Tuesday, 26 May 2020

Medication: For Every Action An Interaction

 Dave R May 2020
Unfortunately many people with a chronic illness, also have to deal with other conditions at the same time. Given that the meds for the most serious problem must come first; how can we be sure that other prescribed drugs, or vitamins, or minerals and herbal supplements are not interacting negatively?

Most people have to deal with various illnesses and complaints during their lifetime and by definition, the older you get, the more likely something will come along to ruin your year. If you are unlucky enough to have a chronic condition, then that’s something that most other people will have avoided but for you, it’s an extra burden on top of the illnesses you might have reasonably expected to get according to your age and lifestyle. This means that at one time or another or if you’re really unlucky, you’ll be permanently taking multiple medications at the same time to deal with what’s ailing you. This is when you really need to watch out for what you’re putting into your body because the very things meant to cure or control your problem may end up fighting each other in your system, to the detriment of one, or the other, or both. Not only medications can interact negatively but supplements and vitamins can influence the working of your medical treatment. You need to be on top of your game…it’s a veritable minefield!

Drug interactions are a serious issue and for people living with HIV, or cancer, or any other serious condition, it’s not just a question of avoiding the famous medication influencers, grapefruits and St. John’s wort. It requires careful checking of each of your HIV drugs and components against anything else you might be taking, to see if one reduces the efficiency of another, or worse, interferes with it to the point of making it dangerous.

Most people take medications on trust. They go to their doctor or specialist and are prescribed something to treat a specific problem. If you’re lucky you’ll be warned about possible side effects but mostly you take your doctor’s word as being gospel and swallow your drugs at the appointed times each day without a second thought. Furthermore, most people don’t read the information leaflet inside the box, a) because they don’t want to become paranoid about all the possible side effects and b) because the print is sometimes so small you need the Hubble telescope to read it or c) because they just can’t be bothered.

The list of potential side effects is indeed intimidating but if you remember that it’s there to cover the pharmaceutical company’s ass if something goes wrong – “Well, you were warned in the leaflet!”; you can read the most common side effects and then do your own research on the internet. However, reading the leaflet anyway is not a bad idea, if only to see whether the recommendations match up with what your doctor has told you. If they don’t then you’re entitled to phone and ask why; there may well be a reasonable explanation but leave nothing to chance.

Doctors are also human beings who make mistakes; they shouldn’t but they do and we should be able to forgive them for it, considering their workload and stress levels plus the fact that you may be patient number 35 of the day and he/she can’t remember that this particular antibiotic actually clashes with this other particular medication. It happens more frequently that you may think and when something goes wrong it may be some considerable time later and the mistake may be very difficult to trace back. HIV and cancer meds for instance, are complex compounds and in order to work to the optimum, they have to be taken at the recommended times and regularly but if they are mixed with other chemical drugs meant for other diseases, the clashes may have consequences. It’s logical really. In the best of all possible worlds, the right prescription is given for the right disease and the eventual interactions will flash up on your chemist’s computer screen before you even begin the course. However, in the real world things will be missed; especially when it comes to taking supplements over which your doctors or pharmacists generally have little control.

It’s up to us then to check everything we throw down our throats because simply put, it’s in our own best interests. The links shown here are two of the best sites for checking both what’s in your drugs, what the side effects are and what the possible interactions with other drugs can be.
How do your medications interact with others? (http://www.drugs.com/drug_interactions.html)

There are other good drug comparison sites on the Net but these two are trustworthy and you really need accurate information. If in doubt double check somewhere else.
Whenever you come away from the doctor or specialist, take a few minutes (it really doesn’t take long) to use these sites to see exactly what you’re taking and what its purpose is and then check its interactions with any other medicines, or supplements you may use. 

N.B sometimes you will need to enter the proper name of the drug and not just its market name. For example, Truvada is a combination of Tenofovir and emtricitabine and Isentress is Raltegravir. This is because different countries often have different brand names for drugs but you will always find the proper name on the box, generally in brackets after the brand name. Most common supplements can also be checked on the second link.

If you have any doubts at all about clashes or contra-indications, or even side-effects; first check that you haven’t misread the information and then don’t hesitate to contact the person who has prescribed it for you. They may be slightly irritated that you’ve had the nerve to question their judgement but really they should be pleased that you’re so on the ball because if there is a problem and your HIV or other drugs are compromised by something else you’re taking, then they won’t work properly and the last thing you want is to be resistant to this that or the other because of other chemical influences. Doing a bit of research on your own may save wasting time and money due to complications later.

If you think that you’re perfectly healthy; your HIV regime is working fine and everything is hunky dory, remember that you may become diabetic, or be unlucky enough to get a cancer, or any one of a myriad of lesser or greater diseases later in life – it happens! Remember also, alcohol is one of the commonest negative interacters with drugs so everybody needs to keep their wits about them. Besides that, even antibiotics issued for common infections, can interact with your primary meds for other conditions. There are almost always enough good alternatives, so why put yourself through more misery for the sake of a few minutes reading up the facts.

I’m aware that this all sounds a bit like a lecture from your parents and I apologise for that but so many people are unaware of both what they put into their bodies every day and how one chemical can work against another, that it can’t do any harm to at least consider adding these two links to your favourites, in case something comes up in the future. Don’t rely 100% on doctors; they just don’t have the time or the resources any more to check absolutely everything in the pantheon of medicines and remember your case is unique; you may react badly to a certain drug while others don’t. It seems a no-brainer to be at least partially responsible for looking at our own treatment efficiency and sharing the load with our doctors. Your treatment should ideally be a partnership between you and your doctor instead of being one-sided and assuming that ‘God doesn’t fuck up every now and then’. Don’t let yourself be caught out by ignorance; you’re the only one who may suffer in the end.

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