How do drugs interact? What is this process? You will find answers to these and other questions in the article. Interaction of medicines is a qualitative or quantitative transformation of the effects caused by the sequential or joint use of two or more medicines. Consider the interaction of drugs in more detail below.
Solvation
The interaction of drugs with each other can lead to a weakening or increased action of one or more drugs in combination. Clinically significant relationship is often predictable and, as a rule, undesirable, as it can lead to a lack of therapeutic effect or manifestation of side effects.
Clinicians sometimes use predictable inter-drug relationships to achieve the desired therapeutic result. Thus, the simultaneous administration of ritonavir and lopinavir to a patient with HIV inhibits the metabolism of lopinavir and increases its plasma concentration, which increases the effectiveness of healing.
Pharmaceutical Interconnection
This type of drug interaction occurs outside the body. At the stages of the creation and storage of compound medicines, as well as when mixing drugs in one syringe, transformations may appear that make the drug unsuitable for use. At the same time, the activity of the components of the mixture disappears or decreases, or new qualities appear, often toxic. Pharmaceutical incompatibility may be:
- physical;
- physical and chemical;
- chemical.
The relationship is pharmacological
In this type of interaction, medications introduced into the body transform the pharmacokinetics or pharmacodynamics of each other. The pharmacokinetic type of relationship appears at the following stages:
- at the time of absorption of a substance from the intestinal lumen into the blood;
- during biotransformation, which occurs in the liver;
- at the time of binding of substances with blood proteins;
- during the removal of substances from the body through its excretory system.
And what is the pharmacodynamic type of cooperation? Here, depending on the final result of the relationship of drugs, the following options are distinguished:
- antagonism;
- synergism (summation, sensitization, additive action, potentiation);
- indifference.
Minimizing the relationship of medications
The attending physician must be aware of all medications that the patient is taking, including those prescribed by other doctors, over-the-counter drugs, as well as nutritional supplements. He should interview the patient about alcohol consumption and nutrition.
Usually, doctors prescribe the smallest amount of medication at the lowest effective dose for the shortest amount of time. Doctors also determine the result of the action (desired and secondary) of all medications taken, since they usually contain a range of potential drug interactions.
In order to avoid manifestations of toxicity, the doctor should use drugs with a wider therapeutic range.
Patients are monitored for the development of objectionable reactions, especially after changing the treatment regimen. Some types of interactions (for example, due to the induction of an enzyme) can be detected after a week or later.
The relationship of drugs should be considered as an acceptable cause of any unexpected complications. With the development of a sudden clinical reaction, the doctor can detect the concentration of individual drugs taken in blood serum. Further, based on this information, he will correct the dose until the desired effect is achieved.
If the correction is ineffective, the doctor will replace the drug with another one that does not communicate with those received by the patient.
How to avoid problems?
Experts recommend the following:
- When a doctor prescribes a medication for you, be sure to ask him about the interaction of this drug with other medicines, as well as drinks, food and nutritional supplements.
- Follow all the doctor’s recommendations strictly (including those related to taking the medicine after eating or on an empty stomach, the time of administration, the need to drink it).
- Always read the instructions for medicines carefully.
- Purchase all medicines in one pharmacy.
- Keep the preparations with instructions and in packages so that you can always refresh your data in case of questions.
- Tell your doctor about all the medicines and nutritional supplements you are taking.
- If you are breast-feeding, pregnant or have any chronic ailments, try not to take any medications, including OTC, without consulting a doctor.
- Keep a diary of all nutritional supplements (including herbs) and medications you are taking. At each visit to the doctor, take it with you.
- If you are taking any prescription drugs, consult your pharmacist or doctor before taking any over-the-counter drugs.
Medicines and Alcohol
And what is the interaction with alcohol medications? In medicine, there is one clearly defined canon that is often forgotten in real life. It says: the combination of medicines and alcohol is an extremely undesirable, mutually exclusive and even harmful concept. Why is such a formidable taboo imposed on the simultaneous reception of medications and alcoholic beverages? Because alcohol can affect the behavior of drugs in the human body in the most unexpected way:
- weaken their effect (inhibits);
- amplifies (potentiates);
- will pervert up to the opposite.
Often, even the doctor cannot predict what the patient expects if he takes medications with alcohol. Here, a very large number of factors should be taken into account: the specifics of alcohol and tablets, the dose, the individual qualities of the body, and so on.
That is why you will not find recommendations in any instruction to drink alcohol with tablets. After all, not a single beneficial combination of alcohol with medicines exists. Interaction with alcohol medications can cause a variety of consequences:
- chills;
- nausea
- suffocation;
- vomiting
- lack of coordination;
- respiratory arrest;
- drop in blood pressure;
- palpitations;
- fatal outcome.
Therefore, it is very important to consciously abandon the synchronous intake of medicines and alcohol, since they are essentially incompatible.
Analgesics and alcohol
Consider the compatibility features of alcohol and, for example, analgesics. Nise tablets are a pharmacological agent that has anti-inflammatory, antipyretic and analgesic effects. It also prevents the formation of blood clots, that is, performs an antiplatelet function.
