction.

4. Eating at the end of the party eases hangovers

If only it were so! It would be great if after a rampant drinking you could eat a couple of large hamburgers and a bowl of french fries – and wake up the next morning in perfect order. Actually it is not.

Food can certainly help prevent hangovers, but you should eat before drinking. The best choice would be fatty foods that are slowly digested. If you drink alcohol on a full stomach, it will be absorbed into the blood more slowly, and the hangover the next day will be a little easier.

5. A hangover occurs only if you drink a lot. At the same time, in order to earn a hangover, it is not necessary to get drunk every time, for some, just one serving is enough for this. The occurrence of a hangover, among other things, is affected by your weight and gender. In addition, hangovers are more likely to occur in people, for example, those who suffer from migraines or take medications that affect liver enzymes.

6. Beer and wine are better than strong alcohol

Some people literally swear that beer and wine do not cause such a bad hangover as strong drinks. In fact, you will get drunk and hangover from any alcoholic drink, since they all contain ethanol. And it doesn’t matter in what order you drink them.

In addition, it is useful to remember that:

• red wine contains tannins that cause headaches in some people;
• mixing different drinks irritates the stomach and may increase hangovers;
• Highly contaminated drinks, usually dark in color – such as red wine, brandy and port – cause more severe hangovers;
• If you start the evening with strong alcohol, you often quickly lose your moderation and end up drinking more than you intended.

7. Workout Helps

While exercising the next morning can relieve conscience, no study has so far confirmed that it helps alleviate the physical effects of drinking alcohol. You can only burn calories from alcohol. In addition, after drinking alcohol, your body is ruled by a lack of fluids and nutrients. When you exercise, you again lose fluid and essential substances, so the end result can be further deterioration of well-being, and in severe cases, even a health-threatening condition. With a lack of fluid, the thermoregulation of the body is disturbed, so that when playing sports in hot weather, you can easily overheat.

During a hangover, both reaction speed, eye-hand coordination, and balance are impaired, which will affect your athletic performance, requiring fast and accurate action.

8. Bedtime pain relievers

When taken with alcohol, acetaminophen (known as the cold medicine Tylenol/Tylenol) can destroy the liver. Other pain relievers, such as aspirin, paracetamol, and ibuprofen, can irritate the stomach and cause bleeding when combined with alcohol.

Also, taking a painkiller in the evening won’t do you any good: it will only give you pain relief for a few hours, but you don’t feel any pain while you sleep. Take a pain reliever in the morning if necessary.

9. Women and men get hangovers the same way

In fact, women get hangovers more easily. Even if a woman is exactly the same weight as a man, she needs less alcohol to get drunk. The male body contains more water, which dilutes alcohol and helps to reduce its effects. The male body also produces more of the enzyme that breaks down alcohol.

10. Hangover is not a big problem

Hangover shows that the body is poisoned by excess alcohol. Heavy drinking affects the nervous system and brain chemistry, leading to headaches, drowsiness, and nausea. Your intestines are irritated and inflamed. Yes, in fact, you will recover quickly and may not be affected by suffering after a good party. But overdoing it with alcohol is always a risk. Too much alcohol can lead to alcohol poisoning, you may pass out, and breathing may be difficult. You may even die. No party is worth it.

Also, while you’re hungover, you’re wasting a lot of precious time that could have been better spent. Perhaps you will not have time for work or not get there at all, perhaps precious hours of communication with family and loved ones will be lost. You have to consider if it’s worth it.

Which medicines do not go well with food?

Even the healthiest food can become poisonous if seasoned with medicines.

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Some foods contain very specific substances that some medications can counteract.

Contents of the article

1.

Grapefruit and cough medicine

Also combination of medicine with lime and pomelo. These fruits block the production of an enzyme that breaks down statins and other drugs, such as the cough medicine dextromethorphan. As a result, the drug accumulates in the blood, which can lead to unwanted side effects. In the case of a combination of citrus fruits with dextromethorphan, hallucinations and drowsiness may appear, and with statins – serious muscle damage. The effect of these fruits lasts a little more than a day, which means that they and medicines should be taken with an interval of at least 24 hours.

2. Dairy products and antibiotics

Some antibiotics, such as ciprofloxacin, combine in the stomach with calcium, iron and other minerals found in milk. This leads to the fact that the antibiotic is poorly absorbed and, accordingly, the effectiveness of its fight against infections is sharply reduced. When you buy a new medicine for asthma or colds, the first thing to ask is if it belongs to the group of so-called tetracyclines or fluoroquinols. If it does, try to avoid milk, yogurt, and cheese for 2 hours before and after taking your medication. And if you are also taking multivitamin or mineral complexes, then check this period with your pharmacist, as they may have a similar effect.

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3. Smoked meats and antidepressants

Read the label of your pills carefully. If it contains monoamine oxidase inhibitors (MAOIs), then taking them along with foods rich in the amino acid tyramine will lead to a dangerous surge in blood pressure. Unfortunately, the list of foods containing this amino acid is not limited to barbecue and smoked salmon. It also includes red wine, sauerkraut, hot dogs, aged cheeses, and draft or home-brewed beer. However, do not panic ahead of time! Canned or bottled beer probably won’t hurt you, and monoamine oxidase inhibitors are rapidly being replaced by new generation antidepressants that don’t have these side effects.

4. Chocolate and Ritalin

In addition to caffeine, chocolate also contains a stimulant called theobromine. It is because of this substance that chocolate is harmful to dogs – they simply cannot digest it. Both of these stimulants entering your body can lead to unpredictable consequences and cause seizures. Just like the effects of caffeine, the effects of combining chocolate and Ritalin are highly individual. So the best solution is this: if you are nervous, overly irritable and aroused after taking Ritalin and a chocolate bar, then try increasing the time between taking the medicine and chocolate dessert. Or choose milk or white chocolate: the darker the chocolate, the more caffeine and theobromine it contains.

5. Apple juice and allergy medicines

If you are taking hay fever medicine, never take apple, orange or grapefruit juice with it without waiting 4 hours after taking the pills. These juices inhibit the peptide that transports the drug from the intestines to the blood. As a result, the effectiveness of the drug is reduced by 70 percent, which will make it almost pointless to take it, and your runny nose and sneezing will become non-stop. Also avoid these juices when using the antibiotic ciprofloxacin, the synthroid thyroid remedy, or the allergy and asthma remedy singular.

6. Cassia cinnamon and warfarin

People who have been taking the blood-thinning drug warfarin for a long time know that vitamin K is very important when taking it. broccoli or leafy greens. They contain a large amount of vitamin K, which plays a key role in blood clotting, and its decrease will have a bad effect on its density. But here another problem arises. Cassia cinnamon (cheap cinnamon from China, Vietnam, and Indonesia, often sold as “Indonesian cinnamon”) contains coumarin, which, like warfarin, is a blood thinner. Taking both of these substances can cause serious liver damage. If you are taking warfarin but cannot live without a cup of flavored cinnamon coffee, then switch to a high quality Ceylon cinnamon variety.

7. Alcohol and paracetamol

Your body uses the same enzyme to break down alcohol and paracetamol.