What Foods to Avoid with Metronidazole - Alcohol, Tyramine, Yeast, Juices

What Foods to Avoid with Metronidazole - Alcohol, Tyramine, Yeast, Juices
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What Foods to Avoid While Taking Metronidazole

Metronidazole is an antibiotic commonly used to treat bacterial infections from Helicobacter pylori, Clostridium difficile, vaginosis, pelvic inflammatory disease, and more. While highly effective, metronidazole can cause side effects when combined with certain foods and beverages.

Metronidazole food restrictions are established to maximize drug absorption and avoid negative interactions. Understanding exactly what to eat and drink while taking metronidazole ensures safe and effective treatment.

How Does Metronidazole Work?

Metronidazole eliminates infection-causing bacteria in the body. The drug disrupts bacterial DNA, preventing microbes from multiplying and spreading infection.

For metronidazole to work properly, enough steady concentration needs to remain in the bloodstream. But certain substances can influence absorption levels and activity.

Avoiding these products is crucial for allowing metronidazole to effectively fight targeted infections.

Common Uses for Metronidazole

Doctors commonly prescribe oral or intravenous metronidazole for treating:

  • Bacterial vaginosis
  • Pelvic inflammatory disease
  • Stomach ulcers from H. pylori bacteria
  • Infected surgical wounds
  • Sepsis and blood poisoning
  • Lung abscess or empyema
  • Clostridium difficile diarrhea
  • Gum infections
  • Skin and tissue abscesses

Potential Foods and Drinks to Avoid with Metronidazole

Multiple substances can alter metronidazole effects or react negatively, requiring avoidance until completing the prescription.

Alcohol

All alcohol consumption should cease with a metronidazole prescription. The antibiotic reacts with alcohol, similar to antabuse used for alcoholism treatment.

Just small amounts of beer, wine, liquor, or alcohol-containing foods can trigger reactions like:

  • Flushing red skin
  • Nausea
  • Vomiting
  • Rapid heartbeat
  • Shortness of breath
  • Headache

Avoid alcohol in cooking as well. Check medication labels on over-the-counter cough syrup, mouthwash, and hand sanitizers for added alcohol content.

Aged and Fermented Foods

Foods prepared through aging and live-culture fermentation can also produce small amounts of alcohol as byproducts. These trace alcohols may be enough to cause negative metronidazole interactions.

Restrict the following while taking metronidazole:

  • Pickled vegetables
  • Kimchi
  • Kombucha
  • Kefir
  • Vinegar
  • Soy sauce
  • Worcestershire sauce
  • Sourdough bread
  • Cured meats like salami
  • Certain cheeses like blue and gorgonzola
  • Sauerkraut
  • Yogurt

Tyramine-Rich Foods

Tyramine is an amino acid producing mild pressor effects when consumed, including increased blood pressure. Metronidazole appears to inhibit breakdown of ingested tyramines.

Accumulating high amounts leads to a hypertensive crisis with potentially life-threatening spikes in blood pressure. This reaction requires emergency medical treatment.

Avoid eating large quantities of the following tyramine-containing items:

  • Aged cheeses
  • Smoked or pickled meats
  • Certain beans like broad or fava beans
  • Yeast extracts or spreads
  • Sauerkraut
  • Avocados, bananas, or canned figs
  • Raspberries or plums

Smaller servings may be tolerated, but consult your prescribing physician.

Fortified Nutritional Yeast

While tiny amounts of brewer’s or baker’s yeast seem harmless, large doses of fortified nutritional yeast should be avoided. Nutritional yeast is fortified with tyramines and can produce dangerous interactions.

Nutritional yeast gives flavor and vitamins to foods like:

  • Pastas
  • Popcorn
  • Soups
  • Gravies
  • Salad dressings

Check ingredient labels and ask about preparations when dining out.

Fruit Juices

While reasonable fruit consumption generally poses little risk, large quantities of fruit juices are possibly problematic. Both citrus and apple juices exhibit antimicrobial activity which could reduce metronidazole effectiveness.

Fruit juices also acidify urine, speeding elimination of metronidazole from the body. This is hypothesized to lower circulating antibiotic levels. Drinking 8 or more ounces of juice per day while taking metronidazole is not advised.

Foods Causing Metronidazole Side Effects

In addition to negative drug interactions, certain foods can independently worsen common metronidazole side effects like:

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain
  • Constipation
  • Headache
  • Dizziness
  • Metallic taste

Avoiding consumption of other gut-irritating or strong-flavored items helps limit unpleasant or dangerous GI symptoms.

Fatty and Fried Foods

High-fat greasy foods are harder to digest for sensitive stomachs. These energy-dense calories also delay gastric emptying, exacerbating nausea and discomfort.

While taking metronidazole, avoid:

  • Fried fast food
  • Pizza
  • Whole milk dairy
  • Fatty red meats
  • Baked goods and desserts
  • Oily nuts and nut butters
  • Fried rice or noodles

Spicy Foods

Heavily spiced dishes can inflame sensitive intestinal lining. Chili peppers and other ingredients also stimulate gastric acid secretions, worsening reflux.

The following spices may aggravate metronidazole side effects:

  • Chili powder
  • Curry blends
  • Pepper
  • Cayenne
  • Ginger
  • Cinnamon
  • Garlic
  • Onion

High Fiber Foods

While healthy otherwise, fiber-rich foods bulk up stool and hasten bowel movements. This stimulates intestinal contractions and diarrhea.

When diarrhea or constipation occurs, cut back on:

  • Whole grains
  • Bran cereals
  • Beans and lentils
  • Vegetables like broccoli
  • Fruits like berries
  • Dried fruits
  • Nuts and seeds

Safe Foods to Enjoy While Taking Metronidazole

Focusing diet around bland, low-fiber staples alleviates GI upset. These easily digested items shouldn’t worsen medication side effects or interact negatively.

Low-Fat Dairy Foods

Plain or vanilla yogurt and milk-based puddings supply protein without stomach irritation. Soft cheeses like mozzarella or cottage cheese are also gentle options.

Refined Carbohydrates

Plain white bread, pasta, rice, crackers and cold cereals are usually well-tolerated. The low fiber keeps digestion simple.

Tender Meat and Seafood

Ground or stewed lean meats like turkey, chicken, pork, or white fish don’t overload digestion. Bake, boil or grill without heavy sauces or spices.

Canned Fruits and Vegetables

Well-cooked canned produce like peeled potatoes, skinless applesauce, or seedless fruit cups provide potassium without excess fiber.

Clear Broths and Beverages

Sipping clear fluids like water, flat soda, ginger ale, clear broths keeps hydration up while resting inflamed guts.

What to Expect When Taking Metronidazole

Modifying eating habits helps ensure metronidazole works effectively while minimizing unpleasant reactions.

Common expectations when taking a metronidazole prescription include:

  • Abstaining from all alcohol and alcohol-containing products
  • Avoiding fermented or aged foods to prevent reactions
  • Preventing dangerous tyramine buildup from certain high-protein foods
  • Steering clear of excess citrus and apple juices
  • Easing metronidazole side effects like nausea by sticking to a bland, low-fat, low-fiber diet

With discipline avoiding problematic substances, metronidazole works well treating targeted infections. Consult prescribing doctors with any food questions or concerns while taking antibiotics.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.

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