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Problems With Mixing Medications

This should not be taken Some foods and liquids, like grapefruits and alcohol, for example, should not be taken with certain medications, even non-prescription medications, because they may interfere with the drug's effectiveness, and some seemingly harmless over-the-counter medications and even herbal supplements can cause problems when taken together with certain prescription drugs.

Recently, for example, it was reported in a newspaper in England that women taking Tamoxifen (a drug given in order to stop the recurrence and spread of some breast cancers) together with certain antidepressants were more likely to die from breast cancer than those women not taking Tamoxifen with certain antidepressants.  These antidepressants, according to the research, seem to interfere with the metabolism of the Tamoxifen.

Another example is a thyroid medication used to treat low thyroid function that should not be taken with calcium tablets because the calcium interferes with the body's ability to absorb the thyroid medication which makes the thyroid drug less effective.  Since, in this case, the consequences do not create severe health problems, there are no red flags that would make the doctor or pharmacist warn you about mixing calcium and this thyroid medication.  Mixing may result in your having to take a higher dose of the thyroid medication, though, to get the desired result.

Calcium, as a matter of fact, is one of those seemingly harmless, over-the-counter supplements that can interfere with the absorption of many medications, so I recommend taking calcium supplements many hours apart from other medications.

Not all research is good research, so not every study requires us to panic or change our routines.  Always tell your doctor, therefore, about all the prescription, over-the-counter drugs and herbal supplements you are taking and ask about which can be taken together.  And ask your pharmacist the same question.   In the end, you must take responsibility for being informed  so you can make the right decisions for yourself. 

I'm Dr. Blokar.  For more information, click on the following resources:

Medication Errors

You:The Smart Patient:An Insider's Handbook for Getting the Best Treatment 

Taking Your Medicine:A Guide to Medication Regimens and Compliance for Patients and Caregivers 

Preventing Medication Errors and Improving Drug Therapy Outcomes:A Management Systems Approach  

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