✅ Safety: Who reviewed the rules

How the review works

1. The rules are written in plain language and shown to the reviewer first.
2. A rule is used by the app only after the reviewer marks it approved. The same applies to each medicine group.
3. The safety checks are fixed rules in code. An AI model never decides what is excluded or cautioned.
4. Sources are named for each rule. They were named from general knowledge and still need checking.

This is a hackathon demo with fictional data. It is not medical advice. Ask your pharmacist or doctor.

Rule 1

✕ Dish is left out

Food: grapefruit; grapefruit juice; pomelo; Seville (bitter) orange, e.g. in marmalade

Medicine or need: Statins: simvastatin, lovastatin (strong effect); atorvastatin (smaller effect)

What the app says: Grapefruit can raise statin levels in the blood and increase the risk of muscle side effects.

Swap: Orange (sweet), apple, pear or berries

Source: FDA consumer page 'Grapefruit Juice and Some Drugs Don't Mix'; statin product information

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 2

✕ Dish is left out

Food: grapefruit; grapefruit juice; pomelo; Seville (bitter) orange

Medicine or need: Calcium-channel blockers: felodipine, nifedipine (dihydropyridines)

What the app says: Grapefruit can raise levels of these blood-pressure medicines and cause low blood pressure, dizziness or swelling.

Swap: Orange (sweet), apple, pear or berries

Source: FDA consumer page on grapefruit; BNF / product information for felodipine and nifedipine

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 3

! Dish shown with a caution

Food: grapefruit; grapefruit juice; pomelo; Seville (bitter) orange

Medicine or need: Other medicines known to interact with grapefruit (for example some immune, heart-rhythm and anxiety medicines), when the person's list says 'grapefruit-sensitive'

What the app says: This medicine may interact with grapefruit. Ask your pharmacist or doctor before including it.

Swap: Orange (sweet) or apple

Source: FDA consumer page on grapefruit; product information for the specific medicine

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 4

! Dish shown with a caution

Food: large portions of spinach, kale, broccoli, Brussels sprouts, cabbage, collard or turnip greens, parsley; green-vegetable-heavy dishes such as saag

Medicine or need: Warfarin

What the app says: 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.

Swap: Keep portions regular rather than removing them

Source: NHS warfarin guidance; NIH Office of Dietary Supplements vitamin K fact sheet

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 5

! Dish shown with a caution

Food: cranberry juice in large amounts; cranberry products taken daily

Medicine or need: Warfarin

What the app says: Some reports link large amounts of cranberry to INR changes. The evidence is mixed, so treat this as a caution only.

Swap: Apple or pear juice, small servings

Source: Warfarin product information and interaction references; evidence is mixed

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy. Note: Reviewer: keep, as a WARN.

Rule 6

✕ Dish is left out

Food: alcoholic drinks; dishes served with wine, beer or spirits; flambeed dishes; tiramisu and other alcohol-soaked desserts

Medicine or need: Sedatives: benzodiazepines, Z-drugs (zopiclone), sedating antihistamines, opioid painkillers, sedating antidepressants and antipsychotics, gabapentinoids

What the app says: Alcohol adds to drowsiness and can raise the risk of falls and breathing problems in older adults.

Swap: Alcohol-free version of the drink or dish

Source: Product information for these medicine groups; NHS alcohol and medicines guidance

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 7

! Dish shown with a caution

Food: alcoholic drinks; large amounts of alcohol in dishes

Medicine or need: Metformin

What the app says: Heavy alcohol use with metformin raises the risk of lactic acidosis. Alcohol can also cause low blood sugar in people with diabetes.

Swap: Alcohol-free version

Source: Metformin product information

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 8

! Dish shown with a caution

Food: dishes cooked with wine, beer or spirits where most of the alcohol is cooked off

Medicine or need: Sedatives (as R06) and metformin (as R07)

What the app says: Cooking removes only part of the alcohol. Low risk for most people, but mention it for people on sedatives.

Swap: Stock-based version

Source: USDA alcohol retention in cooked food tables

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy. Note: Reviewer: keep, as a WARN.

Rule 9

! Dish shown with a caution

Food: salty or cured dishes: ham, bacon, salami, smoked fish, canned soup, stock cubes, soy sauce, pickles, olives, many takeaway dishes

Medicine or need: High blood pressure or heart failure (any blood-pressure or water tablets)

What the app says: High salt intake can raise blood pressure and cause fluid build-up.

Swap: Same dish seasoned with herbs, lemon, garlic or pepper; low-salt version

Source: NHS salt guidance (adults: no more than 6 g salt a day); WHO sodium guideline

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 10

✕ Dish is left out

Food: potassium-based salt substitutes (e.g. 'LoSalt')

Medicine or need: ACE inhibitors, angiotensin receptor blockers (sartans), spironolactone and similar; kidney disease

What the app says: Potassium salt substitutes can push potassium too high with these medicines.

Swap: Herbs, spices, lemon, vinegar

Source: BNF warnings on potassium with these medicine groups; NHS information on LoSalt

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 11

! Dish shown with a caution

Food: large servings of potassium-rich foods: bananas, dried fruit, potatoes, tomato sauce, spinach, avocado, coconut water

Medicine or need: ACE inhibitors, angiotensin receptor blockers (sartans), spironolactone and similar; kidney disease

What the app says: Ordinary servings are usually fine. Very large or frequent servings may raise potassium in some people.

Swap: Apple, berries, rice, pasta

Source: BNF; kidney charity dietary potassium guidance

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy. Note: Reviewer: keep, as a WARN.

