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Medications That Interfere with Ketosis

author avatar Dr. Eric Berg 08/31/2023

The many health benefits of the ketogenic diet are hard to ignore, but medications can interfere with ketosis however many people opt for the keto lifestyle to improve existing health conditions. 

But is keto possible if you are on medication? The short answer is yes! Understanding how a keto diet affects your medication and how your medication may affect your ketosis is crucial in getting the most health benefits out of your keto diet. 

Different medicine bottles

What is keto?

The keto diet was initially formulated to treat seizures, drug-resistant epilepsy, and other neurological disorders. This high-fat, moderate-protein, and low-carb diet puts your body into fat-burning mode. 

As you break down fat, your liver creates large quantities of ketones, a type of acid and very efficient fuel for your body. In fact, your heart, brain, and muscles prefer ketones as a source of energy compared to relying on sugars and carbohydrates. 

Ketones enter your circulation to fuel your body—this state is known as ketosis. To maintain ketosis, consume no more than 20 to 50 grams of carbs daily.

Many lifestyle diseases like obesity, diabetes, and high blood pressure develop from chronically elevated blood glucose and insulin levels. Because of its unique high-fat to low-carb ratio, the ketogenic diet keeps blood sugar levels balanced and supports healthy insulin levels. 

Priming your metabolism to utilize fats, not sugars, as the primary energy source has numerous health benefits. 

Here are some examples of why the keto diet is an excellent choice for your health: 

  • As you burn fat, you lose weight easier and maintain a healthy weight long-term.

  • You have more energy and improved cognitive function as a result of the increase in your metabolic rate.

  • Ketosis supports blood sugar balance and lowers cravings.

  • Ketones support healthy levels of insulin, your chief metabolic hormone responsible for fat storage.

  • Your body can fight inflammation and infections more effectively.

How prescription drugs may affect ketosis

The ketogenic diet is a natural approach to weight loss, helps improve diabetes, and lowers risk factors linked to heart disease. Unsurprisingly, many patients are choosing a keto diet to enhance their health. 

Taking medications and going keto can overlap, but there is good news. As your keto regime improves your health, you may need lower doses or can stop your prescriptions altogether.

Don’t stop or lower your medication without consulting your doctor or pharmacist. Drugs often have to be tapered and blood levels checked to ensure your health and well-being. Watch the video above to learn how to do keto while on medication. 

Let’s look at common prescription medications that can interfere with low-carb diets.

Diabetes medication

Type 2 diabetes is a medical condition resulting from chronically elevated blood glucose levels,  imbalanced insulin, and insulin resistance. Depending on the severity of your diabetes, you may be prescribed insulin or a blood sugar-lowering drug like metformin.

These drugs target blood glucose control and insulin regulation, which are closely linked to carbohydrate intake. 

Your metabolism is unable to reach ketosis if insulin is high. But, as you reduce your carb intake on keto, your body's insulin balance improves, lessening the need for medication and making ketosis possible. 

Be cautious, particularly during the early phase of your keto plan while on medication. A combination of low-carb and certain drugs can cause side effects, like hypoglycemia, which is very low blood sugar. 

Listen to your body, monitor changes, and work closely with your doctor to adjust medication as you become keto-adapted.


Different diabetes medications

Blood pressure medication

If you are diagnosed with hypertension, your doctor probably prescribed an antihypertensive medication like diuretics, vasodilators, or beta-blockers to lower high blood pressure.


This recent study found that a ketogenic diet is beneficial in reducing blood pressure. A combination of weight loss and healthy metabolic changes resulting from keto is likely the reason for improved blood pressure. 

Follow Healthy Keto®, a keto diet focusing on high-quality, nutrient-rich, and organic foods for optimal nutrition to support healthy blood pressure and cardiovascular health. Speak to your doctor before lowering the dose of your antihypertensive medicines. 

High cholesterol medications 

High cholesterol is a common health issue. It’s generally believed that high dietary cholesterol causes elevated cholesterol, but that’s not necessarily true. High-carb intake combined with elevated insulin levels triggers cholesterol production in your liver, increasing cholesterol levels in your blood. 

Statins are frequently prescribed to lower cholesterol but can cause side effects. Statins block the production of essential hormones, deplete nutrients required for energy production, and can cause hair loss. 

The keto diet can be a great choice to balance insulin levels and support healthy cholesterol levels. Have your levels checked frequently, and only lower your statin dosage in consultation with your doctor.

Patient taking medication

Psychiatric medications

Antipsychotic drugs and drugs prescribed for central nervous system conditions and depression can increase insulin levels, interfering with your body's ability to achieve ketosis.

However, this does not mean keto isn't possible for you. As you slowly reduce your carbs and increase your fat intake, take notes of any changes and tweak your diet accordingly. Talk to your doctor about your diet and explore alternatives to your current medication. 

You may find your symptoms improve on keto. The keto diet profoundly impacts your metabolism and brain chemistry, and research indicates that ketogenic diets can improve symptoms in patients with depression and affective disorder.


