Avoiding Harmful Drug Interactions and Medication Reactions

Don't mix drugs with alcohol

Woman in bathrobe taking vitamins
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Make sure your doctor knows about every drug you are taking, including drugs you obtain without a prescription. If you have any problems related to medication, call your physician or pharmacist immediately. One drug may interact with another, in some cases creating serious medical problems.

And, remember, medication should never be taken during pregnancy without the advice of your physician.

Don't Mix Drugs and Alcohol

It is a good rule of thumb to avoid consuming alcohol while taking any drug unless a physician or pharmacist indicates that the combination is acceptable.

Cigarettes can also diminish the effectiveness of medication or create added hazards with certain medications.

Caffeine, which is found in coffee, tea, soft drinks and chocolate and some medications, can also affect the action of some drugs.

Antihistamines

Antihistamines are used to relieve or prevent the symptoms of colds and hay fever and other types of allergy. They act to limit or block histamine which is released by the body when we are exposed to substances that cause allergic reactions.

Some commonly used antihistamine brompheniramine (Dimetane), Bromphen, chlorpheniramine (Chlor-Trimeton), Teldrin, diphenhydramine (Benadryl) and Benaphen. Avoid taking antihistamines with alcoholic beverages because it may cause drowsiness and slowed reactions.

Bronchodilators

Bronchodilators are used to treat the symptoms of bronchial asthma, chronic bronchitis and emphysema. These medicines relieve wheezing, shortness of breath and troubled breathing.

They work by opening the air passages of the lungs.

Some commonly used bronchodilators are aminophylline (Phyllocontin), Somophyllin, theophylline (Slo-Phyllin) and Theo-Dur. Avoid eating or drinking large amounts of food or beverages which contain caffeine because both bronchodilators and caffeine stimulate the central nervous system.

Aspirin

Many over-the-counter cold remedies contain aspirin in combination with other active ingredients. Aspirin reduces pain, fever, and inflammation. Aspirin is available in many brands. Because aspirin can cause stomach irritation, avoid alcohol. To avoid stomach upset, take with food. Do not take with fruit juice.

Corticosteroids

Cortisone-like drugs are used to provide relief to inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions.

Some commonly used steroids are betamethasone, dexamethasone, hydrocortisone, methylprednisolone, prednisone and triamcinolone.

Avoid alcohol because both alcohol and corticosteroids can cause stomach irritation. Also, avoid foods high in sodium (salt). Check labels on food packages for sodium. Take with food to prevent stomach upset.

Ibuprofen and Other Anti-Inflammatory Agents

Ibuprofen relieves pain and reduces inflammation and fever.

Some commonly used anti-inflammatory agents are ibuprofen (Advil), Haltran, Medipren, Motrin, Nuprin and naproxen (Naprosyn).

These drugs should be taken with food or milk because they can irritate the stomach. Avoid taking the medication with those foods or alcoholic beverages that tend to bother your stomach.

Indomethacin

This medication is used to treat the painful symptoms of certain types of arthritis and gout by reducing inflammation, swelling, stiffness, joint pain, and fever.

A commonly used brand name is Indocin. This drug should be taken with food because it can irritate the stomach. Avoid taking the medication with the kinds of foods or alcoholic beverages which tend to irritate your stomach.

Piroxicam

This medication is used to treat pain, inflammation, redness, swelling and stiffness caused by certain types of arthritis.

A commonly used brand name is Feldene. This medication should be taken with a light snack because it can cause stomach irritation. Avoid alcohol because it can add to the possibility of stomach upset.

Diuretics

Diuretics increase the elimination of water, sodium, and chloride from the body. Some commonly used diuretics are furosemide (Lasix), triamterene (Dyrenium), hydrochlorothiazide (Esidrix) and Hydrodiuril.

Diuretics vary in their interactions with nutrients. Loss of potassium, calcium, and magnesium occurs with some diuretics. Your doctor may prescribe a potassium supplement. With some diuretics, potassium loss is less significant. Consult with your doctor or pharmacist.

Vasodilators

Vasodilators are used to relax veins or arteries to reduce work of the heart. Some commonly used vasodilators are nitroglycerine (Nitrogard) or Nitrostat.

Use of sodium (salt) should be restricted for medication to be effective. Check labels on food packages for sodium.

Anti-Hypertensives

Anti-hypertensives relax blood vessels, increase the supply of blood and oxygen to the heart and lessen its workload. They also regulate heart beat.

Some commonly used antihypertensives are atenolol (Tenormin), captopril (Capoten), hydralazine (Apresoline), methyldopa (Aldomet) and metoprolol (Lopressor).

Use of sodium (salt) should be restricted for medication to be effective. Check labels on food packages for sodium.

Anticoagulants

Anticoagulants are used to reduce clotting of the blood. Some commonly used anticoagulants are warfarin (Coumadin) and Panwarfin.

