Bades: Interaction with drugs

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Bades: Interaction with drugs – complete guidance

Chapter 1: Understanding of dietary supplements and drugs

1.1 Definition and classification of dietary supplements

The dietary supplements, or biologically active additives, are concentrates of natural or identical to natural biologically active substances intended for direct intake with food or introduction into food products. They are not drugs and are not intended for the treatment, prevention or diagnosis of diseases. Their main goal is to optimize nutrition, maintain health and reduce the risk of developing some conditions.

The classification of dietary supplements is quite wide and can be carried out according to various criteria:

  • By composition:

    • Vitamins: Contain one or more vitamins (for example, vitamin D, vitamin C, vitamins of group B).
    • Minerals: Contain one or more minerals (for example, calcium, magnesium, iron).
    • Amino acids: Contain amino acids, construction blocks of proteins (for example, L-carnitine, glutamine).
    • Plant extracts: Contain extracts of various plants (for example, green tea extract, echinacea extract).
    • Probiotics and prebiotics: Contain living microorganisms (probiotics) or substances that stimulate their growth (prebiotics).
    • Paul -saturated fatty acids (PNS): Contain omega-3 and omega-6 fatty acids.
    • Other: Contain various substances, such as coenzyme Q10, chondroitin, glucosamine.

  • By the form of release:

    • Tablets: A solid form convenient for dosing and reception.
    • Capsules: They contain active substances in the gelatin shell that provides protection against destruction in the stomach.
    • Powders: Require dissolution in water or other liquid before use.
    • Liquids (solutions, drops, syrups): Convenient for dosing and reception, especially for children.
    • Bats and other products: They contain dietary supplements as part of a food product.

  • By purpose:

    • To increase immunity: Contain vitamins, minerals, plant extracts.
    • To improve digestion: Contain probiotics, prebiotics, enzymes.
    • To maintain joint health: Contain chondroitin, glucosamine.
    • To improve the work of the cardiovascular system: Contain omega-3 fatty acids, coenzyme Q10.
    • To improve cognitive functions: Contain B vitamins, plant extracts.

1.2 Classification and mechanisms of action of drugs

Medicines are substances or their combinations intended for the prevention, diagnosis and treatment of diseases. They undergo strict clinical trials and are recorded by authorized bodies.

The classification of drugs is extremely diverse and can be based on various criteria:

  • By the pharmacological group: Classification based on the mechanism of action and therapeutic effect (for example, antibiotics, analgesics, antihypertensive drugs).
  • In chemical structure: Classification based on the chemical structure of the molecule of the drug (for example, beta-lactam antibiotics, benzodiazepines).
  • By the method of application: Classification based on the method of administration of the drug (for example, tablets for oral administration, solutions for intravenous administration, ointment for external use).
  • By therapeutic application: Classification based on diseases for the treatment of which the drug is intended (for example, drugs for the treatment of arterial hypertension, drugs for the treatment of diabetes).

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

  • Interaction with receptors: Binding with receptors on cells, which leads to a change in the function of the cell.
  • Inhibition of enzymes: Blocking the activity of enzymes involved in various metabolic processes.
  • Changing the permeability of cell membranes: A change in the permeability of cell membranes for ions and other substances.
  • Influence on genetic information: Influence of synthesis DNA or RNA.
  • Cytotoxic action: Destruction of cells.

1.3 Pharmacokinetics and pharmacodynamics: Fundamentals of interaction

Understanding pharmacokinetics and pharmacodynamics is critical for understanding the interactions between dietary supplements and drugs.

Pharmacokinetics Describes what the body does with medicine or dietary supplement. It includes four main stages:

  • Absorption (absorption): The process of entering a substance from the place of administration into the blood. Factors, such as the solubility of the substance, pH of the stomach, the presence of food in the stomach, the rate of emptying of the stomach and the intestinal condition, can affect absorption.
  • Distribution: The process of distributing a substance from the blood into various tissues and organs. Factors, such as blood supply to tissues, binding of a substance with plasma proteins, permeability of the hematoencephalic barrier, can affect the distribution.
  • Metabolism (biotransformation): The process of converting a substance in the body, usually in the liver. Metabolism can lead to activation, inactivation or change in the activity of a substance. An enzymes of cytochrome P450 (CYP) play an important role in metabolism.
  • Display (excretion): The process of removal of a substance from the body is usually through kidneys or liver. Factors, such as the function of kidneys and liver, the speed of glomerular filtration and tubular secretion, can affect the withdrawal.

