Safety: By food
Look up a food to see which medicines or needs the rules connect it to.
Not medical advice. Fictional demo. Ask your pharmacist or doctor about any real medicine.
56 foods shown
aged cheese (mature cheddar, blue cheese, parmesan)
- Rule 12 Dish shown with a caution
With: MAOI antidepressants (phenelzine, tranylcypromine, isocarboxazid); also moclobemide at lower risk
High tyramine foods can cause a sharp rise in blood pressure with MAOIs.
Instead: Fresh cheese such as cottage cheese, fresh meat or fish cooked the same day.
alcoholic drinks
- Rule 6 Dish is left out
With: Sedatives: benzodiazepines, Z-drugs (zopiclone), sedating antihistamines, opioid painkillers, sedating antidepressants and antipsychotics, gabapentinoids
Alcohol adds to drowsiness and can raise the risk of falls and breathing problems in older adults.
Instead: Alcohol-free version of the drink or dish. - Rule 7 Dish shown with a caution
With: Metformin
Heavy alcohol use with metformin raises the risk of lactic acidosis. Alcohol can also cause low blood sugar in people with diabetes.
Instead: Alcohol-free version. - Rule 23 Dish shown with a caution
With: Warfarin
Alcohol can change how warfarin works and affect the INR. Small amounts used in cooking are usually less of a concern, but drinks and desserts with liqueur should be discussed. Ask your pharmacist or doctor.
Instead: Alcohol-free version of the drink or dish.
any food that mixes thin liquid and solid pieces
- Rule 20 Dish shown with a caution
With: Needs: swallowing difficulty (dysphagia)
Mixed thin liquid and solids are hard to control when swallowing. Whether thin drinks are allowed is for the person's speech and language therapist to say.
Instead: Smooth blended soup, porridge, thick and uniform textures.
breakfast
- Rule 22 Dish shown with a caution
With: Levothyroxine
Levothyroxine should be taken on an empty stomach, 30 to 60 minutes before breakfast and before coffee.
Instead: Plan breakfast and coffee 30 to 60 minutes after the tablet.
broad bean pods
- Rule 12 Dish shown with a caution
With: MAOI antidepressants (phenelzine, tranylcypromine, isocarboxazid); also moclobemide at lower risk
High tyramine foods can cause a sharp rise in blood pressure with MAOIs.
Instead: Fresh cheese such as cottage cheese, fresh meat or fish cooked the same day.
calcium supplements and calcium-fortified drinks
- Rule 21 Dish shown with a caution
With: Tetracycline antibiotics (e.g. doxycycline) and ciprofloxacin (and other quinolones)
Milk, yoghurt, cheese and calcium supplements can stop these antibiotics being absorbed properly. Take the antibiotic and these foods at least 2 hours apart.
Instead: Plan the meal 2 hours away from the antibiotic dose, or choose a dairy-free dish.
cereal in milk
- Rule 20 Dish shown with a caution
With: Needs: swallowing difficulty (dysphagia)
Mixed thin liquid and solids are hard to control when swallowing. Whether thin drinks are allowed is for the person's speech and language therapist to say.
Instead: Smooth blended soup, porridge, thick and uniform textures.
cheese
- Rule 21 Dish shown with a caution
With: Tetracycline antibiotics (e.g. doxycycline) and ciprofloxacin (and other quinolones)
Milk, yoghurt, cheese and calcium supplements can stop these antibiotics being absorbed properly. Take the antibiotic and these foods at least 2 hours apart.
Instead: Plan the meal 2 hours away from the antibiotic dose, or choose a dairy-free dish.
chewy or gristly meat
- Rule 17 A swap is suggested
With: Needs: easy-to-chew foods
Tough meat is hard to chew.
Instead: Slow-cooked stew, minced meat, flaked fish, meat in gravy.
chicken on the bone
- Rule 18 Dish is left out
With: Needs: easy-to-chew foods or swallowing difficulty
Small hard pieces can cause choking.
Instead: Boneless fish, peeled or chopped fruit, shredded chicken.
chops
- Rule 17 A swap is suggested
With: Needs: easy-to-chew foods
Tough meat is hard to chew.
