Bades: interaction with medicines and consequences – complete management
Section 1: What is dietary supplements and why is it important to understand their interaction with medicines?
Biologically active additives (dietary supplements) have become an integral part of a modern health culture. From multivitamins to herbal extracts, the market offers a wide range of products promising to improve well -being, strengthen immunity and even treatment of various diseases. However, despite their popularity, it is important to understand that dietary supplements are not just “natural” products that do not require attention. Their interaction with drugs can be complex and unpredictable, leading to undesirable, and sometimes dangerous consequences.
1.1 Definition and classification of dietary supplements.
Bades 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 the body’s functions within physiological norms and increasing resistance to adverse environmental factors.
Classification of dietary supplements can be based on various criteria:
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By composition:
- Vitamin-mineral complexes: contain vitamins and minerals in various combinations.
- Herbal additives: made on the basis of medicinal plants and their extracts.
- Probiotics and prebiotics: contain living microorganisms or substances that stimulate the growth of beneficial intestinal microflora.
- Amino acids: contain separate amino acids or their complexes.
- Fatty acids: contain polyunsaturated fatty acids (omega-3, omega-6).
- Others: enzymes, dietary fiber, antioxidants, etc.
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By the form of release:
- Tablets, capsules, powders, liquids.
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For the purpose of application:
- To maintain immunity, to improve digestion, to strengthen the cardiovascular system, to improve the condition of the skin, hair and nails, etc.
1.2 Bad regulation.
Unlike drugs, dietary supplements do not go through strict clinical trials necessary to confirm their effectiveness and safety. The regulation of dietary supplements is usually less rigid, and manufacturers are not required to prove their healing properties. In most countries, dietary supplements are considered as food, and not as medicines, which affects the requirements for their production, labeling and advertising. This means that consumers should be special caution when choosing and using dietary supplements.
1.3 The prevalence of the use of dietary supplements.
The popularity of dietary supplements is growing all over the world. People use them for various purposes:
- Prevention of diseases.
- Maintaining general health and well -being.
- Improving sports results.
- Treatment of chronic diseases (as an addition to the main therapy).
However, it is important to understand that dietary supplements are not a replacement for good nutrition and a healthy lifestyle. Their use should be conscious and reasonable.
1.4 The meaning of understanding of the interaction of dietary supplements with medicines.
The uncontrolled use of dietary supplements, especially in combination with drugs, can lead to serious health problems. The interaction of dietary supplements with medicines can:
- Strengthen or weaken the effect of drugs.
- Call unwanted side effects.
- Worsen the absorption of drugs.
- Change the metabolism of drugs in the body.
Therefore, before taking any dietary supplement, especially if you take any drugs, you need to consult a doctor or pharmacist.
Section 2: mechanisms for the interaction of dietary supplements with medicines.
The interaction of dietary supplements with medicines is a complex process that can occur at different levels: pharmacokinetic and pharmacodynamic. Understanding these mechanisms allows you to anticipate possible consequences and prevent undesirable reactions.
2.1 Pharmacokinetic interactions.
Pharmacokinetics studies how the body affects the medicine: absorption (absorption), distribution, metabolism and excretion (excretion). Bades can influence each of these stages.
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Influence on absorption (absorption): Some dietary supplements can affect the absorption of drugs in the gastrointestinal tract. For example, dietary fiber can bind medicinal substances, reducing their absorption. Antacids containing calcium or magnesium can change the stomach pH, affecting the solubility and absorption of certain drugs. Iron can reduce the absorption of some antibiotics (for example, tetracyclines).
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Influence on the distribution: After absorption, the medicine is distributed throughout the body. Some dietary supplements can affect the binding of drugs with blood plasma proteins, which can change the amount of medicine available for exposure to the target organ. For example, St. John’s wort can influence the level of some drugs in the blood.
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Influence on metabolism: The metabolism of drugs occurs mainly in the liver with the participation of cytochromes P450 (CYP). Many dietary supplements can induce (accelerate) or inhibit (slow down) the activity of these enzymes, which leads to a change in the concentration of drugs in the blood. St. John’s wort is a well -known CYP3A4 inducer, which can reduce the effectiveness of many drugs metabolized by this enzyme (for example, warfarin, oral contraceptives, some antidepressants). Grapefruit juice is an inhibitor of CYP3A4, which can increase the concentration of some drugs in the blood and increase the risk of side effects.