Nise is a non-narcotic analgesic. With the simultaneous administration of alcohol and medication, the absorption of the latter from the gastrointestinal tract is accelerated. However, alcohol simultaneously enhances the traumatic effect on the mucous membrane of the stomach and liver.
Communication of the active substances of the drug with ethanol causes adverse effects: incredibly toxic substances are released that accumulate in the kidneys. Alcohol in combination with narcotic analgesics has a depressing effect on the nervous system and respiratory center. In this case, an increase in the effect of anesthesia is possible, however, the likelihood of the appearance of powerful side effects increases significantly:
- aggressiveness;
- shortness of breath
- malaise;
- fountain-like vomiting;
- headache.
Ethanol is not compatible with analgesics. Such substances reduce blood flow to the liver and kidneys. Because of this, the filtering functions of the body and overall performance are reduced, and the communication of drugs with alcohol only enhances side effects. Depending on the particular condition of each person, the symptoms may not express themselves, be invisible, or turn out to be so significant that hospitalization is required.
Therefore, you do not need to harm your health by reckless use of medicines and alcohol. Refuse alcohol for the duration of your medical treatment.
Sofosbuvir and Daclatasvir
What is the interaction of sofosbuvir and daclatasvir with other medicines? DAA - direct-acting antiviral medicines. They were created recently. With their occurrence, such a formidable ailment as viral hepatitis C, ceased to be considered a death sentence. In 98 cases out of 100, today it is possible to completely defeat the disease, and it is most often forced to retreat.
The most famous DAAs used to combat the HCV virus (the causative agent of hepatitis C) are sofosbuvir (Sovaldi), daclatasvir (Daclinza), simeprevir, Harvoni, Vikeira Pak.
Solvadi was registered as a medicine in 2013 and immediately became unusually in demand. Today it is listed as a vital drug used to combat HCV. For pills based on sofosbuvir and daclatasvir, interactions with other medicines are important to consider.
The fact is that some of the funds taken by the patient reduce the effectiveness of these DAAs, which ultimately significantly reduces the therapeutic effect. For example, you need to carefully study the compatibility of daclatasvir and sofosbuvir with antibiotics, which often lower the therapeutic effect of taking DAAs.
In addition, DAAs can, on the contrary, increase both the therapeutic effect and side effects from the use of other drugs, which can also lead to extremely undesirable consequences, especially when it comes to very powerful pills. So, the doctor should very carefully prescribe antibiotics and sofosbuvir. Strong CYP2C19 inhibitors, such as the well-known Levomycetin (chloramphenicol), can be weakened by the use of inhibitors when taken simultaneously with DAAs. The same effect is produced by a number of popular anti-TB drugs (including rifampicin), infusions of herbs (St. John's wort) and some well-known anticonvulsants.
Therefore, if the patient is taking Sovaldi and needs to be prescribed antibiotics, the compatibility of these drugs must be checked. For the same reason, during the course of DAAs, you can not take any hepatoprotectors (milk thistle, Heptral, Phosphogliv, etc.), intestinal antibiotics, since they inhibit the absorption of medicines. A variety of sorbents are recommended to be eaten no later than 5 hours before receiving DAA. Doctors also advise Omez to eat a couple of hours after taking Sovaldi.
Many drugs are compatible with daclatasvir and sofosbuvir, but there are still some that you need to take with extreme caution or even cancel them for the duration of the course of treatment. So, while taking Sovaldi, drugs that are heavily dependent on CYP3A are also harmful (a short designation of cytochrome P450 3A4, an enzyme involved in the metabolism of xenobiotics that enter the human body). Medicines - powerful inducers of CYP3A and CYP2C8, can not only reduce the effectiveness of daclatasvir, Sovaldi, Havroni and others, but also increase the concentration of plasma polymerase non-nucleoside NS5B inhibitors. As a result, life-threatening arrhythmias may appear.
Therefore, for those who began to use daclatasvir and sofosbuvir, compatibility with other drugs of these medicines is very important. Including, when it comes to antiarrhythmic, painkillers, beta-blockers, medications that normalize heart function and increase blood pressure.
It is known that sofosbuvir can be taken synchronously with certain immunosuppressants, calcium channel blockers, medications that lower blood pressure, anticoagulants. But the simultaneous use of antiarrhythmic pills (for example, "Amiodarone") is contraindicated during the healing period of Sovaldi. Whether daclatasvir and sofosbuvir are compatible with Artikain, which is often used in dentistry as an anesthetic, is still unknown. Therefore, it is better to take Sovaldi a couple of hours before going to the dentist.
Carefully study the interaction of sofosbuvir with other medicines. When prescribing a DAA, the doctor should specify in advance the rules for taking uninterrupted or most commonly used medications.
Let's talk a little about daclatasvir. This is the strongest drug of the last generation, a pangenotypic inhibitor of the NS5A replication complex. It is used to treat all genotypes of the hepatitis C virus. For extremely effective action, the drug is prescribed in combination with other antiviral medications.
