What medicines should not be taken with milk?🥛🥛🥛

Milk is a great natural nutritional supplement. It is also a drink that many people drink every day. Although drinking milk has many benefits for people, it will affect the absorption of drugs when it is taken with many drugs at the same time. It may even interact with those drugs and make them less effective. One of the main reasons is that milk can form a thin film on the surface of gastric mucosa and drugs. When the film is digested and absorbed, the drug may miss its optimal absorption period. As a result, drug absorption and efficacy are reduced. In addition, milk can also produce physical or chemical reactions with some drugs. It may adversely affect medicines. Milk contains substances such as iron, calcium, phosphorus, protein, fat and multivitamins. They react chemically with some drugs and form insoluble salts or stable chromium compounds. This can make it difficult for the body to absorb the medicine and can even lead to gallstones or kidney stones. Some drugs are listed below for specific explanation:

1. Preparations containing iron, zinc or calcium.

Calcium, zinc, or iron preparations such as calcium lactate, calcium gluconate, zinc gluconate, ferrous gluconate, ferrous fumarate, and ferrous succinate can form clots with the protein in milk. In addition to reducing the absorption of drugs and reducing the peak plasma concentration of drugs, this clot will also increase the burden on the gastrointestinal tract. Iron can also be precipitated by phosphorus in milk and affect its absorption. Iron is absorbed mainly in the duodenum and proximal jejunum in the form of ferrous ions. Calcium ions in milk compete with iron for absorption in the duodenum. It reduces iron absorption and effectiveness. Therefore, when patients take calcium, zinc or iron preparations, they should be separated from milk for 1 to 2 hours.

2. Antacids and gastric mucosal protective agents.

Aluminum hydroxide, bismuth potassium citrate, calcium carbonate, magnesium hydroxide, sodium bicarbonate, etc. are clinically commonly used antacids and gastric mucosal protective agents containing metal ions. The above-mentioned drugs containing metal ions also form clots with proteins in milk. It will reduce the efficacy of drugs and increase the burden on the gastrointestinal tract, but also affect the body's absorption of nutrients in milk. In addition, when sodium bicarbonate is taken together with milk, milk-alkali syndrome can occur.

3. Most antibacterial drugs.

Almost all quinolones such as ciprofloxacin, levofloxacin, and norfloxacin will be combined into insoluble chelates by metal ions in milk. These chelates will affect the absorption of antibacterial drugs, reduce their antibacterial effect, and make the drug less effective or even completely ineffective. Therefore, most antibacterial drugs should not be taken together with milk.

4. Drugs for the treatment of cardiovascular diseases.

Drink a lot of milk while taking digoxin, digitoxin and other drugs for the treatment of chronic heart failure. The toxicity of these drugs will be increased by the calcium ions in the milk. When patients with severe hypertension take antihypertensive drugs, if they take milk or milk products at the same time, their blood pressure may rise sharply. In severe cases, the patient's blood pressure will continue to rise, and even hypertensive crisis will occur.

5. Anti-Parkinson's disease drugs.

Milk should not be taken together with anti-Parkinson's disease drugs such as carbidopa and levodopa. These drugs need a carrier to help them move in the body when they are absorbed in the small intestine. The aromatic amino acids contained in protein in milk will compete with them for the same carrier system and affect their absorption.

6. Antidepressants.

Monoamine oxidase inhibitors in antidepressants should not be taken with milk. When monoamine oxidase is inhibited, tyramine, which is rich in milk, will accumulate in the body in large quantities. It can cause cardiac arrhythmia, sudden increase in blood pressure, and severe cases can lead to cerebral hemorrhage and even death.

7. Constipation medicine.

The stimulant laxative bisacodyl is used to treat acute, chronic, and habitual constipation. The enteric coating of bisacodyl is prematurely dissolved by the milk, making it irritating to the stomach and duodenum. Therefore, milk should not be consumed for 2 hours before or after taking this medicine.

8. Other drugs.

Calcium and bone metabolism regulators such as alendronate sodium, ibandronate sodium, anticancer drugs such as estramustine, etc. should not be taken together with milk.

Unless instructed by a doctor, it is best to take the medicine with water, not milk, tea, etc.