Pharmacodynamics Describes that the medicine or dietary supplement makes with the body. She includes:

  • The mechanism of action: How a substance interacts with cells and tissues to achieve its effect.
  • Pharmacological effects: Desired and undesirable effects of a substance.
  • Toxicity: The potential of the substance cause harmful effects.

Intections between dietary supplements and drugs can occur at any of these stages of pharmacokinetics or pharmacodynamics. For example, dietary supplements can affect the absorption of the drug, changing the stomach pH or contacting the drug in the intestines. Bad can also affect the metabolism of the drug, inhibiting or inducing CYP enzymes. Finally, dietary supplements can have an additive or synergistic effect with the drug, enhancing its effect, or antagonistic effect, weakening its effect.

Chapter 2: Types of interactions of dietary supplements with medicines

2.1 Pharmacokinetic interactions

Pharmacokinetic interactions arise when dietary supplement affects the absorption, distribution, metabolism or excretion of the drug. This can lead to a change in the concentration of the drug in the blood and, therefore, to a change in its effectiveness or toxicity.

  • Influence on absorption:

    • Change PH of the stomach: Some dietary supplements, such as calcium or magnesium, can increase the stomach pH, which can reduce the absorption of some drugs requiring an acidic medium for dissolution (for example, ketoconazole, itraconazole).
    • Binding by a drug in the intestines: Some dietary supplements, such as activated charcoal or fiber, can be associated with drugs in the intestines, preventing their absorption.
    • The effect on the motor skills of the gastrointestinal tract: Some dietary supplements, such as laxatives, can accelerate the motility of the gastrointestinal tract, which can reduce the contact time of the drug with the intestinal mucosa and, therefore, reduce its absorption.
    • Competition for transport proteins: Some dietary supplements and drugs can compete for the same transport proteins in the intestines, which can reduce the absorption of both substances.

  • Influence on the distribution:

    • Binding with plasma proteins: Some dietary supplements and drugs can compete for binding with plasma proteins, such as albumin. If the dietary supplement displaces the drug from the connection with proteins, then the concentration of the free drug in the blood increases, which can lead to an increase in its effect or toxicity.

  • Influence on metabolism:

    • Inhibition of CYP enzymes: Some dietary supplements, such as grapefruit juice, perfumed St. John’s wort, curcumin, can inhibit CYP enzymes, especially CYP3A4, which participate in the metabolism of many drugs. Inhibition of CYP enzymes can lead to an increase in the concentration of the drug in the blood and, therefore, to an increase in its effect or toxicity.
    • Cyp enzymes induction: Some dietary supplements, such as St. John’s wort, can induce CYP enzymes, which leads to an increase in their activity. The induction of CYP enzymes can lead to the acceleration of the metabolism of the drug and, therefore, to a decrease in its concentration in the blood and its effectiveness.

  • Influence on excretion:

    • Change pH of urine: Some dietary supplements can change pH urine, which can affect the excretion of drugs through the kidneys. For example, urinary clamping 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 kidney transport proteins: Some dietary supplements and drugs can compete for the same kidney transport proteins, which can affect the excretion of both substances.

2.2 Pharmacodynamic interactions

Pharmacodynamic interactions arise when dietary supplements and drug have a similar or opposite effect on the body. This can lead to an increase or weakening of the effect of the drug.

  • Additative effect: Bad and the drug have a similar effect, and their joint use leads to an increase in this effect. For example, the simultaneous intake of dietary supplements containing caffeine and drugs that stimulate the central nervous system can lead to excessive stimulation, insomnia and anxiety.
  • Synergic effect: Bad and the drug have a similar effect, but their joint use leads to a greater increase in the effect than a simple addition. For example, the simultaneous intake of dietary supplements containing antioxidants and drugs with antioxidant properties can lead to a more pronounced protective effect against oxidative stress.
  • Antagonistic effect: Bad and the drug have the opposite effect, and their joint use leads to a weakening of the effect of the drug. For example, the simultaneous intake of dietary supplements containing vitamin K and anticoagulants, such as warfarin, can reduce the effectiveness of anticoagulants and increase the risk of thrombosis.

2.3 impact on laboratory indicators

Some dietary supplements can affect the results of laboratory tests, which can lead to improper interpretation of the results and incorrect solutions in treatment.

