Archive for the ‘adverse events’ Category

Mix Grapefruit Juice With Your Cocktails Not With Your Medications

November 27, 2012

Grapefruit Juice- Careful How You Mix It With Your Medications

Grapefruit Juice- Careful How You Mix It With Your Medications


Grapefruit juice has many medicinal uses including acidify urine, provide vitamin C which can help prevent colds and flu-like symptoms, and has ingredients that may be beneficial in preventing cancer. However, the juice for all its benefits may have a deleterious interaction with many medications.

Research about the interaction of grapefruit juice with drugs suggests that compounds in grapefruit juice, called furanocoumarins (for example, bergamottin), may be responsible for the effects of grapefruit juice. Researchers believe that furanocoumarins block the enzymes in the intestines that normally break down many drugs. One glass of grapefruit juice could elicit the maximum blocking effect, and the effect may persist for longer than 24 hours. Since the effects can last for such a prolonged period of time, grapefruit juice does not have to be taken at the same time as the medication in order for the interaction to occur. Therefore, unlike similar interactions, where the interaction can be avoided by separating the administration of the two interacting agents by a couple of hours, administration of grapefruit juice with susceptible drugs should be separated by 24 or more hours to avoid the interaction. Since this is not practical for individuals who are taking a medication daily, they should not consume grapefruit juice when taking medications that are affected by grapefruit juice.

The grapefruit juice-drug interaction can lead to unpredictable and hazardous levels of certain important drugs. For example Viagra is of special interest to men. The clinical information is incomplete, but men who take Viagra should be aware that grapefruit juice might boost blood levels of the drug. That could be a good thing for some men with erectile dysfunction, but it could trigger headaches, flushing, or low blood pressure.

Bottom Line: Grapefruit juice can be of benefit to many people who drink it on a regular basis. However, the juice can impair the metabolism of many medications thus placing juice drinkers at risk for developing higher than normal blood levels of their medication. I suggest if you are a frequent grapefruit juice drinker, that you check with your doctor.

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When Medicines Make You Sick

September 11, 2011

Most middle age and older men and women take more than one medication on a regular basis. Unfortunately these medications can interact with each other and produce undesired effects; sometimes the side effects are worse than the disease or condition that the original medication was intended to treat. It is estimated that 4.5 million Americans will return to the doctor’s office or even have to go to the emergency room because of the side effects of medication. There are an estimated 2 million serious drug reactions each year and drug reactions are the fourth leading cause of hospital deaths exceeding only by heart disease, cancer and stroke.

Side effects can produce symptoms ranging from lethargy, insomnia, muscle aches, depression, dizziness, diarrhea, constipation, and even chest paid.

So what can you do to avoid side effects of medications? First be sure your doctor knows what medications you are currently taking. Ask if the drug he is prescribing has any interactions with the drugs you are currently taking. There are computer programs that are available that will alert the doctor of any possible drug interactions. One of the most popular programs is e-Pocrates where the doctor or nurse can write in the drug being prescribed and the drug(s) the patient is currently taking and will list any potential drug interactions. Most electronic medical record programs that are becoming so prevalent among physicians’ practices will notify the doctor of any potential drug interactions.
Also, you can go to the Internet and use one of the search engines such as Google and type in the name of the medication and the phrase “drug interactions” and you will learn what drugs should not be taken together. There are drug interaction checkers available online. One of the best is aarp.org/healthtools.

Next, ask the doctor what are the most common side effects and what is the likelihood of having any of the side effects. If the medical problem is not serious and not incapacitating, you may decide to forgo any new medications.

Also, ask your doctor if there are any lifestyle changes you can make as an alternative to taking medications. For example, if you have newly diagnosed high blood pressure, you can undergo a weight loss program and significantly reduce the salt in your diet, and you may avoid taking blood pressure lowering medications, which have side effects.

If you are taking multiple medications, you can ask your pharmacist to review all of your medications and the pharmacist will let you know which drugs are incompatible. Some pharmacists will charge you a few for this review but it is certainly worth it especially if you are older and if you take multiple medications. Also, if you are in a Medicare Advantage program, you may qualify for its medications therapy management services.

If you begin to experience a change or symptoms shortly after starting a new medication, you should contact the doctor’s office and speak to the doctor or nurse to find out if this is an expected side effect, how long it might last, or if the side effect is more serious and the drug should be discontinued.

It is also important to mention to your doctor any supplements, herbal medications, or vitamins that you routinely take as these may interact with your prescribed medications.

Final advice: Even if you are experiencing side effects due to medications, don’t stop taking the medication without calling your doctor first.

Bottom Line: For the most part drugs properly prescribed can be very helpful and will alleviate symptoms and treat your medical condition. However, all medications have side effects and you can minimize these side effects by being knowledgeable and informed about drugs and drug side effects.