What’s more, according to the U.S. Food and Drug Administration, some drinks, foods, or substances can potentially make a drug more or less effective or increase the risk of side effects. Here are six common drinks people living with rheumatoid arthritis should know more about.
1. Grapefruit Juice
This breakfast table staple is one of the beverages that’s a big drug-interaction culprit, says Dr. Jalloh. “Grapefruit juice blocks the protein known as CYP3A4 that helps the body process medications.” This is not the case with every type of prescription drug, but it does have an impact on oral Sandimmune (cyclosporine), an immunosuppressant taken by people with RA who have eye conditions such as dry eyes. Regular consumption of grapefruit juice affects the body’s ability to metabolize the drug, meaning that the levels of the drug increase, which can lead to more side effects, according to research published in Clinical Pharmacology & Therapeutics. “In a sense, you are getting extra drug levels that can get dangerously high in people,” says Jalloh. If you take cyclosporine or methotrexate (Rheumatrex, Trexall), which may also be affected by the juice, talk to your doctor if you want to drink grapefruit juice on a regular basis. RELATED: Rheumatoid Arthritis Medication: Beware of Sunburn if You Take These Drugs
2. Alcohol
Alcohol and prescription medications both put the liver to work, so mixing the two may increase the risk of organ damage. While moderate consumption of alcohol may be okay for some people with rheumatoid arthritis — that’s one drink a day for women and two for men — the downsides of drinking beer, wine, and spirits may quickly outweigh the benefits. Methotrexate guidelines from the American College of Rheumatology clearly state that alcohol should be avoided while on this medication, since it significantly increases the risk for liver damage. If you have questions, talk to your doctor about rare or occasional alcohol use. RELATED: 10 Common Food and Medication Interactions to Avoid For example, willow bark can be problematic for people with rheumatoid arthritis. An ancient Chinese herbal pain relief remedy, willow bark is chemically similar to aspirin, and some medical studies support the use of willow bark in joint pain and osteoarthritis. But for people on many medications that could interact with the tea, willow bark tea isn’t recommended. If you take methotrexate, nonsteroidal anti-inflammatory medications (NSAIDs), or blood-thinning medication, do not take willow bark. In other cases, there may be other risks or medication interactions to consider, so talk to your doctor before using this tea.
4. Cola Drinks
Methotrexate-takers take note: Drinking acidic diet cola may be problematic for you. A report in the British Journal of Clinical Pharmacology found that cola drinks can alter the pH of urine, making it harder for the immunosuppressant drug to leave the body. The study authors recommend that patients who are receiving high doses of methotrexate avoid having any cola drink for 24 hours before, and during administration of the drug, and until the drug has been completely eliminated from the body. Cola drinks often also contain caffeine, which may have an impact on RA medicines such as prednisone, per the Arthritis Foundation.
5. Citrus Juices
Grapefruit juice isn’t the only type of juice to be cautious about if you’re taking RA medications. Some past research has suggested that other citrus juices, like those made from Seville oranges, limes, and pomelos, may also affect how CYP3A4 works in the body. Additionally, orange juices have been known to inhibit molecules called organic anion-transporting polypeptides (OATPs), which aid in drug absorption. While studies have shown mixed results on just how much these juices interact with RA drugs, it’s a good idea to talk to your doctor about your citrus juice consumption if you take prescription medicines.
6. Cow’s Milk or Dairy Drinks
You may have heard drinking milk can strengthen your bones, but you should also be aware that dairy can interfere with the medicines you take. Milk and other calcium-fortified beverages can affect how some drugs are absorbed in the body and make them less effective. RELATED: 8 Common Medications That May Cause Dehydration Specifically, the Arthritis Foundation notes that calcium is known to interfere with certain antibiotics and bisphosphonates, which are used to treat osteoporosis. A study published in August 2015 in the journal Clinical Therapeutics also found that milk may affect the absorption of NSAIDs, which are commonly used by people with RA. Authors of the research suggest drinking milk at a different time than you take your medicines to be on the safe side. Like with most things, it’s best to consume these drinks in moderation and talk to your doctor if you have any concerns.
