Bades and medicines: compatibility – full guidance

Section 1: Fundamentals of dietary supplements and drugs

1.1 What are dietary supplements (biologically active additives)?

Biologically active additives (dietary supplements) are concentrates of natural or identical to natural biologically active substances, designed for direct intake or introduction into food products in order to enrich the ration with individual food or biologically active substances and their complexes, as well as to maintain normal and improve the functional state of the body and its organs and systems. It is important to note that dietary supplements Not drugs. They are not intended for the treatment, diagnosis or prevention of diseases. They are designed to maintain health and well -being.

Bades can be represented in various forms, including:

• Tablets: Compressed powders or granules of active substances.
• Capsules: Active substances enclosed in a gelatin or plant membrane.
• Powders: Active substances in chopped form designed for dissolution in water or other liquid.
• Liquids: Solutions, tinctures, extracts of active substances.
• Chaent: A mixture of herbs and other plant ingredients.
• Bars: Food enriched with active substances.

The composition of the dietary supplement may include:

• Vitamins: Organic compounds necessary for the normal functioning of the body. (For example, vitamin D, vitamin C, B vitamins B)
• Minerals: Inorganic substances necessary for various biochemical processes. (For example, calcium, magnesium, iron)
• Amino acids: Building blocks of proteins. (For example, L-carnitine, creatine)
• Plant extracts: Concentrated extracts from plants with biological activity. (For example, green tea extract, echinacea extract)
• Probiotics: Living microorganisms that are healthy intestinal health. (For example, lactobacilli, bifidobacteria)
• Prebiotics: Substances that contribute to the growth and activity of beneficial bacteria in the intestines. (For example, inulin, fruitoligosaccharides)
• Paul -saturated fatty acids (PNS): The fatty acids necessary for the health of the cardiovascular system and brain. (For example, omega-3, omega-6)
• Enzymes: Proteins that accelerate biochemical reactions in the body. (For example, Bromelein, Papain)

1.2 What is medicine?

Medicines (drugs) are substances or combinations of substances designed for the treatment, prevention or diagnosis of diseases in humans or animals, as well as to change the physiological functions of the body. Unlike dietary supplements, medicines are held by strict clinical trials and are regulated by state bodies such as FDA (Food and Drug Administration) in the USA or Roszdravnadzor in Russia.

Medicines are classified according to various criteria, including:

• By the form of release: Tablets, capsules, injection solutions, ointments, creams, suppositories, patching, etc.
• By the method of application: Oral (taken orally), parenteral (introduced injection), local (applied to the skin or mucous membranes), inhalation.
• By the pharmacological group: Antibiotics, analgesics, antihypertensive drugs, antidepressants, anti -inflammatory drugs, etc.
• By the mechanism of action: Substances that block certain receptors inhibiting enzymes that stimulate certain body functions, etc.

Medicines are developed and produced by pharmaceutical companies. The process of developing a new drug includes several stages, including:

• Research and Development: Identification of the target (for example, protein involved in the development of the disease), the development and synthesis of potential drugs, preclinical studies on cells and animals.
• Clinical trials: Checking the effectiveness and safety of medicines in humans. Clinical tests are usually carried out in three phases:
  • Phase I: Assessment of medicine safety on a small group of healthy volunteers.
  • Phase II: Assessment of the effectiveness of the medicine in a small group of patients suffering from a disease for the treatment of which the medicine is intended.
  • Phase III: Assessment of the effectiveness and safety of the drug in a large group of patients suffering from a disease for the treatment of which the medicine is intended compared to placebo or other existing medicine.
• Registration Medicines: Application for registration of medicine to the regulatory authorities. The regulatory authorities consider clinical testing data and other information to determine whether the medicine is safe and effective, and allow its sale.
• Post -marketing monitoring: Continuation of safety monitoring and the effectiveness of the medicine after its entry into the market.

1.3 Key differences between dietary supplements and medicines

Characteristic	Bad	Medication
Appointment	Maintaining health, enriching the diet	Treatment, prevention, diagnosis of diseases
Clinical trials	Usually not required, or required in a simplified form	Strict clinical trials (phases I, II, III) are required
Regulation	Less strict than for drugs	Strict regulation by state bodies
Evidence base	Often limited or absent, based on the traditional application	An extensive evidence base is required, confirming efficiency and safety
The instructions of the doctor	Usually not required	May be required depending on the drug
Side effects	Less likely, but possible, especially with an overdose	Various side effects are possible, requiring attention and correction
Interactions	Can interact with medicines, although less studied	Can interact with other medicines and dietary supplements

Section 2: possible interactions of dietary supplements and drugs

2.1 Pharmacokinetic interactions

Pharmacokinetics studies how the body affects the medicine, including suction processes, distribution, metabolism and excretion. Bades can affect these processes, changing the concentration of the medicine in the blood and, therefore, its effectiveness and safety.

