Bades and medicines: compatibility reviews

Bades and medicines: Reviews about compatibility – detailed analysis and guide

Part 1: Fundamentals – understanding of dietary supplements, medicines and their interaction

1.1. What are dietary supplements? Definition and legislative regulation

Biologically active food additives (dietary supplements) are concentrates of natural or natural biologically active substances that are intended for direct intake or introduction into food products in order to enrich the diet with individual food or biologically active substances and their complexes, as well as to maintain normal or restoration of impaired health. It is important to emphasize that dietary supplements are not drugs.

Legislative regulation of dietary supplements varies in different countries. In the Russian Federation, Rospotrebnadzor exercises control over dietary supplements. Dad manufacturers are required to receive a certificate of state registration (SGR), confirming the compliance of products with sanitary and epidemiological requirements. However, unlike drugs, dietary supplements do not pass clinical trials in the same amount as drugs. This means that the evidence base of their effectiveness and safety can be less extensive.

1.2. Classification of dietary supplements: diversity and purpose

Bad can be classified according to various criteria, including the composition, form of release and the proposed purpose. The main categories include:

• Vitamins and minerals: Complexes containing individual vitamins (A, B, C, D, E, K, etc.) and minerals (calcium, magnesium, iron, zinc, selenium, etc.) or their combinations. Designed to replenish the deficiency of nutrients and maintain overall health.
• Plant extracts and herbs: Contain extracts of medicinal plants with various pharmacological properties. For example, echinacea extract to strengthen immunity, valerian extract to improve sleep, ginkgo biloba extract to improve cognitive functions.
• Amino acids: Contain separate amino acids or their complexes. They are used to maintain muscle mass, improve sports results, support the nervous system. For example, creatine, BCAA, L-carnitine.
• Probiotics and prebiotics: They contain living microorganisms (probiotics) or substances that contribute to the growth of useful microflora in the intestines (prebiotics). They are used to improve digestion, strengthen immunity and normalize intestinal microbiots.
• Omega-3 fatty acids: Contain polyunsaturated fatty acids that are important for the health of the heart, brain and joints.
• Enzymes: Contain enzymes that facilitate the digestion of food. They are used for digestive disorders, such as the failure of the pancreatic enzymes.
• Other biologically active substances: Include substances such as Q10 coenzyme, alpha-lipoic acid, chondroitin and glucosamine (to support joints) and others.

1.3. Medicines: determination and mechanisms of action

Medicines are substances or combinations of substances intended for the treatment, prevention or diagnosis of diseases, as well as to change the physiological functions of the body. Unlike dietary supplements, medicines are held strict clinical trials to confirm their effectiveness and safety, as well as to determine the optimal dosage and possible side effects.

The mechanisms of the action of drugs are diverse and depend on a particular drug. They can include:

• Interaction with receptors: Medicines can be associated with receptors on the surface of the cells or inside them, causing certain physiological effects.
• Inhibition of enzymes: Medicines can block the activity of enzymes involved in metabolic processes, thereby changing the speed of these processes.
• Impact on ion channels: Medicines can affect the permeability of ion channels in cell membranes, changing the electric potential of cells.
• Antimicrobial action: Antibiotics and other antimicrobial drugs kill or suppress the growth of microorganisms.
• Immunomodulatory action: Medicines can modulate the activity of the immune system, enhancing or suppressing the immune response.

1.4. Pharmacokinetics and pharmacodynamics: key concepts

To understand the interactions between dietary supplements and drugs, it is important to understand the basics of pharmacokinetics and pharmacodynamics.

• Pharmacokinetics: Studies how the body affects the medicine. It includes four main processes:

  • Absorption (absorption): The process of receiving the medicine into the bloodstream from the place of administration.
  • Distribution: The process of distribution of medicine over various tissues and organs of the body.
  • Metabolism (biotransformation): The process of turning the medicine into other substances (metabolites), usually in the liver.
  • Display (excretion): The process of removing the medicine and its metabolites from the body, usually through the kidneys or intestines.

• Pharmacodynamics: Studies how the medicine affects the body. It includes the study of the mechanisms of action of the drug, its therapeutic effects and side effects.

Interactions between dietary supplements and drugs can affect the pharmacokinetics and pharmacodynamics of both substances, which can lead to a change in their effectiveness and safety.

1.5. Types of interactions between dietary supplements and medicines

Interactions between dietary supplements and drugs can be classified according to various criteria. The main types include:

• Pharmacokinetic interactions: Influence the absorption, distribution, metabolism or excretion of the medicine.

  • Influence on absorption: The dietary supplement can change the stomach pH, ​​contact the medicine in the intestines or influence the motor skill of the gastrointestinal tract, which can reduce or increase the absorption of the medicine.
  • Influence on metabolism: Bad can induce or inhibit the liver enzymes involved in the metabolism of the drug, which can accelerate or slow down its metabolism and, accordingly, reduce or increase its concentration in the blood.
  • Influence on excretion: Bad can affect the function of the kidneys or liver, which can change the rate of removal of the medicine from the body.

