food interaction
6 interactions related to food interaction
maoi + tyramine foods
Monoamine oxidase inhibitors block MAO-A in the gut and liver, preventing the breakdown of dietary tyramine. Unmetabolized tyramine triggers a massive release of stored norepinephrine, producing a hypertensive crisis ('cheese reaction') with severe blood pressure spikes, stroke, or death.
aged cheese + linezolid
Linezolid is a reversible monoamine oxidase inhibitor, and aged cheeses (cheddar, parmesan, blue cheese, brie, gruyere) accumulate large amounts of tyramine through protein breakdown during aging. With MAO inhibited, ingested tyramine triggers massive norepinephrine release and can produce a hypertensive crisis with severe headache, palpitations, and blood pressure spikes of 30 to 50 mmHg within 30 to 120 minutes.
fermented foods + maois
Fermented foods accumulate tyramine through microbial decarboxylation of tyrosine during fermentation, and MAOIs block the monoamine oxidase enzyme that normally clears tyramine from the gut and bloodstream. Unmetabolized tyramine then triggers massive norepinephrine release, which can produce a hypertensive crisis with systolic blood pressure spiking above 180 mmHg.
cacao + maois
Raw, unroasted cacao (often sold as ceremonial cacao or raw cacao paste) contains higher levels of tyramine, tryptamine, and phenylethylamine than processed chocolate. With irreversible MAOIs in the system, these vasoactive amines can drive a hypertensive reaction and, theoretically, contribute to serotonin syndrome.
kimchi + warfarin
Kimchi is fermented Napa cabbage and contains roughly 65 micrograms of vitamin K1 per cup, which provides the cofactor for the very clotting factors warfarin blocks. Inconsistent kimchi intake can lower the INR and reduce warfarin's anticoagulant effect, increasing clot risk.
alprazolam + grapefruit
Grapefruit juice contains furanocoumarins that inhibit intestinal CYP3A4, the enzyme that partially metabolizes alprazolam. The interaction can raise alprazolam blood levels and prolong sedation, although the magnitude is modest compared to other benzodiazepines because alprazolam has high oral bioavailability.