Do the medications you take affect each other? (Drug Interactions) Let's find out exactly about this!

These days, many of us take medication for more than one condition. You may be taking one for your blood pressure, another for your cholesterol, and another for your diabetes. You may even take a painkiller from the pharmacy for a sore throat. But have you ever thought that these medications can "talk" to each other, and sometimes "fight" with each other? That's what we call drug interactions, or simply ``Drug Interactions''. This is a very important topic that we all need to be aware of.

What is a drug interaction?

Simply put, a ``Drug Interaction'' is when a medicine you take changes the way it works because of something else that enters your body (it could be another medicine, food, drink, vitamin), or another illness you have. This is like cars on the road. If each car goes its own way, there is no problem. But if one car comes the wrong way, there can be an accident, right? The same thing happens with medicines.

When this kind of interaction occurs, three main things can happen:

• Decreased effectiveness of the medication: This means that the medication is not working properly. Even if you take medication for blood pressure, if it is not absorbed properly by the body due to something else, the blood pressure will not decrease.
• Overdosage: Sometimes a medication starts to work too much, which can do more harm than good.
• Side effects or toxicity: Two medications can interact with each other and cause new side effects or toxicity.

Just think, any medication you take may interact with things like:

• Another medicine you take (it can be a prescription from a doctor or an over-the-counter (OTC) medicine you buy from a pharmacy).
• Dietary supplements like vitamins, iron tablets, and herbals.
• You can buy food or drinks.
• Alcohol.
• Tobacco.
• Other drugs.

Not only these things, but some medications may not be suitable for you because of other medical conditions you have. For example, a medication for one condition may aggravate another condition you have.

But don't worry. Most of the time, these drug interactions are temporary and manageable. Your doctor may change the dosage of your medication or tell you to stop eating certain foods for a while. But some interactions can be very serious and even life-threatening. So being aware of them and taking steps to avoid them can help you get the most out of your treatment.

Who is at greater risk?

Drug interactions can happen to anyone of any age, but if you are taking multiple medications or have multiple medical conditions, the risk is much higher.

Generally, as we age, we develop more chronic conditions. So the amount of medication we take increases. Think about it, when there are so many chemicals and processes working together inside your body, the chances of something going wrong are also higher, right?

It's like throwing a party. If you only talk to a few friends you know well, you'll be able to have a great party. But the more guests you talk to, the more likely it is that there will be some disagreements. Just like people at a party, medications can interact with each other in ways that aren't so friendly.

That's why it's important to talk to your doctor before taking any new medication or supplement, or before making any changes to your current medication list. Your doctor can help you determine which medications are best for you, the most beneficial, and the safest, and whether they're safe to take alone or in combination with other medications.

What are the main types of drug interactions?

These interactions can be divided into four main categories. Let's see what they are.

1. Drug-drug interactions

This is the type we see most often. One drug changes the way another drug works. This can happen:

• Between two medications prescribed by a doctor.
• Between two medications you bought at the pharmacy.
• Between a medicine prescribed by a doctor and a medicine you bought at the pharmacy.

Also, tobacco, alcohol, or other drugs can interact with the medication you are taking and cause unwanted effects.

Things that can happen with this kind of interaction:

• Side effects may increase: Imagine taking two medications with the same active ingredient together. For example, if you take a pain reliever containing acetaminophen for a sore throat and then another medicine containing acetaminophen for a cold, the amount of acetaminophen that reaches your body will increase. This can increase side effects or even cause liver toxicity.
• Medications may work less well: Some medications work against each other. One may block a protein in the body, while the other stimulates it. In this case, both medications will not have the desired effect.
• The way a medicine works can change: Some medicines affect how well other medicines are absorbed into the body. Also, some medicines change the speed at which our liver breaks down other medicines. This can either cause the medicine to break down too quickly and become ineffective, or it can stay in the body too long and become too strong.

Therefore, before taking any new medication (whether it's a prescription or OTC), be sure to talk to your doctor. Tell him or her about all the medications you're currently taking. If you use alcohol, cigarettes, or other drugs, it's important for your own safety to be open about it.

