JustCare

Category: Drugs and alcohol

  • PPIs found to increase risk of kidney failure

    PPIs found to increase risk of kidney failure

    Routine use of proton pump inhibitors, common over-the-counter medications used to treat acid reflux, can increase the risk of kidney failure four-fold.

    Researchers examined health data on more than 190,000 patients over a 15-year period in a retrospective study. None of the patients had existing kidney disease at the start. Researchers compared patients who were eventually given a PPI and those who weren’t ever given one. Common PPIs include Prevacid (lansoprazole), Prilosec (omeprazole) and Nexium (esomeprazole).

    Results, published in Pharmacotherapy, found that those on a PPI had a 20% increased risk of chronic kidney disease compared with those not on the drug. In addition, those on a PPI were four times as likely to experience kidney failure. The study authors noted that the risks were highest in those 65 and older.

    Although PPIs are only meant for short-term use, overuse of the medications are as high as 70% of patients.

    Lead author David Jacobs, PharmD, PhD, assistant professor of pharmacy practice at the University of Buffalo School of Pharmacy and Pharmaceutical Sciences, noted that doctors need to be educated on the dangers of overuse of PPIs and deprescribing initiatives developed.

    Last month, a study that analyzed adverse events reports sent to the FDA found that PPIs were associated with an increased risk of kidney disease.

    This story first appeared on Medshadow.org.

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  • Millions safely import low-cost drugs from abroad

    Millions safely import low-cost drugs from abroad

    In 2017, Kaiser Health News reported that 19 million Americans import their prescription drugs from abroad. They can fill their prescriptions and save a lot of money. But, the pharmaceutical industry and its allies continue to perpetuate the myth that drug importation is unsafe. In fact, all the evidence suggests that if you use a verified pharmacy, you can safely import low-cost drugs from abroad.

    Today, Americans pay twice as much as our peers in Japan and Europe for the same exact drugs. There is no good reason that we pay more. Congress simply has not been willing to regulate drug prices in the US, while governments in other wealthy countries have. But, public pressure is mounting, and there is now a bill in Congress introduced by Senator Bernie Sanders and Congressman Ro Khanna that would ensure we paid no more for our drugs than people in other wealthy countries.

    Senator Sanders’ Medicare for All bill, which is receiving a lot of attention these days, would also drive down the price of prescription drugs, along with all health care costs. Other bills proposed to fix our dysfunctional health care system, most of which offer Medicare as a health insurance option for individuals, are not designed to bring down drug prices.

    Since it will be a while before Congress regulates drug prices–we likely will need a Democratic Senate, House, and President–the safety of imported drugs has been top of mind for many people. Drug prices in the US are unaffordable for millions of Americans. The pharmaceutical industry wants you to believe you must get your drugs in the US. And, the federal government helps the pharmaceutical industry by making it a crime to import drugs–though it has never prosecuted anyone for importing drugs for personal use.

    Today, some 45 million Americans do not fill their prescriptions because of the cost. Some suffer quietly. Some die. Why do our representatives in Congress continue to make it illegal to import prescription drugs, when they allow imported food and other products, and people’s health and lives hang in the balance? They are not representing their constituents but rather the pharmaceutical industry.

    Wendell Potter reports for Tarbell that Pharma hires “experts” to promote the myth that it is unsafe to import drugs from abroad. Pharma has also used ad campaigns and supported a novel, The Karasik Conspiracy, to mislead the public about the safety of imported drugs.

    People can buy drugs safely from abroad. PharmacyChecker.com verifies pharmacies around the world from which it is safe to buy drugs. No one has died from buying drugs from a verified pharmacy abroad with a valid prescription.

    If you want Congress to rein in drug prices, please sign this petition.

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  • Six things to know about your over-the-counter medications

    Six things to know about your over-the-counter medications

    Over-the-counter medications are drugs you can buy without a prescription to treat common problems. However, you should still use them with caution. A number of recent studies have revealed worrisome side effects from incorrect use of OTC medicines. Here are six things you should know about over-the-counter medications (OTC) to keep you and your loved ones safe.

