Updated July 21, 2006

Dangerous Drug Combinations

by Mark T. Marino, M.D.

Are you at risk?
With all of these potential interactions, how do you find out if you may be at risk? Start by consulting your physician and your pharmacist. Bring a list of all of the drugs you take (or simply bring the drugs themselves), including prescription drugs, over-the-counter drugs, and any supplements, herbal or otherwise, to a doctor appointment or to your pharmacy. Ask your doctor or pharmacist to look over your list for any potentially dangerous combinations.

You can also learn more about drug interactions on the following Web site of the FDA: www.fda.gov/cder/consumerinfo/druginteractions.htm.

If you are interested in much more detailed information, look up the following Indiana University Web site, http://medicine.iupui.edu/flockhart, which has lists reflecting both basic science research as well as information intended more for physicians. It also links to the National Library of Medicine’s PubMed database, where you can view and download abstracts and articles of published research.

Be careful about relying on commercial Internet sources for drug information. Several Internet drugstore sites that I evaluated did not list repaglinide and gemfibrozil or rosiglitazone and gemfibrozil as potentially interacting drugs.

Adverse drug effects are very common and represent a large part of the reasons that people visit doctors’ offices, emergency rooms, and eventually hospitals. Don’t hesitate to notify your doctor if you think you are experiencing a drug side effect or to ask about potential drug interactions. If you see different doctors for different medical conditions, one may not be aware of what the others have prescribed for you. Similarly, if you get different prescriptions filled at different pharmacies, no one pharmacist will have access to all of your information, and potential interactions may be missed. For this reason, it is recommended that people fill all their prescriptions at one pharmacy, if possible. In addition, maintain a list of all of your medicines and update it when one is added or removed. Review your list with your doctor or pharmacist regularly, particularly when you begin taking a new medicine.

Dr. Marino is a clinical pharmacologist and the Vice President for Clinical Research and Development at Kyowa Pharmaceutical, Inc., in Princeton, New Jersey.

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