2. Drug-supplement interactions

We often think that because things like vitamins and herbal supplements are "natural," they can do no harm. That's a big mistake. Some supplements can reduce or increase the effectiveness of the medications you take, or cause dangerous side effects.

One of the most dangerous of these is the herbal remedy St. John's wort . It interacts with many medications, sometimes in a life-threatening way. For example, when St. John's wort is taken with a class of medications called selective serotonin reuptake inhibitors (SSRIs), which are used to treat conditions such as depression, it can cause a dangerous condition called serotonin syndrome.

Some additional things that can cause more problems:

• Garlic extracts: These are blood thinners. If you are taking blood-thinning medications like Warfarin, or if you are preparing for surgery, taking these may cause excessive bleeding.
• Goldenseal: This also affects the way the liver breaks down medications and can cause problems with many medications.
• Concentrated green tea supplements: These are not the green tea we drink, but concentrated supplements. These can interact with the ``pseudoephedrine'' found in some cold medicines.

These are just a few examples. Before you take any supplement, it's important to check with your doctor to make sure it's safe for you. You should think twice about taking it, especially if you have any of the following conditions:

• If you are taking a medication with a narrow therapeutic range: This means that the level of the medication must be very precise in the body. Even a little too much or too little can be dangerous. Some supplements can upset this balance. Examples: Carbamazepine, Phenytoin, and Warfarin, which are used to prevent blood clotting.
• If you are preparing for surgery: Some supplements can affect the medications used for anesthesia, increase bleeding, and affect blood pressure or heart rate.

3. Drug-food/beverage interactions

Yes, what you eat and drink can also change the way your medications work. Some foods and drinks:

• It can prevent the medicine from being absorbed into the body.
• The metabolism of a drug can be altered, increasing or decreasing its effectiveness.
• It can delay the elimination of the drug from the body and cause toxicity.

Let's see what are the main foods and drinks that cause these kinds of problems.

This is why some medications are said to be taken on an empty stomach before meals, and some are said to be taken with meals. So, follow your doctor's instructions exactly.

4. Drug-condition interactions

What happens in this case is that the medicine you take for one illness worsens another illness you have.

Also, painkillers (NSAIDs) (e.g., Ibuprofen, Naproxen) and some steroids can also increase blood pressure. If you have any of the following conditions, you should be very careful when taking new medications.

• Diabetes
• High blood pressure
• Glaucoma condition
• Enlarged prostate
• Stomach ulcer

How can these drug interactions be avoided?

There are some simple, but very important things you can do to protect yourself from these dangerous situations.

1. Keep an up-to-date list of everything you buy.

Make a book or sheet of paper with details of every medicine, vitamin, and herbal supplement you take. Include the following information in it:

• Full name of the medicine/supplement.
• The active ingredient it contains.
• Why are you taking it?
• Dosage and timing.
• How long should it take?
• Special instructions, such as before and after meals.
• The name of the doctor who prescribed the medicine.

Keep this list up to date. Give your family doctor, specialist, and all your other doctors an up-to-date copy of this list. If possible, get all your medications from the same pharmacy. That way, they will also be aware of your medications. Keep a copy of this list in your purse at all times.

2. Talk to your doctor before starting anything.

This is the most important thing. Communication is the key here.

• Always ask before taking a new medication, vitamin, or herbal supplement. It doesn't matter if it's something you can get at the pharmacy or if you've been taking it for years. Our bodies and medical needs change over time.
• If you don't understand something about the medicine, ask.
• Ask what to do if you miss a dose of medication.
• Tell your doctor if you experience new side effects .
• Tell me if you feel like the medicine isn't working.

When your doctor prescribes a new medication, don't forget to ask these questions:

• How much should I take and how many times a day?
• Should I take it with food or on an empty stomach?
• What foods and drinks should I avoid while taking this medicine?
• Do I need to stop taking any other medications I am currently taking?
• What side effects can you expect? What should you talk about if they occur?

3. Keep everything in order.

It is also important to take your medication correctly and at the right time. Things like these can help:

• Stick a calendar with medication times somewhere visible, such as on the fridge.
• Use a pill box with daily doses (keep it out of reach of children).
• Set reminders on your phone.
• Tell someone else at home about your medication times.