How do drug interactions occur? What is this process? You will find answers to these and other questions in the article. The interaction of medications is a qualitative or quantitative transformation of the effects caused by the sequential or joint use of two or more medications. Consider drug interactions in more detail below.
Solvation
The interaction of drugs with each other can lead to a weakening or strengthening of the effect of one or more drugs in combination. A clinically significant association is often predictable and generally undesirable as it may result in no therapeutic effect or side effects.
Clinicians sometimes use predictable drug interactions to achieve the desired therapeutic outcome. Thus, the simultaneous administration of ritonavir and lopinavir to a patient with HIV inhibits the metabolism of lopinavir and increases its plasmaconcentration, which increases the effectiveness of healing.
Pharmaceutical relationship
This kind of drug interaction occurs outside the body. At the stages of creating and storing compound medicines, as well as when mixing drugs in one syringe, transformations may occur 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 can be:
- physical;
- physical and chemical;
- chemical.
Pharmacological relationship
In this type of interaction, medications introduced into the body transform the pharmacokinetics or pharmacodynamics of each other. The pharmacokinetic type of relationship appears in the following steps:
- at the time of absorption of a substance from the intestinal lumen into the blood;
- during the biotransformation that occurs in the liver;
- at the moment of binding substances to blood proteins;
- during the excretion of substances from the body through its excretory systems.
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 drug interactions
The attending physician must know about all medications thataccepted by the patient, including those prescribed by other doctors, over-the-counter, as well as nutritional supplements. He should ask the patient about alcohol use and diet.
Typically, 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 side effects) of all medications taken, as they usually contain a spectrum of potential drug interactions.
To avoid toxicity, the doctor should use drugs with a wider therapeutic range.
Patients are observed for the development of objectionable reactions, especially after changing the treatment regimen. Some types of interactions (for example, due to enzyme induction) may be detected after a week or later.
Drug interactions should be seen as a tolerable cause for any unexpected complications. With the development of a sudden clinical reaction, the doctor can determine the concentration of individual drugs taken in the blood serum. Then, based on this information, he will adjust 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 that the patient receives.
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,provisions and nutritional supplements.
- Strictly follow all the doctor's recommendations (including those regarding taking the medicine after meals or on an empty stomach, the time of taking, the need to drink it).
- Always read the instructions for medicines carefully.
- Buy all medicines in one pharmacy.
- Keep medications with instructions and in packages so that you can always refresh the data in case of questions.
- Tell your doctor about all medications and nutritional supplements you take.
- If you are breastfeeding, pregnant, or have any chronic medical conditions, avoid taking any medication, including over-the-counter medications, without consulting your doctor.
- Keep a diary of all food supplements (including herbs) and medications you take. Take it with you every time you visit the doctor.
- If you are taking any prescription medication, check with your pharmacist or doctor before taking any over-the-counter drug.
Medicines and alcohol
And what is the interaction with alcohol drugs? In medicine, there is one clearly defined canon that is often forgotten in real life. It says that the combination of drugs and alcohol is a highly undesirable, mutually exclusive and even harmful concept. Why is such a formidable taboo imposed on the simultaneous intake of medications and alcoholic beverages? Because alcohol can affect the behavior of drugs in the human body in the most unforeseen way:
- weaken their action (inhibits);
- enhances (potentiates);
- pervert to the opposite.
Often, even a doctor cannot predict what a patient expects if he uses medications along with alcohol. Here, a very large number of factors should be taken into account: the specifics of alcohol and pills, the dose, the individual qualities of the body, and so on.
That is why you will not find recommendations to drink alcohol with pills in any instructions. After all, there is not a single beneficial combination of alcohol with medicines. Interactions with alcohol medications can cause a variety of effects:
- chill;
- nausea;
- suffocation;
- vomit;
- discoordination;
- breathing stops;
- drop in blood pressure;
- increased heartbeat;
- fatal.
Therefore, it is very important to consciously refuse to take drugs and alcohol at the same time, as they are inherently incompatible.
Analgesics and alcohol
Consider the compatibility 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, it performs an antiplatelet function.
