If you’re taking a prescription drug, be aware that it might impair your ability to get a good work-out. It may cause drowsiness, impair reaction time, upset the stomach, decrease endurance, or cause low blood sugar or muscle cramps.
Antianxiety drugs (alprazolam, diazepam, lorazepam)
Antibiotics
Antidepressants (amitriptyline, desipramine, imipramine, nortriptyline)
Beta-blockers (atenolol, metoprolol, propanolol)
Diabetes drugs (insulin, glipizide, glyburide, tolazamide, tolbutamide)
Diuretics (bumetanide, furosemide, hydrochlorothiazide)
Because drugs have potent and specific actions, they can easily become toxic in excess. One of the biggest reasons that natural remedies are preferable to use over prescription drugs whenever possible is that the natural remedies tend to be much gentler and safer if you take too much.
Drugs That Can Sink Your Sex Life
If you’re a guy, you may think that your sex drive has dropped just because you’ve passed the age of 50. Not necessarily so! Although a man of 50 doesn’t have the energy of an 18-year-old, most male impotence after the age of 50 has to do either with clogged arteries or with the drugs physicians love to hand out to men at that age.
If you’re suffering from impotence and are taking a prescription drug, call your pharmacist or your physician and ask if one of the side effects of the drug is impotence. If you’re taking more than one drug, including over-the-counter drugs, it could be causing your impotence even if it is not listed as a side effect.
Common Drugs That Can Deplete Nutrients
There are many more drugs that deplete nutrients, which you’ll read more about later in the drug lists, but this list gives you some of the more common drugs that deplete important nutrients.
The consequences of chronic nutrient depletion caused by taking a drug long-term are serious and include, for example, senile dementia (B12), birth defects (folic acid), osteoporosis (minerals), chronic muscle pain (CoQ10), and liver damage (acetaminophen).
Drugs That Can Sink Your Sex Life
Antibiotics
Anticholinergics (used for ulcers and other gastrointestinal disorders, for nausea, for tremors caused by Parkinson’s and psychiatric drugs, and sometimes for asthma)
Anticonvulsants
Antidepressants
Antihistamines (for allergies and sinus congestion)
Antihypertensives (drugs that lower blood pressure)
Antipsychotics
Appetite suppressants
H2 blockers such as Tagamet, Pepcid, and Zantac
Heart disease medications (many), including beta-blockers, calcium channel blockers, ACE inhibitors, and antiangina drugs
Painkillers such as indomethacin, naproxen, and naltrexone
Prostate drugs such as Proscar
Sedatives, tranquilizers, sleeping pills
Again, if you’re considering taking a new drug, please check carefully to find out what other drugs, foods, or supplements may interact with it. The best source of information is a face-to-face visit with a good pharmacist. Compounding pharmacies are often a good place to go for detailed information. Otherwise, do an online search for the drug and read the prescribing information sheet. Check the section “Resources and Recommended Reading” at the end of this book for more recommendations.
Drugs That Can Deplete Nutrients
* * *
Chapter 4
How Drugs Interact with Food, Drink, and Supplements
Everything you put in your mouth has some effect on your body, so it makes sense that drugs would have an effect on what you eat, and what you eat would have an effect on how your body processes drugs. Although the possible interactions and effects of drugs, food, drink, and supplements on your unique biochemistry are nearly infinite, we can make some generalizations and watch for some dangerous combinations.
A nutrient can increase the effect of a drug, decrease its effect, or delay its action, and a drug can interfere with the absorption of nutrients. Deficiencies in a vitamin, mineral, or other nutrient such as protein can increase or decrease a drug’s action.
Taking Medication with or Without Food
When you fill a prescription, it should always say either, “Take with food,” or “Take between meals” (without food). Some drugs will be virtually ineffective if you take them with food, and others will give you an upset stomach unless you take them with food. Most drug absorption takes place in your small intestine, and how your digestion is working will have a major impact on how the drug is absorbed. If you take a medication with a very fatty meal, it will take your stomach longer to empty and that will delay the action of the drug. If you eat a small, acidic meal with very little fat, your stomach may empty very quickly and the drug may take effect more quickly than usual. Some drugs will bind to your food, others will compete with nutrients for receptor sites, and others will stimulate digestion.
