What should not be taken with fish oil?

Under normal circumstances, fish oil should not be taken with high-fat milk, soybeans, spinach, lemon, red wine, or medications such as warfarin sodium tablets, simvastatin tablets, ibuprofen tablets, fluoxetine hydrochloride capsules, and carbamazepine tablets. If any discomfort occurs, medical attention should be sought promptly. Specific details are as follows:

I. Food Interactions

1. High-Fat Milk
The omega-3 unsaturated fatty acids in fish oil are prone to oxidation. Saturated fatty acids in high-fat milk can increase oxidative stress in the gastrointestinal tract, accelerating the oxidation of fish oil and reducing its nutritional value. Additionally, calcium in high-fat milk may bind with fatty acids in fish oil, forming insoluble precipitates that are difficult to absorb, thereby impairing the absorption of fish oil.

2. Soybeans
Soybeans contain abundant phytoestrogens, which may compete with certain components in fish oil for absorption, reducing the bioavailability of fish oil. Furthermore, dietary fiber and phytic acid in soybeans may also interfere with the absorption and metabolism of fish oil.

3. Spinach
Spinach contains large amounts of oxalic acid, which can bind with minerals such as calcium and magnesium in fish oil to form insoluble oxalate salts, thus impairing the absorption and utilization of these minerals. The dietary fiber in spinach may also adsorb fatty acids from fish oil, reducing their absorption.

4. Lemon
Lemons are rich in citric acid and vitamin C, which may react with certain components in fish oil, affecting its stability and nutritional value. In particular, citric acid can accelerate the oxidation of fish oil, diminishing its antioxidant properties.

5. Red Wine
Red wine contains various phenolic compounds and alcohol, which may interact with fatty acids in fish oil, affecting its absorption and utilization. Alcohol can increase gastrointestinal permeability, accelerating the metabolism and excretion of fish oil, thereby reducing its bioavailability.

II. Drug Interactions

1. Warfarin Sodium Tablets
Warfarin sodium is a commonly used anticoagulant for preventing and treating thrombosis. Omega-3 unsaturated fatty acids in fish oil can enhance the anticoagulant effect of warfarin, increasing the risk of bleeding.

2. Simvastatin Tablets
Simvastatin is a statin drug used to lower blood lipids and prevent cardiovascular diseases. Omega-3 fatty acids in fish oil may interact with simvastatin, increasing the risk of muscle pain and rhabdomyolysis.

3. Ibuprofen Tablets
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. Fish oil can increase the permeability of the gastrointestinal mucosa; when taken with ibuprofen, it may elevate the risk of gastrointestinal bleeding and ulcers.

4. Fluoxetine Hydrochloride Capsules
Fluoxetine hydrochloride is a commonly used antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class. It may interact with omega-3 fatty acids in fish oil, affecting their absorption and utilization. Concurrent use may also increase the risk of bleeding.

5. Carbamazepine Tablets
Carbamazepine is a common antiepileptic drug used to prevent and treat seizures. Fish oil can increase the metabolic rate of carbamazepine in the body, lowering its blood concentration and therapeutic efficacy. Individuals taking carbamazepine should avoid consuming large amounts of fish oil.

When taking fish oil, it is important to be aware that combining it with the above foods and medications may affect its effectiveness and lead to adverse reactions. Careful consideration should be given to food and medication combinations based on individual health conditions.