Drug–Food Interactions

🍊 Grapefruit Juice

• Statins (Atorvastatin, Simvastatin): ↑ drug levels → risk of muscle pain, liver damage.
• Calcium Channel Blockers (Felodipine, Nifedipine): ↑ absorption → risk of low BP, dizziness.
• Anti-anxiety / Psych drugs (Buspirone, some SSRIs): ↑ drug levels → risk of drowsiness, serotonin problems.
• Immunosuppressants (Cyclosporine): ↑ concentration → risk of toxicity, kidney damage.

🥬 Green Leafy Vegetables (Vitamin K–rich)

• ↓ effectiveness of aspirin & warfarin (blood thinners).

🥛 Dairy Products (Milk, Yogurt, Cheese)

• ↓ absorption of antibiotics (e.g., tetracyclines, fluoroquinolones).

Herb–Drug Interactions

🧄 Garlic

• ↓ platelet aggregation.
• With anticoagulants (warfarin, heparin, DOACs) → ↑ risk of bleeding/bruising.

🍃 Ginkgo Biloba

• ↓ platelet function, ↑ blood flow.
• With anticoagulants → risk of GI or intracranial bleeding.

🌱 Ginseng

• Alters clotting + metabolism.
• May ↓ warfarin effectiveness (↑ clot risk) OR ↑ bleeding depending on dose/type.

🫚 Ginger

• Mild ↓ platelet activity.
• With anticoagulants → ↑ bleeding risk.

🌿 Aloe Vera

• External: wound healing, burn relief.
• Internal: laxative effect → may cause arrhythmias, neuropathies, edema.

🌸 Black Cohosh

• For menopausal symptoms (hot flashes, palpitations).
• Potentiates insulin & oral hypoglycemics → risk of hypoglycemia.

🌼 Echinacea

• Stimulates immune system.
• Used for colds, flu, UTIs (limit to 2 weeks).

🌼 Feverfew

• For migraines, RA, PMS.
• ↓ platelet aggregation → ↑ bleeding risk.

🌿 Hawthorn

• For heart failure, angina.
• Can cause hypotension with nitrates, PDE-5 inhibitors, or antihypertensives.

🌱 Kava Kava

• For relaxation, anxiety.
• Causes CNS sedation, may be hepatotoxic (avoid alcohol).

🍬 Licorice

• Anti-inflammatory, antimicrobial.
• In large amounts → ↑ BP and electrolyte issues.

🌾 Milk Thistle

• For liver/gallbladder disorders.
• May potentiate antidiabetic drugs → hypoglycemia risk.

🌸 St. John’s Wort (depression, viral infections)

• For depression, viral infections.
• May cause serotonin syndrome if combined with other antidepressants.

🌴 Saw Palmetto (prostate)

• For benign prostatic hyperplasia (BPH).
• Stop 1–2 weeks before PSA testing.

⚠️ General Hazards of Herbs

1. Can interact with prescription and OTC drugs.
2. Avoid during pregnancy/nursing.
3. Not recommended for infants or young children.