Thursday, June 28, 2007
Common Drug Interactions
Did you know that a lack of acid in the stomach significantly affects the body's ability to absorb thyroid hormone? That is just one of many facts that patients often don't know. Here are a few others:
* Proton Pump Inhibitors (PPI's like Prilosec, Aciphex, Protonics, Nexium) reduce calcium absorption. If you are on these pills,(and millions of people are) you will need extra Calcium.
* Warfarin (Coumadin) levels are increased if you take Prednisone also. The list of drugs that interacts with warfarin is long so make sure you ask your physician for the list and monitor all of the meds you take.
* Thyroid hormone (Synthroid, Levoxyl)will not be absorbed if taken with Iron,PPI's, Antacids or Calcium. Make sure your doctor knows if you take any of these with Thyroid pills.
* Antifungals (Nizoral, Sporanox)also depend upon acid for absorbtion. PPI's block acid in the stomach so these expensive pills that treat fungal infections will not work if you take acid-blockers also.
*Statins (Mevacor,Lipitor,Crestor,Pravachol)have increased toxicity risk if used with Niacin, Erythromycin or Biaxin, Verapamil or protease inhibitors.
These are just a few of the interactions we see with commonly used medications. The amount of medical knowledge a doctor must keep in his/her head has outstripped brain neurons. Electronic Health Records will help us all because they have decision support that alerts a physician when drug interactions are likely. But under 18% of doctors have this type of EHR tool, so until that time...make sure you keep an up to date medication list in your wallet and pull it out at every doctor visit. Visit my prior post on medication errors for more tips.
Posted by Toni Brayer, MD at 11:49 PM