Bades and medicines: can you take together?

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Bades and medicines: can you take together?

The interaction of biologically active additives (dietary supplements) and drugs is a complex and multifaceted topic that requires attentive consideration. The uncontrolled intake of dietary supplements against the background of drug therapy can lead to unpredictable consequences, from reducing the effectiveness of drugs to the development of serious side effects. In this article, we will analyze in detail aspects of compatibility of dietary supplements and drugs, consider the mechanisms of their interaction, discuss the most common and dangerous combinations, and also provide practical recommendations for the safe use of dietary supplements in combination with drugs.

I. Basic concepts and definitions:

  1. Biologically active additives (dietary supplements): Dietary supplies are concentrates of natural or identical to natural biologically active substances designed for direct intake or introduction to food products in order to enrich the diet with individual food or biologically active substances and their complexes. Bad are not drugs and are not intended for the treatment of diseases. Their main goal is to maintain health, the prevention of scarce conditions and improve the functional state of the body. Bad are available in various forms: tablets, capsules, powders, liquids, etc. The composition of dietary supplements may include vitamins, minerals, amino acids, plant extracts, probiotics, prebiotics, dietary fiber and other components.

  2. Medicines: Medicines are substances or combinations of substances intended for the treatment, prevention or diagnosis of diseases. Medicines undergo a strict process of development, preclinical and clinical trials before being allowed to use. Their effectiveness and safety are confirmed by research results. Medicines are produced in various forms: tablets, capsules, injection solutions, ointments, creams, etc.

  3. Interaction of drugs: The interaction of drugs (Drug-Drug Intections) is a change in the pharmacological effect of one drug under the influence of another. Interaction can lead to increased (synergism) or weakening (antagonism) of the effect of the drug, as well as to a change in its pharmacokinetics (absorption, distribution, metabolism, excretion).

  4. Interaction of dietary supplements and medicines: The interaction of dietary supplements and drugs (Dietary Supplement-Drug Intections) is a change in the pharmacological effect of the drug under the influence of a biologically active additive. Interaction mechanisms can be similar to interactions between drugs.

  5. Pharmacokinetics: Pharmacokinetics is a section of pharmacology that studies the processes of absorption, distribution, metabolism and elimination of drugs (or dietary supplements) from the body.

  6. Pharmacodynamics: Pharmacodynamics is a section of pharmacology that studies the mechanisms of action of drugs (or dietary supplements) on the body and their pharmacological effects.

II. Mechanisms for the interaction of dietary supplements and medicines:

The interaction of dietary supplements and drugs can occur at different levels and through various mechanisms:

  1. Pharmacokinetic interactions:

    • Suction: Bad can affect the absorption of drugs in the gastrointestinal tract. For example, the dietary fiber contained in some dietary supplements can slow down the absorption of drugs, associated with them and forming complexes. Minerals, such as calcium, magnesium, iron, zinc, can form insoluble complexes with some drugs, reducing their absorption. On the other hand, some dietary supplements can enhance the absorption of drugs by changing the stomach PH or affecting the activity of transport proteins in the intestines.

    • Distribution: Bad can affect the binding of drugs with blood plasma proteins. If the dietary supplement competes with the medicine for connecting with proteins, then the concentration of free medicine in the blood increases, which can lead to increased its effect or the development of side effects.

    • Metabolism: Bad can affect the metabolism of drugs in the liver, mainly through the enzymes of the P450 cytochrome system (CYP). Some dietary supplements can induce (accelerate) or inhibit (slow down) the activity of these enzymes, which leads to a change in the concentration of the drug in the blood. The induction of enzymes can reduce the effectiveness of the medicine, and inhibiting can increase its concentration and risk of side effects. The most studied is the effect of St. John’s wort-based dietary supplement (Hypericum Perforatum), which is a powerful inducer of enzymes CYP3A4, CYP2C9, CYP2C19 and P-glycoprotein.

    • Display: Bad can affect the excretion of medicines from the body through the kidneys or intestines. For example, some dietary supplements can change pH urine, which affects the excretion of drugs metabolized in the kidneys. Some dietary supplements can also affect the activity of transport proteins in the kidneys or intestines involved in the excretion of drugs.

  2. Pharmacodynamic interactions:

    • Synergism: Some dietary supplements can enhance the effect of drugs acting on the same receptors or body systems. For example, the joint intake of dietary supplements containing vitamin K and anticoagulants (for example, warfarin) can increase the risk of thrombosis.

    • Antagonism: Some dietary supplements can weaken the effect of drugs, blocking their effect on receptors or body systems. For example, the joint intake of dietary supplements containing calcium and calcium channels can reduce the effectiveness of the latter in reducing blood pressure.

    • Additative effect: Some dietary supplements and drugs can have the same effect on the body, which, with joint use, leads to an increase in this effect and risk of side effects. For example, the joint administration of dietary supplements that reduce blood pressure (for example, Q10 coenzyme), and antihypertensive drugs can lead to an excessive decrease in blood pressure.