"Nise" is a non-narcotic analgesic. With the simultaneous intake of alcohol and medication, the absorption of the latter from the gastrointestinal tractis accelerating. However, alcohol simultaneously enhances the traumatic effect on the gastric mucosa 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, but the likelihood of the most powerful side effects also increases significantly:
- aggressivity;
- shortness of breath;
- malaise;
- fountain vomiting;
- headache.
Ethanol is incompatible with analgesics. These substances reduce blood flow to the liver and kidneys. In view 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 each individual's individual condition, symptoms may be subtle, subtle, or so severe as to require hospitalization.
Therefore, do not harm your he alth by reckless use of medicines and alcohol. Stay away from alcohol during your treatment.
Sofosbuvir and daclatasvir
What is the interaction of sofosbuvir and daclatasvir with other drugs? DAAs are direct acting antivirals. They were created quite recently. With their emergence, such a formidable disease as viral hepatitis C has ceased to be considered a death sentence. In 98 cases out of 100today it is possible to completely defeat the disease, and most often it is forced to retreat.
The best-known DAAs used today to fight the HCV virus (the causative agent of hepatitis C) today are sofosbuvir (Sovaldi), daclatasvir (Daklinza), simeprevir, Harvoni, Viekira Pak.
Solvadi was registered as a medicine back in 2013 and immediately became extremely popular. Today it is included in the list of essential drugs used to combat HCV. For sofosbuvir and daclatasvir based pills, interactions with other drugs are important to consider.
The fact is that some drugs 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 reduce 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 unpleasant consequences, especially when it comes to very powerful pills. So, the doctor should very carefully prescribe antibiotics and sofosbuvir. Such strong inhibitors of CYP2C19, such as the well-known Levomycetin (chloramphenicol), when taken simultaneously with DAAs, can weaken the effect of inhibitors. A number of popular anti-tuberculosis drugs (including rifampicin), herbal infusions (St. John's wort) and some well-known anticonvulsants have the same effect.
Therefore, if a patient is taking Sovaldi and needs to be prescribed antibiotics, the compatibility of these drugs should be checked. For the same reason, during the course of DAAs, one should not take any hepatoprotectors (milk thistle, Heptral, Phosphogliv, etc.), intestinal antibiotics, as they inhibit the absorption of medicines. And it is recommended to eat a variety of sorbents no later than 5 hours before taking DAAs. Doctors also advise eating Omez a couple of hours after taking Sovaldi.
Many drugs are compatible with daclatasvir and sofosbuvir, but there are still some that need to be taken with extreme caution or even discontinued during the course of treatment. So, while taking Sovaldi, drugs that are largely dependent on CYP3A (a short designation for cytochrome P450 3A4, an enzyme that takes part in the metabolism of xenobiotics entering the human body), are also harmful. Drugs - powerful inducers of CYP3A and CYP2C8, can not only reduce the effectiveness of daclatasvir, Sovaldi, Khavroni and others, but also increase the plasma concentration of polymerase non-nucleoside NS5B inhibitors. This can result in life-threatening arrhythmias.
Therefore, for those who have started using daclatasvir and sofosbuvir, compatibility with other drugs of these medicines is very important. Including when it comes to antiarrhythmics, painkillers, beta-blockers, medicines that normalize heart function and increase blood pressure.
It is known that sofosbuvir cantake synchronously with some immunosuppressants, calcium channel blockers, with medications that lower blood pressure, anticoagulants. But the simultaneous use of antiarrhythmic pills (for example, Amiodarone) is contraindicated during the period of healing Sovaldi. Whether daclatasvir and sofosbuvir are compatible with Articaine, often used in dentistry as an anesthetic drug, 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 drugs. When prescribing DAAs by your doctor, discuss in advance the rules for taking incessantly or the most frequently used medications.
Let's talk a little about daclatasvir. This is the strongest drug of the latest generation, a pangenotypic inhibitor of the NS5A replication complex. It is used to treat all genotypes of the hepatitis C virus. For the most effective action, the drug is prescribed in combination with other antiviral drugs.
Daklatasfir and Sofosbuvir is the first interferon-free oral hepatitis C regimen with the highest efficacy. In the process of clinical testing, it was possible to achieve almost one hundred percent even in patients with the third genotype of the virus and in patients with liver pathologies.