    To minimize the risk of harmful drug interactions, always keep a list of all the drugs you are taking in your wallet (both prescription drugs and OTC drugs) and share the list with your doctors and the people you most trust. If you are getting headaches, diarrhea, constipation, or have a dry mouth, it might be a minor side effect of the drugs you’re taking; some side effects can be life-threatening, including severe bleeding or liver or kidney damage.

    1. Just because medicines are OTC does not make them risk-free. Do not assume that because you do not need a prescription for OTC medications that they are always safe to use. Depending upon the other medications you are already taking and your health condition, OTC drugs may be dangerous and can be toxic if overused. While it is generally okay to take the correct dose of an OTC drug for a specific problem (for example, taking ibuprofen to help relieve a headache), all medications carry different risks and benefits. If you have a complex health condition or simply have concerns about an OTC medication, check with your doctor before taking it. People with very bad symptoms, who do not know what is wrong with them, or with long-term medical problems also should check with their doctor before taking an OTC medication.
    2. Our knowledge about the risks and benefits of different OTC drugs is continuously changing. As with other areas of medicine, researchers are constantly learning new things about OTC drugs that change the way they should be used. For example, after receiving numerous reports of severe liver damage associated with the use of acetaminophen (the active ingredient in Tylenol), in 2011 the FDA changed the maximum amount of acetaminophen that could be contained in single OTC dosage to 325 mg. And the risks may differ depending upon your age, weight and medical condition.
    3. OTC drugs may interact with other medications you are taking. Just as two or more prescription medications can interact with one another, creating adverse or unintended side effects, OTC drugs can also change the way a prescribed medication works in your body. If you are taking prescription medications, including opioids, check with your doctor before combining them with an OTC medicine.
    4. OTC drugs may interact with diet or lifestyle factors. OTC medications can be harmful if they interact with alcohol in your system or certain foods in your diet. They can also affect other health conditions. Check with your doctor if you have specific medical or lifestyle considerations that may need to be taken into account when starting an OTC medication. As a general rule, you should not consume alcohol when taking any type of medication, unless your doctor gives you permission to do so.
    5. OTC drugs may affect older people differently. While everyone should be careful when taking medications, older people need to take extra caution. The body changes how it absorbs food and drugs as it ages; and, older people generally take more medications than younger people, putting them at higher risk for adverse interactions.
    6. Your doctor may decide to provide you with different treatments based on the OTC medications you take. Always report your OTC medications to your doctor, whether at check-ups or during hospital visits. Always let healthcare providers know about any medications you are currently taking, including OTC medicines.

    Many people take vitamin and herbal supplements to feel better. As a general rule, eating a healthy diet of foods with different vitamins is the best way to make sure you have the vitamins you need. Like over-the-counter drugs, vitamin supplements are not risk-free. Watch John Oliver explain the issues with vitamin supplements. You can learn more from about vitamin supplements on this site from Dr. Salomeh Keyhani, including vitamin C supplements, vitamin E supplements, vitamin B6 supplements, and vitamin B12 supplements.

    Dr. Keyhani’s evidence comes largely from Cochrane.org, which is an independent group that analyzes a range of studies and summarizes the best evidence from research. Also keep in mind that vitamin supplements you buy at the drugstore or other retail stores are not regulated by the Food and Drug Administration, and so they may not be what they appear to be, as the New York Attorney General’s office found. 

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  • Talk to your doctor before taking a cold medicine

    Talk to your doctor before taking a cold medicine

    With cold and flu season in full swing, people with high blood pressure that is not controlled well or who have heart disease need to be careful with over-the-counter cold medicines, as they may cause a spike in blood pressure.