  • The effect on blood tests: Some dietary supplements can affect the level of glucose, cholesterol, triglycerides, hormones and other blood substances. For example, dietary supplements containing chrome can reduce blood glucose, and dietary supplements containing red yeast can reduce cholesterol.
  • Impact on urine analysis: Some dietary supplements can affect the color, pH and the content of various substances in the urine. For example, dietary supplements containing riboflavin (vitamin B2) can paint urine in bright yellow, and dietary supplements containing cranberries can acidify urine.
  • Influence on other tests: Some dietary supplements can affect the results of other laboratory tests, such as coagulogram, ECG and EEG.

It is important to inform the doctor about all the dietary supplements before the tests so that he can correctly interpret the results and avoid errors in diagnosis and treatment.

Chapter 3: common dietary supplements and their interactions with drugs

3.1 St. John’s wort.

St. John’s wort is a popular plant tool used to treat depression, anxiety and other mood disorders. However, it has significant potential for interaction with drugs.

  • The mechanism of interaction: The St. John’s wort is a powerful inducer of CYP enzymes, especially CYP3A4, CYP2C9 and CYP1A2, as well as a P-glycoprotein transport protein (P-GP). This means that it can accelerate the metabolism of many drugs, reducing their concentration in the blood and their effectiveness.
  • Medicines with which St. John’s wort can interact:
    • Antidepressants: The St. John’s wort can reduce the effectiveness of antidepressants, such as selective serotonin (SIOOS) reversal inhibitors (for example, sertralin, paroxetine, fluoxetine), tricyclic antidepressants (for example, amitriptyin, Imipramine) and Monoaminoxidase inhibitors (IMAO) (for example, phenels, Trunnicipromin). The joint use of the St. John’s wort of the perforated and SiOS can increase the risk of serotonin syndrome, a potentially dangerous state characterized by tremor, sweating, excitement and other symptoms.
    • Anticoagulants: St. John’s wort can reduce the effectiveness of anticoagulants, such as warfarin, increasing the risk of thrombosis.
    • Immunocationthretarite: St. John’s wort can reduce the effectiveness of immunosuppressants, such as cyclosporine and tacrolimus used to prevent organs from preventing organs after transplantation.
    • Broadcasting tablets: St. John’s wort can reduce the effectiveness of birth control pills, increasing the risk of unwanted pregnancy.
    • Antiviral drugs: St. John’s wort can reduce the effectiveness of antiviral drugs, such as indinovir and other proteases used to treat HIV infection.
    • Statin: St. John’s wort can reduce the effectiveness of statins used to reduce cholesterol.
    • Digoxin: St. John’s wort can reduce the concentration of digoxin in the blood used to treat heart failure and arrhythmias.

3.2 garlic (Allium sativum)

Garlic is a widely used spice and a plant product, known for its potential healthy health properties, including a decrease in blood pressure, cholesterol and improve immunity.

  • The mechanism of interaction: Garlic can inhibit platelet aggregation, increase fibrinolytic activity and reduce cholesterol. He can also affect the enzymes CYP and P-GP.
  • Medicines with which garlic can interact:
    • Anticoagulants and anti -agents: Garlic can enhance the anticoagulant effect of drugs, such as warfarin, clopidogrel and aspirin, increasing the risk of bleeding.
    • Proteases inhibitors: Garlic can reduce the concentration of protease inhibitors used to treat HIV infection, such as saquinavir.
    • Isaonazid: Garlic can reduce the effectiveness of isoniazide used to treat tuberculosis.

3.3 ginger (Zingiber Officinale)

Ginger is a common spices and a plant tool used to facilitate nausea, vomiting and other digestive disorders.

  • The mechanism of interaction: Ginger can inhibit platelet aggregation and influence CYP enzymes.
  • Medicines with which ginger can interact:
    • Anticoagulants and anti -agents: Ginger can enhance the anticoagulant effect of drugs, such as warfarin, clopidogrel and aspirin, increasing the risk of bleeding.
    • Hypoglycemic drugs: Ginger can enhance the effect of hypoglycemic drugs, such as metformin and insulin, which can lead to hypoglycemia.

3.4 ginkgo biloba (Ginkgo Biloba)

Ginkgo biloba is a plant used to improve memory, concentration and blood circulation.

  • The mechanism of interaction: Ginkgo bilobe can inhibit platelet aggregation and influence CYP enzymes.
  • Drugs with which ginkgo biloba can interact:
    • Anticoagulants and anti -agents: Ginkgo bilobe can enhance the anticoagulant effect of drugs, such as warfarin, clopidogrel and aspirin, increasing the risk of bleeding.
    • Antidepressants: The ginkgo bilobe can interact with antidepressants such as SiOS and IMAO, increasing the risk of serotonin syndrome.
    • Anticonvulsants: Ginkgo bilobe can reduce the effectiveness of anticonvulsants, such as valproic acid and carbamazepine.

