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What You Need To Know About Food And Drug Interactions If You Have Arthritis

Mar 25, 2008
Medicines can treat and help with many medical problems such as arthritis. However they must be taken according to instructions to ensure they are safe and effective. Many medicines have ingredients that interact with other medicines and which also affect human organ function in different ways. This article discusses some important information for arthritis sufferers.

Medications often interact with food. Both the type of food, the timing of food intake, as well as lifestyle factors can have an effect on a drug's ability to work effectively. Certain foods, beverages, alcohol, caffeine, and even cigarettes can interact with different types of medicines. This may make them less effective or even may cause dangerous side effects.

When a person takes a medicine, they must be careful to follow the physician's and pharmacist's instructions to the letter to get the maximum benefit with the least risk. Factors that play a role in a drug's effects on the body include food interactions, alcohol, caffeine as well as other considerations such as dose of medicine, age, weight, gender, and overall health.

So let's talk about the major category of medicines used to treat arthritis conditions.

Analgesic medicines treat pain. An example is acetaminophen. For rapid relief, this medicine should be taken on an empty stomach because food may inhibit the absorption of acetaminophen. Avoidance or limited use of alcohol should be undertaken because the combination of alcohol with acetaminophen can cause damage to the liver.

Non-steroidal anti-inflammatory drugs (NSAIDS) reduce pain and inflammation. However, because these medicines potentially can cause damage to the stomach, it is best to take them with food or milk.

Avoidance or limited use of alcohol is a good idea because chronic alcohol intake can increase the risk of stomach bleeding or liver damage. Corticosteroids are used to reduce inflammation. These drugs should be taken with food or milk to reduce stomach irritation. Corticosteroids taken along with NSAIDS are a particularly harmful combination for the stomach.

Narcotic analgesics provide relief from moderate to severe pain. Some of these drugs also are used in combination with acetaminophen, aspirin, or even in cough preparations. These medicines need to be used with caution because they may cause serious side-effects such as liver damage, dizziness, or drowsiness. Concomitant use of alcohol increases the sedative effects of these medicines. Since drug absorption occurs more rapidly on an empty stomach, patients should be consistent about when they take these medicines to avoid "peaks and valleys." Generally, taking these types of drugs with food is advisable.

Non-narcotic analgesics such as tramadol should also be taken with food since stomach upset is not uncommon.

Methotrexate, azathioprine (Imuran), hydroxychloroquine (Plaquenil), and sulfasalazine (Azulfidine) are disease-modifying anti-rheumatoid drugs (DMARDS). These drugs slow down the progression of arthritis. These drugs may be taken with food but also may cause nausea. Split-dosing these medicines, meaning taking half the dose in the morning and the other half in the evening may help alleviate the nausea.

However, if a person feels sick, they should contact their physician since severe nausea may be an indication of an allergic reaction.

Some drugs like cyclosporine should not be taken with grapefruit juice or taken when a patient is eating grapefruit because there may be problems with drug metabolism and cyclosporine may not be able to be excreted in a timely fashion.

Alcohol should be strictly limited if you take these drugs particularly if a person is taking methotrexate because of the danger of toxicity to the liver.

In patients with co-morbid conditions- ie., other medical conditions, the combination of medicines required for different conditions can also lead to problems with drug-drug interaction. It is important that patients with arthritis who are taking multiple medicines for a number of conditions coordinate their medicines with their various physicians.

In any event make sure you alert your pharmacist as to what you're taking so that he or she can run a drug interaction report and make sure your medicines are compatible with each other.
About the Author
Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info: Arthritis Treatment
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