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from Lovin Life After 50: Tucson February 2020

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Ask the Expert Common drug interactions you should be aware about

BY TMC HEALTHCARE

When prescribed a new medication, it’s good to know how it may interact with vitamins, supplements and other medications you are taking.

Some combinations can make medications ineffective or make you sick.

We talked to Zachary Hodges, the medication safety officer at Tucson Medical Center, to share a few common combinations you should know about.

“These are just a few common drug interactions,” Hodges says. “Always make sure to read the labels and ask your pharmacist or doctor any ques- tions you may have when starting a new medication or supplement.”

WARFARIN AND MOST ANTIBIOTICS

Most antibiotics decrease the num- ber of bacteria in the gut. These bacteria play an essential role in the pro- cessing and absorption of vitamin K. Without these bacteria, vitamin K levels drop and increase the effect of warfarin, a common blood thinner (also sold under brand names Coumadin and Jantoven), leading to increased bleeding risk.

WARFARIN AND ACETAMINOPHEN This combination can cause increased bleeding and can slow down the blood-clotting process. While acetaminophen is safer than NSAIDs such as ibuprofen and naproxen, those taking warfarin should use the lowest possible acetaminophen dosage.

FLUOROQUINOLONES, DOXYCYCLINE, MINOCYCLINE AND ANTACIDS, DAIRY, OR CALCIUM PRODUCTS

You should not take doxycycline, minocycline, or fluoroquinolone antibiotics (ciprofloxacin, moxifloxacin and levofloxacin), which are all used to treat serious bacterial infections, with antacids containing aluminum, calcium or magnesium. These antacids bind the antibiotic in the stomach and intestines and do not allow the antibiotic to work.

These drugs should also not be taken with medicines or supplements containing iron or zinc. In addition, the use of multivitamins or other supplements containing calcium should be avoided within six hours of taking one of these antibiotics.

LINEZOLID AND SSRI ANTIDEPRESSANTS

Linezolid is an antibiotic commonly used for hard-to-treat infections, such as MRSA. Linezolid is also in a class of drugs called MAO inhibitors which can increase the levels of natural sub- stances in the body such as dopamine, norepinephrine and serotonin. If taken with certain antidepressants (fluoxe- tine, paroxetine and citalopram) it can potentially cause a serotonin excess called serotonin syndrome, which is characterized by diarrhea, confusion, changes in blood pressure, rapid heart rate and tremors. (Serotonin is respon- sible for controlling mood, attention, sleep and pain.)

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