• Influence on absorption:

  • Change PH of the stomach: Some dietary supplements, such as calcium or magnesium, can change the stomach pH, ​​affecting the absorption of drugs that require a certain acidity for dissolution and absorption. For example, the absorption of ketoconazole (antifungal drug) can be reduced while taking antacids.
  • The formation of complexes: Some minerals, such as iron, calcium and magnesium, can form complexes with drugs such as tetracycline antibiotics, reducing their absorption. It is recommended to divide these drugs and dietary supplements for several hours.
  • Influence on intestinal motility: Bades with a laxative or antidiaarean effect can affect the speed of the medicine through the intestines, changing its absorption.

• Influence on the distribution:

  • Binding with plasma proteins: Some dietary supplements containing phytochemicals can compete with drugs for connecting blood proteins. This can lead to an increase in the free (active) fraction of the medicine in the blood, enhancing its effect or increasing the risk of side effects.

• Influence on metabolism:

  • Enzyme induction: Some dietary supplements, such as St. John’s wort, can induce liver enzymes, especially P450 (CYP) cytochrome, which are involved in the metabolism of many drugs. The induction of enzymes can accelerate the metabolism of drugs, reducing their concentration in the blood and reducing their effectiveness. For example, St. John’s wort can reduce the effectiveness of warfarin (anticoagulant), contraceptives and antidepressants.
  • Inhibition of enzymes: Other dietary supplements, such as grapefruit juice, can inhibit liver enzymes, slowing down the metabolism of drugs. Inhibition of enzymes can lead to an increase in the concentration of drugs in the blood, increasing the risk of side effects. For example, grapefruit juice can increase the concentration of some statins (drugs to reduce cholesterol), which can lead to myopathy (muscle damage).

• Influence on excretion:

  • Change pH of urine: Some dietary supplements can change pH urine, affecting the excretion of drugs through the kidneys. For example, alkalization of urine can increase the excretion of weak acids, such as salicylates, and acidification of urine can increase the excretion of weak bases, such as amphetamines.
  • Influence on the function of the kidneys: Bades with a diuretic effect can increase the excretion of medicines through the kidneys, reducing their concentration in the blood.

2.2 Pharmacodynamic interactions

Pharmacodynamics studies how the medicine affects the body, including its mechanism of action and pharmacological effects. Bades can interact with medicines at the pharmacodynamics level, increasing or weakening their effect.

• Synergism: Bad and medicine can enhance each other’s effect. For example, the simultaneous intake of warfarin (anticoagulant) and vitamin E can increase the risk of bleeding.
• Antagonism: Bad can weaken the effect of the medicine. For example, vitamin K can reduce the effectiveness of warfarin, since vitamin K is involved in the process of blood coagulation, and warfarin prevents this process.
• Additative effect: Bad and medicine can have a similar effect on the body, which leads to an increase in the effect, but also to an increase in the risk of side effects. For example, simultaneous intake of dietary supplements that reduce blood pressure and antihypertensive drugs can lead to excessive decrease in blood pressure (hypotension).

2.3 The most common interactions

• St. John’s wort and medicine: St. John’s wort (Hypericum Perforatum) is a famous inducer of CyP enzymes and P-glycoprotein. It can reduce the effectiveness of many drugs, including:
  • Antidepressants (for example, SIOS)
  • Contraceptives
  • Warfarin
  • Digoxin
  • VIV proteases inhibitors
  • Immunosuppressants (for example, cyclosporin)
• Vitamin K and Warfarin: Vitamin K is the antagonist of Varfarin. Patients taking warfarin should maintain stable vitamin K intransigence and avoid sharp changes in the diet.
• Grapefruit juice and medicine: Grapefruit juice inhibits the CYP3A4 enzyme, which is involved in the metabolism of many drugs. It can increase the concentration in the blood and the risk of side effects of the following drugs:
  • Statin (eg, Atorvastatin, Simvastatin)
  • Calcium channel blockers (for example, Fedipine, Nifedipine)
  • Immunosuppressants (for example, cyclosporine, takrolimus)
  • Antiarrhythmic drugs (for example, amiodarone)
• Ginseng and medicine: Ginseng can interact with anticoagulants (for example, warfarin, aspirin), increasing the risk of bleeding. It can also interact with antidepressants (for example, Maoi), causing anxiety, headache and insomnia.
• Garlic and medicine: Garlic can enhance the anticoagulant effect of warfarin and aspirin, increasing the risk of bleeding.
• Ginkgo Biloba and Medicines: Ginkgo bilobe can enhance the anticoagulant effect of warfarin and aspirin, increasing the risk of bleeding. It can also interact with antidepressants (for example, SIOS) and anticonvulsants.
• Fish oil and anticoagulants: Fish oil containing omega-3 fatty acids can enhance the anticoagulant effect of warfarin and aspirin, increasing the risk of bleeding.
• Coenzym Q10 and Warfarin: Coenzym Q10 (COQ10) can reduce the effectiveness of warfarin.
• Calcium and medicine: Calcium can reduce the absorption of some drugs, such as tetracycline antibiotics and levothyroxine (thyroid hormone).
• Iron and medicine: Iron can reduce the absorption of some drugs such as tetracycline antibiotics and levotyroxine.
• Magnesium and medicine: Magnesium can reduce the absorption of some drugs such as tetracycline antibiotics and bisphosphonates.