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Influence on excretion (excretion): Some dietary supplements can affect the excretion of medicines by kidneys or through the intestines. For example, diuretics (diuretic) dietary supplements can accelerate the excretion of drugs in urine, reducing their concentration in the blood.
2.2 Pharmacodynamic interactions.
Pharmacodynamics studies how the medicine affects the body: the mechanism of action, the therapeutic effect and side effects. Bades can interact with medicines at this level, enhancing or weakening their effect.
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Synergism: Some dietary supplements can enhance the effect of drugs, which can be useful in certain cases, but can also increase the risk of side effects. For example, a combination of warfarin (anticoagulant) with additives containing vitamin K can enhance the anticoagulant effect and increase the risk of bleeding.
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Antagonism: Some dietary supplements can weaken the effect of drugs, making them less effective. For example, vitamin K can reduce the effectiveness of warfarin.
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Additative effect: Bad and medicine can have similar effects, and their joint use can lead to excessive strengthening of these effects. For example, a combination of dietary supplements that reduce blood pressure with antihypertensive drugs can lead to hypotension (low blood pressure).
2.3 Factors affecting the probability and degree of interaction.
The probability and degree of interaction of dietary supplements with drugs depend on many factors:
- Bad type and dose: Some dietary supplements are more prone to interaction than others. High doses of dietary supplements increase the risk of interaction.
- Type and dose of the drug: Some drugs are more sensitive to interaction than others. High doses of drugs increase the risk of interaction.
- Individual characteristics of the body: Age, gender, genetic characteristics, state of health, the presence of liver and kidney diseases – all this can affect metabolism and excretion of drugs and dietary supplements, as well as their interaction.
- Duration of dietary supplement: Long -term use of dietary supplements increases the risk of interaction.
- Simultaneous intake of several dietary supplements and drugs: The more drugs a person takes, the higher the risk of interaction.
Section 3: Examples of common dietary supplements and their interactions with medicines.
There are many dietary supplements, and their interaction with drugs can be complex and diverse. Consider some of the most common dietary supplements and their potential interactions with drugs.
3.1 St. John’s wort (Hypericum Perforatum).
St. John’s wort is a popular herbal additive used to treat depression. It is a powerful inducer CYP3A4, CYP1A2 and CYP2C9, as well as P-glycoprotein. This means that it can accelerate the metabolism of many drugs, reducing their concentration in the blood and, therefore, their effectiveness.
- Interactions:
- Antidepressants (SIOOS, TCA): can reduce their effectiveness and increase the risk of serotonin syndrome.
- Varfarin (anticoagulant): reduces its effectiveness and increases the risk of thrombosis.
- Oral contraceptives: reduces their effectiveness and increases the risk of pregnancy.
- Digoxin (heart glycoside): reduces its effectiveness.
- Cyclosporin (immunosuppressant): reduces its effectiveness and increases the risk of organ rejection.
- Indinavir and other proteases (antiretroviral drugs): reduces their effectiveness.
- Statins (drugs to reduce cholesterol): reduces their effectiveness.
3.2 garlic (Allium sativum).
Garlic is known for its antioxidant, anti -inflammatory and antibacterial properties. It can affect blood coagulation and blood pressure.
- Interactions:
- Anticoagulants and antiplatelets (warfarin, clopidogrel, aspirin): can enhance their effect and increase the risk of bleeding.
- ACE inhibitors (enalapril, lysinopril): can enhance their effect and lead to hypotension.
- Insulin and other sugar -free drugs: can enhance their effect and lead to hypoglycemia.
3.3 Ginko Biloba (Ginkgo Biloba).
Ginko Biloba is used to improve memory and concentration. It can affect blood coagulation and blood pressure.
- Interactions:
- Anticoagulants and antiplatelets (warfarin, clopidogrel, aspirin): can enhance their effect and increase the risk of bleeding.