    Many cold medicines contain decongestants and nonsteroidal anti-inflammatory drugs (NSAIDs), both of which can raise blood pressure. Examples of decongestants are pseudoephedrine and phenylephrine. Some NSAIDs are Advil (ibuprofen) and Aleve (naproxen).

    “People with uncontrolled high blood pressure or heart disease should avoid taking oral decongestants,” Sondra DePalma, a physician assistant at UPMC Pinnacle in Pennsylvania, told American Heart Association News. “And for the general population or someone with low cardiovascular risk, they should use them with the guidance of a healthcare provider.”

    Guidelines released last year by the American Heart Association and the American College of Cardiology dealing with high blood pressure management say that decongestants should be used for as short a time as possible, and to try alternatives such as nasal saline or antihistamines.

    Regarding NSAIDs, guidelines say to use Tylenol (acetaminophen) or topical NSAIDs as other options.

    Healthcare professionals also say if your cold symptoms are mild or moderate, rest and drink plenty of fluids. Avoiding dehydration can help reduce body aches and may reduce the need for decongestants.

    This article was originally published in Medshadow.org

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  • FDA permits doctors to implant untested medical devices at extreme risk to patients

    FDA permits doctors to implant untested medical devices at extreme risk to patients

    In an op-ed for the Washington Post, Jeanne Lenzer and Shannon Brownlee describe how the FDA permits doctors to implant untested medical devices at extreme risk to patients. Today, 32 million people have one of these devices implanted in them.

    They report that many patients with implantable devices are at risk. They describe, for example, the implantation of a pain-relieving device in the top of patients’ spines that can cause respiratory distress and even death. The FDA approved it in 2003 even though it had never been tested on people. Likewise, artificial hips have been found to cause cobalt poisoning, harming the heart and brain and defibrillators can provide too great a shock to patients.

    Many medical devices have caused harm to patients in the last ten years–1.7 million injuries and more than 80,000 deaths.  And, many hundreds of thousands of people have medical devices implanted in them that have been recalled. But, often these devices cannot be taken out or can only be taken out at severe risk to patients.

    A lot of the blame for these faulty medical devices can be attributed to the FDA’s lax approval process. Acknowledging its responsibility, back in November, the FDA had said it would make changes to the way it approved the vast majority of devices. But, it still is not insisting on testing of these devices in people. Only a small fraction of highly risky heart devices go through stringent clinical trials.

    The issue stems from an old FDA policy to grandfather in for approval all new devices that have “substantial equivalence” to a device that was approved before 1976. As a result, about 80 percent of new devices are approved without testing. If it’s a simple device like a cane or stretcher, automatic approval makes sense. If it’s a highly complex device, such as artificial joints or a pacemaker, it is dangerous.

    Even new surgical mesh implants can be dangerous. Researchers at the University of Oxford determined that about one in eight surgical meshes sold in the US between 2013 and 2015 were like surgical meshes that had been recalled because of the harm they caused. The FDA reports that it does not look at the earlier approved device when approving the new device. And, it is doing nothing to fix this issue.

    A second way medical device manufacturers can avoid clinical trials for new devices is if they tell the FDA that they are updating a device in small ways, a pre-market “supplement pathway.” According to Harvard research, the FDA allowed virtually all “updated” pacemakers and defibrillators to be sold without clinical trials between 1979 and 2012. No surprise, one defibrillator ended up putting people’s hearts into a lethal rhythm. At the time, 250,000 people had the device implanted in them.

    The FDA has done nothing to address the flawed process. As a result of a federal law passed several years ago, MDUFA, the FDA now takes money from the medical device industry to cover its costs. And, it sees the manufacturers as its customers. The FDA head, Scott Gottlieb, supports the FDA’s inaction to correct the medical device approval process saying that “the FDA’s caution is hazardous to our health.”

    What should be done? All new high-risk implanted medical devices should go through clinical trials before the FDA approves them as safe and effective. There should also be a medical device registry that records patient outcomes. And, the FDA should operate with no conflicts of interest. It should not take money from the device manufacturers as the law currently requires, and the head of FDA should have no financial conflicts of interest.

