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.


K said...

Man, how did people live before there were all these drugs to keep their cholesterol low, or reduce their heartburn, or whatever else people take because they're apparently not healthy?

Sorry for the snark, but MAN it is amazing to me how many prescription drugs people take and no one bats a dang eye over it. Sure, the mortality rate was higher back in ye olden days, but it wasn't because someone had high cholesterol, it was because they frikkin got malaria or tuberculosis or something similar. I know I'm oversimplifying, but seriously it boggles my mind.

Toni Brayer MD said...

I share your amazement and also believe people take too many pharmaceuticals. We ARE living longer (not necessarily healthier) due to drugs and medical technology. Much of that has to do with antibiotics but at the turn of the century the most common cause of death in women was childbirth!! If you look back at old family photos....our great grandparents looked really old at 50. I am not sure it is the drugs that have helped as much as hair dye.

Scott said...

Hmmmmm....I've been taking Prilosec for a number of years and find myself drinking more milk and eating more cheese, then I ever did. Do you think this is because my body needs more colesterrol...and I'm listening?

K said...

I am indeed pleased with the fact that I'm less likely to die giving birth, it is for sure. Yikes.

As for how good older people look now - moisturizer that doesn't involve hippo dung. That's right, Ancient Egypt, I'm sassing you

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