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6 Jun

Common Drug Interactions: Don't Make These Dangerous Mistakes!

Common Drug Interactions: Don't Make These Dangerous Mistakes!

Even though most prescription bottles come with auxiliary labels, or those small colored stickers with advice on what to do and not do with the medication, it is all too easy to miss or forget that important information. Many of the prescription medications we take have interactions with other over-the-counter medications or even food, making it critical that you check with your pharmacist before starting a new over-the-counter medication. Some of these interactions are:

Grapefruit and some cholesterol medications: Lovastatin (Mevacor), simvastatin (Zocor), and atorvastatin (Lipitor), all from a group of cholesterol medications commonly known as statins, interact with grapefruit and grapefruit juice. Chemicals in the fruit are known to interfere with how the body breaks down these medications, causing them to stay in your body longer than expected. This could cause the levels of the medication to be too high and potentially cause dangerous side effects, such as muscle pain or even breakdown of the muscle.

Over the counter pain relievers and blood thinners: If you are on a medication that keeps your blood from clotting such as Plavix (clopidogrel) or Coumadin (Jantoven/Warfarin), be careful what pain reliever you reach for if you have pain. Aspirin, ibuprofen (Motrin), and Aleve (naproxen) can boost the effect of these medications and increase your risk of bleeding. This goes for patients who are taking new anticoagulants too, such as Pradaxa, Eliquis, and Xarelto. Check with your doctor or pharmacist, but typically patients who are on anticoagulants or antiplatelet medications can only use Tylenol (acetaminophen) as a non-prescription option for pain.

Cough medications and antidepressants: Dextromethorphan, a common medication used to suppress cough and found in products such as Delsym and Robitussin, interacts with many antidepressants such as paroxetine (Paxil), venlafaxine (Effexor), sertraline (Zoloft), and numerous others. Using these medications together can increase your risk for high levels of serotonin, known as serotonin syndrome, which is characterized by shivering and diarrhea in more mild cases, to muscle rigidity, fever, and seizures in more severe cases. Severe serotonin syndrome can be fatal if not treated, so check with your doctor or pharmacist if you are on an antidepressant and need a cough medication.

Opioid pain medication and antihistamines: Hydrocodone/acetaminophen (Lortab) and oxycodone/acetaminophen (Percocet) are examples of medications used for chronic or severe pain. This class interacts with Benadryl (diphenhydramine), which is found in some cold and allergy medications as well as other medications used for sleep (Tylenol PM, Simply Sleep, etc.). Used together, these drugs can cause intense drowsiness, leading to difficulty breathing, and even coma or death. If you take a prescription opioid medication for pain, make sure your over the counter medications do not include diphenhydramine, and check with your pharmacist if you aren’t sure.

 

Remember, it is always better to check with your primary care practitioner or pharmacist before taking any medication over the counter! They can check to ensure the new medication is safe with your prescription medications.

 

Sources:

Grapefruit/statins: http://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/food-and-nutrition/faq-20057918

Serotonin Syndrome: http://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/basics/definition/CON-20028946