First, it's important to carefully consider the source of information and then to discuss the information you find with your health care professional. These questions and answers can help you determine whether the health information you find on the Internet or receive by e-mail from a Web site is likely to be reliable. The medicines that sold online can be fake (counterfeit or 'copycat' medicines); can be too strong or too weak, or have dangerous ingredients, or have expired (are out-of-date), or haven't been approved or checked for safety and effectiveness, can be made using non-safe standards, or not safe to use with other medicine or products you use. You have to talk with your doctor and have a physical exam before you get any new medicine for the first time. Use only medicine that has been prescribed by your doctor or another trusted professional.
For example, every time you get into a car, there are risks---the possibility that unwanted or unexpected things could happen. You could have an accident, causing costly damage to your car, or injury to yourself or a loved one. But there are also benefits to riding in a car: you can travel farther and faster than walking, bring home more groceries from the store, and travel in cold or wet weather in greater comfort. The benefit and risk decision is sometimes difficult to make. The best choice depends on your particular situation. You must decide what risks you can and will accept in order to get the benefits you want. You have to always tell your doctor if you are or might become pregnant, or if you are nursing a baby. Always ask questions about any concerns or thoughts that you may have. Before starting any new medicine or dietary supplement (including vitamins or herbal supplements), ask your doctor again if there are possible interactions with what you are currently using. Ask your doctor if there is anything you can do to minimize side effects, such as eating before you take a medicine to reduce stomach upset. You always have to pay attention to how you are feeling; note any changes. Write down the changes so that you can remember to tell your doctor, pharmacist, or other health care professional. You have to know what to do if you experience side effects and when to notify your doctor, and know when you should notice an improvement and when to report back.
There are more opportunities today than ever before to learn about your health and to take better care of yourself. It is also more important than ever to know about the medicines you take. Drug interactions may make your drug less effective, cause unexpected side effects, or increase the action of a particular drug. Some drug interactions can even be harmful to you. The most important enzymes in the liver that metabolize drugs are called the cytochrome P450 family of enzymes. These enzymes break down drugs when they pass through the liver or small intestine. It used to be that the only way to test for drug interactions was in people. Now drug companies can take five test tubes with the five major pathways for metabolism and put their drugs in to see whether it's metabolized by CYP450. This allows to generate a list of possible interactions based on their findings. Researchers say there are several important variables that affect individual differences in how drugs are metabolized, including race, gender, age, and health conditions. For example, people with kidney or liver disease don't eliminate drugs from their system as well as people who are healthy. Very young children and older people have slower drug metabolism than others, and women may metabolize drugs differently than men in some cases. Over the last several years, there has been a substantial increase in the number of drug-interaction studies the FDA sees in new drug applications. If drug interactions are significant enough, they can prevent a drug from being approved by the FDA. If the agency determines that known drug interactions can be managed and that a drug's benefits outweigh the risks for the intended population, a drug will be approved. Drug-interaction information then goes into the drug's labeling in the sections on "clinical pharmacology," "precautions," "warnings," "contraindications," and "dosage and administration." In addition to having a good grasp of drugs and their effects, doctors take medication histories, and they consult with other members of their team to guide them in making decisions about drug interactions. They also use concise drug summaries and resources on pharmacological principles. The large number of drugs on the market, combined with the common use of multiple medications, makes the risk for drug interactions significant. Consumers need to tell doctors what they're taking and ask questions, and health professionals could do a better job at trying to get the information they want. Some antibiotics, such as rifampin, can lower the effectiveness of birth control pills. Sildenafil, the active ingredient in the erectile dysfunction drug Viagra, should not be taken with nitrates for heart treatment because of the potential for dangerously low blood pressure. Drug interactions with food and beverages, for example, taking quinolone antibiotics such as ciprofloxacin with food and drinks such as colas, coffee, and chocolate that contain caffeine may cause excitability and nervousness. There can be a potentially fatal increase in blood pressure if food containing tyramine is eaten when taking monoamine oxidase inhibitors, drugs that treat mood disorders.
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