7 Medications That Can Interact With Dairy Products: Antibiotics, Levothyroxine, and More

Goran13/iStock via Getty Images

A fairly common question you might have when picking up a prescription is whether or not you can take it with food. You may be surprised to learn that some oral medications should be separated from calcium-rich dairy products, including milk, yogurt, and ice cream. In some cases, the calcium can bind to the medication and affect how it works in your body. This means they may be less effective than intended.

Just because a medication interacts with dairy products doesn't necessarily mean that you can't ever enjoy a dairy product again. In many cases, you may just need to separate your medication dose from dairy for a certain amount of time to prevent the interaction.

Below, we'll review common oral medications that can interact with dairy products and other calcium-fortified foods. We'll also provide the steps you can take to safely enjoy your favorite dairy treat. Keep in mind that this list isn't comprehensive. So make sure to speak with your prescriber or pharmacist about all your medications.

1. Tetracycline antibiotics

Tetracyclines are a class of antibiotics that treat a variety of infections, such as skin infections. They work by preventing bacteria from growing. A few examples of tetracycline antibiotics include:

• Tetracycline

• Minocycline (Minocin)

• Doxycycline (Doryx, Oracea, Vibramycin)

Antibiotic interactions are particularly concerning since you're taking the medication to treat an infection. The calcium in dairy can bind to tetracyclines, which affects absorption. If your body isn't absorbing as much of your dose, your infection may not be treated effectively or completely.

Some tetracyclines are best taken on an empty stomach, while others can be taken with food. Either way, you should avoid consuming dairy products at the same time that you take them. In general, it's a good idea to take oral tetracyclines at least 1 hour before or 2 hours after any dairy products.

2. Fluoroquinolone antibiotics

Fluoroquinolones are a class of antibiotics that are used to treat respiratory tract and urinary tract infections. They also work by preventing bacteria from growing. A few examples of fluoroquinolones include:

• Ciprofloxacin (Cipro)

• Levofloxacin

• Moxifloxacin (Avelox)

Much like dairy's interaction with tetracyclines, a similar result happens with fluoroquinolones. Again, this means that your infection may not be treated effectively or completely. This can potentially make the germ harder to treat in future infections.

Dairy products can still be consumed while taking oral fluoroquinolones. Just don't take your dose with dairy on its own (such as a glass of milk). But taking fluoroquinolones with food that contains a small amount of dairy is generally OK. For dairy by itself, it's a good idea to separate it from your fluoroquinolone dose by 2 hours before or after.

3. Bisphosphonates

Bisphosphonates are a medication class used to help prevent or treat bone loss from conditions such as osteopenia (weakening of bones) and osteoporosis (weak and brittle bones). They work by interfering with the process of the body breaking down bone tissue.

Examples of bisphosphonates include risedronate (Actonel), alendronate (Fosamax), and ibandronate (Boniva). All three medications are available as oral tablets, but ibandronate is also available as an injection.

Food, including dairy products, can interfere with how your body absorbs oral bisphosphonates. When you absorb less of your dose, you may not get as much of a benefit. This can put you at greater risk for bone fractures (broken bones).

To manage this interaction, oral bisphosphonates are typically taken first thing in the morning on an empty stomach. With alendronate and risedronate, you need to wait at least 30 minutes after taking the medication before consuming any dairy products. With oral ibandronate, you need to wait at least 60 minutes. Dairy isn't an issue with injectable ibandronate.

Some people taking bisphosphonates may be instructed to also take calcium supplements to help with their bone health. As with dairy products, you'll want to separate these supplements from your dose.

4. Iron supplements

Iron is an important mineral that's needed for your red blood cells to carry oxygen throughout your body. Most people are able to get enough from their diets. But others may be at risk for their iron levels becoming too low. Examples include those with heavy menstrual cycles or certain underlying conditions.

If you don't have enough iron in your body, it can result in iron-deficiency anemia. In this case, your healthcare team may have you take an iron supplement to help restore your iron levels. Examples of iron supplements include ferrous sulfate and ferrous gluconate.

The calcium in dairy products can prevent you from absorbing as much iron from your dose. That's why it's recommended to wait at least 2 hours after consuming dairy products before taking your iron supplement.

5. Thyroid medications

Thyroid hormones help regulate how your body uses energy and can affect nearly every organ. Hypothyroidism is a condition where your thyroid gland doesn't make enough thyroid hormones to meet your body's needs. In this case, you may be prescribed medications to help replace and normalize your thyroid hormone levels.

There are a few medications that can help treat hypothyroidism, including levothyroxine (Synthroid, Unithroid), Armor Thyroid, and liothyronine (Cytomel). Levothyroxine and liothyronine are also available together in one tablet.

All thyroid medications should be taken on an empty stomach. But levothyroxine, in particular, has been shown to interact with dairy, resulting in less of it being absorbed. This means that you may not be getting enough thyroid hormone from your dose. If this happens, you may experience hypothyroidism symptoms, such as fatigue.

Thyroid medications should be taken on an empty stomach - 30 to 60 minutes before breakfast. However, you should wait 4 hours before having calcium-rich foods, such as dairy products.

6. Lithium

Lithium (Lithobid) is a medication that treats bipolar disorder. The manufacturer doesn't specifically say to avoid milk or dairy products with lithium. But there are a few considerations to know about.

For example, long-term use of lithium can lead to a buildup of calcium in the body. This can cause health problems if you have too much calcium. This may be worsened if you take calcium supplements or get a large amount of calcium in your diet (such as from dairy products).

What's more, your salt (sodium) intake can affect lithium levels. This is because of how your kidneys remove lithium from your body. Consuming more salt in your diet can lower lithium levels. Some dairy products like cheese may contain high amounts of salt. And some foods (including dairy products) have lithium in them. In these cases, consuming large amounts might have an effect on your body's response to your lithium medication.

Your prescriber will likely be monitoring your lithium levels during treatment. Talk with them if you have questions about consuming dairy products while taking lithium.

7. Dolutegravir

The HIV medication dolutegravir (Tivicay, Dovato) can be affected by calcium supplements. The manufacturer has specific recommendations for how to time your dose around them. There isn't information regarding dairy products. However, it may be a good idea to follow the same precautions as with calcium supplements, unless directed otherwise.

If you're taking dolutegravir on an empty stomach, it should be taken 2 hours before or 6 hours after dairy products or calcium supplements. But when dolutegravir is taken with food, supplements or vitamins that contain calcium can be taken at the same time. This is because food increases dolutegravir absorption, counteracting the issues caused by calcium.

Talk to your healthcare team for specific recommendations about dairy products if you take dolutegravir.

Frequently asked questions about dairy product interactions

Public link

Please use the above public link if you want to share this noodl on another website.