Written by Kaylea Swearingen, PharmD | Reviewed by Christina Aungst, PharmDPublished on August 31, 2021
Key takeaways:
- When combined with certain medications, dairy products can affect how a medication works in your body — potentially making it less effective.
- Certain antibiotics and osteoporosis medications are more commonly associated with potential dairy product interactions, but there are a few others you should know about.
- Talk with your pharmacist or healthcare provider to get the most accurate and up-to-date interaction information about your personal medications.
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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 medications should be separated from calcium-rich dairy products, including milk, yogurt, cheese, and ice cream. In some cases, the calcium can bind to the medication and affect how it works in your body.
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.
Let’s review a few common medications that can interact with dairy products — as well as other calcium-fortified foods and supplements — and the steps you can take to safely enjoy your favorite dairy treat.
Which medications should be separated from dairy products?
Below are a few medications that can interact with dairy products. A few of them are available in different dosage forms (e.g., eye drops, injections), but we’ll be focusing on interactions with their oral forms — tablets, capsules, and liquids.
For the list below, the calcium in dairy products can interfere with how these medications are absorbed by your body. This means they may be less effective than intended. Keep in mind that this list isn’t all-inclusive, so make sure to speak with your healthcare provider or pharmacist about all your medications.
Tetracycline antibiotics
Tetracyclines are a class of antibiotics that treat a variety of infections, including respiratory tract infections, urinary tract infections, and skin conditions like acne and rosacea. They work by preventing bacteria from growing.
A few examples of medications in this class include tetracycline, minocycline, and doxycycline.
Antibiotic interactions are particularly concerning, since you’re taking the medication to treat an infection. If your body isn’t absorbing as much of your dose, your infection may not be treated effectively or completely.
To avoid this interaction, you’ll want to take tetracyclines at least 1 hour before or 2 hours after any dairy products.
Fluoroquinolone antibiotics
Fluoroquinolones are a class of antibiotics that are commonly 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 (Levaquin), and 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 fluoroquinolones. However, it’s recommended to take them either 2 hours before or 4 hours after a dairy product.
Bisphosphonates
Bisphosphonates are a medication class used to help prevent or treat bone loss from conditions like osteopenia (weakening of bones), osteoporosis (weak and brittle bones), Paget’s disease, and some bone cancers. They work by interfering with the process of the body breaking down bone tissue.
Medications classified as 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.
When your body absorbs less of your bisphosphonate dose, you may not get as much of a benefit, which can put you at greater risk for bone fractures (broken bones). This is why you’ll need to separate your dose to avoid this interaction.
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.
It’s important to note that 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.
Iron supplements
Iron is an important mineral that’s needed for your red blood cells to carry oxygen throughout your body. While most people are able to get enough from their diets, others may be at risk for their iron levels becoming too low — including people with heavy monthly bleeding 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 provider 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.
Thyroid medications
Thyroid hormones control 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, Levoxyl, Unithroid, Levothroid), 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, potentially causing you to experience hypothyroidism symptoms (e.g., fatigue, weight gain, constipation).
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, like dairy products.
How can you find out if dairy will interact with any medications you’re taking?
If you have questions about whether the medications you’re taking interact with dairy, it’s best to speak with your healthcare provider or pharmacist. They will be able to provide you with accurate and up-to-date information about all interactions for your personal medications.
It’s also important to identify other calcium-containing foods and beverages you’re consuming that may have a similar effect — like calcium-fortified orange juice and over-the-counter supplements.
The bottom line
Dairy products include milk, cheese, ice cream, yogurt, or cottage cheese, among others. While these products may be delicious, they also have the potential to interfere with your medications.
Certain antibiotics, osteoporosis medications, and thyroid medications are a few examples of medications that may be affected when taken with dairy products. But there is the option to take those medications and still enjoy your dairy product of choice — you may just need to wait a bit before or after your dose.
Talk with your healthcare provider or pharmacist to get the most up-to-date information about your personal risk for medication interactions. Make sure to share all medications, including vitamins or supplements, that you are taking with your provider.
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