3.5 ginseng (Panax Ginseng)

Ginseng is a plant tool used to increase energy, improve cognitive functions and strengthen immunity.

  • The mechanism of interaction: Ginseng can affect the level of glucose in the blood, the immune system and CYP enzymes.
  • Drugs with which ginseng can interact:
    • Anticoagulants and anti -agents: Ginseng can enhance the anticoagulant effect of drugs, such as warfarin, clopidogrel and aspirin, increasing the risk of bleeding.
    • Hypoglycemic drugs: Ginseng can enhance the effect of hypoglycemic drugs, such as metformin and insulin, which can lead to hypoglycemia.
    • Immunocationthretarite: Ginseng can reduce the effectiveness of immunosuppressants, such as cyclosporin and takrolimus.
    • Had: Ginseng can interact with the Imao, increasing the risk of anxiety, insomnia and headache.

3.6 Coenzim Q10 (COQ10)

Coenzyme Q10 is a substance that is naturally contained in the body and plays an important role in the production of energy. It is also available as dietary supplements.

  • The mechanism of interaction: Coenzym Q10 can affect the anticoagulant effect of warfarin.
  • Medicines with which Coenzym Q10 can interact:
    • Varfarin: Coenzyme Q10 can reduce the effectiveness of warfarin, requiring dose adjustment.

3.7 vitamin K.

Vitamin K plays an important role in blood coagulation.

  • The mechanism of interaction: Vitamin K counteracts the effect of warfarin.
  • Drugs with which vitamin K can interact:
    • Varfarin: The use of a large amount of vitamin K can reduce the effectiveness of warfarin, requiring dose adjustment. It is important to maintain stable vitamin K consumption, especially when taking warfarin.

3.8 grapefruit juice

Grapefruit juice is known for its interaction with a wide range of drugs.

  • The mechanism of interaction: Grapefruit juice inhibits the CYP3A4 enzyme in the intestines, which can lead to an increase in the concentration of many drugs in the blood.
  • Medicines with which grapefruit juice can interact:
    • Statin: Grapefruit juice can increase the risk of side effects of statins, such as myopathy.
    • Calcium channel blockers: Grapefruit juice can enhance the effect of calcium channels, such as nifedipine and amlodipine, which can lead to a decrease in blood pressure.
    • Immunocationthretarite: Grapefruit juice can increase the concentration of immunosuppressants, such as cyclosporin and tacrolimus, increasing the risk of side effects.
    • Benzodiazepines: Grapefruit juice can enhance the effect of benzodiazepines, such as diazepam and alprazzles, which can lead to drowsiness and inhibitory.

Chapter 4: How to minimize the risk of interactions

4.1 Informing a doctor

The most important step in minimizing the risk of interactions between dietary supplements and drugs is to inform the doctor about all the dietary supplements, including the dosage and frequency of administration. The doctor should know the complete list of all drugs and dietary supplements that you take to evaluate potential risks and take appropriate measures. Do not hide information about the admission of dietary supplements, even if you consider them “natural” and safe.

4.2 Reading labels and instructions

Carefully read the labels and instructions for all dietary supplements and drugs. Pay attention to warnings about interactions with other substances. If you are not sure of the safety of the joint administration of dietary supplements and the drug, consult a doctor or pharmacist.

4.3 Consultation with a pharmacist

Pharmacists are experts in the field of drugs and their interactions. They can provide valuable information about the potential risks of the joint administration of dietary supplements and drugs and offer alternative options, if necessary. Feel free to contact the pharmacist with questions about interactions.

4.4 Separation of admission

If possible, divide the intake of dietary supplements and drugs for several hours. This can reduce the risk of interaction, especially if the dietary supplement affects the absorption of the drug. Discuss with the doctor or pharmacist the optimal time of taking each substance.

4.5 Monitoring of the condition

Carefully follow your condition after the start of dietary supplements, especially if you take any drugs. Pay attention to any unusual symptoms or changes in your well -being. If you notice anything suspicious, see a doctor immediately.

4.6 Avoiding polypraggmasia

Polypragmasis is a simultaneous intake of a large number of drugs and dietary supplements. The more substances you accept, the higher the risk of interactions. If possible, avoid polypragmasis and discuss with the doctor the possibility of simplifying the treatment regimen.

4.7 Caution with new dietary supplements

Be careful with new dietary supplements, especially if they contain several ingredients. Insufficiently studied substances can have unpredictable interactions with drugs. Before taking a new dietary supplement, be sure to consult a doctor.

