OVER-THE-COUNTER (OTC) MEDICATIONS:
Whenever an over-the-counter item is taken with a prescription medication, there is a chance that there will be an interaction between them. The interaction
may increase or decrease the effectiveness and/or the side effects and might also result in a new side effect that is not generally seen with the medications individually. The likelihood of drug interactions increases as the number of combinations increases.
Most drug interactions are due to altered absorption in the intestine and can change the blood flow to the intestines, metabolism of the drug by the intestine, increased movement in the intestines resulting in diarrhea or constipation, alterations in the acidity
of the stomach and a change in the bacteria of the gut region. The liver and kidney are where most drugs are eliminated and therefore are important sites of drug interactions. Drug interactions can be complex and unpredictable, so minimizing the risk is essential.
Antihistamines (Benadryl, Dimetapp, NyQuil, Alka-Seltzer Night-Time Cold, Thera Flu, etc).
Over-the-counter (OTC) antihistamines are drugs that temporarily relieve a runny nose, or reduce sneezing, itching of the nose or throat,
and itchy watery eyes. However, antihistamines increase the effect of benzodiazepines and sleeping pills and can cause cognitive deficits, dangerous drops in blood pressure, suppression of the lungs and extreme sedation. Antihistamines also alter the metabolism
of many SSRIs, increasing blood levels of the Antidepressant and increasing their side effects. Combining antihistamines with hypertension medication may cause an increase in heart rate and blood pressure.
(Afrin, Neosynephrine, Sudafed, ect.):
Most nasal decongestant sprays will cause increased adrenaline and norepinephrine, which can worsen anxiety and depression. Use of decongestants for longer than 3-5 days can damage the nasal tissue and lead to
chronic congestion. Nasal decongestants may decrease the effectiveness of some blood pressure medications, and the most common side effects are stomach upset, trouble sleeping, dizziness, lightheadedness, headache, nervousness, fast heartbeat, loss of appetite
Pain Relievers (Acetaminophen - Tylenol, Excedrin, ect. / Ibuprofen - Motrin, Advil, ect.):
Painkillers such as Acetaminophen and Ibuprofen are called analgesics, which numb pain. Both can have a
profound effect on other medications, the absorption of nutrients and therefore to our general health. Acetaminophen, also known as Paracetamol, is widely used in over-the-counter pain reliever and fever reducer derived from coal tar and has been shown to
reduce glutathione production (the body’s master antioxidant). Acetaminophen is metabolized primarily in the kidneys with a lesser amount traveling through the liver, where a toxic by-product called N-acetyl-p-benzoquioneimine (NAPQI) is produced in
response to the acetaminophen, and is extremely harmful to the liver. The side effects of acetaminophen include nausea, vomiting, loss of appetite, diarrhea, sweating, irritability, abdominal pain (particularly near the liver), yellow eyes or skin, liver or
kidney failure, heart problems and seizures. Ibuprofen reduces melatonin levels and may affect sleep if taken at bedtime. Other drugs that interfere with melatonin production are Valium, Xanax, diuretics, beta-blockers, calcium channel blockers, alcohol and
caffeine. Ibuprofen may also exacerbate anxiety and depression by causing a disruption in the hormone system that participates in the contraction and relaxation of the muscles, blood vessels and modulates inflammation. Side effects include rash, riming of
the ears, headaches, dizziness, abdominal pain, nausea, diarrhea, constipation, heartburn, bruising, tingling, numbness, nervousness, depression and insomnia.
Stomach Relievers (Maalox, Tums, Tagamet, Prilosec OTC,
Pepcid, Zantac, ect.):
Over-the-Counter medications that reduce the production of stomach acid can upset the natural balance of healthy bacteria required for good health, and allow unhealthy bacteria to proliferate. Proton-pump inhibitors block stomach
acid production AND increase the risk of a common infectious form of diarrhea. Taking a heartburn medication (Nexium, Losec) significantly increase the risk of diarrhea from the Clostridium difficile bacteria. Frequently prescribed anti-heartburn drugs called
H2 antagonists (Zantac, Prevacid) double the risk of the bacterial diarrhea. PPIs and H2 antagonists reduce gastric acid, allowing for bacteria to multiply in the digestive system. While antibiotics formerly blamed for outbreaks of the illness have declined
in use, the acid-blocking drugs have become steadily more popular to treat ulcers and conditions such as gastric reflux disease. Additionally, stomach medications can slow the absorption of benzodiazepines and sleeping pills and lead to increased anxiety and
insomnia. Antacids taken with antibiotics, heart and blood pressure or thyroid medications can decrease their absorption up to 90 percent, and may pose a concern with certain antidepressants. Antacids also bind to nutrients and prevent proper absorption.
Medications for GERD and acid reflux can potentiate the benzodiazepines in your system. The proton pump inhibitors (PPIs) are the most effective antisecretory agents used to treat acid-related disorders. As such, they are frequently
prescribed for patients who are concurrently using other medications. PPIs may interact with other drugs through numerous mechanisms. The most important include competitive inhibition of hepatic cytochrome P (CYP) 450 enzymes involved in
drug metabolism, and alteration of the absorption of other drugs via changes in gastric pH levels. Poor metabolizers, who lack CYP2C19, may be particularly predisposed to drug interactions. Although the potential for drug interactions
is high, few clinically significant interactions have been reported for the PPIs. Nevertheless, caution is indicated when certain drugs are co-prescribed with these agents. The incidence of clinically significant drug interactions increases
proportionately with the number of drugs taken and with the age of the patient. The drug interaction with the greatest clinical importance is the reduction in benzodiazepine clearance by omeprazole.
--Division of Gastroenterology,
Stanford University School of Medicine, CA, USA. MAY
DO NOT TAKE ANY ANTIBIOTIC THAT IS IN THE FLOUROQUINOLONE FAMILY. These usually have "flox" in the name-levafloxacin (Levaquin),
ciprofloxacin (Cipro), ect. This family of antibiotics cause a SEVERE adverse reaction when taken with benzodiazepines.
Added information and noted contraindications:
Activated charcoal can cause an acute withdrawal reaction when used while on benzodiazepines.
Detoxification can strip the active ingredients of medications from your body and blood stream putting you at risk for a
cold turkey reaction that can be difficult to pinpoint since you may be still taking your medication daily. Please be mindful that detox will rid the body of good nutrients, medications, and in some cases even your intestinal flora and yeasts that can cause
major side effects to even someone who is very healthy.