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  • If Merck knew that Fosamax causes bone fractures and kept silent, shouldn’t it be liable?

    If Merck knew that Fosamax causes bone fractures and kept silent, shouldn’t it be liable?

    How would you feel if you were harmed by a medicine you took as prescribed and then learned that the drug company wasn’t liable — even though it knew about the risk and didn’t tell you or your doctor?

    This is exactly what has happened in the case of Fosamax (alendronate), a drug used to treat bone-thinning osteoporosis and osteopenia. After it was approved by the Food and Drug Administration and women across the country began taking the drug, the FDA and its maker, Merck, started receiving reports about spontaneous fractures of the thigh bone among women taking the drug.

    These fractures, dubbed “Fosamax fractures,” happen with no warning and usually require surgery. Although they are a rare side effect of the drug, millions of women have taken the drug. While the true number of Fosamax fractures isn’t known, about 500 women have sued Merck for failing to warn them about the risk of this painful and possibly debilitating side effect. These lawsuits are at the heart of a case, Merck, Sharp & Dohme Corp. v. Doris Albrecht, et al., that will be argued before the U.S. Supreme Court on Jan. 7, 2019.

    MedShadow Foundation, the nonprofit organization I founded in 2012 to inform the public about the side effects of medicines, along with three former FDA officials, filed an amicus curiae brief in support of Albrecht, the defendant in the case. Such “friend of the court” briefs are filed by individuals or organizations that aren’t parties in a case.

    Merck Admits Fosamax Caused The Fractures

    Merck acknowledges that Fosamax caused these fractures and that the company knew about them. In 2008, Merck started the process to get the FDA’s permission to put a warning on the drug label — the inserts that come with all medicines, providing information such as instructions on how to take a drug, what it can be used for, and warnings. The FDA reviews and must approve any information on drug labels for accuracy. These labels are generally considered fair warning to users about possible side effects or adverse events and, in that way, provides legal protection for drug companies from being sued for causing them.

    The FDA relies on manufacturers to update and make changes to drug labels throughout the lives of their drugs. That’s because approvals for new drugs are often based on small clinical trials of 1,000 or fewer people that normally last less than a year. Unusual or rare side effects and can’t be detected in such small, short-term trials. Once a drug is approved and thousands or millions of people are taking it, new side effects and adverse events can emerge.

    The spontaneous fractures caused by Fosamax didn’t begin appearing until the drug had been on the market for five years. And these fractures aren’t the only significant bone problems linked to the drug. Cases of osteonecrosis (literally “bone death”) of the jaw, a painful condition where jaw bones become exposed, were reported by people taking Fosamax. In 2013, Merck agreed to pay $27.7 million to settle 1,140 lawsuits from individuals who alleged that Fosamax caused them to develop this condition.

    Pharmaceutical companies have the best access to reports of adverse events, and they pay attention to updating drug labels as an important patient-protection safeguard.

    When Merck applied to the FDA for a label change to reflect these fractures, the FDA rejected its request. Why? Because Merck described them as stress fractures, which are minor and quite different from far more serious spontaneous fractures. A stress fracture is an incomplete bone break that is generally treated by rest and inactivity. A spontaneous fracture is a complete break that occurs in a seemingly normal bone without any trauma and must often be repaired with surgery.

    Although drug companies are responsible for updating labels, the FDA can require updates. In 2010, the FDA convened a panel to review the increasing number of reports of Fosamax-related spontaneous fractures. After reviewing the research, the panel found a clear connection between Fosamax and spontaneous thigh bone fractures. The FDA then ordered Merck to change the label.

    Women Suing Merck Claim Drugmaker Failed to Warn Them

    The women suing Merck claim that the company failed to warn them about a known adverse event. Merck is claiming that the FDA did not allow the company to change the label, making it impossible for Merck to warn women or their doctors.

