Medicine-Medicine Interaction

Medicine-Medicine Interaction

For each medicine we take, we must consider its effects, side effects, and possible interaction with other medicines taken concomitantly.

The list of Drug Interactions is endless. So it is better to refrain from taking many drugs at the same time. A common mistake often made is consulting more than one doctor at a time and taking medicines prescribed by all of them. A multivitamin, Supplements, Antacids, Antibiotics, and Painkiller is commonly prescribed by any doctor be it an ENT, Eye, GI, Respiratory, Urinary, Genital, Neurologic, Skin, Bone, and Joints problem. Repetition of medicines can occur.

For Example, if there is patient going for simultaneous consultations to
  • Cardiologist- BP Medicine, Antacid and Multivitamins are given
  • Dermatologist- Vit A, multivitamin-minerals, Antacid, Steroid given
  • Gastroenterologist- Antacid, Antibiotic given
  • Diabetologist- Oral hypoglycemic agent, Antibiotic given

There will be overlap and significant drug-drug interactions.

Also, anybody with Diabetes should not take Sweetened Preparations like Cough Syrup, Laxatives

Anybody with Kidney disease or BP should not take Painkillers (NSAID)

Pregnant women should remember any drug they take can affect their baby

Children do not tolerate drug combinations like adults

Anybody can manifest with an idiosyncratic, unknown, unique allergy to any drug, drug combinations

The combined action of more than one drug may be beneficial- Eg Antibiotic and Antifungal for combating mixed infections.

Sometimes we are clearly aware of the opposing actions of medicines, but we still prescribe them together as the combined benefit outweighs the expected risk- Eg. antibiotics and Steroids to combat inflammations, but the steroid can actually help the bacteria to persist.

Two medicines can augment each other- BP medicines and Diuretics, Painkillers- paracetamol and aspirin

Two medicines can counteract each other- Betablockers for BP and Asthma medicines.

There are some useful combination of medicines which is widely accepted

Multidrug Regimen in infections like TB, AIDS, and Leprosy to make the patient effectively fight the microorganisms early.

For Diabetes- Insulin resistance can be combated by taking Metformin with other hypoglycemic drugs

Antibiotics- Spectrum of activity is increased, Gram positive and Gram Negative- Quinolones and Imidazoles- Ofloxacin and Ornidazole

Antibiotics with intestinal bacteria- Doxy with Lactobacilli

Vitamins and Minerals- B12, Folic acid Iron, and calcium for pregnant women

Fever, cold, body pain- paracetamol and allergy medicine

Vaccines - Triple Antigen for infants

Rheumatology- Painkillers, Immunosuppressants, and Anti-inflammatory medicines are all given together

Some drug combinations are alright for occasional use

Running Nose- Nasal Decongestant and antisecretory medicines

Motion Sickness- Depressants

Vomiting- antiemetics

Acute injury with swelling- Steroids

Some drugs which cannot be given together, Even multivitamin-minerals tablets can pose grave problems

Vit D and Calcium in high doses can cause toxicity and permanent skeletal damage

Vit A, D,E, K in pregnant women can cause fetus malformations

Vit B6, (Pyridoxine) and Levodopa. Any Neurologic symptoms- we treat with B complex vitamins. In Parkinson's disease, Vit B6 reduces the Dopamine available in the brain and can worsen the disease.

Potassium supplements and Diuretics, BP tablets

Iodine and Thyroid medicines

Oral Contraceptives have a wide range of drug interactions and should NOT be given along with some BP, TB, or Diabetes medicines

So, it is mandatory to be careful while taking more than one medicine and we must always inform our doctor about the medications already taken, so any repetition or unwanted drug-drug interaction can be avoided.