Foods to Avoid on Immunosuppressants: A Crucial Safety Guide

January 7, 2026 •

4 min read

According to the Centers for Disease Control and Prevention (CDC), immunocompromised individuals are at a higher risk for severe illness from food poisoning. For this reason, knowing what foods to avoid on immunosuppressants is vital for protecting your health and preventing infections that your body is less equipped to fight off.

Quick Summary

People taking immunosuppressants must avoid high-risk foods like unpasteurized dairy, raw meat, and uncooked eggs to prevent severe foodborne illness. Proper food handling, preparation, and storage are also critical to minimize infection risk while on these medications.

Key Points

Avoid Raw Foods: Completely eliminate raw and undercooked meat, poultry, seafood, and eggs from your diet to prevent severe bacterial infections.
Check for Pasteurization: Only consume dairy products and juices that are clearly labeled as pasteurized; avoid soft and mold-ripened cheeses unless cooked thoroughly.
Wash Produce Meticulously: Always wash all fresh fruits and vegetables under running water, and avoid raw sprouts and pre-cut produce from delis or salad bars.
Practice Safe Kitchen Hygiene: Use separate cutting boards for raw meat and produce, wash hands and surfaces frequently, and avoid cross-contamination.
Exercise Caution When Dining Out: Limit fast-food and buffet meals due to high risk of improper food handling and sanitation.
Reheat Leftovers Properly: Ensure all leftovers are reheated to a safe temperature of 165°F (74°C) and only consume within a few days of preparation.
Be Aware of Specific Drug Interactions: Check with your doctor about potential interactions between your medication (e.g., tacrolimus) and certain foods like grapefruit.

Why Is Food Safety So Critical on Immunosuppressants?

Your immune system is your body's natural defense against infection, but immunosuppressant medications deliberately weaken this system to prevent it from attacking healthy tissue or transplanted organs. While essential for managing conditions like autoimmune diseases, cancer, or post-transplant care, this weakened state leaves you far more vulnerable to pathogens found in food.

A healthy person might recover from mild food poisoning in a day or two, but for someone on immunosuppressants, the same bacterial exposure could lead to a severe, life-threatening infection requiring hospitalization. This is why dietary precautions are not optional but a critical component of your overall treatment plan.

High-Risk Foods to Avoid When Immunocompromised

Raw and Undercooked Meats, Poultry, and Seafood

Raw or undercooked animal products are among the most common sources of foodborne pathogens like Salmonella, E. coli, and Listeria. For those on immunosuppressants, all meat, poultry, and fish must be thoroughly cooked to the safe internal temperatures recommended by food safety authorities. This means no rare or medium-rare meats, no sushi or sashimi, and no raw oysters or shellfish. Processed and deli meats should also be heated until steaming to kill any potential bacteria.

Unpasteurized Dairy and Juices

Products that are not pasteurized can contain harmful bacteria that are easily destroyed by the heat of the pasteurization process. This includes unpasteurized milk, yogurt, and cheese. Soft and mold-ripened cheeses like Brie, Camembert, and blue cheese are particularly high-risk and should be avoided, even if pasteurized, unless cooked until steaming hot. Always check labels to ensure dairy products are pasteurized. Similarly, all fruit and vegetable juices should be pasteurized.

Raw Eggs and Related Products

Raw or undercooked eggs can carry Salmonella. Avoid any foods made with raw eggs, such as homemade mayonnaise, hollandaise sauce, Caesar dressing, or unbaked cookie dough. Stick to thoroughly cooked eggs where the yolk is firm. For recipes requiring raw eggs, use pasteurized egg products.

Unwashed Fruits and Vegetables

Even with a healthy immune system, eating unwashed produce carries risk. For immunocompromised individuals, this risk is heightened significantly. All fresh fruits and vegetables must be washed thoroughly under running water before eating or peeling. Avoid salads from salad bars or buffets, as cross-contamination is a high risk. Raw sprouts, including alfalfa and bean sprouts, should be avoided entirely. Frozen or canned fruits and vegetables are safer alternatives.

Certain Fast Foods and Dining Precautions

Fast food establishments and buffets pose a significant risk due to potentially inconsistent food handling and preparation standards. It is often difficult to confirm that meats are cooked thoroughly, produce is washed properly, and food has not been sitting in the temperature 'danger zone' for too long. If you do eat out, choose fresh, well-cooked options and request individually packaged condiments to minimize risk.

Water Quality

While tap water is generally safe in most areas, well water should be boiled for at least one minute before drinking, especially if it is not tested regularly. Bottled water should be from a trusted source, and restaurant fountain drinks should be avoided, as ice machines can harbor bacteria.

