Many people take more than one medication – sometimes permanently, sometimes only temporarily. To this come often over-the-counter preparations, herbal remedies or dietary supplements. Exactly here interactions can arise. This sounds at first technical, is in everyday life but very relevant: When medications influence each other, can a remedy act stronger or weaker than expected, or side effects occur more likely. As a pharmacist in the neighborhood we experience such questions daily – and often risks can already be significantly reduced with a quick glance at the entire medication plan.

What are drug interactions actually?

One speaks of an interaction when a medication changes the effect of another. This can happen in various ways. Some medications influence the absorption in the gastrointestinal tract, others change the breakdown in the liver or the excretion through the kidneys. Again others have similar side effects that can add up.

Important is: Not every combination is automatically dangerous. Many medications are deliberately used together because they complement each other meaningfully. It becomes problematic when the combination is unintentional or when comorbidities, age or dosage increase the risk.

In Australia this is particularly relevant because many people use several medications in parallel. According to the Australian Institute of Health and Welfare, older Australians often take several prescription medications at the same time, and with each additional medication the likelihood of interactions and medication-related problems increases.

What you can particularly pay attention to in everyday life

A good first step is to always keep an overview of all preparations you take. This includes not only prescribed medications, but also everything you have bought yourself at the pharmacy, in the supermarket or online.

• Keep a current medication list – ideally with name, strength and time of intake.
• Mention at every doctor's or pharmacy visit also herbal remedies, vitamins and minerals.
• Take medications as accurately as possible according to instructions, especially when it comes to intervals to meals or other preparations.
• Do not change dosages on your own, even if a remedy seems “harmless”.

In Australian pharmacies, medication checks and personal consultations are among the most important services to recognize such risks early. Especially with multiple medications, this overview is worthwhile.

Which combinations cause problems more often?

Some interactions occur particularly often in practice. Blood-thinning medications like warfarin can for example be influenced by other medications, certain antibiotics or also herbal products. Then the risk of bleeding can increase or the effect fluctuate.

Painkillers from the group of non-steroidal anti-inflammatory drugs – such as ibuprofen, diclofenac or naproxen – are also a typical example. They can conflict with blood pressure medications, diuretics and medications for kidney function. In some people, this increases the risk of kidney problems, stomach bleeding or worse blood pressure control.

Also medications that cause drowsiness can enhance each other. These include some sleeping pills, strong painkillers, some antihistamines, tranquilizers and certain antidepressants. When several such preparations come together, drowsiness, confusion and risk of falls can increase – especially in older people.

Another common topic is medications that influence serotonin levels. If certain antidepressants are combined with other serotonergic substances, the risk of serious side effects can increase. Such combinations must be particularly carefully examined by a doctor and pharmacist.

How to avoid unnecessary risks

Often, just a few practical habits help. One example: Buy your medications preferably at the same pharmacy. This makes it much easier to keep a complete overview. If prescriptions come from different doctors, the pharmacy can help identify possible overlaps or problematic combinations. Related: Azithromycin 500mg.

• Read the instructions for use, especially regarding alcohol, meals and time intervals.
• Ask before you add a new painkiller, cold preparation or antihistamine.
• Be cautious with “natural” products – natural does not automatically mean safe.
• Have your medication checked when a new drug is added or discontinued.

Pharmacists not only check interactions between prescription medications. They also advise on over-the-counter remedies, inhalers, dosing aids and when a time interval between preparations makes sense.

Also food, alcohol and herbal remedies can play a role

Interactions arise not only between two medications. Also food, alcohol and herbal preparations sometimes play a role. A well-known example is grapefruit juice, which can influence the breakdown of certain medications. This can cause the active substance level in the body to rise.

St. John's Wort is another classic example. It is often taken for low mood or sleep problems, but can accelerate the breakdown of numerous medications – including the birth control pill, some heart medications, immunosuppressants and other important therapies. This can significantly impair the effectiveness. Related: Get Fildena 150mg Online.

Also calcium, magnesium or iron preparations are not always as harmless as they seem. They can reduce the absorption of certain antibiotics or thyroid medications if taken at the same time. Here, often just the right time interval helps.

Alcohol, in turn, can enhance the sedative effect of some medications or further burden the liver. Particularly with sleeping pills, opioids, anxiety medications and some antidepressants, special caution is important.

Special caution with older people and in multiple diseases

The more medications are taken, the more complex the therapy becomes. Older people are particularly at risk because metabolism, kidney function and sensitivity to medications can change with age. In Australia, medication-related problems are a common reason for hospital admissions, especially in older patients. Part of these events is related to side effects or interactions. Learn more about Ear Infections: Symptoms,.

Also people with chronic kidney disease, liver disease, epilepsy, cardiovascular diseases or diabetes often need particularly exact coordination of their medication. Even a new short-term therapy – such as an antibiotic or an antifungal – can influence existing medications.

This is why regular medication reviews are so valuable. In Australia, structured medicine reviews can help identify unnecessary medications, check dosages and make therapy safer, depending on the situation.

Practical questions you can ask at the pharmacy

Many people do not want to ask anything “wrong” – but these questions are often the most important. If you receive a new medication, it can be helpful to specifically ask about possible combinations.

• Does this medication interact with my other medications?
• Do I need to take it with a gap to dietary supplements or antacids?
• Are there signs I should watch for, such as severe fatigue, bleeding or dizziness?
• May I drink alcohol or drive with this?
• What should I do if I forget a dose or need a new over-the-counter remedy?

Such conversations are not an extra, but an important part of the safe use of medications. Especially in hectic everyday life, it can easily be overlooked that cough medicine, allergy tablets or mineral preparations can also play a role.

When you should see your doctor

If unusual symptoms occur after starting a new medication or after a change in your therapy, you should have this medically evaluated. This includes, for example, severe fatigue, confusion, dizziness, fainting, heart palpitations, unusual bleeding, black stool, breathing difficulties, skin rash or suddenly worse control of an existing condition.

Also if a medication seemingly no longer works properly – such as with blood pressure, blood sugar, pain or contraceptive protection – an interaction could be behind it. Do not independently discontinue prescribed medications, but discuss it with your doctor or pharmacist.

Particularly important is medical advice if you take many medications, have just been discharged from the hospital, are pregnant, breastfeeding or have received a new diagnosis. In such phases the medication often changes, and especially then a second look is particularly worthwhile.

This information is for general purposes only and does not replace professional medical advice.