Serotonin syndrome and bleeding may be the result of taking two types of medication simultaneously
As much as they can help, drugs, if they are badly combined, can even hurt more. Problems with the heart, blood vessels, the nervous system and respiratory tract, for example, occur occasionally due to the simultaneous taking of two types of drugs, which are intended for the treatment of various diseases. Certain medications should not be combined, while prescribing a third drug in order to reduce the risk of side effects of the previous two, is an option that is often practiced.
Bleeding from the digestive tract is one of the most common problems that arise when taking two medications that can jointly cause health complications.
- Bleeding can be a consequence of an increase in the anticoagulant effect of drugs, in the case when another drug is used that reduces the release of anticoagulants from the body. Therefore, doctors and pharmacists should take into account both during prescription and during the issuance of prescriptions - says Professor Miroslav Savić from the Faculty of Pharmacy in Belgrade, a member of the Commission for the Registration of Human Medicines Agency for Medicines and Medical Devices of Serbia.
Simultaneous administration of monoamine oxidase inhibitors and antidepressants from the serotonin withdrawal inhibitor groups may cause serotonin syndrome.
- Such medications can be used after the drug initially initiated is discontinued, and after a certain period of time the application of the other one begins - says prof. Savić.
Prescribing a third drug, which reduces the risk of side effects of one or more drugs that are applied concurrently, is one of the solutions. Proton pump inhibitors are used to protect the gastric mucosa, when the patient is taking several drugs at the same time, which is the case during recovery after a myocardial infarction. To reduce gastric juice, antisecretory drugs are used.
- If a bad reaction occurs, an adequate solution should be found. Nevertheless, it does not necessarily mean that the same combination of drugs will cause problems for everyone. Most of the complications that result are not severe, unless absolute contraindications are clearly not indicated - says prof. Savić.
Apart from two drugs that mutually reinforce or have the opposite effect, individual foods can also strongly affect drug metabolism. Grapefruit juice inactivates the enzyme involved in the activation of certain drugs, as well as the inactivation of some others.
- In the first case there is a decrease, and in the second an increase in the effects of drugs. Comparative application of grapefruit juice together with antiagregative drug prasugrel leads to a decrease in the activity of the drug, in this case reducing the antiaggregatory effect - explains prof. Savić.
Changes and problems that did not exist before the application of therapy are one of the main signs that the patient is poorly responding to therapy and that it is necessary to perform an additional medical examination.
THE EFFECTS CAN BE PREDICTEDUnwanted effects can usually be predicted and must be indicated on the package.
- Contraindications can endanger the patient's life, they must be emphasized in expert information on medicines. Doctors and pharmacists have an obligation to avoid the comparative use of such drugs when prescribing or issuing medicines - says prof. Savić.
