drugs
Precautions With Over the Counter Drugs
Drug Drug Interactions
Many people neglect to mention their use of over-the-counter (OTC) drugs to their doctor or pharmacist. Drugs taken intermittently, such as drugs for colds, constipation, or an occasional headache, are mentioned even less often. Health care practitioners may not think of asking about use of OTC drugs or medicinal herbs when they are prescribing or dispensing a prescription. Yet many OTC drugs and medicinal herbs can interact adversely with a wide range of drugs (see Drug Interactions ). Some of these interactions can be serious, interfering with the effectiveness of a drug or causing side effects. For example, takingaspirinwith the anticoagulantwarfarincan increase the risk of abnormal bleeding. An antacid containing aluminum or magnesium can reduce the absorption ofdigoxin, taken for heart disease. Taking a multiple vitamin and mineral supplement can interfere with the action of some prescription drugs. For example, the antibiotictetracyclinemay be ineffective if swallowed with a product that contains calcium, magnesium, or iron. OTC drug-drug interactions have not been studied systematically. Many serious problems have been discovered accidentally, after side effects or deaths were reported. Even when interaction warnings are printed on the label for OTC drugs, the language may be meaningless to most people. For example, the labels of some cold remedies that containpseudoephedrinecaution against using the product with a monoamine oxidase inhibitor (MAOI—used infrequently for depression and certain other medical problems) or during the 2 weeks after discontinuing the MAOI. For the many people who do not know that the antidepressant they are taking is an MAOI (such asphenelzineandtranylcypromine), this important warning is not helpful. The best way to reduce the risk of drug-drug interactions is to ask the pharmacist to check for them. Additionally, the doctor should be told about all drugs being taken, both prescription and OTC. 