The following lists identify drugs that react with food. Some drugs are absorbed more quickly when you take them with food, mainly because they increase the production of bile, which speeds up digestion, or because they change the pH of the stomach, again speeding or slowing digestion. If you have been taking a drug between meals and then suddenly take it with food, or vice versa, you could get an overdose or not enough.
Drugs That Are Absorbed More Quickly When Taken with Food
Drugs That Are Not Absorbed as Well When Taken with Food
Ampicillin
Atenolol
Captopril
Chlorpromazine
Erythromycin
Isoniazid
Levodopa (Don’t take with high-protein foods, because it competes with amino acids for absorption.)
Lincomycin
Methyldopa (Don’t take with high-protein foods, because it competes with amino acids for absorption.)
Nafcillin
Penicillamine (Don’t take with dairy products, iron-rich foods, or vitamins, because it binds with some minerals, including calcium.)
Penicillin G
Penicillin VK
Propantheline
Rifampin
Tetracyclines (Don’t take with dairy products, iron-rich foods, or vitamins, because they bind with some minerals, including calcium.)
Drugs and Nutrients
Although not many nutrients such as vitamins, minerals, and amino acids, taken in normal doses such as in a daily multivitamin, will adversely affect drugs, many drugs can cause nutritional deficiencies. Antacids deplete calcium; aspirin depletes vitamin C and folic acid; diuretics deplete minerals (especially calcium, magnesium, potassium, and zinc); some cholesterol-lowering drugs interfere with the absorption of fat-soluble vitamins such as A, D, and E; corticosteroids such as prednisone deplete vitamin D, potassium, and some of the B vitamins; some cholesterol-lowering drugs deplete coenzyme Q10 and vitamin E; and conventional hormone replacement therapy and birth control with progestins deplete magnesium, the B vitamins, and folic acid.
Drugs that block folic acid production or absorption include the arthritis and chemotherapy drug methotrexate, anticonvulsants such as phenytoin and carbamazepine, nonsteroidal anti-inflammatory drugs (NSAIDs, including ibuprofen, aspirin, and indomethacin), some antiulcer drugs (the H2-receptor antagonists, such as cimetidine and ranitidine), and bile acid sequestrants for lowering cholesterol levels, cholestipol and cholestyramine.
Both excess potassium (such as is caused by ACE inhibitors) and cimetidine (Tagamet) and proton pump inhibitors such as omeprazole can interfere with the absorption of vitamin B12. A deficiency of B12 can cause symptoms of senility. How many older people have been put into nursing homes because they were taking cimetidine long-term, which blocked B12 absorption? We see ads on TV for these drugs over and over and over again, and eventually, even though we know better, we think the drugs are harmless because that’s how they’re portrayed in the advertising.
The tuberculosis drug isoniazid depletes vitamin B6, as do
the yellow dyes called tartrazines found in 60 percent of all prescription drugs and in many processed foods. Among the many symptoms of a B6 deficiency are hormonal imbalances and carpal tunnel syndrome.
Grapefruit juice can increase the strength of many drugs by blocking the liver enzymes that are used to clear the drug out of the body. The following drugs can all interact dangerously with grapefruit juice: the calcium channel blockers (including felodipine, nicardipine, nifedipine, nimodipine, and isradipine); the statin drugs (lovastatin, simvastatin); the antianxiety drug buspirone; the benzodiazepine tranquilizers; the psychotropic drugs carbamazepine, nefazodone, and quetiapine; the antihistamine loratadine (Claritin); ethinyl estradiol (the main ingredient in oral contraceptives); the heart drug amiodarone; the impotence aid sildenafil (Viagra); and the steroid methylprednisone.
Many, many drugs will increase the strength of alcohol and vice versa. Always use caution when combining any drug with alcohol.
Fiber can block absorption of a drug and may even carry most of it right through the digestive tract. If you’re taking any type of fiber such as psyllium (e.g., Metamucil) to treat constipation and irregularity, take medications at least an hour before or two hours after you take the fiber.
