6 Medications You Should Never Mix With Dairy

Medically reviewed by Kristie Reed, PharmD

There’s more calcium in your body than any other mineral. It makes up your bones and teeth, and keeps certain body tissues strong and flexible for movement. It even helps your blood clot, your blood vessels and muscles contract, and your body can’t make hormones without it.

Because it has great calcium content, the dairy you’re eating and drinking is important, but there are some medications you shouldn't mix with dairy. Some medications can react with milk and other dairy foods, either causing less of the medicine to be absorbed, or causing changes in your blood calcium levels.

But you don’t have to avoid dairy if you take any of these medications. In most cases, the Food and Drug Administration (FDA) has announced guidelines for how long to wait to enjoy dairy after taking your medicine. You just need to time it well.

Here are six medications you shouldn't mix with dairy.

Thyroid Medication

Millions of Americans take medication for hypothyroidism, a condition where your thyroid gland-the butterfly-shaped gland in front of your throat-does not make enough thyroid hormone. It’s an important hormone because it helps with energy, weight regulation, body temperature, and the growth of your hair and nails.Synthroid (levothyroxine) replaces that missing thyroid hormone in your body, if you have hypothyroidism.

All thyroid medications should be taken on an empty stomach, but levothyroxine is a bit different. Eating or drinking calcium-containing foods or taking a calcium supplement can cause less of the medication to be absorbed. A small 2018 study showed that drinking milk was associated with lower levels of circulating levothyroxine.  The FDA recommends waiting four hours to ingest dairy after taking your medicine.

Antibiotics

Antibiotics are life-saving drugs that work against bacterial infections. They do not work against viruses, the flu, or the common cold. Millions of antibiotics are prescribed every year, and there is much concern about growing antibiotic resistance. But when they’re absolutely necessary, antibiotics can be life-saving.

• There are many antibiotics that should not be taken with dairy foods because the calcium in the food can reduce how much of the medication your body can use. Space out your medicine and your dairy by at least two hours. Speak with your healthcare provider to make sure the antibiotic you're taking is OK to consume with dairy, or not.

Iron Supplements

Some people take iron supplements for anemia, a condition where your blood doesn’t have enough red blood cells. If the anemia is severe enough, iron infusions may be needed, but many times a healthcare provider will prescribe iron supplements for you to take by mouth.

Studies show that iron is best taken on an empty stomach because it will be absorbed better that way. Sometimes, iron supplements cause uncomfortable side effects, like an upset stomach. In that case, it’s good to take the supplement with a little bit of food, but make sure it isn’t a high-calcium dairy food because they can interact. Be sure to space out the two by around two hours.

Osteoporosis Medication

Osteoporosis is a condition common in older people, especially women, where their bones thin out and become fragile. Your risk of breaking a bone increases if you have osteoporosis. Medications called bisphosphonates are prescribed to strengthen bones.

Dairy products, but also other foods high in calcium, like fortified orange juice, are known to cause less of the medication to be absorbed and used by your body. These medications are Actonel (risedronate), Fosamax (alendronate), and Boniva (ibandronate). If you take these medications, be sure to wait several hours before drinking milk or eating other dairy products.

Lithium

Lithium salts are medications that help reduce manic episodes for people who have been diagnosed with bipolar disorder. It works by stabilizing your mood, and because of that it is sometimes prescribed for other psychiatric illnesses, like depression or schizophrenia.

The use of lithium long term can cause a build-up of calcium in your body. Lithium medications are sold under the brand names Eskalith and Lithobid. If you take these medications, talk to your healthcare provider about whether you should reduce, avoid, or time your dairy foods in a specific way.

HIV Medication

Over 1 million Americans are living with HIV. Dovato and Tivicay (dolutegravir) are both antiretroviral medications that are used to help treat HIV/AIDS. They are used in combination with other medications to treat the disease. Sometimes, dolutegravir is prescribed as a prophylactic to help prevent HIV infection after exposure.

Taking dolutegravir and calcium supplements is OK if taken with a meal. Otherwise, the interaction can cause less of the medication to be absorbed. Combining the two can cause reduced blood levels of the medication. It is recommended to take dolutegravir either two hours before or six hours after any calcium-rich foods or supplements.

When To See A Healthcare Provider

If you take any of these medications, it’s wise to speak with your healthcare provider about how to time your medicine and your meals. In most cases, you can continue to enjoy dairy foods like milk, cheese, yogurt, and ice cream, but you may have to time things correctly.

If you choose to take a calcium supplement or a multivitamin that contains calcium, talk to your healthcare provider first-they can give you specific recommendations.

A Quick Review

There are several medications that interact badly with calcium-rich dairy foods and supplements. Antibiotics, and medications for HIV, osteoporosis, mental health, anemia, and thyroid problems should never be taken with dairy foods. Combining the two can cause levels of either calcium or your medication to be altered. 

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