    If Merck prevails, the disingenuous tactic it used for Fosamax could be replicated by other pharmaceutical companies and have far-reaching effects.

    Suppose a pharmaceutical company discovers that one of its drugs causes a serious adverse event. The company files an application for a change to the drug label, but knowingly designs the change so the FDA won’t accept it — either by minimizing the risk of the adverse event or by not accurately reflecting the risk. The drug company could then claim it isn’t liable for not warning consumers about that adverse event because the FDA denied the label change.

    If the Supreme Court allows drug companies to circumvent the law this way — which is what Merck is attempting to do in this case — it would remove the motivation for pharmaceutical companies to provide the FDA with timely and transparent information.

    MedShadow Foundation is a small nonprofit with limited resources. Yet we have taken on the costly and time-consuming process of filing an amicus brief because we believe that pharmaceutical companies cannot be allowed to obscure the risks, side effects, and adverse events of drugs — or exaggerate their benefits.

    The foundation’s mission is to protect quality of life by ensuring that people have all the known information about side effects before deciding to take a prescription or over-the-counter drug. Today, pharmaceutical companies are motivated to reveal previously unknown risks and warn the medical community so they can’t be sued for damages. The FDA and the law must maintain that obligation to protect people from unnecessary harm.

    There will always be some risk with medicines, but consumers have the right to all the information about benefits and risks of drugs — whenever that information is discovered — so they can make informed decisions about their health and well-being.

    This article originally appeared on Stat and is also on Medshadow.org.

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  • Is alcohol naughty or nice?

    Is alcohol naughty or nice?

    With the Holiday Season upon us, there are many opportunities to drink alcohol. Some are undoubtedly tempted to over-indulge, and people who struggle with alcohol may find this time of year particularly challenging and stressful. But what are the benefits and risks of alcohol? Many people can enjoy alcohol without any immediate problems, and may find that it helps them to relax and socialize. In some cultures, it is important for observing traditions or celebrating religious feasts. But does an apparent lack of alcohol-related problems make it safe?

    The science on the possible benefits and safety of alcohol use resembles a mudslide more than a crystal-clear glass of chardonnay. Certainly, heavy alcohol use is associated with myriad health problems, from mental illness and dementia, to heart disease and stroke, to cancer and liver disease, to earlier death. But what about light-to-moderate alcohol consumption? Some studies have actually linked moderate alcohol use with health benefits, including decreased risk of ischemic heart disease, ischemic stroke, diabetes, dementia, and mortality.

    However, since we can’t randomly assign people to take alcohol or placebo, these studies have numerous limitations. For one, there is the “sick abstainer effect,” whereby a subset of people reporting no alcohol may actually have quit drinking due to a history of problems from past heavy alcohol use, which would put them at elevated long-term risk of certain health problems. Another problem is confounding. For instance, people who moderately consume alcohol have been shown to have higher average socioeconomic status, which is associated with better health and a longer life. Researchers have tried to control for potential confounders, but it isn’t possible to account for all of them; only randomization can do that. Finally, almost all studies are based on self-reports of drinking behavior, which is fraught with potential error and bias. We know that people tend to under-report “undesirable” behaviors like heavy drinking, and studies have attempted to correct for this, but no adjustment strategy is perfect.

    Recently, an extremely large, international study tried to get a definitive answer to the question about the safety of alcohol use. Using data from 195 locations across the globe, including 694 data sources about alcohol consumption, 592 studies on the health effects of alcohol use, and a combined study population of 28 million people, the researchers sought to determine the total burden of disease and disability caused by alcohol use between 1990 and 2016. Importantly, they did not solely rely on self-reported drinking, but adjusted alcohol consumption estimates using alcohol sales data, which were further corrected for tourism-related and unrecorded consumption.