Section 3: How to minimize the risk of interactions

3.1 Consultation with a doctor or pharmacist

The most important step is a consultation with a doctor or a pharmacist before taking any dietary supplements, especially if you take drugs by prescription or have any chronic diseases. A doctor or a pharmacist can evaluate your individual risk of interactions and give recommendations on the safe use of dietary supplements and drugs. Give the doctor or pharmacist a complete list of all drugs, dietary supplements and vitamins that you accept, including the dosage and frequency of administration.

3.2 Information on admission of dietary supplements

It is important to inform all doctors and other medical workers whom you visit that you are accepting dietary supplements. This will help them avoid the prescription of drugs that can interact with dietary supplements. Feel free to ask questions about possible interactions.

3.3 separation of dietary supplements and drugs

If possible, divide the intake of dietary supplements and drugs for several hours to minimize the risk of interaction. For example, if you take tetracycline antibiotics, take them 2 hours before or 4 hours after taking calcium, iron or magnesium additives.

3.4 Reading information on labels

Carefully read the information on the labels of dietary supplements and medicines. Pay attention to warnings about possible interactions with other substances. If you are not sure of something, consult a doctor or pharmacist.

3.5 Caution with new dietary supplements

Be especially careful with new dietary supplements, about which there is little information. Avoid taking a large number of dietary supplements at the same time. Start with small doses and carefully monitor your condition.

3.6 buying dietary supplements from reliable manufacturers

Buy dietary supplements only from reliable manufacturers who comply with quality and safety standards. Make sure that the composition of the product, dosage and information about the manufacturer are indicated on the label. Avoid buying dietary supplements from dubious sellers or on the Internet, especially if they offer goods at very low prices. Remember that cheap dietary supplements may contain low -quality ingredients or be polluted by harmful substances.

3.7 health monitoring

Carefully monitor your health state and inform the doctor about any unusual symptoms or side effects that you experience after the start of dietary supplements or drugs. This may be a sign of interaction between substances.

3.8 special cases

• Pregnancy and breastfeeding: Pregnant and lactating women should be especially carefully consulted with a doctor before taking any dietary supplements, since some substances can be harmful to the child.
• Elderly people: Older people often take several drugs at the same time, which increases the risk of interactions. They should especially carefully consult a doctor or a pharmacist before admission of dietary supplements.
• Patients with chronic diseases: Patients with chronic diseases such as diabetes, heart disease or kidneys should be especially carefully consulted with a doctor before taking dietary supplements, since some substances can affect the course of the disease or on the effectiveness of treatment.
• Preparation for the operation: Tell your doctor about all the dietary supplements that you accept at least two weeks before the operation. Some dietary supplements (for example, ginkgo bilobe, garlic, ginseng, fish oil) can increase the risk of bleeding during surgery.

Section 4: Examples of safe use of dietary supplements and drugs

Despite potential risks, dietary supplements and medicines can be safely used together if you observe certain precautions and follow the recommendations of a doctor or pharmacist.

• Vitamin D and calcium: Vitamin D helps the body absorb calcium, so they are often taken together to maintain bone health. If you take bisphosphonates for the treatment of osteoporosis, be sure to consult a doctor to make sure that taking vitamin D and calcium is safe and will not affect the effectiveness of the medicine.
• Probiotics and antibiotics: Probiotics can help restore the intestinal microflora after taking antibiotics. Take probiotics a few hours after taking antibiotics to minimize their interaction.
• Omega-3 and statins: Omega-3 fatty acids can help reduce the level of triglycerides in the blood, which is useful for the health of the heart. If you take statins to reduce cholesterol, consult a doctor to make sure that taking omega-3 is safe and will not affect the effectiveness of the medicine.
• Multivitamins and general health: Multivitamins can help replenish the deficiency of vitamins and minerals in the diet. However, do not take too many vitamins and minerals, as this can lead to an overdose and side effects. It is especially important to observe the recommended dosages for vitamins A, D, E, and K, which are fat -soluble and can accumulate in the body.

Section 5: Future of studies of dietary supplements and drugs

Studies of dietary supplements and drugs are an actively developing area. Further research is needed for:

• Identification of more interactions between dietary supplements and medicines.
• Determining the mechanisms of these interactions.
• Development of strategies to minimize the risk of interactions.
• Providing more accurate information to doctors, pharmacists and patients about the safe use of dietary supplements and drugs.

With the development of genomics and personalized medicine in the future, it will become possible to predict the risk of interactions of dietary supplements and drugs based on the human genetic profile. This will allow doctors and pharmacists to give more individual recommendations on the safe use of dietary supplements and drugs.

Section 6: Additional resources

• U.S. Products and Medications Office (FDA): https://www.fda.gov/
• National Health Institutes of the USA (NIH): https://www.nih.gov/
• National Center for Complementary and Integrative Health (NCCIH): https://www.nccih.nih.gov/
• Roszdravnadzor: https://roszdravnadzor.gov.ru/

It is important to remember: This information is intended only for educational purposes and should not be considered as a medical consultation. Always consult a doctor or pharmacist before taking any dietary supplements or medicines.