Like all drugs, MAOIs and RIMAs can have effects that are not intended and are not part of the treatment that the drugs provide. In this class of drug, these include a risk of a hypertensive crisis. This can be caused by high levels of tyramine; such as by eating cheese (except cream or cottage cheese, meat extracts such as Bovril, yeast extract, stock cubes, fermented soya bean products, alcohol (especially fortified wine (port, sherry), beer and chainti wine. Also preserved fish, preserved poultry, offal, avocado, banana skins, broad bean pods and pickled or smoked herring must be avoided. Certain medications can also cause a hypertensive crisis with MAOIs and RIMAs, such as; amphetamine, fenfluramine, ephedrine, phenlyephrine, phenylpropanolamine, nasal decongestants, L-dopa, pethidine and tricyclic antidepressants. Use of a RIMA rather than a MAOI can reduce these side-effects, however tyramine rich foods should still be avoided.