Clash of remedies
Supplements can enhance or reduce the effects of prescription medicine, deplete nutrients in the body, offset side effects and even give drugs a boost
Natural remedies can react in many ways when combined with conventional medications, says pharmacist and author Sherry Torkos.
These effects are not necessarily negative, says Torkos, who has just released a revised edition of her reference book, The Canadian Encyclopedia of Natural Medicine.
The word natural carries some misunderstandings with it, she says.
“There are things that are natural that are not necessarily safe. Like arsenic.”
Be honest and upfront with your doctor and pharmacist about what you’re taking, she urges.
“Not all drug-supplement interactions are bad, but you need to get an expert involved. Today, pharmacists are more and more trained about natural medicines.” HERE ARE FIVE WAYS NATURAL REMEDIES CAN REACT WITH PRESCRIPTION MEDICATION:
1 Some supplements enhance a drug’s effects
Some people take both antidepressants and St. John’s wort, the so-called “herbal Prozac,” for example. But Torkos warns that using both at the same time can increase the risk of serotonin syndrome. Symptoms include racing heart, anxiety confusion and nausea. Ginkgo biloba is often used to boost memory and concentration, particularly among seniors. If you are using a blood thinner, such as coumadin, it can lead to increased risk of bleeding, she warns. Licorice, an herb that is often taken for immune support and to improve digestion can interact with the drug digoxin, used by patients with congestive heart failure. Using the two together increases the risk of digoxin toxicity. Symptoms include confusion, visual changes and palpitations. Red yeast rice extract, a fermented rice used in traditional Chinese medicine, is another in this category. It can enhance the effects of statin drugs — and the risk of side effects.
2 Supplements can reduce the effects of prescription drugs
These include minerals such as iron and calcium, which are commonly found in multivitamin formulas, says Torkos. For example, minerals bind to quinolone antibiotics, which include norfloxacin, ciprofloxacin, ofloxacin, and levofloxacin. These are commonly prescribed to treat bladder and urinary tract infections, lung infections and pneumonia. You can avoid the risk of reducing an antibiotic’s effectiveness simply by talking to a pharmacist about the best way to time taking antibiotics and supplements, says Torkos. Echinacea can also reduce the effects of prescription drugs. Some people use the herbal supplement to boost immune function, but cancer patients should be cautious because it can reduce the efficacy of certain cancer treatments.
3 Some drugs deplete nutrients in the body
These include anti-convulsants such as phenytoin and phenobarbital; corticosteroids such as prednisone; H2 receptor blocker drugs such as ranitidine, and famoditine as well as calcium channel blockers such as verapamil. All these deplete vitamin D. If you take them, it’s a good idea to get a blood test to check vitamin D levels, says Torkos, who lives in the Niagara region and is a certified fitness instructor. Vitamin C can be depleted by regular use of Aspirin as well as NSAIDS and oral contraceptives, she says. B vitamins can also be depleted by oral contraceptives.
4 Supplements can sometimes offset drug side effects
Antibiotics kill good as well as bad bacteria, for example. This upsets the “flora” in the gut for up to six months, resulting in upset stomach, gas, bloating, diarrhea and thrush and yeast infections, says Torkos. This can be offset by using probiotics at the same time as antibiotics, and continuing to take probiotics for 10 days after the antibiotics are finished. In children, regular prebiotic use reduces infections, she says. Statin drugs such as atorvastatin, simvistatin and lovastatin deplete coenzyme Q10, a vital antioxidant. Symptoms include muscle weakness, fatigue and cardiomyopathy. Avoid this by supplementing with Q10.
5 Some supplements complement drug effect
These include omega-3 fatty acids from fish oil and GLA (gamma linolenic acid), which enhance the anti-inflammatory effect of NSAIDs such as ibuprofen. These supplements can even reduce dosage and use of the drug, Torkos says. Chromium can help improve blood-sugar control and insulin sensitivity for patients taking oral hypoglycemic drugs for Type 2 diabetes. Taking chromium may reduce the dosage requirement of hypoglycemic drugs, she says. People with Type 2 diabetes should be monitored closely and check their blood-sugar levels regularly to avoid hypoglycemia when using drugs or supplements with additive effects.