Which food-drug pairing requires client counseling for potential interactions?

• A. Prednisone and grapefruit juice
• B. Warfarin and vitamin D-containing foods
• C. MAO inhibitors and tyramine-containing foods
• D. Sibutramine and vitamin C-containing foods

Answer: (C)

When a drug class blocks the normal breakdown of certain compounds in the body, what you eat can become a dangerous issue. MAO inhibitors stop the enzyme that normally degrades tyramine, a substance found in many aged or fermented foods. If tyramine isn’t broken down, it can trigger a large release of norepinephrine, leading to a sudden, dangerous surge in blood pressure—a hypertensive crisis that can be life-threatening. Because of this risk, people on MAO inhibitors must receive counseling about avoiding or limiting high-tyramine foods (such as aged cheeses, cured meats, some fermented products, and certain wines).

Other pairings don’t carry the same immediate, well-known dietary danger. Prednisone with grapefruit juice is not a classic, widely required counseling interaction. Warfarin’s major dietary concern is vitamin K-containing foods, not vitamin D-rich foods, so this pairing isn’t typically highlighted for counseling about interactions. Sibutramine with vitamin C-containing foods doesn’t have a strong, recognized interaction that necessitates counseling in the same way the MAOI-tyramine combination does.