Drug Interactions: What You Need to Know
What Are Drug Interactions?
BY Workineh
Date 09/02/2017 E.C
When a medication works right, it boosts your health or helps you feel better.
But a drug can bring on problems if it doesn't mix well with something else you
put into your body, like another medication, a certain food, or alcohol.
When that happens, it's called a drug interaction. It could make your medication
stop working, become less effective, or too strong. It could also trigger side
effects.
The more you learn about drug interactions, the better you'll be able to avoid
them. Here's what you need to know.
What Are the 3 Types of Drug Interactions?
The main types are:
1. Drug-drug interaction. This is when a medication reacts with one or
more other drugs. For example, taking a cough medicine (antitussive) and
a drug to help you sleep (sedative) could cause the two medications to
affect each other.
2. Drug-food/drink interaction. This is when something you eat or drink
affects a drug. For instance, it can be dangerous to drink alcohol while
you're on certain medications. Some vitamins and dietary supplements
interact with medicines, too.
3. Drug-condition interaction. This is when you have a health problem
that makes it risky for you to take certain meds. For example, if you have
a condition like high blood pressure, taking a decongestant for a cold
could drive up your blood pressure even more.
What Drugs Can You Not Take Together?
There are many types of drugs you shouldn't take together, but in general, don't
take combinations like these:
Two or more drugs that share an active ingredient. You could have
side effects or an overdose. Active ingredients are the chemicals in
medications that treat your condition or symptoms. Always check for
them on the drug label.
Blood-thinning drugs with NSAIDs. Your odds for a dangerous bleed
could go up. NSAIDs (nonsteroidal anti-inflammatory drugs) are pain
relievers like ibuprofen or naproxen. If you're on a blood thinner, ask
your doctor to suggest a different type of over-the-counter pain
medication and dose that's safer for you.
Pills with antihistamines. Taking these together can cause you to react
more slowly, which would make it dangerous for you to drive or work
with heavy machines.
Some other drug-drug combinations that can be dangerous are:
An NSAID pain reliever with a blood pressure drug
A thyroid drug called levothyroxine with an acid-blocking proton
pump inhibitor drug called omeprazole
An SSRI antidepressant with another medicine that affects serotonin
(such as dextromethorphan, linezolid, tramadol, and trazodone)
A cholesterol-lowering statin with antifungal and fibrate meds that are
commonly called "azole" drugs (Their technical names are "imidazole
and triazole derivatives." They lower blood fats called triglycerides.)
The antibiotic clarithromycin with a type of blood pressure drug called
a calcium channel blocker
What Are Common Drug Interactions?
Certain foods and drinks don't mix well with some medications.
A few of these are:
1. Alcohol. Booze can bring on dangerous side effects with many
medications, including some drugs for:
Allergies
Cold and flu
High cholesterol
High blood pressure
Attention deficit hyperactivity disorder (ADHD)
Depression
Diabetes
Infections
Pain
Poor sleep
Before you start a new medication, ask your doctor or pharmacist if it could
interact with alcohol. Check the drug label for alcohol warnings, too.
2. Grapefruit or grapefruit juice. Too much of either can affect some
drugs like:
Statins
Antihistamines
Blood pressure drugs
Anxiety meds
Transplant anti-rejection drugs
Grapefruit juice doesn't mix badly with every type of drug in these classes of
medications. Check your drug's label or information pamphlet for any warnings
about it. Also, ask your doctor or pharmacist if it's safe to have grapefruit or its
juice in any amount with your specific drug. If they tell you to stop eating or
drinking it, ask if any other fruits or juices might have similar effects on your
medicine.
3. Foods with vitamin K, like leafy greens. These can interact with the blood
thinner warfarin. You don't have to stop eating them, but it's important to
be consistent and not overdo it. Ask your doctor how much food with
vitamin K you can have, then eat the same amount around the same times
each week.
4. High-potassium foods and drinks, like bananas, salt substitutes, and
orange juice. These can affect blood pressure drugs called ACE
inhibitors. Your doctor will track your potassium levels, and they may tell
you to cut back on foods with it.
5. St. John's wort. This herbal dietary supplement can affect many
medications for heart disease, HIV, depression, and other conditions. It
can also affect birth control pills and the cancer drugs irinotecan and
imatinib.
Always get your doctor's or pharmacist's OK before you try a new supplement.
It's also possible for a medication you take to interact with a health condition
you have.
