How can I avoid drug interactions?

Timothy Maly, MD, is family practice physician at Berthoud Family Physicians.

Question; How can I avoid problems with drug interactions?

Answer: For those of you on multiple medications, you also should learn how those drugs interact with each other. How do you know the pill you take for condition No. 1 won’t react with the pill you take for condition No. 2. Face it, some of us have conditions Nos. 3 and 4. You also have to be aware of the interactions your medications may have with certain foods and dietary supplements.

According a 2007 report on medication safety from the Institute for Safe Medication Practices, two-thirds of patients who see a physician leave with at least one prescription for medication, and sometimes will have four or more prescriptions. When you have that many, the rate of adverse drug interactions increases quite a bit.

With food, a big concern is how that food might affect the rate at which your body absorbs the medication or if it will allow absorption.

According to the Food and Drug Administration, alcohol, grapefruit juice, licorice and chocolate are four examples of foods or drinks that can adversely interact with medication.

Alcohol is a given. If you are on medications, avoid alcohol which can increase or decrease the effect of many drugs.

Grapefruit juice interacts with certain blood-pressure medications and with drugs used to prevent organ transplant rejection. It also interacts with drugs used to treat insomnia, anti-malaria medication and anti-anxiety medication.

Surprisingly, treats like licorice and chocolate can be a problem with medications. For licorice, a concern is its effect on certain heart failure and abnormal heart rhythm medications. Meanwhile, chocolate interacts with MAO inhibitors used to treat depression and also will affect Ritalin and Ambien.

Dietary supplements include things you eat or drink that contain herbs, vitamins, botanicals and amino acids. Many of us in the older population turn supplements to maintain a healthy lifestyle. Supplements such as St. John’s Wort, Ginseng and vitamin E can produce a reaction with many common medications.

One big step you can take to help avoid adverse drug interactions is to write down the names and dosages of the medications you take. Carry that list in your purse or wallet in case of an emergency and give a copy to your spouse or loved ones. If you become a patient in the hospital, having that current list of medications will be invaluable to the providers caring for you.

Another step you can take: be open and up front with your physician about dietary supplements you take and whether you drink alcohol or take illegal drugs. Sometimes patients don’t want to tell their physician those things, but for your health you must be honest. You won’t hurt your doctor’s feelings; and he or she won’t judge you.

The FDA offers additional tips to avoid adverse drug reactions:

•  Read drug labels carefully.
•  Learn about the warnings for all the drugs you take.
•  Keep medications in original containers so you can easily identify them.
•  Ask your doctor what to avoid when you start a new medication. (Food, drinks, supplements and other medications.)
•  Check with your doctor or pharmacist before taking an over-the-counter drug if you take prescription medications.
•  Use a single pharmacy to fill your prescriptions.
•  Keep your health care professionals informed about everything that you take.

The FDA has a Web site where you can get more information and download a sample of a record to keep track of your medications: www.fda.gov/cder/consumerinfo/my_medicine_record.htm