    The findings were sobering. In 2016, alcohol was the seventh overall cause of death and disability globally, accounting for 2.2% of deaths among females and 6.8% among males. Among people aged 15 to 49 years old, alcohol was the leading risk factor for death and disability, with 3.8% of female deaths and 12.2% of male deaths attributable to alcohol use. And the study was unable to identify any safe level of alcohol consumption (or in other words, the safest amount of drinking was zero).

    But don’t pour your eggnog and brandy down the drain just yet. Even though this was a massive study with key methodological innovations, there were still limits. Like all previous studies, it wasn’t randomized, so confounding remains a possible explanation for some of the links between alcohol and health problems. Further, the findings have more obvious implications for public health than for individual risk. That means that while the study revealed important harms of alcohol use within the population at large, the danger to any individual person remains quite small. For instance, the top three causes of alcohol-related death for younger people were tuberculosis, road injuries, and self-harm. If you don’t live in the developing world, the first basically doesn’t apply to you. And if you never mix your moderate drinking with driving and have never had a problem with suicidal thinking, the next two aren’t relevant either (though someone else’s drinking and driving could still hurt you).

    For the older group, cancers were the main causes of alcohol-related deaths. This risk technically applies to everyone who drinks any amount, but the actual increase in cancer risk that an individual would experience from moderate drinking is small. For example, if a man in the United States drinks 3-4 drinks per day (moderate-to-heavy drinking), his risk of developing colorectal cancer would increase from about 4.6% to around 5.7%. Assuming this 1.1% absolute risk increase is entirely due to alcohol (and not confounders), this would mean that alcohol is causing a lot of cancer cases in the overall population, but that it arguably does not present a very significant danger for an individual person.

    Finally, especially in wealthier countries, light-to-moderate alcohol consumption was associated with a protective effect against ischemic heart disease for men and against ischemic heart disease and diabetes among women. So you might kick yourself for drinking if you develop a possible alcohol-related cancer at 70 years old, but you’d have no way of knowing whether or not this same alcohol use prevented you from dying of a heart attack at 68.

    So, by now you’re likely asking whether you should drink. Unfortunately, I can’t make a strong recommendation. Yes, there are real risks associated with alcohol, but many also find benefits in light-to-moderate drinking, and every decision we make requires some amount of weighing the risks and benefits (e.g., driving a car is fairly risky but also confers many social and economic benefits). Each person’s calculation will be personal and different. But what we do clearly know is that heavy and/or problematic drinking is very unhealthy. Heavy drinking is defined as more than 3 standard drinks a day or more than eight a week for a woman, and more than 4 a day or 14 a week for a man; and a standard drink is much less than you might think (that martini is likely 2-3 standard drinks). If associated with social, occupational, or health problems, any amount of alcohol can be considered problematic. If your drinking habit matches these definitions, you should consider cutting back and speak with your doctor if you need help. But if you enjoy light-to-moderate drinking without any problems, you may decide that enjoying a little Holiday cheer is worth the risks.

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  • Amarin makes unsupported claims about its heart disease medicine

    Amarin makes unsupported claims about its heart disease medicine

    As we all know, some pharmaceutical companies will go very far to sell their products. Shefali Luthra reports for Kaiser Health News that Amarin has been making unsupported claims about the benefits of its medicine, Vascepa. Don’t believe their fishy marketing.

    Amarin’s medicine is simply purified fish oil. And, Amarin is claiming that it can work miracles for people with cardiovascular (heart) disease. The problem is that the evidence it just released to support its claims is questionable at best. Cardiologists who reviewed its study say that the placebo–mineral oil–to which Vascepa was compared, may have caused blood test changes, according to Forbes. So, comparing Amarin to the placebo, which may have caused heart problems or strokes, may be inappropriate. Put differently, Amarin’s use of a placebo that was not inert in its clinical trials could have made Vascepa, by comparison, appear to have clinical benefits it does not in fact have.

