Milk is a common dairy product in modern life, but taking milk with many drugs at the same time will affect the absorption of the drugs , and even interact with each other to reduce the efficacy of the drugs.
On the one hand, milk can form a thin film on the surface of the drug and the gastric mucosa. After the film is digested and absorbed, the drug has missed the best absorption period, thus reducing the absorption and efficacy of the drug. On the other hand, milk can react adversely with some medications, either chemically or physically. Milk contains a lot of inorganic salts, such as calcium, phosphorus, iron, multivitamins, proteins, amino acids, fats and other chemical substances, which are prone to chemical reactions with drugs to form stable chromium compounds or insoluble salts. class, making it difficult for the drug to be absorbed, and in severe cases, gallstones, , and kidney stones may be formed.
1. Calcium, zinc preparations and iron preparations
The protein in milk can be combined with calcium lactate (new cover, middle cover, calcium in calcium), calcium gluconate , zinc gluconate and other calcium and zinc preparations The formation of clots not only affects absorption and reduces the peak blood drug concentration, but also increases the burden on the gastrointestinal tract. Iron preparations include: ferrous succinate, ferrous fumarate , ferrous gluconate, etc. And the phosphorus in milk can precipitate iron supplement , which can also affect the absorption of iron. Iron is mainly absorbed in the duodenum and proximal jejunum in the form of ferrous ions . The calcium ions in milk can compete with iron at the duodenal absorption site, reducing iron absorption and reducing efficacy. In addition, avoid tea when taking iron preparations to avoid being precipitated by tannins and becoming ineffective. Therefore, patients should be told that the interval between taking iron preparations and milk should be 1 to 2 hours.
2. Chinese herbal medicine or Chinese patent medicine
It is especially not suitable to take Chinese medicine with milk, because Chinese medicine often contains sugar, polysaccharide, protein, polypeptide , amino acids, etc., and some contain ginsenoside , glycyrrhizin, vitamins, volatile oils, organic Acid, trace elements. The calcium, phosphorus and iron in milk easily react with organic compounds in traditional Chinese medicine to form insoluble substances, destroying the active ingredients of milk and medicine. In addition, the protein and fat in milk sometimes affect drug absorption.
3. Gastric mucosal protective agents and antacids
Commonly used gastric mucosal protective agents and antacids containing metal ions include: aluminum hydroxide , magnesium hydroxide , calcium carbonate, sodium bicarbonate , Aluminum magnesium carbonate , magnesium trisilicate , aluminum magnesium plus, potassium bismuth citrate , colloidal bismuth pectin, bismuth aluminate and their compound preparations. When the protein in milk is combined with the above-mentioned drugs containing metal ions, it can form clots, which not only reduces the efficacy of the drug, increases the burden on the gastrointestinal tract, but also affects the absorption of milk nutrients. In addition, when sodium bicarbonate is combined with calcium-containing drugs and milk, it can lead to milk-alkali syndrome .
4. Most antibacterial drugs
Most antibacterial drugs should not be taken with milk. Almost all quinolones, such as norfloxacin , levofloxacin , ciprofloxacin , etc., combine with metal ions in milk to form insoluble chelates, which affects absorption, reduces antibacterial effects, and reduces drug efficacy. , or even completely ineffective. However, some drugs can be taken with milk, such as: amoxicillin , amoxicillin clavulanate potassium , cefadroxil, cefaclor , clarithromycin , roxithromycin , minocycline can be taken with milk.
5. Drugs for treating cardiovascular diseases
such as digoxin, digoxigenin , etc. used to treat chronic heart failure. If you drink a lot of milk while taking medicine, the calcium ions in the milk can increase the toxicity of this type of medicine and even cause accidents. When antihypertensive drugs such as Youjiangning used by patients with severe hypertension come into contact with milk or dairy products, they may cause a sudden rise in blood pressure. In severe cases, the blood pressure may continue to rise, or even cause a hypertensive crisis .
6. Anti-Parkinson’s disease drugs
Anti-Parkinson’s disease drugs Levodopa , carbidopa and their compound preparations should not be taken with milk. Levodopa is absorbed in the small intestine and needs a carrier to help it move through the body.The aromatic amino acids contained in milk protein (such as phenylalanine ) compete with levodopa for the same carrier system, thus affecting its absorption.
7. Antidepressants
Milk cannot be taken at the same time as monoamine oxidase inhibitors in antidepressant drugs, because milk is rich in tyramine. When this enzyme is inhibited, tyramine will accumulate in large amounts, causing a sudden rise in blood pressure. , heart rhythm disorder, severe cases can lead to cerebral hemorrhage or even death.
8. Constipation treatment drug
Bisacodyl is a stimulant laxative used to treat acute, chronic constipation and habitual constipation. Milk may cause the enteric coating of bisacodyl to dissolve prematurely and may cause gastric or duodenal irritation. Therefore, do not drink milk 2 hours before and after taking the medicine.
9. Other drugs
anti-cancer drug estramustine, calcium and bone metabolism regulators ( alendronate sodium , ibandronate sodium, pamidronic acid, ibandronic acid,; clodronic acid, etc. ), cannot under any circumstances be taken with milk, food or medicines containing calcium or other divalent cations , as they will reduce the absorption of the medicine. In short, it is best to take the medicine with water instead of milk, tea, etc. There should be an hour's interval between taking medicine and drinking milk. Babies should also take a period of time after taking medicine before taking breast milk to avoid interactions and affect the efficacy of the medicine. Add unnecessary side effects.
Source: Drug Review Center