Table: High-Risk vs. Safer Food Choices


Food Category	Foods to Avoid	Safer Alternatives
Meat & Poultry	Raw, medium-rare, or undercooked meats, poultry, and fish (e.g., sushi, ceviche). Cold cuts and deli meats not heated until steaming.	Well-cooked meats, poultry, and fish (no pink showing). Shelf-stable canned meats. Deli meats heated until steaming hot.
Dairy	Unpasteurized milk, yogurt, and cheese. Soft cheeses like Brie, Camembert, Feta, Blue Cheese (unless cooked).	Pasteurized milk, hard cheeses (Cheddar, Swiss, American). Cooked soft cheeses (e.g., in a hot casserole).
Eggs	Raw or undercooked eggs (runny yolks). Foods made with raw eggs (homemade mayonnaise, Caesar dressing).	Hard-boiled or thoroughly cooked eggs (firm yolk). Pasteurized egg products for uncooked recipes.
Fruits & Vegetables	Raw, unwashed produce. Raw sprouts (alfalfa, clover). Pre-cut fruits/vegetables from grocery stores. Salads from deli/salad bars.	Thoroughly washed raw fruits (thick-skinned and peeled). Cooked vegetables (fresh, frozen, or canned). Pasteurised juices.
Dining Out	Salad bars, buffets, street vendors, and fast food.	Food from reputable restaurants where preparation is fresh. Order well-cooked, hot food.

Kitchen Hygiene: Preventing Cross-Contamination

Proper food handling is as important as avoiding specific foods. Cross-contamination can spread bacteria from high-risk foods to safe ones.

Segregation and Storage

Use separate cutting boards for raw meats and produce. Store raw meat on the bottom shelf of your refrigerator to prevent juices from dripping onto other items. Keep your refrigerator below 40°F (4°C).

Cleaning and Washing

Wash your hands thoroughly with soap and warm water before and after handling any food. Sanitize all countertops, cutting boards, and utensils after contact with raw ingredients. Use paper towels for cleanup rather than sponges or dishcloths, which can harbor bacteria.

Thawing and Leftovers

Thaw frozen foods in the refrigerator, not on the counter. Refrigerate or freeze leftovers within two hours of cooking, or one hour if the temperature is above 90°F (32°C). Reheat leftovers thoroughly to 165°F (74°C), and only reheat once.

Conclusion

Following a strict food safety protocol is a critical part of managing your health while on immunosuppressants. By avoiding high-risk foods and prioritizing meticulous hygiene in your kitchen, you can significantly reduce your risk of serious foodborne illness. Always consult your healthcare provider or a registered dietitian before making any significant dietary changes. This personalized guidance will help ensure your nutritional needs are met safely while protecting your compromised immune system.

Disclaimer: This guide is for informational purposes only and is not a substitute for professional medical advice. Always consult your doctor or a qualified dietitian regarding your specific dietary needs while on immunosuppressants.

Important Considerations

Some immunosuppressants, particularly those used for organ transplants (like tacrolimus and cyclosporine), can interact with specific foods like grapefruit and pomegranate, which can increase medication levels to dangerous concentrations in the bloodstream. This is a drug-specific interaction, so it is crucial to discuss potential food and medication interactions with your doctor or pharmacist.

Frequently Asked Questions

Yes, you can eat fresh fruit, but it must be thoroughly washed under running water and peeled if possible. Fruits with thick, inedible skins like bananas and oranges are safer, but the exterior should still be washed before peeling. Avoid unwashed, damaged, or bruised fruit.

Deli meats are generally not recommended due to potential Listeria contamination. If you choose to eat them, they must be heated until steaming hot before consumption. Commercially packaged, shelf-stable options are considered safer.

You can have cheese made from pasteurized milk, but you should avoid soft, mold-ripened cheeses like Brie, Feta, Blue Cheese, or Camembert unless they are cooked until steaming hot. Hard cheeses like Cheddar and Swiss are generally safe, provided they are pasteurized.

Tap water from a municipal source is generally safe. Well water should be boiled for at least one minute before drinking. Bottled water is a safe alternative if it has been distilled or filtered through reverse osmosis. Avoid ice and fountain drinks from restaurants, as their sanitation can be inconsistent.

Eating out carries a higher risk due to variable food handling standards. If you do, choose well-cooked, hot foods from reputable establishments. Avoid salad bars, buffets, and street vendors, and consider asking for individually packaged condiments.

Refrigerate or freeze leftovers within two hours of cooking. Reheat them thoroughly to an internal temperature of 165°F (74°C) and only reheat them once. Don't keep refrigerated leftovers for more than 2–4 days.

Grapefruit and certain other citrus fruits can interact with specific immunosuppressant medications, like tacrolimus, by affecting the enzymes in your body that metabolize the drug. This can cause medication levels in your bloodstream to rise to potentially toxic levels. It is critical to discuss this specific interaction with your doctor.