Daklatasfir is not intended for monotherapy. In combination with it, sofosbuvir, peginterferon or ribavirin is always taken.
Mexidol
And now consider the interaction with other Mexidol drugs. This drug is one of the best todayantioxidants on the market. Synthesized in Russia in early 1980. It can help with a variety of ailments, ranging from vegetovascular dystonia, ending with ischemic heart disease.
As a rule, if "Mexidol" is taken with any other drug, it will enhance its effect or simply perform its function. An increase in action is also manifested when taking sedative and psychotropic drugs. In such cases, it is prescribed in order to reduce the dosage of these drugs.
Mexidol also often acts as part of a comprehensive treatment of coronary heart disease and further maintenance of treatment. As a learning enhancement, it is sometimes prescribed along with nootropics. Another important effect is the reduction of the toxic effect of ethyl alcohol when taking Mexidol.
ASD-2
Let's study the interaction of ASD-2 with other drugs. ASD-2 is Dorogov's antiseptic stimulator. This is a product obtained by high-temperature sublimation of animal material, namely meat and bone meal. This medicine contains carboxylic acids, derivatives of aliphatic amines, water, compounds with an active hydrophilic group, cyclic, aliphatic hydrocarbons, amide derivatives.
It is known that experiments were carried out on guinea pigs and mice, during which it was found that in small doses ASD-2 provokes excitation of the central nervous system, as well as its higher autonomic centers with manifestations of motor anxiety in animals. There was also an increaseactivity of the digestive glands, increased excretion of sweat and urine, increased peristalsis.
High doses also cause convulsions, skeletal muscle tremors, as well as CNS depression and incoordination. Shortness of breath is replaced by sharp shortness of breath as a result of bronchospasm, as well as paralysis of the respiratory muscles. Animals die due to asphyxia. It has also been found that if certain medications are administered to animals before the use of ASD, their condition returns to normal.
Scientists have been investigating how ASD interacts with other drugs in dogs as well. 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 stimulant weakens. It is better to postpone the intake of medicines and juices containing acid for 2-3 hours.
It is known that ASD-2 affects the body in many ways. The drug normalizes metabolism in tissues, improves the functioning of the gastrointestinal tract, stimulates metabolism, the activity of the heart and lungs. There is no official recorded scientific data on the drug interaction with drugs when using ASD in humans. Such testing has not been carried out. It is known that the medicine goes well with almost all groups of medications. It is only important to take it three hours after taking any drug.
Kagotsel
Interaction with other drugs "Kagocel" is interesting to everyone. This remedy is prescribed for the treatment and prevention of influenza and other acute viral respiratory ailments, the treatment of herpes in adults. Kagocel is greatcombined with other antiviral drugs, antibiotics and immunomodulators.
Ingavirin
What is the interaction of "Ingavirin" with other drugs? 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, a number of pathogenic microorganisms that provoke the development of acute respiratory viral infections.
No episodes of interaction between Ingavirin and other medicines have been registered. In experiments, an increase in the effectiveness of the complex treatment of bacterial and viral infections with bronchitis, secondary pneumonia, and the like was noted with the use of Ingavirin and antibiotics.
Warfarin
Let's study the interaction of warfarin with other drugs. It is an oral anticoagulant that should be monitored for both efficacy and safety. If you need to prescribe a drug that can transform the effects of warfarin, the doctor determines the INR. He then adjusts the dose of warfarin throughout the compound treatment and during the withdrawal of the supplementary agent.
Phenibut
How does phenibut interact with other drugs? 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,neuroleptic 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, broad-spectrum antibacterial agent from the group of semi-artificial penicillins.
Interaction with other drugs of amoxicillin should be known to everyone. This medicine affects only multiplying microorganisms. Therefore, it is prescribed synchronously with antimicrobial drugs that act 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, oxifenbutazone, to a lesser extent - sulfinpyrazone and acetylsalicylic acid inhibit tubular secretion of penicillin drugs, which increases the concentration and half-life of amoxicillin in blood plasma. Take your medications right and stay he althy!