    Amarin’s stock price is up for the moment. But, its advertising and promotion of its questionable claims about Vascepa’s clinical benefits may be leading to unwarranted increases in sales of its medicine. Some doctors will be more likely to prescribe it to people who may not benefit at all from it.

    It is concerning that Amarin is able to market and advertise its drug as helping with heart disease without strong supporting evidence and FDA approval. To date, the FDA only has approved Vascepa to address high triglyceride levels, which can cause pancreatic issues.

    Without a good clinical trial with an inert placebo, Amarin’s claims about Vascepa are likely to be inaccurate; its clinical benefits may be no better than standard fish oil supplements, which may have little if any benefits.

    Supplements can be harmful for a number of reasons, including that they are not overseen by the FDA and can contain ingredients that can be dangerous to your health. Amarin is trying to suggest that because its fish oil product is FDA-approved it is safer. But, it is difficult to know for several years whether a drug is safe or who if anyone it helps. In this case, there is no evidence to suggest Vascepa is any better than fish oil supplements.

    Vascepa costs $280 a month today, up more than 40 percent in five years.

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  • Finish your antibiotics!

    Finish your antibiotics!

    There are two simple ways to get the most out of your antibiotics and avoid promoting antibiotic resistance.
    • First, if your doctor prescribes an antibiotic, please take the entire course (even if you are feeling better). Finish your antibiotics! When you don’t take the whole course or skip doses, there could still be surviving target bacteria. Surviving target bacteria can develop a resistance to the antibiotic and spread that resistance to other bacteria.  If you need to take that antibiotic drug again, it might not be effective, and you will be left with fewer options to fight your infection.
    • Second, you should only take an antibiotic if you know for sure that you have a bacterial infection that it will cure. Ask your doctor before assuming you need an antibiotic.  If you take an antibiotic when you don’t have a bacterial infection, it will only kill the good bacteria in your body, which are part of your natural immunity. Killing your good bacteria can lead to other infections in your body, like a GI problem or yeast infections in women.

    Antibiotics have potential drug interactions. So, please be sure to take the correct ones and know which medications you shouldn’t be taking with them. Keep a list of all your medications in your wallet to share with your doctor. Taking the wrong antibiotics will only promote resistance in bacterial communities. Antibiotics continue to be lifesaving. Let’s keep them that way by not promoting antibiotic resistance.

    Originally published January 15, 2015

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  • If you take supplements, beware of potentially serious supplement-drug interactions

    If you take supplements, beware of potentially serious supplement-drug interactions

    Millions of seniors that take herbal supplements in addition to prescription drugs may be at risk for potentially serious supplement-drug interactions.

    Researchers in the UK polled older adults 65 and older, finding that about one-third of them take at least one supplement in addition to their regular medications. Based on an evaluation of those supplements and drugs, researchers say that one-third of that group are at risk for potentially serious adverse events, they reported in the British Journal of General Practice.

    Some of the adverse events are a risk of bleeding, an increase in blood sugar concentration and reducing the effectiveness of the medication an individual is taking.

    Researchers identified three supplement-drug combinations they say pose a “significant” hazard: calcium and the underactive thyroid drug levothyroxine; peppermint and Prevacid (lansoprazole), which is used for acid reflux; and St. John’s wort and amlodipine, a blood pressure-lowering medication. In the first combination, the efficacy of levothyroxine can be reduced by calcium. Antacids like Prevacid can eat away at protective coatings on peppermint oil pills, potentially leading to nausea and heartburn. And St. John’s wort can reduce the levels of amlodipine in the blood.

    Other potentially serious combinations include fish oil pills and bisoprolol, a beta blocker, as well as glucosamine, a supplement used for arthritis relief, and the diabetes drug metformin. The first combination can lead to a potentially unsafe lowering of blood pressure, while the second can increase blood sugar.

    The study authors conclude that doctors should ask senior patients about supplement use to potentially avoid interactions with medications.

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    This article originally appeared in medshadow.org.

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