Most people know that alcohol and prescription drugs don’t mix. “But, drugs and alcohol are just one of many potentially dangerous combinations,” says Kelli Miller, PharmD, a pharmacist with Park Nicollet Clinic—St. Louis Park. Many combinations of herbal supplements, foods, prescription and over-the-counter drugs also can trigger bad reactions.

‘Natural’ doesn’t mean safe
“Many people are surprised to learn that herbal supplements aren’t always good for you. Just because they are derived from nature doesn’t necessarily mean they are safe,” Miller says. “Also, many supplements have not been reviewed by the Food and Drug Administration, so people may not always have the information they need to make good decisions.”

To avoid potentially harmful reactions, people considering herbal supplements should discuss them with their doctor and pharmacist. They should also read labels carefully to know about potential risks. Miller also recommends people visit the Web site for the National Center for Complimentary and Alternative Medicine, nccam.nih.gov to become more informed on a wide range of interactions involving herbal supplements, foods, OTC and prescription drugs. Some important ones are listed below.

Familiar supplements, unfamiliar results

• Ginsing is known for reducing stress and boosting energy. It may lower blood sugar, which can be dangerous for people with diabetes.
• Garlic capsules are known for lowering cholesterol and blood pressure. It has anti-clotting properties that could have additive effects with anticoagulant drugs or cause prolonged bleeding.
• St. John’s Wort is known for treating mild depression. However, it’s important to avoid mixing it with prescription antidepressants, birth control pills and anticoagulants among other medications because of the way it can increase or decrease the breakdown of these medications.

Healthy foods, unhealthy reactions

• Fiber can affect the absorption of many medications, especially some cholesterol lowering medications, and digoxin, a popular heart medication.
• Green, leafy vegetables, such as spinach and broccoli, can decrease the effectiveness of warfarin, an oral anticoagulant. It is important to be consistent with the intake of such foods while taking warfarin.
• Coffee, tea and chocolate in large amounts can increase the toxicity of theophylline, a medication to treat asthma.

Over-the-counter drugs, counter effects

• Aspirin can interact with some diabetic medications, causing blood sugar to drop dangerously low. It also can interfere with the effectiveness of arthritic medications, some prescription steroids and diuretics.
• Antacids can decrease drug absorption by up to 90 percent when taken with certain antibiotics, thyroid, heart and blood pressure medications.
• Antihistamines should be avoided when taking medications to treat anxiety or depression because of the risk for increased drowsiness.

To remain safe, Miller encourages people to work with one pharmacy, keep a list of all herbal supplements, prescription and OTC drugs and share it with doctors and pharmacists whenever new medications are prescribed.

The Pharmacy @ Park Nicollet has 13 clinic-based locations and access to patient’s computerized medical records, which helps prevent potentially dangerous interactions. “We also make sure to ask our patients about any herbal supplements and OTC medications they may be taking,” she adds.

To learn more about mixing drugs and supplements, call 952-993-5500. Or visit parknicollet.com/stores/pharmacy to learn more about Pharmacy @ Park Nicollet.