III. The most common and dangerous combinations of dietary supplements and medicines:

  1. St. John’s wort (Hypericum Perforatum) and drugs: St. John’s wort is a powerful inducer of enzymes CYP3A4, CYP2C9, CYP2C19 and P-glycoprotein, which can reduce the effectiveness of many drugs, including:

    • Anticoagulants (warfarin): decrease in efficiency, thrombosis risk.
    • Contraceptives (ethinyl estradiol): reducing effectiveness, risk of unwanted pregnancy.
    • Immunosuppressants (cyclosporin, takrolimus): decrease in efficiency, the risk of rejection of the transplant.
    • HIV proteases (Indinavir): decrease in efficiency, the risk of resistance to HIV therapy.
    • Antidepressants (SIOOS, tricyclic antidepressants): the risk of serotonin syndrome.
    • Digoxin: decrease in efficiency, risk of heart failure.
    • Statins (Simvastatin, Atorvastatin): Reducing effectiveness, risk of cardiovascular diseases.

  2. Vitamin K and anticoagulants (warfarin): Vitamin K is a blood coagulation factor and can reduce the effectiveness of anticoagulants, such as warfarin, increasing the risk of thrombosis. Patients taking warfarin should strictly control the consumption of products rich in vitamin K, and avoid taking dietary supplements containing vitamin K.

  3. Garlic, ginger, ginkgo bilobe and anticoagulants/antitromobocytic drugs (warfarin, clopidogrel, aspirin): Garlic, ginger and ginkgo bilobe have anticoagulant and antitromobocytic properties and can enhance the effect of anticoagulants and antithrombocytic drugs, increasing the risk of bleeding.

  4. Grapefruit juice and drugs: Grapefruit juice contains substances that inhibit the CYP3A4 enzyme, which can increase the concentration of many drugs in the blood and increase the risk of side effects. The combination of grapefruit juice with the following drugs is especially dangerous:

    • Statins (Simvastatin, Atorvastatin): The risk of myopathy (muscle damage).
    • Calcium channel blockers (Fedipine, Nifedipine): Risk of hypotension (decreased blood pressure).
    • Immunosuppressants (cyclosporin, takrolimus): risk of nephrotoxicity (kidney damage).

  5. Coenzyme Q10 and antihypertensive drugs: Coenzyme Q10 can reduce blood pressure and enhance the effect of antihypertensive drugs, which can lead to an excessive decrease in blood pressure (hypotension).

  6. Iron and levotiroxin (thyroid hormone): Iron can reduce the absorption of levotyroxine, which can lead to a decrease in the effectiveness of hypothyroid therapy. It is recommended to take a levotyroxin 4 hours before or after taking iron preparations.

  7. Calcium and antibiotics (tetracyclines, fluoroquinolons): Calcium can form insoluble complexes with tetracycline and fluoroquinolones, reducing their absorption and effectiveness. It is recommended to take antibiotics 2 hours before or after taking calcium drugs.

  8. Vitamin E and anticoagulants: High doses of vitamin E can have an anticoagulant effect and enhance the effect of anticoagulants, increasing the risk of bleeding.

  9. Chrome and insulin/sugar -lowering drugs: Chrome can improve insulin sensitivity and enhance the effect of sugar -lowering drugs, which can lead to hypoglycemia (a decrease in blood sugar).

  10. Magnesium and some medicines for the heart: Magnesium can interact with digoxin and some calcium channels, enhancing their effect or causing undesirable side effects.

IV. Practical recommendations for the safe use of dietary supplements in combination with drugs:

  1. Tell the doctor about all the dietary supplements: It is important to inform the doctor about all the dietary supplements that you accept, including the dosage and duration of the reception. This will allow the doctor to evaluate the potential risks of the interaction of dietary supplements and drugs and take the necessary precautions.

  2. Consult with the pharmacist: The pharmacist can provide information on potential interactions of dietary supplements and drugs, as well as give recommendations on the safe use of dietary supplements.

  3. Read the instructions carefully: Before taking dietary supplements and drugs, carefully read the instructions for use, paying attention to contraindications and possible interactions.

  4. Buy dietary supplement from trusted manufacturers: Buy dietary supplements from famous and reliable manufacturers that guarantee the quality and safety of your products. Avoid buying dietary supplements from dubious sellers or through Internet sites that have no license.

  5. Follow the recommended doses: Do not exceed the recommended doses of dietary supplements indicated on the packaging or in the instructions for use. Exceeding the dose can increase the risk of side effects and interactions with drugs.

  6. Follow the intervals between dietary supplements and drugs: If possible, follow the interval of several hours between dietary supplements and medicines to minimize the risk of interaction at the suction level.

  7. Pay attention to side effects: Carefully monitor your condition and pay attention to any unusual symptoms or side effects that may occur after the start of dietary supplements. In the case of side effects, see a doctor immediately.

  8. Be especially careful when taking it:

    • Anticoagulants (warfarin, clopidogrel, aspirin).
    • Antidiabetic drugs (insulin, metformin).
    • Antidepressants (SIOS, tricyclic antidepressants).
    • Immunosuppressants (cyclosporine, takrolimus).
    • Drugs for the treatment of cardiovascular diseases (digoxin, hundred

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