- NSAIDs (Ibuprofen, Narksen): can increase the risk of bleeding.
- Antidepressants (SIOOS): can increase the risk of serotonin syndrome.
- Insulin and other sugar -lowering drugs: can affect the level of glucose in the blood.
3.4 ginseng (Panax Ginseng).
Ginseng is used to increase energy and strengthen immunity. It can affect blood coagulation, blood pressure and blood glucose.
- Interactions:
- Anticoagulants and antiplatelets (warfarin, clopidogrel, aspirin): can enhance their effect and increase the risk of bleeding.
- Insulin and other sugar -free drugs: can enhance their effect and lead to hypoglycemia.
- Antidepressants (Maoi): can cause manic episodes.
- Digoxin (heart glycoside): can increase the level of digoxin in the blood.
3.5 Echinacea (Echinacea Purpurea).
Echinacea is used to strengthen immunity and prevention of colds. It can affect the activity of cytochrome P450 enzymes.
- Interactions:
- Immunosuppressants (cyclosporin, takrolimus): can reduce their effectiveness.
- Antifungal drugs (ketoconazole, itraconazole): can affect their metabolism.
3.6 Vitamin K.
Vitamin K plays an important role in blood coagulation.
- Interactions:
- Varfarin (anticoagulant): reduces its effectiveness and increases the risk of thrombosis.
3.7 Coenzim Q10 (COQ10).
Coenzym Q10 is used to maintain the health of the cardiovascular system and increase energy.
- Interactions:
- Varfarin (anticoagulant): can reduce its effectiveness.
- Statins (drugs to reduce cholesterol): can reduce the level of COQ10 in the body.
3.8 fish oil (omega-3 fatty acids).
Fish oil is used to maintain health of the cardiovascular system and reduce triglycerides.
- Interactions:
- Anticoagulants and antiplatelets (warfarin, clopidogrel, aspirin): can enhance their effect and increase the risk of bleeding.
3.9 Calcium.
Calcium is used to maintain the health of bones and teeth.
- Interactions:
- Tetracycline and chinolons (antibiotics): reduces their absorption.
- Levotyroxin (thyroid hormone): reduces its absorption.
- Bisphosphonates (drugs for the treatment of osteoporosis): reduces their absorption.
3.10 iron.
Iron is necessary for the formation of hemoglobin and oxygen transportation.
- Interactions:
- Tetracycline and chinolons (antibiotics): reduces their absorption.
- Levodopa (drug for the treatment of Parkinson’s disease): reduces its absorption.
Section 4: The consequences of the interaction of dietary supplements with medicines.
The consequences of the interaction of dietary supplements with drugs can be diverse and depend on specific substances, doses, individual characteristics of the body and other factors. They can vary from minor discomfort to serious and even life -threatening states.
4.1 Strengthening the side effects of drugs.
Some dietary supplements can enhance the side effects of drugs, which can lead to increased discomfort and increase the risk of complications.
- Example: The combination of anticoagulants (warfarin, clopidogrel) with dietary supplements containing garlic, ginko biloba or fish oil can significantly increase the risk of bleeding. This can manifest itself in the form of nasal bleeding, bleeding gums, the appearance of bruises, hemorrhages in the skin, as well as more serious bleeding, such as gastrointestinal bleeding or hemorrhage into the brain.
4.2 Reducing the effectiveness of drugs.
Some dietary supplements can reduce the effectiveness of drugs, making them less effective or even useless.
- Example: St. John’s wort, being a powerful inducer of cytochrome P450, can significantly reduce the effectiveness of many drugs metabolized by these enzymes, such as antidepressants, oral contraceptives, warfarin, cyclosporin and others. This can lead to a deterioration in the patient’s condition, inefficiency of treatment and the need to increase the dose of the drug.
4.3 Development of new side effects.
The combination of dietary supplements with drugs can lead to the development of new side effects that are not observed when taking each drug separately.
- Example: The combination of antidepressants of the SIOOS group (selective inhibitors of the reverse capture of serotonin) with dietary supplements containing St. John’s wort or tripophane can increase the risk of developing serotonin syndrome – a potentially dangerous state characterized by anxiety, excitement, muscle spasms, increased body temperature, rapid palpitations and other symptoms.
