Do I tell my pharmacist?
A huge proportion of Australians take some form of complementary or ‘alternative’ medicine, regularly, or from time to time. Health professionals recognise this as a growing trend and are happy to talk to you about how to use them safely.
Non-prescription, complementary and alternative medicines and supplements
It is important that you always tell your pharmacist and doctor about all other non-prescription medicines you may be taking. These may include over-the-counter (OTC) preparations (e.g. antacids for stomach acid, or aspirin or paracetamol products for pain), alternative or complementary medicines and other supplements (e.g. vitamins or alternative health products). These can affect how well your medicines work, and what side effects might occur.
Natural products and foods
Many ‘natural’ products (including some foods) can also affect how well your medicines work, and may increase the side effects. Some natural products can influence how a medicine is absorbed or eliminated from the body, thus affecting the amount of medicine active in your system. They may counteract or enhance the effect of the medicine you have been prescribed or advised to use by your pharmacist.
Make a list and take it with you
The interactions between medicines and other products (the ways medicines affect each other’s actions) are often difficult to predict. This is because their ingredients are sometimes not listed, and not all the effects of alternative medicines and dietary supplements are known (they are not studied as well as conventional medicines). But many interactions have been identified, and some are very important. So, it is a good idea to make a list of all your prescription, OTC and complementary or alternative medicines, and take it along when you next visit your doctor or pharmacist. Remember to include:
- OTC pharmacy and supermarket medicines
- vitamins and supplements
- complementary medicines or traditional medicines
- particular foods you consume in quantity (e.g. garlic, grapefruit, liquorice).
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One common medicine interaction is with St John’s wort, which is widely used to relieve symptoms of mild depression. However, it is known to interfere with the way a number of other medicines work, including the oral contraceptive pill.
Some foods are also important. Grapefruit and grapefruit juice can increase the levels of some drugs in your bloodstream to an unsafe level. Eaten in quantity, liquorice can also affect the actions of a number of important medicines.
Registered pharmaceutical medicines and complementary medicines
When pharmaceutical medicines are registered for use by the government their composition, dose, actions, uses and known side effects are listed in the Prescribing Information.
The evidence for the safe and effective use, and side effects, of registered medicines has come from large international studies, and their safety is monitored in Australia on an ongoing basis by the Therapeutic Goods Administration.
Complementary medicines, natural products and dietary supplements are not regulated or monitored in the same way. They are currently classified as foods, and are subject to foods legislation. There is no requirement for studies of their actions and effects to have been performed, and these products are not permitted to carry any therapeutic claims.