Buying prescription drugs online

The Internet has changed the way we live, work and shop. The growth of the Internet has made it possible to compare prices and buy products without ever leaving home. But when it comes to buying medicine online, it is important to be very careful. Some websites sell medicine that may not be safe to use and could put your health at risk.

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or 'copycat' medicines); can be too strong or too weak, or have dangerous ingredients, or have expired (are out-of-date), or haven't been approved or checked for safety and effectiveness, can be made using non-safe standards, or not safe to use with other medicine or products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.

Drug interactions: what you should know

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.

Early in a drug's development, companies conduct research to detect or predict potential interactions between drugs. Experts evaluate the drug-interaction studies as part of assessing a drug's safety.

Mixing two drugs together could make one of the drugs ineffective. The combination also could increase a drug's effect, and be harmful. The result might be mild symptoms such as nausea, stomach upset, or headache, or more serious symptoms such as a dramatic drop in blood pressure, irregular heart beat, or damage to the liver-the primary way that drugs pass through the human body.

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.

Not everything that happens in a test tube will become meaningful in humans, though. Results from these test-tube studies can tell us whether need to do further testing in people to find out if an interaction is clinically significant.

Three phases of clinical trials in humans must happen before a drug can be marketed. Phase 1 studies focus on a drug's side effects and how the drug is metabolized and eliminated from the body. Phase 2 studies focus on a drug's effectiveness. And Phase 3 studies gather more information on safety and effectiveness, which includes using the drug in combination with other drugs.

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.

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.

Health professionals also use computer systems with drug-interaction screening software, electronic prescribing, and other technology. Mark Langdorf, M.D., chair of the department of emergency medicine at the University of California, Irvine, says, "In a busy emergency room, you have to quickly find out what a patient is taking and how those drugs could interact with other treatments."

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.

Drug interactions with other drugs includes both prescription and over-the-counter medicines. Tricyclic antidepressants such as Elavil (amitriptyline) and Pamelor (nortriptyline) can interfere with blood pressure-lowering Catapres (clonidine). Taking the antibiotic Cipro (ciprofloxacin) with antacids lowers Cipro's effectiveness.

Drug interactions with dietary supplements includes herbs and vitamins, which can interact with drug-metabolizing enzymes. St. John's wort is an herb commonly used by people with cancer to improve mood, but research has shown it interferes with the metabolism of irinotecan, a standard chemotherapy treatment. Vitamin K (in dietary supplements or food) produces blood-clotting substances that may reduce the effectiveness of blood-thinning medicines like warfarin.

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