Instead: Slow-cooked stew, minced meat, flaked fish, meat in gravy.
coffee
- Rule 22 Dish shown with a caution
With: Levothyroxine
Levothyroxine should be taken on an empty stomach, 30 to 60 minutes before breakfast and before coffee.
Instead: Plan breakfast and coffee 30 to 60 minutes after the tablet.
cranberry juice in large amounts
- Rule 5 Dish shown with a caution
With: Warfarin
Some reports link large amounts of cranberry to INR changes. The evidence is mixed, so treat this as a caution only.
Instead: Apple or pear juice, small servings.
cranberry products taken daily
- Rule 5 Dish shown with a caution
With: Warfarin
Some reports link large amounts of cranberry to INR changes. The evidence is mixed, so treat this as a caution only.
Instead: Apple or pear juice, small servings.
crisps and popcorn
- Rule 16 Dish is left out
With: Needs: easy-to-chew foods (missing teeth, dentures, weak chewing)
Hard or crunchy foods are difficult to chew and can be a choking risk.
Instead: Soft cooked vegetables, soft bread, soft biscuits dunked in tea, smooth nut butter thinned out.
crusty bread, hard biscuits, crackers
- Rule 16 Dish is left out
With: Needs: easy-to-chew foods (missing teeth, dentures, weak chewing)
Hard or crunchy foods are difficult to chew and can be a choking risk.
Instead: Soft cooked vegetables, soft bread, soft biscuits dunked in tea, smooth nut butter thinned out.
cured or fermented meats
- Rule 12 Dish shown with a caution
With: MAOI antidepressants (phenelzine, tranylcypromine, isocarboxazid); also moclobemide at lower risk
High tyramine foods can cause a sharp rise in blood pressure with MAOIs.
Instead: Fresh cheese such as cottage cheese, fresh meat or fish cooked the same day.
desserts containing liqueur or marsala (e.g. tiramisu)
- Rule 23 Dish shown with a caution
With: Warfarin
Alcohol can change how warfarin works and affect the INR. Small amounts used in cooking are usually less of a concern, but drinks and desserts with liqueur should be discussed. Ask your pharmacist or doctor.
Instead: Alcohol-free version of the drink or dish.
dishes cooked with wine, beer or spirits (e.g. risotto with white wine)
- Rule 23 Dish shown with a caution
With: Warfarin
Alcohol can change how warfarin works and affect the INR. Small amounts used in cooking are usually less of a concern, but drinks and desserts with liqueur should be discussed. Ask your pharmacist or doctor.
Instead: Alcohol-free version of the drink or dish.
dishes cooked with wine, beer or spirits where most of the alcohol is cooked off
- Rule 8 Dish shown with a caution
With: Sedatives (as R06) and metformin (as R07)
Cooking removes only part of the alcohol. Low risk for most people, but mention it for people on sedatives.
Instead: Stock-based version.
dishes served with wine, beer or spirits
- Rule 6 Dish is left out
With: Sedatives: benzodiazepines, Z-drugs (zopiclone), sedating antihistamines, opioid painkillers, sedating antidepressants and antipsychotics, gabapentinoids
Alcohol adds to drowsiness and can raise the risk of falls and breathing problems in older adults.
Instead: Alcohol-free version of the drink or dish. - Rule 23 Dish shown with a caution
With: Warfarin
Alcohol can change how warfarin works and affect the INR. Small amounts used in cooking are usually less of a concern, but drinks and desserts with liqueur should be discussed. Ask your pharmacist or doctor.
Instead: Alcohol-free version of the drink or dish.
dry crumbly foods: dry cake, dry rice
- Rule 19 Dish shown with a caution
With: Needs: swallowing difficulty (dysphagia) or dry mouth
Sticky or dry foods can stick in the mouth or throat.
Instead: Moist foods with sauce, smooth purees, soft moist cake with custard.
dry roast meat
- Rule 17 A swap is suggested
With: Needs: easy-to-chew foods
Tough meat is hard to chew.
Instead: Slow-cooked stew, minced meat, flaked fish, meat in gravy.
fish with small bones
- Rule 18 Dish is left out
With: Needs: easy-to-chew foods or swallowing difficulty
Small hard pieces can cause choking.
