This blog will be short and sweet because the focus is on the new resource! I provide you with the best summary sheet of Food Medication Interactions free!
Here you will find an explanation on the summary list of food medication interactions list that I have seen most commonly used. Along with the medication list – you will find the impact on food/nutrients and GI implications to monitor. It’s important that Dietitian’s are aware of the impact medications have on their patient’s nutritional status.
Read on to find out, why?
You can download the resource at the bottom of this page!
Food – Medication Interactions
I made a big mistake when I was a new Dietitian. I didn’t take into account the medications that affected my patient’s nutrition status! Rookie mistake… You may have a patient now that you can’t quite figure out why they’re declining. Medications have a MAJOR GASTROINTESTINAL (GI) impact!
Browse the list of nutrition implications in the resource below to see what I’m talking about. How can we not take these into account in our nutrition assessment?
Food Medication Interactions Impact
Think about how often your patient receives medications and how many they’re taking per day. The average number of medications a resident is taking is 151!
Each medication is obviously designed for a certain purpose in the body and they alter the natural body processes. So we need to add medications into our nutrition assessment for every patient.
I will make a caveat here, this information is for Dietitians to work WITH the medications a patient has been prescribed. We need to stay within our scope of practice.
If you see that a medication is really negatively affecting a patient’s nutrition status, you can have a discussion with the Doctor. You can ask if there is an alternative that can be tried. Most Doctor’s will at least entertain a discussion. But don’t walk into a meeting with a Doctor and tell them a medication needs to be changed.
Don’t step out of your scope. Use your clinical judgement to find the line of what you can say and how to work together. If you want to read more on how to develop a trusting relationship with Doctors, click here. At the end of the day, you’re both trying to help your patient.
Food Medication Interactions Examples
Let’s take a look at a couple examples for investigation…
Furosemide/Lasix
We see this medication used as an Antihypertensive, frequently I see it used to reduce edema. The side effects of this medication are: Anorexia and increased thirst. GI recommendations are to take on an empty stomach, and discontinue a reduced sodium diet if hyponatremia is noted.
If we think about this medication and the way medications are delivered, do you think this is being given on an empty stomach? In my observations, I see most medications given right before meals (technically on an empty stomach), or during meals. Wrong wrong wrong. If taken on a full stomach or during a meal, the nutrients interact with the medication.
We all know that best practice is to NOT give medications at meal times, but I see this happening with increased frequency. So in the case of Furosemide/Lasix, the medication may see increased side effects if not given on an empty stomach. If you have patient’s on Lasix, look at if the side effects line up with what the list states.
Hydromorphone
I’m using this as another example because I see this one used quite frequently for pain control also called a narcotic.
Just a few examples of the side effects: Anorexia, decreased weight, increased thirst, dehydration, dry mouth, taste changes, dysphagia, oh my goodness… I could keep going, but you can read the list.
In my experience, my patients have frequently had at least one or more of those side effects when they’re on it. It is also unlikely that you will be able to change/alter the use of this medication due to the reason for prescription.
So the question is, with all these side effects, how can we develop a nutrition care plan that helps our patients?
Working with Food Medication Interactions
The first and likely most obvious one is, the directions of the medications needs to be followed. If it says a patient should take it on an empty stomach, that needs to be done. If it says it needs to be taken with juice to reduce the bitter taste, that needs to be done.
This is going to be something you may have to work with your Director of Nursing to figure out. This may mean that you need to a policy change in your facility. You are going to be the squeaky wheel that drives change in your facility.
Secondly, you will have to look at each medication your patient is on, evaluate the possible side effects and implement a nutrition care plan that reflects it.
For example, if a side effect is anorexia, you may look at implementing more frequent snacks (evening, before bed) that are labelled with the patient name. You may look at implementing a high protein, high calorie smoothie once a day. You may liberalize their diet to give more freedom in choices, and increase foods they enjoy.
Each patient will be different, so you will need to evaluate on a case by case basis.
I recommend having a nutrition assessment form that has a space for you to write in their medications. This helps to have an all-encompassing assessment.
If you’re looking for an assessment form, check this one out.
Medications at Mealtimes – What Can I Do?
This is a big issue in today’s practice.
I have worked in many homes where they slip into this practice, whether consciously or not, it needs to be changed. I don’t recommend tackling every battle that you see, but this is a hill I will die on (not literally but you know…).
If you notice that this practice is happening in your facility, meet with your Director of Care or CEO, whoever you know will see the error and correct it. It may be that the way Nurses carry on about their day needs to change. You will definitely get pushback, but they know that within their best practice – Medications are not recommended at meals!
It’s not just Dietitian’s opinions, it’s facts. There’s a reason that food medication interactions is well studied, because research shows that medications interact with nutrients2.
You can read the research on it and bring this to your meeting, that practices need to change. You see interactions that some medications can alter their taste buds – leading to a decrease in food intake3. A perfect example of how medications can change the nutritional status of your patient.
So take a look at this list below, and figure out how it is affecting your patient! Change the practice in your facility if medications are delivered at meal times – because you can make a difference! If you need my help, reach out! I’m always happy to help change practices to improve our patient’s nutrition!
Food Medication Interactions – List
The list I produced is not inclusive of every medication that you will see. But it is a list of the most frequent medications that I have observed.
You can add to it, print it off and use it as a common reference, and develop your own!
I want to take a quick moment to go through the books that I highly recommend you get for your practice! The BEST piece of advice I can give to every Dietitian is GET YOUR WORK TO PAY FOR THEM! I’m amazed at how much my jobs have paid for books, courses, and everything related to practice. Don’t be afraid to ask.
Books You Need To Own!
Here are a few reference guides that I think EVERY Dietitian NEEDS to own! I own every single book I have listed here, I wouldn’t give advice that I don’t follow myself. I have found these books help in my everyday practice even all these years after my internship.
- Food Medication Interactions 18th Edition Book. This book is a MUST OWN. I use this book as a reference on a daily basis at work, and I used it to compile my list. You can click on the picture to take the link. Used copies of this book like in the link are just as good. I’ve found the 18th edition the most useful for me. I’ve read through the newer versions but haven’t found them anymore beneficial, so I recommend this one.
- Mosby’s Diagnostic & Laboratory Test Reference 13th Edition. I love this book as a reference guide. It’s hard to know what every nutrition related lab means, or what you should monitor. I’ve had the same book since my internship ages ago, but recently purchased this one. It’s perfect!
- Nutrition Focused Physical Exam Pocket Guide, Second Edition. I love love love this book. I don’t always remember every area to check for physical changes in nutrition status, so having this book handy on my desk really helps. It can help to diagnose Malnutrition and check areas you don’t remember.
- Abridged Nutrition Care Process Terminology (NCPT) Reference Manual. I don’t know any Dietitian that knows the standardised terminology off the top of their head. Having this book ready when you’re going to make a diagnosis is a must. Click here to view it.
You can click below to get the resource that I’ve been talking about now! The summary list of Food Medication Interactions PDF!
Michelle Saari is a Registered Dietitian based in Canada. She has a Master's Degree in Human Nutritional Sciences and is a passionate advocate for spreading easy to understand, reliable, and trustworthy nutrition information. She is currently a full time online entrepreneur with two nutrition focused websites.
Thank you in advance.
You’re welcome!