Health Information

Food-Drug Interactions: Low Tyramine Diet HF#154

Food

This meal plan is to be used for persons who are taking drugs that are monoamine oxidase inhibitors. These drugs include the following.

isocarboxazid (Marplan®)

linezolid (Zyvox®)

pargyline hydrochloride (Eutonyl®)

phenelzine sulfate (Nardil®)

procarbazine hydrochloride (Matulane®)

tranylcyromine sulfate (Parnate®)

While using the drug _________________________, certain foods should not be eaten and others eaten in only small amounts. Avoiding these foods is very important because they naturally contain a substance called tyramine. Tyramine may combine with your drug treatment to cause your blood pressure to rise too much. This plan eliminates foods that have been aged, dried, fermented, pickled, smoked, or cured. Even after drug treatment has ended, you should still avoid these foods for 2 to 3 weeks.

Food Group

Foods Recommended

Foods to Limit

Foods to Avoid

Breads, Grains and Cereals

Whole wheat and enriched white breads, rolls, crackers, and quick breads
Cooked and dry cereals
Grits, pasta and rice

None

Cheese bread and crackers
Sourdough bread
Fresh, homemade yeast leavened breads

Food Group	Foods Recommended	Foods to Limit	Foods to Avoid
Meats and other proteins	All fresh or frozen meats, fish, or poultry Processed luncheon meats	Canned meats, fish Fresh sausage	Aged, smoked, salted, pickled and fermented (hard) meats and fish (e.g. bologna, country cured ham, salami, summer sausage, pepperoni, pickled herring, pickled eggs) Chicken and beef liver, pate, Cavier Dried meats and meat extracts which may be found in powdered and liquid dietary protein supplements Meat tenderizers
Vegetables	All fresh, frozen, dried and canned and vegetable juice, except those on the Avoid list	None	Chinese pea pods English bean pods Italian broad beans (fava beans) Sauerkraut Fermented soy bean products (miso and some tofu)
Fruits	Fresh, frozen, or canned fruits and juices	Avocados Bananas Canned figs Raisins Raspberries Red plums	Banana peels Overripe fruits
Dairy and Cheese	Milk, cottage cheese, farmer cheese, cream cheese, ricotta, and processed cheese	Cultured dairy products (e.g. buttermilk - limit to 4 oz/day; sour cream – limit to 1/4 cup/day; yogurt- limit to 1 cup/day)	Aged and fermented cheeses and spreads such as bleu, brick, brie, camembert, cheddar, emmentaler, gruyere, mozzarella, parmesan, provolone, roquefort, stilton, and liederkranz Any foods containing these cheeses such as pizza, casserole, salad dressings, quiche

Soups	Cream and broth based soups, except those on the Avoid list	None	Soups from Italian broad beans and fava beans Cheese soup Soup made with beer or wine Canned soups or soup mixes made with bouillon cubes or meat extracts Instant soup powders Miso soup
Sweets, Desserts, and other Fats	Sugars Hard candy Honey Molasses Syrup Cakes and cookies Gelatin Ice cream and sherbets Pastries Pudding	Chocolate and products made with chocolate (e.g. chocolate milk, ice cream, pudding, shakes, cakes, cookies)	Imported chocolate Cheese-filled desserts Cheesecake
Beverages	Decaf coffee and tea Milk Carbonated drinks Non-cola drinks (7-Up®, Sprite®)	Chocolate drinks Caffeine in coffee, tea, soft drinks, (Pepsi®, Coke®, Dr. Pepper®, Mountain Dew®) should be limited to 2 (8-ounce) servings per day White wine Red wine (other than Chianti) Port wine Clear spirits	Beer which is cloudy with large amounts of yeast Ale Champagne Sherry, burgundy, Chianti, vermouth Non-alcoholic beer and wine
Other foods	Salt Nuts and peanut butter Spices and herbs	Teriyaki sauce (limit to 1/8 cup) Brewer’s yeast	Marmite (vegetable extracts) Yeast concentrates Vitamin supplements with brewer’s yeast Monosodium glutamate (MSG) All aged products Fermented soy products (e.g. miso, some tofu products), soy sauce

AVOID any spoiled foods. Bacterially contaminated foods must be avoided. All foods should be properly handled, prepared, stored, and served to prevent bacterial contamination. Perishable food should be eaten within 72 hours because prolonged storage or spoiled foods increases the tyramine levels in foods.

Notes on foods which should be used in limited amounts.

Caffeine and other substances in coffee, tea, cola, cocoa, and chocolate can aggravate a hypertensive reaction or may cause jitteriness. Slowly introduce foods and beverages with these ingredients. Start with 1 cup per day. Increase to 2 cups per day if tolerated.
Other food components such as alcohol and caffeine may interact with tyramine to produce adverse reactions and should also be restricted or eliminated. Caffeine, in coffee, tea and soft drinks aggravate symptoms of headache and hypertension in many persons. Some alcoholic beverages, chocolate, and products made with chocolate may provoke adverse reactions because they are high in other amine compounds.
Herbal teas and herbal supplements should be used with caution because they may interfere with medicine and contain tyramine.
Alcoholic beverages should be used cautiously. When you drink any alcoholic beverages, start with a small amount such as one tablespoon of liquor. If no unusual effects are evident within one hour, you may drink alcoholic beverages in moderation. If unusual effects occur, stop drinking and call your doctor. Many people find they can have 1 to 2 drinks up to 3 to 4 times a week without problems.

Some symptoms of high blood pressure (hypertension) are:

Nausea/vomiting	Facial flushing	Ringing in the ears
Sweating	Weakness	Dizziness
Headache	Apprehension	Restlessness
Chest pain	Shortness of breath	Pounding heartbeat

These same symptoms occur in many other illnesses or as the result of anxiety. If you have any of these see your doctor and have your blood pressure checked.

If you are a UW Health patient and have any questions, please contact any of the numbers below.

Nutrition Clinic

University Station

2880 University Avenue

Madison, WI 53705

(608) 263-5012

Nutrition Clinic

UW Health West Clinic

451 Junction Road

Madison, WI 53717

(608) 265-7526

Nutrition Clinic

UW Health East Clinic

5249 East Terrace Drive

Madison, WI 53718

(608) 265-0963

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 07/10/2012

Copyright © 04/15/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#154

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