Tuesday, December 25, 2007

Holiday mixers: Common drugs can be dangerous with food, drinks

Holiday mixers: Common drugs can be dangerous with food, drinks

The holidays can be a hazard for 91 million Americans taking prescription drugs. It's all too easy to forget about possible drug interactions when faced with platefuls of desserts, cocktail parties and seven-course dinners.

But before you load up on Grandma's English toffee and Aunt Edna's grapefruit spritzers, consider the possibilities: Though some drug interactions cause only mild discomfort, other drugs can produce moderate to severe side effects when combined with certain foods or drinks. Think high-fat foods, grapefruit, dairy or alcohol.

"I don't want to make it sound scary, but all drugs have toxic potential," said Taula Moyers, pharmacy clinical coordinator for Memorial Health System. "Some of them can cause renal problems, some of them can cause liver problems. It's going to be totally dependent on the drug and the extent of the interaction." Some common food-drug interactions include:

- Drinking grapefruit juice while on Lipitor, the most popular drug prescribed to lower cholesterol, increases the amount of Lipitor in the bloodstream, which can increase adverse effects like muscle pain, weakness and stiffness.

- Sular, a high blood pressure medication, shouldn't be taken with high-fat foods for the same reason -- the interaction increases the amount of drug in the bloodstream, increasing the side effects.

- Cipro, an antibiotic prescribed to treat bacterial infections, as well as other antibiotics in its class, can bind with dairy products, preventing proper absorption. However, unlike Lipitor, a patient can ingest dairy products while on their treatment -- just not at the same time as taking the pill.

- Monoamine oxidase inhibitors, a class of antidepressants, interact with foods rich in tyramine, which is found in processed foods, grapes, smoked meats and fish.

- Over-the-counter drugs like Tylenol, Midol and cough and cold products, which all contain acetaminophen, can cause liver damage when combined with large amounts of alcohol.

To avoid being served a dish or drink you can't have, Moyers suggested party-goers and hosts talk about restrictions beforehand.

"It's important that any time you go out to eat that whoever's doing the cooking be aware of any dietary concerns people have," she said. "Be upfront about any dietary restrictions."

Doctors typically outline potential reactions with foods, drinks and drugs when a drug is prescribed, and to further prevent confusion, many pharmacies have methods of flagging prescriptions that interact.

However, some doctors don't explain interactions well (or at all), and patients who visit multiple doctors or pharmacies can create further communication gaps.

"There is a lot of pressure put on the consumer to be aware of the potential for interactions with all medications," said Michael DeLuca, pharmacist and spokesman for pdrhealth.com, a medical resource run by Thomson Healthcare. "It is essential that consumers effectively communicate to their doctors and pharmacists all of the things they are taking."

The best defense against a drug interaction mix-up is fulldisclosure. Be sure to make your doctors aware of all herbs, vitamins and medications, including over-thecounter drugs.

Pharmacies often provide consumers with a printout of common side effects and interactions, and pharmacists can explain how and when to take a certain medication.



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