Daclatasfir and sofosbuvir is the first oral regimen for the treatment of hepatitis C without the use of interferon with the highest efficiency. In the course of clinical trials, it was possible to achieve an almost 100% indicator even in patients with the third genotype of the virus and in patients with liver pathologies.
Daclatasfir is not intended for monotherapy. In combination with it, sofosbuvir, peginterferon or ribavirin is always taken.
Mexidol
Now consider the interaction with other Mexidol drugs. This drug is one of the best antioxidants on the market today. Synthesized in Russia at the beginning of 1980. It can help with a variety of ailments, ranging from vegetative-vascular dystonia, ending with ischemic ailment of the heart.
As a rule, if Mexidol is taken with any other drug, it will enhance its effect or will simply fulfill its function. An increase in action is also manifested when taking sedative and psychotropic medications. In such cases, it is prescribed in order to reduce the dosage of these drugs.
Also, Mexidol often acts as part of a comprehensive treatment of ischemic heart disease and further support treatment. As an improvement in learning ability, it is sometimes prescribed along with nootropics. Another important effect is the reduction of the toxic effects of ethyl alcohol when taking Mexidol.
ASD-2
We study the interaction of ASD-2 with other drugs. ASD-2 is an antiseptic stimulator of Dorogov. This is a product obtained by high-temperature sublimation of animal material, namely meat and bone meal. This medication contains carboxylic acids, derivatives of aliphatic amines, water, compounds with an active hydrophilic group, cyclic, aliphatic hydrocarbons, derivatives of amides.
It is known that experiments were conducted on guinea pigs and mice, during which it was found that in small doses, ASD-2 provokes the excitation of the central nervous system, as well as its higher autonomic centers with manifestations of motor anxiety in animals. There was also an increase in the activity of the digestive glands, an increase in the separation of sweat and urine, and an increase in peristalsis.
Large doses also provoke the occurrence of convulsions, tremor of skeletal muscles, as well as depression of the central nervous system and impaired coordination. Shortness of breath is followed by a sharp shortness of breath as a result of a spasm of the bronchi, as well as paralysis of the respiratory muscles. Animals die due to asphyxiation. It was also revealed that if animals were given some medications before the use of ASD, their condition returned to normal.
Scientists have found out how ASD interacts with other drugs, and in dogs. They determined that it is impossible to take ASD-2 with acids simultaneously, since the drug has an alkaline reaction. Many solution “snack” with lemon, and this action of the antiseptic stimulator weakens. Acceptance of medicines and juices containing acid should be postponed for 2-3 hours.
It is known that ASD-2 affects the body in many ways. The drug normalizes the metabolism in the tissues, improves the digestive tract, stimulates the metabolism, the activity of the heart, lungs. On the medicinal relationship with medicines when using ASD by a person, there are no official, recorded scientific data. Such tests have not been conducted. It is known that the medicine goes well with almost all groups of medications. It is important only to take it three hours after the use of any drug.
Kagocel
Interaction with other Kagotsela medicines is interesting for everyone. This tool is prescribed for the treatment and prevention of influenza and other acute viral respiratory ailments, the treatment of herpes in adults. "Kagocel" is perfectly combined with other antiviral medicines, antibiotics and immunomodulators.
Ingavirin
What is the interaction of Ingavirin with other medicines? This drug has a pronounced effect on parainfluenza pathogens, influenza A and B viruses (the most famous types, including the so-called swine flu), adenovirus, respiratory syncytial infection, and a number of pathogenic microorganisms that provoke the development of acute respiratory viral infections.
There are no episodes of interaction between Ingavirin and other medications. In the experiments, an increase in the effectiveness of the complex treatment of bacterial-viral infections in bronchitis, secondary pneumonia, and the like with the use of Ingavirin and antibiotics was noted.
Warfarin
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How does phenibut interact with other medicines? This drug is a phenyl derivative of phenylethylamine and GABA. It reduces anxiety, tension, fear, improves sleep, has an anxiolytic effect. Also, this medication enhances and lengthens the effect of sleeping pills, antipsychotic and narcotic drugs.
In order to mutually potentiate, sometimes phenibut is combined with other psychotropic drugs, reducing its dose and the drugs combined with it. There is evidence of an increase in the effect of antiparkinsonian drugs under the influence of phenibut.
Amoxicillin
What is the interaction of amoxicillin with other drugs? This drug is a bactericidal acid-resistant antibacterial agent of a wide spectrum of influence from the group of semi-artificial penicillins.
Everyone should know the interaction with other amoxicillin medicines. This medication affects only multiplying microorganisms. Therefore, it is prescribed simultaneously with antimicrobial drugs acting bacteriostatically. If there are positive tests for the sensitivity of the pathogen, amoxicillin can be used in conjunction with other bactericidal antibiotics (aminoglycosides, cephalosporins).
Phenylbutazone, probenicide, oskifenbutazone, to a lesser extent, sulfinpyrazone and acetylsalicylic acid inhibit tubular secretion of penicillin drugs, which increases the concentration and elimination half-life of amoxicillin in blood plasma. Take the drugs correctly and be healthy!