Sometimes it’s a dangerous mix

You are taking a couple of prescription medications and you develop a cold – so you head to the nearest pharmacy to get something for your headache, cough and stuffy nose. Not so fast, experts advise. Mixing medications can be dangerous. Today, thanks to scientific and medical research, we have more opportunity to treat our ills and ailments with medication. It is estimated that as many as 40 percent of the population may be taking four or more prescription medications at one time.

However, without careful attention, the interactions of these treatments may be causing more harm than good. "Medications can have adverse interactions when mixed with certain foods or beverages, other prescribed or over-the-counter (OTC) medications or dietary supplements," said Michelle Brenner, pharmacist at Ministry Saint Joseph’s Hospital. "These interactions may cause a delay, decrease or increase in potency and effectiveness of the medications that a person is taking."

A report by the Centers for Disease Control and Prevention (CDC) found that deaths from accidental drug interactions rose 68 percent between 1999 and 2004. These accidental drug poisonings accounted for nearly 20,000 deaths in 2004, said the CDC, making the problem now the second-leading cause of accidental death in the United States, after automobile crashes. "Prescription drugs, especially prescription painkillers, are driving the prolonged increase," the report stated.

Be aware and avoid problems

If a person is not aware of drug interactions, he or she may not identify the symptoms and “treat” the side effect of the interaction instead of eliminating the problem. This is both expensive and counterproductive to good health. According to the U.S. Food and Drug Administration, there are steps you can take to help you and your health care provider and pharmacist make the right medication mix safe and effective for you.

  • Always read the labels; learn about the warnings and side effects.
  • Keep your medication in its original container.
  • Get to know your pharmacist and ask questions.
  • Ask your doctor or pharmacist about foods, OTC and other medications or supplements that you should avoid while taking a particular prescription.
  • Use one pharmacy for all your prescription and OTC medication.
  • Create a list of all your prescriptions, OTC drugs and dietary or herbal supplements and share them with your health care provider.
The CDC reports that deaths from accidental drug interactions rose 68% from 1999 to 2004.

Be careful what you eat or drink

You probably know that alcohol should not be mixed with any prescription or OTC medication, but did you know that grapefruit juice, licorice and chocolate can have adverse effects on the ways that certain drugs perform? Grapefruit often increases the blood level absorption of certain drugs, which may increase side effects. For instance, when grapefruit is eaten by a person taking high blood pressure medication, the effect may be dangerously low blood pressure since the grapefruit enhances the medication’s effectiveness. Grapefruit should not be eaten with: statins, anti-rejection drugs for transplants, protease inhibitors to treat HIV/AIDS, some anti-anxiety medications or some antihistamines.

Licorice can also cause some unwanted side effects when taken with certain medications. Avoid eating licorice if you are taking angiotensin-converting enzyme (ACE) inhibitors, diuretics, digoxin, corticosteroids, insulin, laxatives or oral contraceptives. Licorice, however, may reduce stomach irritation as well as the risk of stomach ulcers associated with aspirin.

According to the FDA, chocolate should not be eaten when taking MAO inhibitors to treat depression or when taking stimulant drugs such as Ritalin. Chocolate also decreases the effect of certain sedation medications like Zolpidem.

Take your vitamins, minerals and herbs seriously

St. John’s Wort, Vitamin E, fish oil, garlic, ginkgo and ginseng may interact with certain types of drugs to produce an adverse effect. Always tell your pharmacist what vitamins and supplements you are taking, so he or she can advise you on the effects your vitamins may have on the drug’s effectiveness.

Caffeine and alcohol. What’s the big deal?

It is a big deal – the mix can be toxic – even deadly. While drinks like Four Loko have been taken off the market under the scrutiny of the U.S. Food and Drug Administration, energy drinks and alcohol may still be the drink of choice at many bars. The sometimes lethal combination of alcohol and high amounts of caffeine produces a wide-awake drunk with impaired judgment. Since the caffeine often masks the effects of the alcohol, the drinker may think that he or she is not under the influence of alcohol and drink more, drive while over the legal limit of .08, black out or even die of alcohol poisoning.

Dr. Steven Lipshultz was quoted in the LA Times as saying that users of caffeine and alcohol have a higher incidence of risk-taking behavior because their perceptions of limitations were distorted. There have been no conclusive studies about how the human body processes high levels of caffeine and alcohol, because it is too dangerous to conduct tests on people. It is known that the effects of the stimulant and the depressant do not cancel each other out – caffeine revs the body up, while the depressant slows the brain’s function down – a chemical reaction that can kill.

"It’s okay, it’s a prescription."

Not necessarily. Prescription drugs are still drugs. While a drug may work well for one person, it may cause adverse reactions with another person’s body chemistry. That’s why you should never take anyone else’s prescription medication.

Danger in the medicine cabinet

Increasingly, the drugs of choice for teens wanting a quick, easy high are found in mom’s, dad’s or grandma’s medicine cabinet, often with deadly results. According to an American Academy of Family Physicians report, teen prescription drug abuse statistics are staggering:

  • More than 2.1 million teens abused prescription drugs in 2006.
  • Each day, an estimated 2,500 kids ages 12–17 abuse a prescription pain reliever for the first time.
  • Drugs of choice for teens include Vicodin (hydrocodone), OxyContin (oxycodone) and OTC medications containing dextromethorphan. Other popular drugs include depressants, such as sleeping pills and anti-anxiety drugs, and stimulants most often prescribed for attention-deficit / hyperactivity disorder.
  • Half of teens who abuse painkillers also report using two or more other drugs, including alcohol and marijuana.

When teens take prescription medications, they often don’t realize that drugs like sleeping pills and narcotics may have a time-release function and stay in the system for up to 12 hours. Wanting to continue the high, young people will sometimes take more to sustain the feeling. This can be deadly.

As the drug builds up in the body, it can shut down the body’s vital systems – heart rate slows, breathing slows. In tragic cases, the teens abusing these drugs never wake up. “If you suspect a prescription reaction or overdose, seek immediate medical attention,” said Michelle Brenner, pharmacist at Ministry Saint Joseph’s Hospital. “It is extremely important to talk to your children about the dangers of prescription drugs. Prescription drugs that are not prescribed to a person can be more dangerous than street drugs. Even when it is your own medication, be cautious to take it as prescribed and watch for side effects.”

If you are taking medications, keep them in a secure place, inaccessible to others. Dispose of unused or expired prescriptions promptly. But don’t throw them in the trash or flush them down the drain; there are concerns that unused medication may contaminate the water supply. For information on proper medication disposal, please contact your local pharmacy or police department.


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