Rule 12

! Dish shown with a caution

Food: aged cheese (mature cheddar, blue cheese, parmesan); cured or fermented meats; soy sauce, miso, tempeh, fermented tofu; sauerkraut, kimchi; yeast extract spreads; broad bean pods; tap beer

Medicine or need: MAOI antidepressants (phenelzine, tranylcypromine, isocarboxazid); also moclobemide at lower risk

What the app says: High tyramine foods can cause a sharp rise in blood pressure with MAOIs.

Swap: Fresh cheese such as cottage cheese, fresh meat or fish cooked the same day

Source: BNF; MAOI product information

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy. Note: Reviewer: keep, but changed from EXCLUDE to WARN.

Rule 13

! Dish shown with a caution

Food: real liquorice sweets and tea

Medicine or need: Blood-pressure medicines, water tablets (diuretics), digoxin

What the app says: Real liquorice can raise blood pressure and lower potassium, which matters with water tablets and digoxin.

Swap: Fruit sweets or mint

Source: NHS liquorice advice; BNF

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 15

! Dish shown with a caution

Food: sugary drinks, sweet desserts, large portions of white rice, white bread or sugary sauces

Medicine or need: Diabetes, especially insulin or sulfonylureas

What the app says: Sugary or very starchy meals can push blood sugar up. Skipped or irregular meals can cause lows for people on insulin or sulfonylureas.

Swap: Fruit, unsweetened yoghurt, wholegrain options, smaller portions

Source: Diabetes UK healthy eating guidance; NICE type 2 diabetes guidance

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 16

✕ Dish is left out

Food: nuts and seeds; raw hard vegetables (raw carrot, celery); crusty bread, hard biscuits, crackers; crisps and popcorn; hard sweets

Medicine or need: Needs: easy-to-chew foods (missing teeth, dentures, weak chewing)

What the app says: Hard or crunchy foods are difficult to chew and can be a choking risk.

Swap: Soft cooked vegetables, soft bread, soft biscuits dunked in tea, smooth nut butter thinned out

Source: NHS and British Dietetic Association texture guidance; IDDSI framework (levels 5 and 6)

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 17

↔ A swap is suggested

Food: steak; chops; chewy or gristly meat; tough cuts without sauce; dry roast meat

Medicine or need: Needs: easy-to-chew foods

What the app says: Tough meat is hard to chew.

Swap: Slow-cooked stew, minced meat, flaked fish, meat in gravy

Source: IDDSI framework; BDA texture-modified diet guidance

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 18

✕ Dish is left out

Food: fish with small bones; shellfish in shells; whole grapes; fruit with pips or stones; chicken on the bone; skins on beans or sweetcorn

Medicine or need: Needs: easy-to-chew foods or swallowing difficulty

What the app says: Small hard pieces can cause choking.

Swap: Boneless fish, peeled or chopped fruit, shredded chicken

Source: IDDSI framework; Royal College of Speech and Language Therapists guidance

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 19

! Dish shown with a caution

Food: very sticky foods: peanut butter on its own, soft white bread that forms a ball, sticky rice cakes, marshmallow, caramel, toffee; dry crumbly foods: dry cake, dry rice

Medicine or need: Needs: swallowing difficulty (dysphagia) or dry mouth

What the app says: Sticky or dry foods can stick in the mouth or throat.

Swap: Moist foods with sauce, smooth purees, soft moist cake with custard

Source: IDDSI framework; RCSLT guidance

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 20

! Dish shown with a caution

Food: soup with lumps; cereal in milk; any food that mixes thin liquid and solid pieces

Medicine or need: Needs: swallowing difficulty (dysphagia)

What the app says: 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.

Swap: Smooth blended soup, porridge, thick and uniform textures

Source: IDDSI framework (level 4 and level 5); RCSLT guidance

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 21

! Dish shown with a caution

Food: milk; yoghurt; cheese; calcium supplements and calcium-fortified drinks

Medicine or need: Tetracycline antibiotics (e.g. doxycycline) and ciprofloxacin (and other quinolones)

What the app says: Milk, yoghurt, cheese and calcium supplements can stop these antibiotics being absorbed properly. Take the antibiotic and these foods at least 2 hours apart.

Swap: Plan the meal 2 hours away from the antibiotic dose, or choose a dairy-free dish

Source: Product information / BNF for tetracyclines and ciprofloxacin. Leaflets for some products give longer gaps, so check.

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 22

! Dish shown with a caution

Food: breakfast; coffee

Medicine or need: Levothyroxine

What the app says: Levothyroxine should be taken on an empty stomach, 30 to 60 minutes before breakfast and before coffee.

Swap: Plan breakfast and coffee 30 to 60 minutes after the tablet

Source: Levothyroxine product information; NHS levothyroxine guidance

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy.

Rule 23

! Dish shown with a caution

Food: alcoholic drinks; dishes served with wine, beer or spirits; dishes cooked with wine, beer or spirits (e.g. risotto with white wine); desserts containing liqueur or marsala (e.g. tiramisu); flambeed dishes

Medicine or need: Warfarin

What the app says: 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.

Swap: Alcohol-free version of the drink or dish

Source: Warfarin product information; NHS alcohol and warfarin guidance. Sources not yet checked.

Reviewed 2026-10-19 by Pharmacy assistant, 20 years community pharmacy. Note: Added at the reviewer's request as a WARN. Kept separate from rule 6, which excludes alcohol for sedatives.