Joseph R. Anticaglia MD
Medical Advisory Board
With every new drug on the market, there’s one more chance that you’ll suffer an unwanted reaction that ranges from mild to severe. However, such reactions are not limited to drugs. Food, herbs and supplements can be as dangerous as drugs.
Most of the time medicines make us feel better. They can bring down high blood pressure, calm our nerves, help us sleep and relieve headaches and pain. They get diabetes under control and battle infections. But unwanted reactions and interactions can make you itch all over, turn the color of the skin from red to blue and cause you to hunger for air.
Interactions of drugs with other drugs, food or supplements can affect the
- Absorption
- Distribution
- Breakdown and
- Excretion of medications and supplements.
Such interactions are potentially dangerous in patients who are prescribed anticoagulants-blood thinners. The interaction of aspirin can increase the likelihood of hemorrhage. Interference with the absorption of blood thinners can increase the likelihood of blood clots, heart attacks and strokes.
Drug Reactions
Steven was given post-operatively, prochlorperazine, a medication for nausea and vomiting. Several hours after his gall bladder surgery, his reaction to the medication was dramatic. It caused him to have involuntary, jerky movements of the face and jaw and muscle spasms and contractions (dyskinesia).
Food Reactions
Eight years old Ella was enjoying a peanut butter sandwich at school when suddenly she was gasping for air. Fortunately, the school nurse initiated appropriate treatment and then transferred Ella to the hospital’s emergency room in time to prevent a catastrophe. Peanut butter sandwiches were removed from the school’s lunch menu.
Food Interactions
Drugs are metabolized (broken down) so that they can be eliminated from the body. Foods such as grapefruit or grapefruit juice can interfere with the breakdown of drugs or toxins. For example, grapefruit can interact with certain cholesterol-lowering medications (statins). It can cause an increase in the blood level of statins with a greater possibility of side effects.
Grapefruit and grapefruit juice can cause problems with some antihistamines and anti-anxiety drugs, drugs that treat hypertension and arrhythmias. The list of problems with grapefruit is long and the easiest thing to do is to avoid grapefruit or grapefruit juice if you’re taking medications.
Beverage Interactions
Lyle has been taking amitryptiline, an antidepressant medication for several years. The combination of this medication and drinking alcohol made him feel drowsy, sleepy and less alert. It makes driving a car or operating machinery dangerous. The combination of alcohol and medications for pain, sleep or antianxiety can cause similar interactions.
Drug-Drug Interactions
The above happens when two or more drugs react with each other. Oral contraceptives and antibiotics might decrease the effectiveness of oral contraception. Theophylline is a medication used to treat asthma, bronchitis and emphysema. When used in combination with the antibiotic ciprofloxacin, the result could be a toxic increase in theophylline which has been associated with several deaths.
Drug Herb/Supplement Interactions
Ginkgo biloba is a popular herbal supplement which has been used in traditional Chinese medicine for thousands of years. When Ginkgo is combined with blood thinners, it increases the potential for bleeding. The supplement vitamin E interacts with blood thinners increasing the likelihood of bleeding. Patients on these supplements are informed to stop using them prior to surgery.
Drug Reactions and Medical Conditions
Certain drugs can be harmful if taken with an existing medical condition. Persons with hypertension should not use nasal decongestants. People with peptic ulcers should avoid aspirin-like products.
People with renal disease may need to adjust the dose of certain medications. They should avoid aspirin, NSAIDS, and certain antibiotics. Kidney patients are often given a list of products and medications to avoid.
Individuals with liver disease should avoid acetaminophen, certain herbal products and the antibiotic, azithromycin. As in kidney disease, patients are often given a list of products medications to avoid because of their illness.
Interactions of one or more drugs with supplements or food can decrease their effectiveness, increase the potency of the drug, decrease its effectiveness or cause unwanted side effects. The reactions can be mild or life threatening and in rare instances cause death.
Remember to speak to your doctor and pharmacist to understand why you’re taking a particular medication. Look for directions on how to take the medication, its uses, active ingredients and warnings. Should you take it on an empty stomach or with food? Should you avoid antacids or dairy products?
Take the time to understand the medications you need to feel well. Take the time to read the label when you begin a new prescription or over the counter medication. It will be time well spent.
References
- U. S. Food and Drug Administration; Grapefruit Juice and Some Drugs Don’t Mix; July 18, 2017
- Ben D Snyder et al; Drug interactions: principles and practice; Australian Prescriber June 1, 2012
- Ament, Paul et al; Clinically Significant Drug Interactions; Am Fam Physician, March 15, 2000
- Drugs. com; Drugs Interaction Checker
- National Center for Complementary and Integrative Health; Herb-Drug Interactions; Sept, 2015
- U. S. Food and Drug Administration and National Consumers League; Avoid Food-Drug Interactions
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.