Some common drug-condition interactions happen between:
Antacids and kidney disease
Antihistamines and certain breathing problems, glaucoma, and enlarged
prostate
Asthma rescue inhalers and conditions like heart disease, high blood
pressure, thyroid disease, and diabetes
Decongestants and conditions like heart disease, high blood pressure,
thyroid disease, and diabetes
Sleep aids and certain breathing problems, glaucoma, and enlarged
prostate
What Are the Symptoms of a Drug Interaction?
The symptoms of a drug interaction can vary a lot, depending on the drugs
you’re taking and how they’re interacting. Sometimes you might not even know
right away that an interaction is happening.
If you do notice an interaction, it will usually feel like one of these is
happening:
You are having more side effects from a drug
Your drug doesn’t seem to be working as well as it was before
In general, call your doctor if you're having side effects that worry you or if
your medicine doesn't seem to be working, especially after you’ve recently
started or changed doses of a drug.
How Do Drug Interactions Happen?
There are several ways that drugs can interact with one another. Here are some
examples of the most common ways.
When two drugs can cause the same side effect and are used at the same
time, they might cause more of that side effect. For example, if two drugs
can each make you sleepy, taking them together can make you more or
dangerously sleepy.
When the unwanted effects of one drug are the opposite of the desired
effects of another drug, you might end up with less of the desired effects.
For example, taking one medication that raises blood pressure as an
unwanted effect may decrease the benefits of taking another medication
to lower your blood pressure.
Most drugs that you swallow enter your blood through your intestines.
Sometimes a drug or supplement can block or trap another drug in the
intestine before it can be absorbed. For example, supplements like
calcium and iron can prevent absorption of thyroid meds.
Your body has enzymes, such as the cytochrome p450 (CYP) and others,
that process many types of medications. This is called metabolism. It also
has a way to get rid of drugs, usually though your urine. Other drugs may
speed up, slow down, or even completely block these functions. When
this happens, the amount of drug in your body may increase (similar to
taking too much) or decrease (similar to taking too little). Either way, this
could cause serious problems.
How Do You Look for Drug Interactions?
Work closely with your doctor. Make sure they know all the medicines,
vitamins, and supplements you're taking. That's extra important if you have
more than one doctor who prescribes medicines for you. You could show them
a list of the meds you're taking, or bring the medication packages to your
appointment.
Before you take a new drug, ask your doctor or pharmacist questions like:
Can I take this with my other meds?
Should I avoid certain foods, drinks, or other products?
Could this medication interact with any health conditions I have?
Pharmacists are experts on medicine safety, and they can work with your
doctors to help you avoid drug interactions. For example, if you have two
doctors and they separately prescribe drugs that interact, your pharmacist can
warn them -- and you -- before you have a problem.
Read labels carefully. Over-the-counter drug labels include information about
possible drug interactions and the medication's active ingredients. Prescription
medications usually come with a sheet that explains what the drug is and how to
take it safely.
But most drug labels and patient handouts don't list every possible drug
interaction. Talk to your pharmacist to get the full picture. They can also answer
any questions about medical terms or jargon on the drug packages.
SOURCES:
1. American Academy of Family Physicians: "The effect of cytochrome
P450 metabolism on drug response, interactions, and adverse effects."
2. FDA: "Drug Interactions: What You Should Know," "Mixing
Medications and Dietary Supplements Can Endanger Your Health,"
"Grapefruit Juice and Some Drugs Don't Mix," "Why You Need to Take
Your Medications as Prescribed or Instructed."
3. Harvard: "7 things you can do to avoid drug interactions," "Bad mix:
Blood thinners and NSAIDs," "How to talk to your doctor about
medication."
4. Medline: "Drug Reactions."
5. National Institute on Alcohol Abuse and Alcoholism: "Mixing Alcohol
With Medicines."
6. American Heart Association: "Taking medicine for a cold? Be mindful of
your heart."
7. St. Luke's Health: "5 Harmful Medication Interactions You Need to
Know."
8. UC San Diego Health: "OTC Pain Medicines and Their Risks."
9. CDC: "Get to Know Your Pharmacist."
[Link]: "Dangerous and Deadly Drug Combinations."
[Link] Clinic: "How What You're Eating Could Be Affecting Your
Medications," "Why Vitamin K Can Be Dangerous If You Take
Warfarin," "General Medication Guidelines."
[Link]: "Drug-Food Interactions."