• Pharmacodynamic interactions: Affect the mechanism of action of the drug.

  • Synergism: Bad and medicine enhance each other’s effect.
  • Antagonism: Bad and medicine weaken the effect of each other.
  • Additative effect: Summing up the effects of dietary supplements and medicines.

• Direct chemical interactions: Bad and medicine interact chemically outside the body, forming insoluble complexes or changing each other’s structure.

Part 2: specific examples of interactions and reviews

2.1. Vitamins and minerals: interactions with drugs

• Vitamin K and anticoagulants (warfarin): Vitamin K plays an important role in blood coagulation. It is an antagonist of anticoagulants, such as warfarin, which are used to prevent blood clots. Taking vitamin K can reduce the effectiveness of warfarin, which will require adjustments to the dose of the drug. Reviews of patients taking warfarin often indicate the need for thorough control of the level of the MOS (international normalized attitude) when using products or additives containing vitamin K. Some patients report the need to avoid green leafy vegetables (spinach, broccoli, salad) that are rich in vitamin K.

• Vitamin E and anticoagulants: Vitamin E in high doses can have anticoagulant properties. With a joint administration with anticoagulants (warfarin, aspirin), the risk of bleeding can increase. Reviews indicate that with simultaneous use, blood coagulation control is necessary.

• Iron and tetracycline antibiotics: Iron can contact tetracycline antibiotics in the intestines, reducing their absorption and reducing efficiency. It is recommended to take iron and tetracycline antibiotics with an interval of at least 2 hours. Patient reviews indicate the need to comply with a temporary interval to achieve the optimal effect of antibiotic therapy.

• Calcium and levotiroxin (thyroid hormone): Calcium can worsen the absorption of levotyroxine, which can lead to a decrease in its effectiveness. It is recommended to take a levotyroxine on an empty stomach 30-60 minutes before breakfast or taking calcium preparations. Reviews of patients with hypothyroidism emphasize the importance of the correct use of levotyroxine to maintain a stable level of thyroid hormones.

• Magnesium and bisphosphonates (for the treatment of osteoporosis): Magnesium can reduce the absorption of bisphosphonates, such as alendronate. It is recommended to take bisphosphonates on an empty stomach, separately from magnesium preparations.

2.2. Plant extracts and herbs: interactions with drugs

• St. John’s wort and many medicines: St. John’s wort is a powerful inducer of liver enzymes (CYP3A4), which accelerates the metabolism of many drugs and reduces their concentration in the blood. St. John’s wort can interact with antidepressants (SIOS), anticoagulants (warfarin), contraceptives, antiretroviral drugs (for HIV treatment), immunosuppressants (cyclosporin) and other drugs. With a joint administration with St. John’s wort, the effectiveness of these drugs may decrease significantly. Reviews of patients taking St. John’s wort often contain information about undesirable interactions with other medicines, so it is extremely important to consult a doctor before taking St. John’s wort.

• Grapefruit (contains substances similar to St. John’s wort) and many drugs: Grapefruit contains substances that inhibit the liver enzymes (CYP3A4), which are involved in the metabolism of many drugs. The use of grapefruit juice can increase the concentration of some drugs in the blood, which can lead to an increase in the risk of side effects. Medicines that grapefruit can interact with, include statins (to reduce cholesterol), calcium channel blockers (for the treatment of hypertension), immunosuppressants and some antihistamines. Reviews of patients using grapefruit juice often contain warnings about possible interactions with drugs.

• Ginkgo biloba and anticoagulants/antiplatelets: Ginkgo bilobe can have anticoagulant properties. With a joint administration with anticoagulants (warfarin) or anti -signs (aspirin), the risk of bleeding can increase. Reviews of doctors are warned against a combination of ginkgo biloba with drugs affecting blood coagulation.

• Echinacea and immunosuppressants: Echinacea stimulates the immune system. With a joint admission with immunosuppressants (cyclosporin), they can reduce their effectiveness.

• Garlic and anticoagulants/antiplatelets: Garlic can have anti -aggregate properties. With a joint administration with anticoagulants (warfarin) or anti -signs (aspirin), the risk of bleeding can increase.

2.3. Probiotics and prebiotics: interactions with drugs

• Probiotics and antibiotics: Antibiotics can kill both harmful and beneficial bacteria in the intestines, including probiotics. Taking probiotics during or after a course of antibiotics can help restore the intestinal microflora and reduce the side effects of antibiotics, such as diarrhea. However, it is recommended to take probiotics and antibiotics with an interval of at least 2 hours so that the antibiotic does not kill probiotics. Reviews of patients taking antibiotics often indicate a positive effect of probiotics in reducing the risk of antibiotic-associated diarrhea.

• Prebiotics and some drugs: Prebiotics can improve the absorption of some drugs in the intestines, but this interaction is not well studied. Further research is needed.