4.8 Information about risk groups

Some groups of people are more at the risk of interactions between dietary supplements and drugs. These include:

  • Elderly people: Older people often take several drugs at the same time and have a reduced function of kidneys and liver, which can increase the risk of interactions.
  • People with chronic diseases: People with chronic diseases, such as liver, kidneys, heart and diabetes, are also at risk of interactions.
    • People taking certain drugs: Some drugs, such as anticoagulants, antidepressants, immunosuppressants and contraceptives, have high potential for interaction with dietary supplements.
  • Pregnant and lactating women: Pregnant and lactating women should be especially careful with the intake of dietary supplements, since some substances can be harmful to the fetus or child.

Chapter 5: Regulatory aspects of dietary supplements

5.1 regulation of dietary supplements in different countries

Adjustment of dietary supplements is significantly different in different countries. In some countries, such as the United States, dietary supplements are regulated as food, and not as medicines. This means that they do not undergo strict clinical trials and do not require approval before admission to sale. Dietary supplies are responsible for the safety of their products, but regulatory authorities have fewer powers to control and monitor.

In other countries, such as the European Union, the regulation of dietary supplements is more strict. The dietary supplement must comply with certain safety and quality requirements, as well as be registered before entering on sale. However, even in these countries, dietary supplements are less strict than the regulation of drugs.

In Russia, the regulation of dietary supplements is carried out by the Federal Service for Supervision of Consumer Rights Protection and Human Welfare (Rospotrebnadzor). The dietary supplement must comply with the safety and quality requirements established by the technical regulations of the Customs Union. Dad manufacturers must receive a certificate of state registration before entering on sale.

5.2 Problems with the quality and composition of the dietary supplement

One of the main problems with dietary supplements is the lack of strict requirements for the quality and composition of products. Studies show that many dietary supplements contain ingredients that are not indicated on the label, or contain ingredients in irregular dosages. This may pose a serious danger to consumer health, especially if they take drugs.

Some dietary supplements may contain prohibited or hazardous substances, such as steroids, stimulants or heavy metals. These substances can cause serious side effects and interact with drugs.

Bad forgery is also a serious problem. Fake dietary supplements may contain inactive ingredients or ingredients in incorrect dosages, which makes them ineffective and even dangerous.

5.3 The importance of choosing trusted manufacturers

When choosing dietary supplements, it is important to give preference to the products of trusted manufacturers who observe high quality and safety standards. Pay attention to the availability of quality certificates such as GMP (good manufacturing practice). Look for dietary supplements that have undergone an independent laboratory check. Learn more about the reputation of the manufacturer by reading consumer reviews and checking the information on the Internet. Be careful with dietary supplements that promise miraculous healing or contain dubious ingredients.

Chapter 6: The future of studies of dietary supplements and drugs

6.1 The need for additional research

Despite the growing popularity of dietary supplements, studies on the interaction of dietary supplements and drugs are still not enough. Most studies are limited and do not allow us to draw unequivocal conclusions. Large -scale clinical trials are needed, which will identify potential risks and advantages of joint administration of dietary supplements and drugs.

6.2 The role of pharmacogenomics

Pharmacogenomy is a science that studies the effect of genetic factors on the body’s reaction to drugs. Pharmacogenomic studies can help identify people who are more at risk of interactions between dietary supplements and drugs. This will personalize treatment and reduce the risk of side effects.

6.3 Development of databases of interactions

The development of databases of dietary supplements and drugs is an important step in ensuring patient safety. These databases should contain relevant and reliable information about potential risks and advantages of joint intake of dietary supplements and drugs. Databases should be available for doctors, pharmacists and patients.

6.4 Improving regulation

Improving the regulation of dietary supplements is a prerequisite for ensuring consumer safety. Regulatory authorities must tighten the requirements for the quality, composition and labeling of dietary supplements. It is necessary to strengthen control over the production and distribution of dietary supplements, as well as take measures to combat fakes.

6.5 Improving the awareness of the company

Increasing the company’s awareness of risks and advantages of dietary supplements is an important step in protecting consumer health. It is necessary to conduct educational campaigns that will help people make informed decisions on dietary supplements. It is important to emphasize the need to consult a doctor before taking dietary supplements, especially if a person takes any drugs.

This detailed article provides comprehensive information on the interactions between dietary supplements (БАДы) and medications. It is structured for easy reading and includes a thorough exploration of the different types of interactions, common supplements involved, and strategies to minimize risk. The article also addresses regulatory aspects and future research needs.

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