- Several common medications interact with dairy, which can affect how well the medicine works.
- Medications that don’t mix well with dairy include some antibiotics and medicine used to treat influenza.
- You may need to wait for a period of time before and after taking the medication to enjoy dairy foods.
Dairy foods like milk, yogurt and cheese are some of the best sources of calcium, vitamin D and potassium in the American diet. But dairy may be a concern for those who take some commonly prescribed medications. The combination may prevent the medication from working as intended. “The calcium in these foods [dairy and milk products] can bind to some medications in the gastrointestinal tract, making both the medication and the calcium unavailable for your body to absorb,” says Christine D. Sommer, Pharm.D. Sommer emphasizes that most of these issues can be avoided by separating the medication from dairy products.
Toby Amidor, M.S., RDN, says that dairy offers a variety of health benefits, including supporting bone health and reducing the risk for both type 2 diabetes and high blood pressure. “Daily consumption of dairy foods like milk, cheese and yogurt is an integral part for building healthy bones throughout the lifespan from early childhood through late adulthood, as they contain essential nutrients for bone growth and development including calcium, vitamin D, phosphorus, potassium and magnesium,” says Amidor.
The good news is you can continue to enjoy dairy in your diet and reap the many health benefits by making simple adjustments. Read more about the medications most likely to be affected and how you can adjust your diet to promote optimal absorption.
Tetracycline Antibiotics
“The calcium in dairy can form a complex with certain medications such as antibiotics (tetracyclines and fluroquinolones), which decreases how much of the medication and nutrient can be absorbed,” says Erika Gray, Pharm.D. The tetracycline class of antibiotics is used to treat bacterial infections and includes antibiotics like demeclocycline, doxycycline, sarecycline, and tetracycline. Not all antibiotics in this class require separation from dairy to ensure optimal absorption, but for those that do, taking the dose at least two hours apart from dairy is the best practice.
Levothyroxine
Hypothyroidism is a condition that results in the underproduction of thyroid hormones. Levothyroxine, a medication commonly prescribed to manage this condition, should also be taken separate from milk and other dairy foods. Sommer recommends a four-hour window between levothyroxine and dairy products. It’s also suggested to avoid taking these medications with food and instead take on an empty stomach for optimal absorption.
Lithium
Bipolar disorder is a common mental health condition that is characterized by intense mood swings and changes in energy levels. Lithium is often prescribed to treat bipolar disorder and while it isn’t required that it be taken separately from dairy, the drug may influence certain nutrient levels that are found in dairy products. “Long-term use [of lithium] can potentially lead to a buildup of calcium in the body,” says Amidor. “Monitoring how much calcium from dairy products and calcium supplements can help minimize this issue.”
Baloxavir
If you ever find yourself down and out with the flu, you may be prescribed baloxavir as part of your treatment. This antiviral medication should not be taken with dairy products because of its interaction with calcium. The mineral influences the absorption of the baloxavir. This is true for other calcium-rich foods like sardines and tofu, as well as calcium-fortified drinks. Over the counter medications like Tums antacids should also be avoided when taking this medication. “Tums is 500 milligrams of calcium carbonate, and the same cautions apply with Tums and these different medications,” says Gray.
Quinolone Antibiotics
This class of antibiotics is used to treat bacterial infections such as urinary and respiratory tract infections. Some, but not all, quinolone antibiotics should be separated from dairy in the diet. One example is ciprofloxacin, a common antibiotic in this group that must be taken separate from dairy. Amidor recommends consuming dairy products two hours before or after taking the medication.
Eltrombopag
Eltrombopag is prescribed when someone has a condition that results in low platelet count. It’s recommended to avoid dairy for two hours before or four hours after taking the medication due to the possibility of calcium binding and blocking absorption of the drug.
Our Expert Take
A range of medications, from certain types of antibiotics to medicines used to treat influenza or hypothyroidism, can interact with dairy in the diet. But the good news is, you don’t need to completely eliminate all dairy. “Most of the time, it is possible to properly get the most benefit from your medication and still include dairy in your diet—just not at the same time of day,” says Sommer. The time of separation required varies by medication, so it’s important to check with your pharmacist for more information. Remember, dairy offers many essential vitamins and minerals in the diet while helping to fill the gaps of nutrients like calcium, potassium and vitamin D. The multiple health benefits make it worth spending the extra time to adjust your dairy intake to avoid interactions with your medications.
