March 1, 2015
By Christine Cheng (R.Ph) and Frederick Cheng (R.Ph)
“Do not take dairy products, antacids, or iron preparations with this medication.”; “Do not take with ASA.”; “Avoid use of alcohol.” You may have noticed similar messages affixed to your prescription bottles warning against consumption of certain foods and/or other medications. Hopefully, your pharmacist would have taken a moment to highlight these precautions. But, why are we concerned? Well, it is because drug interactions can occur with many medications and in some cases, the interaction can affect how well the medication will work for you and/or how likely you are to experience side effects. Drug interactions can occur between a drug and another drug, a drug and a food item, and a drug and an existing medical condition. Severe cases lead to hospitalizations and even fatalities.
Many things in our daily lives act as “drugs”. An over-the-counter (OTC) medication, a herbal medicine, and even vitamins and minerals are all “drugs”. Taking warfarin and an anti-inflammatory together can increase the risk of bleeding …Taking Tylenol #3 and Benadryl could lead to increased drowsiness, which could increase the likelihood of losing your balance and falling…drinking grapefruit juice while taking certain cholesterol and blood-pressure medications can increase the risk of experiencing side effects of the medication…increasing your consumption of leafy green vegetable while on warfarin can increase your risk of blood clots…using a calcium supplement at the same time as certain antibiotics can prevent the antibiotic from working properly… using 5-hydroxytryptophan at the same time as some antidepressants can lead to a potentially life-threatening situation called serotonin syndrome; same goes for melatonin…taking ibuprofen if you have a history of stomach ulcers can aggravate the situation…and the list goes on and on!
Thankfully, it is very easy to avoid drug interactions and help you get the most benefit from your medications with the help of a pharmacist or physician. Always let them know what other medications you are taking. Be honest and open. Remember to disclose ALL medications, regardless of who prescribed it and/or where you bought it. Discuss any changes in diet and consumption of certain foods if asked. It may not always be necessary to discontinue or avoid certain medications; your doctor and/or pharmacist can advise you on what to do in each situation.
We cannot stress the importance of finding a good pharmacist that will discuss potential side-effects and interactions with you. It is their job. However, not all practice settings allow pharmacists to practice as they are taught. Make use of their expertise to ensure your own safety.
If you are interested in taking a new OTC medication, vitamin, mineral, or other herbal supplement, have a quick chat with your pharmacist. You can even have a formal MEDICATION REVIEW done. You may also want to consider using homeopathic medications, which are the least likely to interfere with any other medication. Keep in mind that most pharmacists do not receive much formal training in natural health products thus if you are considering taking a natural product, invest your time and health in a pharmacist who not only has a passion for integrative medicine, but has the experience to help you choose the safest and most effective product.
In short, drug interactions are not pleasant. Don’t chance it: have your doctor and pharmacist assess whether your medications and OTC regimen are actually safe, let alone beneficial.
(Christine and Fred Cheng are a sister-brother pharmacist team at their unique family-owned and operated Pharmasave in Cloverdale, BC (celebrating their 33rd year). They specialize in natural remedies and compounding for both human and veterinarian use. They would love to hear from you! www.cloverdalewellness.com. Of course, before you begin any activity program or try any OTC supplementation, check with your physician and pharmacist.)