Combining drugs with certain food items can be risky

TOKYO —

On Friday, the Supreme Court approved the sale of drugs via the Internet, paving the way for resumption of online sales of over-the-counter drugs.

Shukan Post (Jan 18) warns readers that there are risks that go beyond the instructions for taking proper drug dosages. Michiko Hori, author of “It’s scary not to know the risks from the dangerous relationship between drugs and foods,” tells the magazine: “Medications have various ingredients and the side effects can change depending on what they’re combined with. If they’re taking a regular medication, people should be able to determine what other drugs to avoid mixing together. That’s why it’s necessary, when they go to the hospital, that they tell the physician what drugs they’re taking.”

But according to Hori, another concern is not being given the attention it fully deserves: the risks of combining drugs with certain food items.

Some combinations that can result in unhappy consequences.

The tyramine present in cheese, for example, causes blood pressure to rise, making it dangerous to eat while taking cold remedies. The pseudoephedrine in decongestants can also be dangerous for people with high blood pressure.

In addition to cheese, fava beans and red wine also contain high levels of tyramine that can cause unpleasant side effects when eating after taking cold remedies.

Even aspirin is known to carry risks, due to its properties as an anticoagulant.

“Taking asprin can be dangerous for people with high blood pressure, as it can lead to cerebral hemorrhage,” cautions Hori. “Similarly the risks from asprin are elevated for people on anticoagulants or drugs for reducing platelet functions.

Tonic drinks and supplements containing turmeric, a substance said to be effective against hangovers, can also be risky.

Those taking fever reducers containing Acetaminophen, such as Contac, are cautioned against eating cabbage.

“Acetaminophen and cabbage don’t mix well,” warns internist Toshiro Ikeya. “Cabbage is high in glucuronic acid, which causes the acetaminophen to be excreted from the body more rapidly, nullifying the effects of the drug. Also for those taking cough remedies containing theophylline, the side effects can be worsened by consuming cacao-based products, as the theobromine in them can lead to headaches or insomnia. So people should avoid eating chocolate or drinking cocoa before or after they take such medications.”

The article warns against other drug and food combinations, including antiseptics and wakame (a sea vegetable); stomach remedies and beefsteak; laxatives and milk; sleeping aids and alcoholic beverages; blood pressure reducers and grapefruit; and athletes foot remedies and fried foods. It also provides a sidebar with warnings on how to avoid potential problems from 16 popular pain killers and other over-the-counter remedies.

Aside from these, numerous other substances can cause the body to react in unpleasant ways when used in combination. If taking a medications to prevent motion sickness and then engaging in exercise, for example, the risk of heat exhaustion is multiplied. Likewise for cold medications containing antihistamines.

“If taking some combination causes you to feel indisposed, it’s important to observe its progression carefully,” advises the aforementioned Dr Ikeda. “If you take countermeasures at an early stage, you can prevent the symptoms from worsening, so there’s no need to panic.”

“In the old days, people would advise against swallowing medicine with green tea, the tannin in which affected the dosage,” points out author Hori. “But now the technology for producing pharmaceuticals has been improved, and they can be taken with green tea with no ill effects.”

Still, one can’t be assured of the benefits of drugs without knowing their accompanying risks.

  • -2

    The_True

    Why in the US people don't have any of this problem? This is a way to scare people like every other industry in Japan always do, so they can keep they control and high price

  • 0

    Virtuoso

    Since it costs virtually nothing for people in Japan with health insurance to visit a doctor, why would anyone want to use over-the-counter meds when they can get real prescription drugs that almost certainly work better? My doctor even suggested I phone for an ambulance (free in Tokyo) to take me to see him, if I was too indisposed to trudging up the hill where his hospital is located. I told him that I'd take a taxi at my own expense.

  • 7

    Newsman

    All right -- suppose all of this is true. Exactly when was the last time I got the same sort of information from my local pharmacy, explaining all of the possible side effects of combining my medicine with certain foods? English OR Japanese? Last time I checked, all the packaging said was "1 day, three times." So how in the world is ordering medicine online any different from the information doctors and pharmacies in Japan provide every single day?

  • 2

    Maria

    This is an interesting article. I can't say I believe all of it is true, but I know a fair bit of it is, and it's worth reading. And people in the US, and anywhere else, are just at risk from these these problems - of taking different meds at the same time, which then interact poorly; of mixing OTC meds with prescribed ones; of taking meds with certain foods which can prevent efficacy, or even make things worse. Don't drink alcohol with your meds - that's a no-brainer!

    Read the small print, ask your doctor, don't self-diagnose an unknown ailment

    .

  • 13

    Frungy

    This article is a red herring. The current dispute is whether drugs sold over the counter in pharmacies should be allowed to be sold on the internet. If you go to Genky, Aoki or some other local drug store you won't receive any more warnings about these things than you would if you bought them online. Instead over the counter drugs rely on you opening the box, reading the documentation and taking the medication in a responsible and adult fashion.

    What is even more dishonest about this article is that it states:

    That’s why it’s necessary, when they go to the hospital, that they tell the physician what drugs they’re taking

    No doctor or pharmacist in Japan has EVER discussed my diet with me before prescribing or dispensing medication. I can only recall a single consultation where the doctor had enough presence of mind to ask if I was taking any over the counter medication that wouldn't appear in my file.

    This article completely misrepresents the reality of the situation by implying an unrealistically high standard of concern over drug interactions in hospitals and a complete lack of warnings in internet medication. The truth is very different from what the author implies.

  • -2

    badsey3

    It seems we should be going to the MD daily or even hourly for our medications (and food) it seems. Why do Doctors always seem to be in worse shape than you?

    Notice: It is all about the over-the-counter (now internets) medications they are talking about that are historically considered safe.

  • 0

    Yubaru

    Since it costs virtually nothing for people in Japan with health insurance to visit a doctor, why would anyone want to use over-the-counter meds when they can get real prescription drugs that almost certainly work better?

    On the surface this sound true but the way doctors here only prescribe the weakest available medicine for nearly everything it makes the patients keep coming back for treatment and raising the costs.

    My daughter had an ear infection here, she ended up going to the doctor here for nearly 6 months before he declared her cured. In the states, she got another ear infection, gone in 3 days thanks to the meds the doctor gave us.

    I can give tons of other examples as well, but the point is over the counter meds here are weak in comparison to other countries, as the hospitals and drug companies control the market and it's all about money.

  • 0

    Seirei Tobimatsu

    Everything in excess is poisonous. Let's go lean & long.

  • -5

    Mike Critchley

    Doctors here in Japan are mostly useless. They undershoot in medication strength, prolonging illness and keeping people coming back (which is one reason why it takes all afternoon to see a doctor). And they certainly don't warn you about possible side effects of anything. Nor do pharmacists. They typically only warn against the more obvious drug reactions.

    So let me buy online any day of the week. Those sites have more information that any Matsumoto Kiyoshi pharmacist will ever give you!

  • 2

    Jack Stern

    Most foreigners I assume, can't find the OTC medications they are used to using in Japan so they search the internet for them. And even when they are found such as Bufferin or Tylenol, they cost much more. Try finding Contac for a reasonable price. Alka-seltzer is not available except on the internet. I do agree that seeing a doctor for prescription medication here is very reasonable.

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