Moderation in consumption of foods high in vitamin K is recommended because vitamin K produces blood-clotting substances. Such foods include spinach, cauliflower, Brussels sprouts, potatoes vegetable oil and egg yolk.

Erythromycin

Erythromycin is an antibiotic used to treat a wide variety of infections, including those of the throat, ears, and skin. Some commonly used erythromycin products are E-Mycin, Ilosone, E.E.S. and E-Mycin E.

Erythromycins vary in their reactions to food; consult your doctor or pharmacist for instructions.

Methenamine

Methenamine is used to treat urinary tract infections. Some commonly used brand names are Mandelamine and Urex.

Cranberries, plums, prunes and their juices help the action of this drug. Avoid citrus fruits and citrus juices. Eat foods with protein, but avoid dairy products.

Metronidazole

This agent is an anti-infective which is used to treat intestinal and genital infections due to bacteria and parasites. Commonly used the brand name is Flagyl.

Do not take alcohol while using this drug, because it may cause stomach pain, nausea, vomiting, headache, flushing or redness of the face.

Penicillins

Penicillins are antibiotics used for the treatment of a wide variety of infections. Some commonly used penicillins are amoxicillin, ampicillin, bacampicillin, penicillin G or penicillin V.

Amoxicillin and bacampicillin may be taken with food; however, absorption of other types of penicillins is reduced when taken with food.

Sulfa Drugs

Sulfa drugs are anti-infectives which are used to treat stomach and urinary infections. Some commonly used sulfa drugs are co-trimoxazole (Bactrim), Septa or sulfisoxazole (Gantrisin). Avoid alcohol, as the combination, may cause nausea.

Tetracyclines

Tetracyclines are antibiotics that are used to treat a wide variety of infections.

Some commonly used brand names are tetracycline hydrochloride (Achromycin), Sumycin and Panmycin.

These drugs should not be taken within two hours of eating dairy products such as milk, yogurt or cheese, or taking calcium or iron supplements.

Aspirin

Aspirin reduces pain, fever, and inflammation. Aspirin is available in many brands. Because aspirin can cause stomach irritation, avoid alcohol. To avoid stomach upset, take with food. Do not take with fruit juice.

Codeine

Codeine is a narcotic that is contained in many cough and pain relief medicines. Codeine suppresses coughs and relieves pain and is often combined with aspirin or acetaminophen in medications.

Some commonly used brand names are Aspirin with Codeine and Tylenol with Codeine. Do not drink alcohol with this medication because it could increase sedative effect of medication. Take with meals, small snacks or milk because this medication may cause stomach upset.

Other Narcotic Analgesics

Narcotics are used for the relief of pain. Some commonly used narcotic analgesics are meperidine, morphine, oxycodone, pentazocine, and propoxyphene. Do not drink alcohol because it increases sedative effect of the medications. Take these medications with food, because they can upset the stomach.

Ibuprofen and Other Anti-Inflammatory Agents

Ibuprofen relieves pain and reduces inflammation and fever. Some commonly used anti-inflammatory agents are ibuprofen (Advil), Haltran, Medipren, Motrin, Nuprin and naproxen (Naprosyn).

These drugs should be taken with food or milk because they can irritate the stomach. Avoid taking the medication with those foods or alcoholic beverages which tend to bother your stomach.

Lithium Carbonate

Most medications for psychiatric or emotional disturbances interact with alcohol in a dangerous manner. Lithium regulates changes in hormone levels in the brain, balancing excitement and depression. Follow the dietary and fluid intake instructions of your physician to avoid very serious toxic reactions.

MAO Inhibitors

MAO Inhibitors are used primarily to treat depression. Some commonly used MAO Inhibitors are isocarboxazid (Marplan), phenelzine (Nardil) or tranylcypromine (Parnate).

A very dangerous, potentially fatal interaction can occur with foods containing tyramine, a chemical in alcoholic beverages, particularly wine, and in many foods such as hard cheeses, chocolate, beef or chicken livers. Be sure to follow physician's instructions.

Also, do not use alcohol with any sleep medications.

Cimetidine, Famotidine, Ranitidine

These medications are prescribed to treat ulcers. They work by reducing the amount of acid in the stomach. Some commonly used brand names are cimetidine (Tagamet), famotidine (Pepcid) or ranitidine (Zantac). Follow the diet your doctor's orders.

Laxatives

Some laxatives stimulate the action of muscles lining the large intestine. Other types of laxatives soften the stool or add bulk or fluid to help food pass through the system.

Most laxatives are available without prescriptions. Excessive use of laxatives can cause loss of essential vitamins and minerals and may require replenishment of potassium, sodium and other nutrients through diet. Mineral oil can cause poor absorption of some vitamins. Discuss the use of laxatives with your doctor or pharmacist.

You can find out more about drug interactions by contacting the Food and Drug Administration.

Reproduced from the Office on Women's Health; Department of Health and Human Services.

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