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Dr Gérald Kierzek (Medical Director)
According to a new American study, many unfortunate combinations of various drugs could have serious or even fatal consequences. While the topic is not new, the study identified 58 new problematic combinations.
Taking blood pressure medication with turmeric supplements, or blood thinners with antibiotics could be dangerous for your health. This is the alert raised by a new American study published on February 20 which analyzed several medications prescribed to millions of patients and their possible interaction with food supplements. No less than 58 new dangerous combinations have been updated, in addition to those already known.
For the study, published in the journal Nature Biomedical Engineering, researchers looked at 23 commonly used prescription and over-the-counter drugs, as well as 28 less commonly used drugs – and more than a thousand investigational drugs. They exposed each of the drugs to cells from a pig’s intestine, to simulate how the drug would be metabolized in the human body. They blocked one of three transporter proteins in the cells and monitored the amount of drug remaining in the tissues. If very little of the drug was detected, it revealed which transporter protein it was using.
The researchers fed this data into a machine learning model to calculate which drugs would likely use the same transporter. Result: nearly 2 million interactions, including these 58 previously unknown.
Combinations that negate the effects or result in overdoses
Taking popular medications like the blood thinner warfarin with certain antibiotics, or combining blood pressure pills with turmeric supplements, could render life-saving medications ineffective or lead to an unintentional and dangerous overdose, the study suggests. . The risk is then to unintentionally expose patients to the risk of fatal heart attack, stroke or major hemorrhage.
More specifically, either a drug is overmetabolized, meaning patients receive a higher dose than they need; or it’s under-metabolized, meaning they’re getting too little of it. The researchers explained that the problem lies in the way the drugs are processed by the body. All oral medications are metabolized via one of the few specialized transport proteins in the intestines.
Sometimes drugs compete for the same transporter proteins, so patients receive too little medication. In some cases, this means patients are receiving too high a dose.
Experts suggest that patients should wait several hours – usually four to six hours – between taking the listed medications to reduce the risk of interactions.
What bad combinations have been discovered?
Researchers indicate that you should avoid taking these medications:
- Ibuprofen (pain reliever);
- Warfarin (prevents blood clots, for patients with heart disease);
- Verelan, name of the drug Verapamil (for high blood pressure);
- Quinine (medication against malaria);
- Ergomar or Cafergot (Ergotamine D-tartrate, used for migraines);
- Ranitidine (to reduce stomach acid);
- Carbamazepine (epileptic patients);
- Atorvastatin (lowers cholesterol);
- Levetiracetam (anti-epileptic medicine);
- Tacrolimus (immunosuppressant);
- Doxycycline (antibiotic).
With these:
- Turmeric supplements;
- Warfarin (prevents blood clots, for patients with heart disease)
- Quinine (medication against malaria)
- Doxycycline (antibiotic)
- Ergomar or Cafergot (Ergotamine D-tartrate, used for migraines)
- Ranitide (to reduce stomach acid)
- Curatil, Tegretol or Carbamazepine (treatment for epilepsy)
- Nadolol (blood pressure medication)
And these:
- Atrovastatin (to lower cholesterol)
- Lasix or Furosemide (treat high blood pressure)
- Ergomar or Cafergot (Ergotamine D-tartrate, used for migraines)
- Ranitidine (to reduce stomach acid)
- Migranal, DHE or Di-hydroergotamine (for migraines)
- Doxycycline (antibiotic)
- Digoxin (a medicine for heart failure)
Always consult your doctor or pharmacist
For Dr Gérald Kierzek, medical director of Doctissimo, this study reminds us of two things:
“When you take supplements, you should always check the risk of interaction with your doctor and pharmacist. It is never trivial, and it is not a question of taking it as you want because a supplement seems appropriate to us.”
But beyond supplements, harmful interactions are also possible between drugs. “This means that in medications, the effect will vary depending on the time it is taken, what it is taken with, in relation to the meal… It is important to discuss this information with your pharmacist in particular” specifies our expert.
Whether at the level of absorption in the stomach or interaction in the liver, prescriptions are never trivial and must comply with precise rules. “It’s not just to look nice that we say “to take 2 or 3 times a day”, “before” or “after meals”, etc.” emphasizes Dr. Kierzek.
If you have any questions regarding your prescriptions, always refer to a healthcare professional.