Instead: Boneless fish, peeled or chopped fruit, shredded chicken.
flambeed dishes
- Rule 6 Dish is left out
With: Sedatives: benzodiazepines, Z-drugs (zopiclone), sedating antihistamines, opioid painkillers, sedating antidepressants and antipsychotics, gabapentinoids
Alcohol adds to drowsiness and can raise the risk of falls and breathing problems in older adults.
Instead: Alcohol-free version of the drink or dish. - Rule 23 Dish shown with a caution
With: Warfarin
Alcohol can change how warfarin works and affect the INR. Small amounts used in cooking are usually less of a concern, but drinks and desserts with liqueur should be discussed. Ask your pharmacist or doctor.
Instead: Alcohol-free version of the drink or dish.
fruit with pips or stones
- Rule 18 Dish is left out
With: Needs: easy-to-chew foods or swallowing difficulty
Small hard pieces can cause choking.
Instead: Boneless fish, peeled or chopped fruit, shredded chicken.
grapefruit
- Rule 1 Dish is left out
With: Statins: simvastatin, lovastatin (strong effect); atorvastatin (smaller effect)
Grapefruit can raise statin levels in the blood and increase the risk of muscle side effects.
Instead: Orange (sweet), apple, pear or berries. - Rule 2 Dish is left out
With: Calcium-channel blockers: felodipine, nifedipine (dihydropyridines)
Grapefruit can raise levels of these blood-pressure medicines and cause low blood pressure, dizziness or swelling.
Instead: Orange (sweet), apple, pear or berries. - Rule 3 Dish shown with a caution
With: Other medicines known to interact with grapefruit (for example some immune, heart-rhythm and anxiety medicines), when the person's list says 'grapefruit-sensitive'
This medicine may interact with grapefruit. Ask your pharmacist or doctor before including it.
Instead: Orange (sweet) or apple.
grapefruit juice
- Rule 1 Dish is left out
With: Statins: simvastatin, lovastatin (strong effect); atorvastatin (smaller effect)
Grapefruit can raise statin levels in the blood and increase the risk of muscle side effects.
Instead: Orange (sweet), apple, pear or berries. - Rule 2 Dish is left out
With: Calcium-channel blockers: felodipine, nifedipine (dihydropyridines)
Grapefruit can raise levels of these blood-pressure medicines and cause low blood pressure, dizziness or swelling.
Instead: Orange (sweet), apple, pear or berries. - Rule 3 Dish shown with a caution
With: Other medicines known to interact with grapefruit (for example some immune, heart-rhythm and anxiety medicines), when the person's list says 'grapefruit-sensitive'
This medicine may interact with grapefruit. Ask your pharmacist or doctor before including it.
Instead: Orange (sweet) or apple.
green-vegetable-heavy dishes such as saag
- Rule 4 Dish shown with a caution
With: Warfarin
Warfarin does not mean avoiding green vegetables. The aim is to keep vitamin K intake steady from week to week. Large changes can affect the INR. Keep the clinic informed of diet changes.
Instead: Keep portions regular rather than removing them.
hard sweets
- Rule 16 Dish is left out
With: Needs: easy-to-chew foods (missing teeth, dentures, weak chewing)
Hard or crunchy foods are difficult to chew and can be a choking risk.
Instead: Soft cooked vegetables, soft bread, soft biscuits dunked in tea, smooth nut butter thinned out.
large amounts of alcohol in dishes
- Rule 7 Dish shown with a caution
With: Metformin
Heavy alcohol use with metformin raises the risk of lactic acidosis. Alcohol can also cause low blood sugar in people with diabetes.
Instead: Alcohol-free version.
large portions of spinach, kale, broccoli, Brussels sprouts, cabbage, collard or turnip greens, parsley
- Rule 4 Dish shown with a caution
With: Warfarin
Warfarin does not mean avoiding green vegetables. The aim is to keep vitamin K intake steady from week to week. Large changes can affect the INR. Keep the clinic informed of diet changes.
Instead: Keep portions regular rather than removing them.
large servings of potassium-rich foods: bananas, dried fruit, potatoes, tomato sauce, spinach, avocado, coconut water
- Rule 11 Dish shown with a caution
With: ACE inhibitors, angiotensin receptor blockers (sartans), spironolactone and similar; kidney disease
Ordinary servings are usually fine. Very large or frequent servings may raise potassium in some people.
