The greatest risks are run by taking alcohol along with drugs that act directly on the nervous system, such as drugs for depression, psychiatric diseases, anxiety, epilepsy or insomnia. In fact, even when taken at in small doses, alcohol can increase the sedative effects produced by these drugs (reduced level of alertness, impaired judgment and criticality skills, more or less severe mood alterations up to coma in cases of major abuse). It is no coincidence that in history, alcohol and barbiturate cocktails have been responsible for the death, accidental or by suicide, of several famous people.
Other noteworthy interactions:
- Alcohol and analgesics (pain control drugs): increased risk of gastric bleeding related to the use of NSAIDs; increased risk of liver damage from overdose of paracetamol (acetaminophen).
- Alcohol and antibiotics (particularly cephalosporins): increased typical ailments associated with a hangover, such as redness of the skin and chest, flushing, headache, vomiting, hypotension and palpitations. The association of alcohol and antifungals is also not recommended for the same reasons.
- Alcohol and antihistamines (allergy medicines): increased sleepiness caused by these medicines.
- Alcohol and antihypertensives (drugs for high blood pressure, such as ace inhibitors, beta-blockers, diuretics and nitrates): concomitant intake with alcohol can cause rapid heartbeat and sudden changes in blood pressure.
- Alcohol and bronchodilators (asthma drugs): increased risk of nausea, vomiting, irritability and headache.
- Alcohol and narcotics (drugs for anesthesia): increased narcotic effect, up to coma and death.
- Alcohol and statins (high cholesterol drugs): increased risk of liver toxicity.
- Alcohol and sulfonylureas (diabetes drugs): increased risk of hypoglycemia.
- Alcohol and warfarin (anticoagulant drugs): increased risk of bleeding (acute intoxication) and reduced efficacy of the drug (in chronic drinkers).
Also the association of alcohol with supplements is not recommended; for example, the association of alcohol and valerian can increase the sedative effect of the latter, while the association of ethanol and caffeine can increase the gastro-damaging effects.
Since even a moderate consumption of alcoholic beverages can induce dangerous interactions with many drugs, it is recommended - especially for women and the elderly, for whom the risk is even greater - to consult a doctor or pharmacist for more and more specifics. information.
, aminophylline or other related xanthines, caffeine can cause excitability, rapid heartbeat, tremors and nervousness.Caffeine also increases the risk of side effects from some drugs used in psychiatry, such as the antipsychotic clozapine; it also reduces plasma lithium levels.
Quinolone antibiotics such as enoxacin, ciprofloxaxcin, grepafloxacin, levofloxacin and norfloxacin cause an accumulation of caffeine in the body (high doses of caffeine in the body can cause problems with nausea, vomiting, nervousness, anxiety, rapid heartbeat and convulsions).
Caffeine interacts with MAO inhibitors, increasing their sympathetic stimulating effects. The combination of MAO-inhibitors and caffeine can therefore lead to episodes of cardiac arrhythmias or severe hypertension.
In subjects being treated with anticoagulants (coumadin - warfarin), the antiplatelet action of caffeine increases the risk of bleeding.
Caffeine reduces the effectiveness of drugs used to combat urinary incontinence.
In case of association with NSAIDs, caffeine can amplify the gastrointestinal effect of the latter.
Serum levels of caffeine can be increased by the simultaneous intake of oral contraceptives.
We recall, to conclude, that caffeine is contained not only in coffee, but also in many foods, such as coca-cola, energy drinks and tea, and in some food supplements (for example those that contain cola, maté or guarana).
, and more generally of all dairy products, interferes with the intestinal absorption of some antibiotics, limiting their effectiveness.In particular, the association between dairy products and tetracyclines (antibiotics less used today in therapy for drug-resistance problems) should be avoided; in fact, these drugs have chelating activity, that is, they bind tenaciously to calcium (but also to iron and magnesium ), including that present in bones and teeth. For this reason, if taken during pregnancy or childhood, tetracyclines can cause problems with bone malformations and yellow coloring of the child's teeth. The problem also arises for ice creams and fortified foods enriched with calcium, magnesium and / or iron, and for the supplements that contain them.
As for the antibiotic ciprofloxacin, it is recommended not to take it together with dairy products (such as milk and yogurt) or calcium-enriched fruit juices individually; however, ciprofloxacin can be taken during a multi-food meal that also contains dairy products.
Milk, on the other hand, is recommended in subjects receiving lithium-based antipsychotics for the treatment of bipolar disorder; in this case the association is positive since it reduces the frequency of gastric disturbances. Even in users of NSAIDs, it is advisable to take these drugs on a full stomach or with milk to reduce their gastric-damaging effect.
As regards soy milk, on the other hand, a possible risk of reduction of the anticoagulant activity of warfarin was reported, with a consequent increase in the risk of thrombosis.
, we speak of "phototoxicity". Unlike rashes and burns, mainly caused by short ultraviolet rays (UVB), toxic reactions are mainly due to the action of UVA. Some substances absorb the energy of solar radiation and transfer it to the skin tissues, causing damage to the DNA or to cell membranes.The symptoms are the same as for sunburn: redness, itching, swelling and burning, up to real burns with the appearance of blisters. They can occur in areas where the topical medicine has been applied or, if the drug is taken orally or parenterally, they can affect all areas exposed to the sun. The dose of the drug and the frequency of treatment also make a difference. The reactions are more pronounced if the sun exposure has been intense or prolonged: they generally last a few days and can leave brown spots. The danger is greater if the exposure coincides with the peak concentration of the active ingredient in the blood. Among the most common drugs that can interact with the sun are: antibiotics (tetracyclines, quinolones and sulfonamides), oral contraceptives (pill), anti-inflammatories (especially those to be applied to the skin, such as ketoprofen-based gels / patches) and antihistamines (promethazine).
A separate discussion deserve the so-called photoallergic reactions that occur only in predisposed individuals the symptoms do not appear immediately, but once sensitized they are also triggered by small doses of the drug.
In any case, it is advisable to always check the information contained in the package leaflet of the medicinal product for compatibility with sun exposure and always use adequate sun protection. If it is not possible to suspend or postpone treatment, avoid the sun both while taking the drug and for the next two weeks.
, hormone replacement therapy or anti-inflammatory, making it difficult to adhere to the skin. As for syrups and eye drops, on the other hand, the excipients that allow the absorption of the active ingredients may be altered, reducing their effectiveness. The anti-inflammatory ointments in heat see the substances separate. fat, which carry the active ingredients. In summer, then, it would be better to avoid aspirin in an effervescent form, more sensitive to heat: it could be ineffective or cause stomach problems.
In general, so that the integrity and safety of medicines is not compromised, the products should be stored in a dry place. In summer, thermal containers can be useful, while the use of the refrigerator must be limited, as temperatures too low and humidity can damage medicines.