Steroids are potent drugs to lower inflammation. Available as pills or injections, steroids treat a wide range of acute and chronic medical conditions. Steroids like prednisone interfere with ketosis because they directly raise blood sugar and insulin levels.

But don’t be discouraged. As your body adapts to keto, you naturally help your body to lower inflammation and boost your immune system, lessening the need for steroid medications.

Why over-the-counter medications can stop ketosis

It may come as a surprise, but many OTC medicines are high-carb and can quickly push you out of ketosis. Some cough syrups contain more than 20 grams of carbs per dosage! 

Don’t just check the active ingredient of your OTC medication. Read labels and ingredient lists to spot added sugars and hidden carbs. 

Try to avoid liquid medications if possible. These products are commonly high in sugar, intended to increase palatability, and will interfere with your keto success. 

Talk to your pharmacists to identify sugar-free alternatives, or call pharmaceutical manufacturers if you can’t find carb counts on the label. 

Here are some examples of common OTC medications high in carbs:

  • Sudafed

  • Advil

  • Tylenol 

  • Zantac

  • NyQuil 

  • DayQuil


Pharmacist helping patients

Key takeaways

The ketogenic diet plan supports weight loss, helps to fight inflammation, and improves insulin regulation. Going keto by default will improve your health, potentially lowering your need for medications. 

There’s no reason to avoid keto if you are on medication. While some medicines can interfere with ketosis, you still get the health benefits of the keto diet. Take this test to gain valuable insights into your body type and discover customized techniques to improve your well-being and manage stress more effectively.

Make slow changes and listen to your body. Work closely with your doctor to adjust medications and dosages as you adapt to keto.

Follow Healthy Keto to support optimal nutrient levels needed for overall health. Don’t forget to check for carbs in OTC medications and talk to your pharmacists to find suitable alternatives.    



1. What medications can affect ketosis?

Medications that increase insulin levels or raise blood sugar will affect ketosis. Insulin, steroids, statins, and psychiatric drugs are common examples. OTC medications can be high-carb, quickly pushing you out of ketosis.

2. Do ketones interact with any medications?

Ketones generally don’t interact with medication. However, the dosage and efficacy of drugs used for seizure control, epilepsy, and other health conditions related to brain chemistry require close monitoring if the patient follows a ketogenic diet.

3. Do statins interfere with ketosis?

Statins don’t directly interfere with ketosis but have many side effects, like hair loss, fatigue, and hormone imbalance.

4. Does the keto diet affect medication?

Because the keto diet generally improves health, your need for pharmaceuticals likely lessens. This can cause your current dosages to be more potent, leading to unwanted side effects. Work with your doctor to adjust your prescriptions as you adapt to keto.

5. What medications are keto-friendly?

Many medications are keto-friendly. Talk to your doctor about your low-carb diet and find drugs suitable for your keto lifestyle. Be aware of the high-carb content of many OTC products. Read labels and work with your pharmacist to identify keto-friendly medications.

6. Do medications contain carbs?

Yes, many medications contain carbs. Carbs act as a bulking agent and hide unpleasant tastes or textures of medicines.

7. Can medications increase ketones?

Yes, some medications can increase ketone production. Always let your doctor know that you are following a ketogenic diet to ensure your ketone levels are monitored closely.

8. Can I do keto while on medication?

Yes, a ketogenic diet while on medication is possible. While some medicines interfere with ketosis, you still benefit from keto’s health benefits. Your need for medication may lessen as your body responds and adapts to the keto diet. Don’t stop medication or lower dosages without consulting with your doctor.

9. Can I take vitamins while on keto?

Yes, you can take vitamins on keto. But remember that many vitamins are synthetic and don’t provide the same health benefits as whole foods. Follow a Healthy Keto diet to combine the high-fat, low-carb protocol with nutrient-rich, organic produce for optimal nutrition.

10. Is there a pill to put you in ketosis?

No pill will put you into ketosis. Commercial products called keto pills contain ketone bodies. Taking these products does not switch your metabolism into ketosis or help you to turn fat into energy.

11. What is the minimum carbohydrate intake required to stop ketosis?

The amount of carbs needed to push you out of ketosis somewhat depends on your metabolism. Research indicates that limiting carbs to 50 grams daily should be sufficient to keep you in ketosis.

12. How many carbs are in amoxicillin?

The amount of carbohydrates in amoxicillin depends on the exact formulation. Liquid suspensions often are high-carb and can contain up to 5 grams of carbs per dosage, quickly adding up to 20 grams per day.

13. What medications keep you out of ketosis?

Medications that affect insulin levels or blood sugar balance can keep you out of ketosis. Insulin, steroids, estrogen, and some psychiatric drugs are common examples. Consider that OTC medications can be high-carb, quickly pushing you out of ketosis.

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Source: Curless, Jeff, PharmD. Medication Management on the Ketogenic Diet. https://www.choc.org/wp/wp-content/uploads/2017/03/RT-6-CurlessJ-RDsInPractice-Keto.pdf

Disclaimer: Our educational content is not meant or intended for medical advice or treatment.

Editor’s Note: This post has been updated for quality and relevancy.

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