2.4. Omega-3 fatty acids: interactions with drugs

• Omega-3 and anticoagulants/anti-agents: Omega-3 fatty acids in high doses can have anticoagulant properties. With a joint administration with anticoagulants (warfarin) or anti -signs (aspirin), the risk of bleeding can increase. It is recommended to control blood coagulation with simultaneous administration. Reviews of patients taking omega-3 fatty acids and anticoagulants emphasize the need for regular monitoring.

2.5. Other dietary supplements: interactions with drugs

• Cohenzim Q10 and anticoagulants (Varfarin): Coenzyme Q10 can reduce the effectiveness of warfarin, which will require adjustments to the dose of the drug. It is necessary to control the level of the MOS.

• Creatine and non -steroidal anti -inflammatory drugs (NSAIDs): The joint intake of creatine and NSAIDs (Ibuprofen, Diclofenac) can increase the risk of kidney damage.

• Chondroitin and glucosamine and anticoagulants (warfarin): There are separate reports that chondroitin and glucosamine can increase the risk of bleeding when taking anticoagulants (warfarin) jointly.

Part 3: Practical recommendations and precautions

3.1. Mandatory consultation with a doctor

Before taking any dietary supplements, especially with the simultaneous medication, you need to consult a doctor or pharmacist. The doctor will be able to evaluate potential risks and advantages of taking dietary supplements in your specific case, taking into account your diseases, medications taken and individual characteristics of the body. The pharmacist can provide information about possible interactions between dietary supplements and medicines.

3.2. Providing complete information about the drugs taken

Tell the doctor or pharmacist about all the drugs that you take, including prescription drugs, over -the -counter drugs, vitamins, minerals and plant additives. Complete information will help a doctor or pharmacist evaluate the risk of interactions and give appropriate recommendations.

3.3. Compliance with the recommendations for admission

Follow the recommendations of a doctor or pharmacist for dosage and dedication and medicine. Do not exceed the recommended doses. Do not take dietary supplements and medicines at the same time, if this is not recommended by a doctor. Pay attention to the instructions for the instructions for the use of drugs regarding compatibility with food and other substances.

3.4. Attentive attitude to their own state

Carefully follow your condition when taking dietary supplements and medicines. If you notice any unusual symptoms, such as allergic reactions, changes in the effectiveness of drugs or new side effects, see a doctor immediately.

3.5. Sources of information about interactions

Use reliable sources of information about interactions between dietary supplements and medicines, such as:

• Doctor or pharmacist: They are the best sources of information about interactions, taking into account your individual characteristics.
• Instructions for the use of drugs: The instructions for the use of drugs usually indicate possible interactions with other drugs and substances.
• National reference books of medicines: Contain detailed information about drugs, including interactions.
• Scientific articles and reviews: Provide information about the latest studies of interactions between dietary supplements and medicines. It is important to pay attention to the authority of sources and critically evaluate the information presented.

3.6. Caution for self -medication

Do not self -medicate dietary supplements, especially in the presence of chronic diseases and medication. Self -medication can lead to undesirable interactions and a deterioration in health.

3.7. Storage of dietary supplements and drugs

Keep dietary supplements and medicines in accordance with the storage instructions indicated on the packaging. Do not store dietary supplements and medicines in the bathroom where high humidity is, or in other places where they can be exposed to heat or light.

3.8. Special groups of patients

Particular caution should be observed when taking dietary supplements and drugs to pregnant and nursing women, children, older people and patients with liver and kidney diseases. In these cases, the risk of interactions and side effects may be higher.

3.9. Information about dietary supplements during hospitalization

During hospitalization, be sure to inform the doctors about all the dietary supplements you accept. This will help doctors avoid undesirable interactions and properly plan the treatment.

3.10. Critical approach to dietary supplements

Be critical to advertising dietary supplements. Do not believe the promises of miraculous healing. Remember that dietary supplements are not medicines and cannot replace the full treatment prescribed by a doctor. Evaluate the information about the dietary supplement in terms of scientific data and recommendations of specialists.

Part 4: The future of studies of interactions of dietary supplements and drugs

Further studies are needed for a more complete understanding of interactions between dietary supplements and drugs. These studies should include:

• Clinical trials: To assess the effectiveness and safety of dietary supplements, especially with simultaneous medication.
• Pharmacokinetic and pharmacodynamic studies: To study the mechanisms of interactions between dietary supplements and medicines.
• Epidemiological studies: To assess the prevalence and consequences of interactions between dietary supplements and medicines in the population.

The development of technologies, such as genomics and proteomics, can help identify genetic factors affecting the metabolism of drugs and dietary supplements, and predict an individual risk of interactions.

Improving the monitoring systems of side effects and the interaction of drugs and dietary supplements, as well as increasing the awareness of doctors and patients about potential risks of interactions, are important steps to ensure the safety of patients.

The creation of publicly accessible databases on interactions between dietary supplements and medicines can help doctors and pharmacists make reasonable decisions on the prescription of treatment.

Integration of information about dietary supplements into electronic medical records of patients can improve medical care coordination and reduce the risk of interactions.

It is important to remember that information about the interactions of dietary supplements and drugs is constantly updated. Follow the new research and recommendations of specialists.