4.4 impact on the results of laboratory tests.
Some dietary supplements can affect the results of laboratory tests, leading to improper interpretation of the results and erroneous diagnostics.
- Example: Dietary supplements containing biotin (vitamin B7) can affect the results of thyroid hormones, troponin and other laboratory indicators, leading to false positive or false negative results. This can lead to improper diagnosis and prescription of inadequate treatment.
4.5 Exacerbation of existing diseases.
Some dietary supplements can aggravate existing diseases or worsen their course.
- Example: Bades containing caffeine or other stimulants can aggravate symptoms of anxiety, insomnia and cardiovascular diseases. Dietary supplements containing iodine can cause hyperthyroidism (increased thyroid function) in people with a predisposition to this disease.
4.6 toxic effects on organs and systems.
In rare cases, the interaction of dietary supplements with drugs can lead to toxic effects on organs and systems, such as liver, kidneys or heart.
- Example: Some herbal additives, especially with prolonged use or in high doses, can cause hepatotoxicity (liver damage) or nephrotoxicity (kidney damage).
Section 5: Groups of patients exposed to the greatest risk of interaction between dietary supplements with medicines.
Some groups of patients are more at risk of interaction between dietary supplements with medicines than others. This is due to the characteristics of their body, the state of health and the use of a large number of drugs.
5.1 Elderly people.
Older people often take several drugs at the same time (polypragmasis), which significantly increases the risk of interaction. With age, the function of the liver and kidneys decreases, which can slow down metabolism and the excretion of drugs and dietary supplements, increasing their concentration in the blood and increasing the risk of side effects. In addition, elderly people are more sensitive to side effects of drugs and dietary supplements.
5.2 Patients with chronic diseases.
Patients with chronic diseases such as cardiovascular diseases, diabetes, liver and kidney diseases often take a large number of drugs to control their condition. This increases the risk of interaction between dietary supplements with medicines. In addition, some dietary supplements can affect the course of these diseases, worsening their control.
5.3 Patients who have undergone organs transplantation.
Patients who have undergone organs transplantation take immunosuppressants to prevent the organ rejection. Many dietary supplements can affect the metabolism and effectiveness of immunosuppressants, which can lead to the rejection of the organ. Therefore, patients after transplantation should avoid taking dietary supplements without consulting a doctor.
5.4 Pregnant and lactating women.
The safety of many dietary supplements has not been studied in pregnant and lactating women. Some dietary supplements can have a negative impact on the development of the fetus or health of the child. In addition, dietary supplements can interact with drugs used to treat diseases during pregnancy and breastfeeding. Therefore, pregnant and lactating women should be especially caught in the reception of dietary supplements and always consult a doctor.
5.5 children.
The safety and effectiveness of many dietary supplements has not been studied in children. Some dietary supplements can have a negative impact on the growth and development of the child. In addition, children are more sensitive to side effects of drugs and dietary supplements. Therefore, children should not give dietary supplements without consulting a doctor.
5.6 Patients undergoing chemotherapy or radiation therapy.
Patients undergoing chemotherapy or radiation therapy are especially vulnerable to the interaction of dietary supplements with medicines. Some dietary supplements can affect the effectiveness of chemotherapy, reduce its effectiveness or enhance side effects. In addition, some dietary supplements can affect the sensitivity of the tumor to radiation therapy. Therefore, patients undergoing chemotherapy or radiation therapy should avoid taking dietary supplements without consulting an oncologist.
Section 6: How to prevent the interaction of dietary supplements with medicines.
Prevention of the interaction of dietary supplements with drugs is an important task to ensure the safety and effectiveness of treatment. Compliance with simple rules and recommendations will help minimize the risk of undesirable consequences.
6.1 Consultation with a doctor or pharmacist.
Before taking any dietary supplement, especially if you take any drugs, be sure to consult a doctor or pharmacist. Tell the doctor or pharmacist about all medicines, dietary supplements and herbs that you take. A doctor or a pharmacist will be able to evaluate potential risks of interaction and give recommendations on the safe use of dietary supplements.