Drugs That Interact with Minerals
Drugs can have a profound effect on how the body handles nutrients. Some reduce mineral absorption, others cause minerals to be excreted in the urine in higher than normal quantities, and others interfere with how the body processes minerals.
• Antibiotics: The antibiotic Neomycin interferes with the absorption of iron. Tetracycline blocks the absorption of dietary minerals; conversely, taking minerals with an antibiotic will also block the action of the antibiotic. The quinolones (Noroxin, Penetrex, Cipro) block the absorption of iron and zinc.
• Anticonvulsants such as carbamazepine, phenobarbital, phenytoin (Dilantin), or primi-done lower levels of copper and zinc.
• Magnesium and aluminum antacids deplete calcium and phosphate. Sodium bicarbonate, also used as an antacid, depletes magnesium and potassium.
• Arthritis medications such as D-penicillamine (Cuprimine) can reduce absorption of zinc, iron, and probably other minerals as well.
• Aspirin and indomethacin (Indocin) can cause enough blood loss through the stomach over time to cause an iron deficiency. Aspirin can also cause potassium depletion.
• Cholesterol-lowering drugs such as cholestyramine (Questran) and colestipol (Colestid) can lower the body’s stores of iron.
• Corticosteroids such as cortisone and prednisone can deplete zinc, calcium, chromium, magnesium, potassium, and selenium.
• Diuretics, frequently used in the treatment of high blood pressure and heart failure, can cause minerals to be lost in urine.
• Conventional HRT (versus natural) can deplete magnesium.
• H2 blockers such as Tagamet and Zantac can deplete calcium, iron, and zinc.
• Laxatives reduce absorption of minerals.
• Oral contraceptives tend to increase levels of copper, which in excess can cause a decrease in blood levels of iron and zinc; they also reduce levels of magnesium and selenium.
• Alcohol depletes iron, selenium, zinc, and magnesium, in addition to many other important nutrients. Alcoholic drinks like wine and whiskey are also relatively high in the toxic element cadmium, which is taken up in greater quantities when zinc levels are low.
Never Mix Drugs and Alcohol
As much as we might like to think alcohol is simply a social lubricant or pleasant accompaniment to dinner, it is a drug and has profound effects on the body. When you mix alcohol with any drug, prescription or over-the-counter, you are entering into the no man’s land of drug-drug interactions. If you use alcohol, even just a glass of wine with dinner, always ask your physician or pharmacist how a drug interacts with alcohol. If they don’t know, ask them to look it up for you.
The drugs listed here are known to either increase the effects of alcohol, are increased themselves by alcohol, or have the potential to cause liver damage when combined with alcohol.
Acetaminophen may cause liver damage.
Antidepressants
Antifungal drugs such as ketoconazole (Nizoral) may cause liver damage.
Antihistamines
Aspirin
Barbiturates
Benzodiazepines and other antianxiety drugs
Bromocriptine (Parlodel)
Calcium channel blockers such as verapamil (Verelan, Calan, Isoptin)
Cephalosporin antibiotics—don’t drink alcohol for at least three days after taking these drugs
Diabetes drugs (oral)
H2 blockers such as cimetidine (Tagamet) and ranitidine (Zantac)
Indomethacin and other anti-inflammatory drugs (Indocin)
Methotrexate may cause liver damage.
Narcotics (Darvon, Empirin, Talwin)
Nitroglycerin
Tranquilizers and sleeping pills
Drugs That Interact Dangerously with Alcohol
If the drug you’re taking isn’t on this list, don’t assume it doesn’t interact with alcohol.
* * *
Chapter 5
How Drugs Interact with Other Drugs
Once you reach the age of 50, you are almost guaranteed to walk out of a physician’s appointment with a prescription for a drug. At the very least, you may be told to take an aspirin every day, and if your blood pressure or cholesterol counts are even a hair above “normal,” you’ll be given prescriptions for blood pressure and cholesterol-lowering drugs.