Instead: Apple, berries, rice, pasta.
milk
- Rule 21 Dish shown with a caution
With: Tetracycline antibiotics (e.g. doxycycline) and ciprofloxacin (and other quinolones)
Milk, yoghurt, cheese and calcium supplements can stop these antibiotics being absorbed properly. Take the antibiotic and these foods at least 2 hours apart.
Instead: Plan the meal 2 hours away from the antibiotic dose, or choose a dairy-free dish.
nuts and seeds
- Rule 16 Dish is left out
With: Needs: easy-to-chew foods (missing teeth, dentures, weak chewing)
Hard or crunchy foods are difficult to chew and can be a choking risk.
Instead: Soft cooked vegetables, soft bread, soft biscuits dunked in tea, smooth nut butter thinned out.
pomelo
- Rule 1 Dish is left out
With: Statins: simvastatin, lovastatin (strong effect); atorvastatin (smaller effect)
Grapefruit can raise statin levels in the blood and increase the risk of muscle side effects.
Instead: Orange (sweet), apple, pear or berries. - Rule 2 Dish is left out
With: Calcium-channel blockers: felodipine, nifedipine (dihydropyridines)
Grapefruit can raise levels of these blood-pressure medicines and cause low blood pressure, dizziness or swelling.
Instead: Orange (sweet), apple, pear or berries. - Rule 3 Dish shown with a caution
With: Other medicines known to interact with grapefruit (for example some immune, heart-rhythm and anxiety medicines), when the person's list says 'grapefruit-sensitive'
This medicine may interact with grapefruit. Ask your pharmacist or doctor before including it.
Instead: Orange (sweet) or apple.
potassium-based salt substitutes (e.g. 'LoSalt')
- Rule 10 Dish is left out
With: ACE inhibitors, angiotensin receptor blockers (sartans), spironolactone and similar; kidney disease
Potassium salt substitutes can push potassium too high with these medicines.
Instead: Herbs, spices, lemon, vinegar.
raw hard vegetables (raw carrot, celery)
- Rule 16 Dish is left out
With: Needs: easy-to-chew foods (missing teeth, dentures, weak chewing)
Hard or crunchy foods are difficult to chew and can be a choking risk.
Instead: Soft cooked vegetables, soft bread, soft biscuits dunked in tea, smooth nut butter thinned out.
real liquorice sweets and tea
- Rule 13 Dish shown with a caution
With: Blood-pressure medicines, water tablets (diuretics), digoxin
Real liquorice can raise blood pressure and lower potassium, which matters with water tablets and digoxin.
Instead: Fruit sweets or mint.
salty or cured dishes: ham, bacon, salami, smoked fish, canned soup, stock cubes, soy sauce, pickles, olives, many takeaway dishes
- Rule 9 Dish shown with a caution
With: High blood pressure or heart failure (any blood-pressure or water tablets)
High salt intake can raise blood pressure and cause fluid build-up.
Instead: Same dish seasoned with herbs, lemon, garlic or pepper; low-salt version.
sauerkraut, kimchi
- Rule 12 Dish shown with a caution
With: MAOI antidepressants (phenelzine, tranylcypromine, isocarboxazid); also moclobemide at lower risk
High tyramine foods can cause a sharp rise in blood pressure with MAOIs.
Instead: Fresh cheese such as cottage cheese, fresh meat or fish cooked the same day.
Seville (bitter) orange
- Rule 2 Dish is left out
With: Calcium-channel blockers: felodipine, nifedipine (dihydropyridines)
Grapefruit can raise levels of these blood-pressure medicines and cause low blood pressure, dizziness or swelling.
Instead: Orange (sweet), apple, pear or berries. - Rule 3 Dish shown with a caution
With: Other medicines known to interact with grapefruit (for example some immune, heart-rhythm and anxiety medicines), when the person's list says 'grapefruit-sensitive'
This medicine may interact with grapefruit. Ask your pharmacist or doctor before including it.
Instead: Orange (sweet) or apple.
Seville (bitter) orange, e.g. in marmalade
- Rule 1 Dish is left out
With: Statins: simvastatin, lovastatin (strong effect); atorvastatin (smaller effect)
Grapefruit can raise statin levels in the blood and increase the risk of muscle side effects.
