| Antacids |
|Nonprescription indigestion remedies
||Foods lessen effects.
||Take 1 hour after eating. |
| Antibiotics |
| In general
||Reduce intestinal production of biotin (a B vitamin), pantothenic acid (vitamin B5), and vitamin K; can speed up passage of food through intestine, decreasing availability for absorption.
||Eat a well-balanced diet, including plenty of vegetables, grains, and cereals, to ensure adequate intake of all vitamins.|
||Food slows absorption but does not alter dose effect.
- Erythromycin stearate
|Food decreases absorption.
||Take 1 hour before or 2 hours after meals.|
- Erythromycin estolate/succinate
|Food improves absorption; fruit juice or carbonated beverages interfere with absorption.
||Take with meals.|
||Binds calcium and iron so that neither antibiotic nor mineral can be absorbed.
||Take 2 hours before or after meals and other medications such as iron supplements or calcium-based antacids.|
| Iron Supplements |
|Various brands in liquid or tablet form
||Milk may interfere with absorption.
||Should be taken with water or slightly acidic drinks like fruit juice to improve absorption.|
||Can interfere with effectiveness of birth control pills.
||Take with fatty meal.|
|Anticonvulsant/Antiepileptic Medications |
|Interfere with vitamin D metabolism and thus with calcium absorption; also alter absorption of folic acid.
||A good intake of vitamin D (found in fortified milk, egg yolks, oily fish, sunlight), calcium (dairy foods, leafy greens, broccoli, canned fish with bones), and folic acid (fresh fruits, vegetables, grains) should offset medication effects; ask your pediatrician about vitamin D and calcium supplements if your child is on long-term epilepsy treatment; folic acid supplements should not be used because overly high blood levels may decrease anticonvulsant efficacy.|
||Better absorbed with food or milk.
||Take with a meal or a glass of milk.|
|Thyroid Medications |
||Take on an empty stomach.|
|Nonsteroidal Anti-inflammatory Medications |
||Interferes with storage of vitamin C; may cause iron loss through bleeding in digestive tract.
||Do not give aspirin to children unless your pediatrician specifically prescribes it because it has been associated with Reye syndrome, a rare but serious disease affecting the brain and liver following viral infections; use acetaminophen or ibuprofen.|
|Antituberculosis Medications |
||Interferes with vitamin B6 (pyridoxine) metabolism.
||Eat a well-balanced diet, including sources of vitamin B6 such as grains, spinach, sweet and white potatoes, bananas, watermelon, and prunes.|
|May promote excretion of potassium and calcium.
||Reduce salt intake; eat foods high in potassium (fresh fruits and vegetables) and calcium (low-fat dairy foods) to counter loss of these minerals; take with food to lessen stomach upset.|
||Interferes with the absorption of fat-soluble vitamins in the first part of the intestine.
||Provide a diet rich in vegetables and fruits for fiber and encourage your child to drink plenty of water; if constipation is a problem, ask your pediatrician’s advice; when mineral oil is prescribed, it should be given at bedtime, after most of the day’s food has passed through the first part of the intestine.|
|Oral Contraceptives |
||Alter blood cholesterol levels; increase need for folic acid and vitamin B6.
||Use another form of contraception if there is a family history of high blood cholesterol or heart disease; consume plenty of fresh fruits and vegetables, grains and cereals, potatoes, and other sources of folic acid and vitamin B6; take with food to prevent nausea; antibiotics may decrease the effectiveness of oral contraceptives.|