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Food and drug interactions

I am off the marijuana this week, and am moving straight into unexpected food-drug interactions.

Local pharmacists dispense advice with medicines on a daily basis. Some of the advice is the expected, “take with food” or “take all”.

Let’s look at the “I never knew that!” category.

Advocado pears or guacamole make a good snack or meal or butter substitute, but did you know that eating this good old Bajan fruit/ vegetable (this is a drug article, so excuse me for not knowing which it is) will interact with your warfarin.

Advocado increases the blood thinning activity of the warfarin. Menthol cough drops, green tea, mango and cranberry juice all interact in a similar way.

Conversely increasing your vitamin K levels without consultation with your doctor or dietitian can also be dangerous. The danger is an increase in the potential to create blood clots.

Regular readers would have read about the effects of ginseng on warfarin, but tumeric is also a problem, whether in curry or curcumin pills. Fish oils also can be problematic for the warfarin user.

Many other drugs or supplements are affected by food and drink:

* Tea (hot or iced) can reduce the absorption of your iron tablets (Ifa and Trihemic included). Tea will also reduce any benefits you may get from spinach.

* Fibre in bran can slow the absorption of digoxin, and most cholesterol busting drugs. Higher fibre foods such as bran muffins can also make some antidepressants less effective. This is an interesting interaction, considering that fibre is recommended to reduce cholesterol levels. A possible compromise may be to take the fibre early in the day and continue the statin at night.

* Peppermint, that popular herb and flavouring agent that is found in sweets, chewing gum and many irritable bowel syndrome treatments, has to be monitored when taking some blood pressure tablets. Plendil (Felodipine) is affected by peppermint. This interaction increases the side effects experienced, as it causes more Plendil to be released into the blood. Even statins have been reportedly affected by peppermint.

* Grapefruit. We all know of the grapefruit and statin interaction, but did you know of the interaction with Norvasc Amlodipine); our friend Plendil; Tegretol and Viagra — yes Viagra. Grapefruit also prevents Allegra from working properly.

* Certain cough syrups, will present problems to persons with glaucoma or enlarged prostates — remedy, seek your pharmacists intervention.

* Chocolate reduces the effectiveness of narcotic pain killers and some antibiotics. Remember that chocolate contains caffeine, so some persons will experience tremors with certain medicines and chocolate may also irritate the stomach lining, thereby increasing the feelings of nausea or stomach irritation when combined with NSAIDS and other drugs.

Obviously these are just a few interactions. Pharmacy is a dynamic science and hence it can be expected that new interactions will emerge. Therefore it makes sense to interact with the only nationally trained group of professionals when taking your medicines.

The role of the Barbadian pharmacist has radically changed to that of an educator and not only a dispenser. Accordingly, your favourite pharmacist will soon have to show proof that they have brushed up on their knowledge on a yearly basis, in order to practise in Barbados.

The tips mentioned in these articles are written, hopefully in a manner that will encourage the reader in going to their pharmacist for further clarification.

Till next time.

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