6.2 Informing a doctor about taking dietary supplements before surgery or other medical procedures.
Some dietary supplements can affect blood coagulation and blood pressure, which can be dangerous during surgery or other medical procedures. Tell the doctor about the admission of dietary supplements before the operation or other medical procedures so that the doctor can take the necessary precautions.
6.3 Reading labels and instructions for use.
Carefully read the labels and instructions for the use of dietary supplements. Pay attention to the composition, dosage, contraindications and possible side effects. Do not exceed the recommended dose of dietary supplements.
6.4 Acquisition of dietary supplements only in reliable sources.
Get dietary supplements only in pharmacies or other reliable sources to avoid buying fakes or low -quality products. Pay attention to the availability of quality certificates and licenses.
6.5 Monitoring of health status.
When taking dietary supplements, carefully monitor your health status. If you notice any unusual symptoms or a deterioration in well-being, stop taking a dietary supplement and consult a doctor.
6.6 maintaining a diary of taking drugs and dietary supplements.
Keep the diary of taking medications and dietary supplements in which note the names of drugs, dosage, time of administration and any changes in the state of health. This will help a doctor or pharmacist evaluate potential risks of interaction and adjust the treatment.
6.7 Avoiding the simultaneous administration of several dietary supplements.
Simultaneous intake of several dietary supplements increases the risk of interaction. If you take several dietary supplements, consult a doctor or pharmacist to evaluate potential risks of interaction and choose the safest combination.
6.8 Caution when using herbal additives.
Herbal additives may contain various biologically active substances that can interact with drugs. Be especially careful when using herbal additives if you take any drugs.
6.9 informing the doctor about any changes in the diet.
Changes in the diet, such as the transition to a vegetarian or vegan diet, can affect the absorption and metabolism of drugs. Tell the doctor about any changes in the diet so that the doctor can adjust the treatment.
6.10 Storage of dietary supplements in an inaccessible place for children.
Keep dietary supplements in no way for children to prevent accidental poisoning.
Section 7: The future of research in the field of interaction between dietary supplements with medicines.
Studies in the field of interaction between dietary supplements with drugs continue and are developing. In the future, it is expected to develop new methods for assessing the risk of interaction, the creation of more accurate databases and the development of personalized approaches to the use of dietary supplements.
7.1 Development of new methods for assessing the risk of interaction.
New methods for assessing the risk of interaction between dietary supplements with medicines are being developed, based on the use of computer models and artificial intelligence. These methods allow you to predict potential interactions and develop individual recommendations for the use of dietary supplements.
7.2 Creating more accurate databases.
More accurate and full databases are created containing information about the composition, pharmacokinetics and pharmacodynamics of dietary supplements, as well as their interaction with medicines. These databases will be available to doctors, pharmacists and patients, which will allow them to make more reasonable decisions on the use of dietary supplements.
7.3 Development of personalized approaches to the use of dietary supplements.
Personalized approaches to the use of dietary supplements based on genetic characteristics, health status and medications are being developed. These approaches will optimize the effectiveness and safety of the use of dietary supplements.
7.4 Conducting clinical tests to assess the effectiveness and safety of dietary supplements.
Clinical tests are carried out to assess the effectiveness and safety of dietary supplements. These tests allow you to obtain more reliable data on the benefits and dangers of dietary supplements and develop recommendations for their use.
7.5 Development of new drugs based on dietary supplements.
The possibility of developing new drugs based on dietary supplements is investigated. Some dietary supplements have pronounced healing properties and can be used to treat various diseases.
7.6 informing the public about the risks of interaction between dietary supplements with medicines.
Campaigns are held to inform the public about the risks of interaction between dietary supplements with medicines. These campaigns are aimed at increasing the public awareness of the safe use of dietary supplements and the need to consult a doctor or pharmacist.
By investing in these areas, researchers hope to provide better information and tools for healthcare professionals and consumers to make informed decisions about the use of dietary supplements and minimize the risk of harmful interactions with medications. This will lead to safer and more effective healthcare outcomes.