Instead: Orange (sweet), apple, pear or berries.
shellfish in shells
- Rule 18 Dish is left out
With: Needs: easy-to-chew foods or swallowing difficulty
Small hard pieces can cause choking.
Instead: Boneless fish, peeled or chopped fruit, shredded chicken.
skins on beans or sweetcorn
- Rule 18 Dish is left out
With: Needs: easy-to-chew foods or swallowing difficulty
Small hard pieces can cause choking.
Instead: Boneless fish, peeled or chopped fruit, shredded chicken.
soup with lumps
- Rule 20 Dish shown with a caution
With: Needs: swallowing difficulty (dysphagia)
Mixed thin liquid and solids are hard to control when swallowing. Whether thin drinks are allowed is for the person's speech and language therapist to say.
Instead: Smooth blended soup, porridge, thick and uniform textures.
soy sauce, miso, tempeh, fermented tofu
- Rule 12 Dish shown with a caution
With: MAOI antidepressants (phenelzine, tranylcypromine, isocarboxazid); also moclobemide at lower risk
High tyramine foods can cause a sharp rise in blood pressure with MAOIs.
Instead: Fresh cheese such as cottage cheese, fresh meat or fish cooked the same day.
steak
- Rule 17 A swap is suggested
With: Needs: easy-to-chew foods
Tough meat is hard to chew.
Instead: Slow-cooked stew, minced meat, flaked fish, meat in gravy.
sugary drinks, sweet desserts, large portions of white rice, white bread or sugary sauces
- Rule 15 Dish shown with a caution
With: Diabetes, especially insulin or sulfonylureas
Sugary or very starchy meals can push blood sugar up. Skipped or irregular meals can cause lows for people on insulin or sulfonylureas.
Instead: Fruit, unsweetened yoghurt, wholegrain options, smaller portions.
tap beer
- Rule 12 Dish shown with a caution
With: MAOI antidepressants (phenelzine, tranylcypromine, isocarboxazid); also moclobemide at lower risk
High tyramine foods can cause a sharp rise in blood pressure with MAOIs.
Instead: Fresh cheese such as cottage cheese, fresh meat or fish cooked the same day.
tiramisu and other alcohol-soaked desserts
- Rule 6 Dish is left out
With: Sedatives: benzodiazepines, Z-drugs (zopiclone), sedating antihistamines, opioid painkillers, sedating antidepressants and antipsychotics, gabapentinoids
Alcohol adds to drowsiness and can raise the risk of falls and breathing problems in older adults.
Instead: Alcohol-free version of the drink or dish.
tough cuts without sauce
- Rule 17 A swap is suggested
With: Needs: easy-to-chew foods
Tough meat is hard to chew.
Instead: Slow-cooked stew, minced meat, flaked fish, meat in gravy.
very sticky foods: peanut butter on its own, soft white bread that forms a ball, sticky rice cakes, marshmallow, caramel, toffee
- Rule 19 Dish shown with a caution
With: Needs: swallowing difficulty (dysphagia) or dry mouth
Sticky or dry foods can stick in the mouth or throat.
Instead: Moist foods with sauce, smooth purees, soft moist cake with custard.
whole grapes
- Rule 18 Dish is left out
With: Needs: easy-to-chew foods or swallowing difficulty
Small hard pieces can cause choking.
Instead: Boneless fish, peeled or chopped fruit, shredded chicken.
yeast extract spreads
- Rule 12 Dish shown with a caution
With: MAOI antidepressants (phenelzine, tranylcypromine, isocarboxazid); also moclobemide at lower risk
High tyramine foods can cause a sharp rise in blood pressure with MAOIs.
Instead: Fresh cheese such as cottage cheese, fresh meat or fish cooked the same day.
yoghurt
- Rule 21 Dish shown with a caution
With: Tetracycline antibiotics (e.g. doxycycline) and ciprofloxacin (and other quinolones)
Milk, yoghurt, cheese and calcium supplements can stop these antibiotics being absorbed properly. Take the antibiotic and these foods at least 2 hours apart.
Instead: Plan the meal 2 hours away from the antibiotic dose, or choose a dairy-free dish.