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Doctors' Answers to "Frequently Asked Questions" - Multiple Medications

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Possible Interactions
Question: I am currently taking the following medications: CENTRUM vitamin 81 mg Bayer Select 2xdaily Flonase 2 sprays per nostril 1xdaily Astelin 2 sprays per nostril 2xdaily Azmacort 4 pubs 1xdaily Zyrtec 5mg 2xdaily Duratuss 1200 mg 2xdaily Mechlazine 25 mg as needed for BPV Allergy shots bi-weekly Could taking all of the above cause any adverse reactions, and if so, which medications would you suggest be either eliminated or replaced?

Answer: Off hand there should be no interactive adverse reactions between these drugs. Aspirin can produce asthma in susceptible patients; but, I suspect you would know if this drug produces asthma in your lungs. Also, Zyrtec has been implicated in liver problems on occasional patients-so, I would check this drug first. The other drugs shouldn't produce too many problems. The duratuss and the meclizine would be the next drugs I'd eliminate in order of potential problems.

Synthroid & Lipitor
Question: I have been prescribed synthroid (.125mg daily) and Lipitor (10 mg. daily). I have not felt as good as I should since these were prescribed together. Is there any truth that they should not be taken together?

Answer: No interaction as far as I know; but, checking your TSH will answer the question.

Question: I have been taking axotal or axocet for headache resulting from head injury intermittently for several years with no side effects other than mild sedation. My doctor prescribed Phenobarbital for me for a suspected seizure disorder. Instead of sedation, I experienced hyperactivity, rapid heart-beat, insomnia, and eventually, skin rash. I have had vastly different reactions to related drugs in the past (e.g. codeine vs. hydrocodone), where the simpler drug seems OK, but the more complex or engineered version gives me problems, plus doesnít do what it is supposed to do. I tend to have allergic/idiosyncratic reactions to newer, engineered (e.g. make it less drows making, but more powerful in the pain-reduction department). Is Phenobarbital an engineered version of a simpler barbiturate? Is there another explanation for this reaction?

Answer: Phenobarbital is one of the older drugs in medicine being invented in 1912 as the first seizure medication. Some patients do experience idiosyncratic reactions to this or any drug. But, it has nothing to do with modern "drug engineering".

Insulin & Lasix
Question: Is there a drug interaction between insulin and LASIX? Does LASIX reduce the activity of insulin?

Answer: Diuretics have the potential to elevate glucose somewhat. The mechanism of action is not entirely clear; but, there does not appear to be any direct effect between lasix and insulin.

Flu Medications
Question: Iíve been told to take some drugs for Flu infection 4 times a day. By deduction it means every 6 hours. But the fact the timing may run into your sleeping time and it seems to me that consumption every 6 hours isn't practical. Related question...What does it really mean after food or before food to consume the medicine...How long before or after will be effective.

Answer: There is a difference between Q6H and QID. These are both pharmaceutical terms. The first means every 6 hours the other means four times a day. In the hospital Q6H means every 6 hours regardless of whether one is sleeping, QID means before bed-on arising and about every 6 hours during the day. Most outpatients take medications QID not Q6H. But, there is a difference-check with your physician. AC means before meals and usually means 20-30 minutes before meals. PC means after meals and usually 20-30 minutes after eating.

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