1. Medications Requiring Increased Water Intake
- Bronchodilators: Theophylline, aminophylline, diprophylline.
- Choleretics: Phenylpropanol, hymecromone, dehydrocholic acid, ursodeoxycholic acid.
- Protease Inhibitors: Ritonavir, indinavir, nelfinavir, amprenavir, lopinavir.
- Bisphosphonates: Alendronate, pamidronate, clodronate.
- Antigout Agents: Benzbromarone, probenecid, allopurinol.
- Antilithics: Herbal stone-expelling decoctions or granules (e.g., Paishi Tang).
- Electrolytes: Oral rehydration salts (ORS).
- Sulfonamides: Sulfadiazine, sulfamethoxazole, cotrimoxazole.
- Aminoglycosides: Streptomycin, gentamicin, kanamycin, amikacin.
- Fluoroquinolones: Ciprofloxacin, levofloxacin, etc.
Note: Alkalinize urine when using antigout drugs, sulfonamides, or aminoglycosides.
2. Medications Requiring Limited Water Intake
- Gastrointestinal Agents:
- Bitter stomachics (e.g., gentian tincture).
- Mucosal protectants (e.g., sucralfate, bismuth pectin).
- Tablets meant to be chewed directly (e.g., antacid chewables).
- Antitussives: Cough syrups (e.g., licorice compound mixture).
- Antianginal Drugs: Sublingual nitroglycerin, Shexiang Baoxin Pills.
- Antidiuretics: Desmopressin.
3. Medications Not to Be Taken with Hot Water
- Digestive Enzymes: Pepsin, pancreatin.
- Vitamins: Vitamin B₁, B₂, C (heat-sensitive).
- Live Vaccines: Oral polio vaccine (sugar pill).
- Probiotics: Lactobacillus preparations (e.g., Lactasin, Zhengchangsheng).
4. Disulfiram-like Reactions
Avoid alcohol when taking:
- Metronidazole, tinidazole.
- Cephalosporins: Ceftriaxone, cefoperazone.
- Others: Chlorpromazine, furazolidone.
5. Interactions with Tea
Tea tannins bind to:
- Metal ions (iron, calcium).
- Proteins.
- Tetracyclines, macrolides, and alkaloids (e.g., quinine).
6. Interactions with Vinegar
Avoid combining vinegar with:
- Sulfonamides, antigout drugs, or aminoglycosides (these require urine alkalinization).
7. Interactions with Fats/Proteins
- Fats enhance absorption of griseofulvin and fat-soluble vitamins (A, D, E, K).
- High-protein diets reduce levodopa efficacy.
- Adrenal corticosteroids: Increase protein intake to counteract muscle wasting.
- Isoniazid: Avoid fish (risk of histamine toxicity due to impaired protein metabolism).
8. Grapefruit Juice Interactions
Grapefruit juice inhibits CYP3A4, increasing bioavailability of:
- Calcium channel blockers: Verapamil, dihydropyridines (e.g., nifedipine, except amlodipine).
- Immunosuppressants: Cyclosporine.
- Statins: Atorvastatin, simvastatin.
- Sedatives: Triazolam, diazepam.
Note: Grapefruit juice has no effect on amlodipine.
Key Reminders:
- Follow dosing instructions precisely to avoid toxicity or reduced efficacy.
- Consult a pharmacist or physician for personalized guidance on drug-food interactions.
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