When you start taking any type of drug, you are heading down a long road full of potentially dangerous drug interactions and side effects. Some 36 percent of all hospitalizations are due to drug reactions, and of those, at least 25 percent are caused by adverse drug interactions. There are approximately 13,000 prescription drugs available in the United States, and yet the FDA does not require drug interaction studies as part of its drug approval process. New drugs have been studied by themselves but not necessarily in combination with other drugs.
When you take a new drug in combination with another drug, you’re a guinea pig for the drug companies and the FDA. Thousands of people die each year in these hidden human experiments. Our educated guess is that tens of thousands of deaths in older people attributed to “natural causes” or heart failure are actually caused by drug reactions or interactions. Even when a physician becomes aware that a hospitalization or death is the result of a drug reaction, he or she will probably not report it.
If you have any new health complaints, be suspicious of the drugs you’re taking. Ask your pharmacist to inform you of any known interactions when you are taking a new drug or experiencing new symptoms, and carefully read the patient insert that should come with every new medication (you may have to use a magnifying glass and a medical dictionary to do this).
Be extremely conservative and cautious about taking prescription drugs. It is not just a matter of life and death, it is also a matter of quality of life. One of the most common side effects of a drug-drug interaction is mental fogginess or confusion. Tragically, many older people are put on as many as eight or a dozen drugs, and when they become lethargic and confused, they are diagnosed as senile and stuck in a nursing home, when a simple change of medication could have remedied the problem and kept them independent.
The other very common scenario is the drug treadmill, where you are given two or more drugs and when you have side effects from them, you are given more drugs to treat the side effects, which creates more side effects, and so on.
Not Only Prescription Drugs
It’s not just prescription drugs that can dangerously interact with each other. Over-the-counter drugs can react with prescription drugs, causing them to be stronger, be weaker, or produce a new symptom. For example, if you’re taking the corticosteroid prednisone and you start taking ibuprofen or aspirin every day to treat chronic headaches, the combination could cause gastric (stomach) b
leeding. Combining ACE inhibitors with ibuprofen can increase potassium to dangerous levels, causing side effects such as muscular weakness, numbness, and an irregular heartbeat.
Most Prescribed Drugs in America 2006
1. Lipitor
2. Hydrocodone APAP
3. Toprol-XL
4. Norvascs
5. Amoxicillin
6. Hydrocodone APAP
7. Synthroid
8. Nexium
9. Lexapro
10. Albuterol
11. Singulair
12. Levothyroxine sodium
13. Lisinopril
14. Ambien
15. Zyrtec
16. Prevacid
17. Zoloft
18. Warfarin sodium
19. Advair Diskus
20. Furosemide
Source: Pharmacy Times, 2007, pharmacytimes.com/issues/articles/2008-05_003.asp.
If you suddenly find yourself suffering from urinary retention or incontinence, it may be because you’re combining an antihistamine such as Benadryl that you bought in the drugstore for your allergies with an anticholinergic drug to treat Parkinson’s disease.
If the drug you have been taking is no longer working, it may have to do with using an H2 blocker such as cimetidine (Tagamet), sold over-the-counter for heartburn. Cimetidine interacts with dozens of drugs, either increasing or decreasing their action.
If you’re taking an asthma drug such as theophylline, watch your caffeine consumption; caffeine can cause an overdose of theophylline, with symptoms of a rapid or irregular heartbeat, nausea, dizziness, headache, and shakiness. Caffeine is present in coffee, most soft drinks, many over-the-counter headache remedies, and Midol. Theophylline levels in the body can also be increased by capsaicin, which is found in Tabasco sauce, chili peppers, and often in natural arthritis formulas. Theophylline levels can be decreased by eating charbroiled meats. Many, many common drugs increase or decrease levels of theophylline.
Most Common Drug Offenders
Because of the thousands of drugs on the market, it is impossible for any physician to know all of the possible drug-drug interactions that could threaten your health and even your life. That doesn’t count the interactions with food, over-the-counter drugs, and supplements. It means it’s up to you to minimize your drug intake and keep close track of what you are taking. Any drug combination can cause a new interaction, because your body and your biochemistry are unique.
Prescription Alternatives Page 6