How Grapefruit Juice Can Interfere With Medications
With most drugs that are affected by grapefruit juice, the juice lets more of the drug enter the blood, says Shiew Mei Huang, Ph.D., of the FDA. When there is too much drug in the blood, you may have more side effects.
For example, if you drink a lot of grapefruit juice while taking certain statin drugs to lower cholesterol, too much of the drug may stay in your body, increasing your risk for liver and muscle damage that can lead to kidney failure.
Many drugs are broken down with the help of a vital enzyme called CYP3A4 in the small intestine. Grapefruit juice can block the action of intestinal CYP3A4, so instead of being metabolized, more of the drug enters the blood and stays in the body longer. The result: too much drug in your body.
The amount of the CYP3A4 enzyme in the intestine varies from person to person. Some people have a lot of this enzyme and others just a little. So grapefruit juice may affect people differently even when they take the same drug.
Although scientists have known for several decades that grapefruit juice can cause too much of certain drugs in the body, more recent studies have found that the juice has the opposite effect on a few other drugs.
Why this opposite effect? Instead of changing metabolism, grapefruit juice can affect proteins in the body known as drug transporters, some of which help move a drug into our cells for absorption. As a result, less of the drug enters the blood and the drug may not work as well, Huang says.
Special Precautions & Warnings
Pregnancy and breast-feedingPOSSIBLY UNSAFE
Not enough is known about the safety of using melatonin when breast-feeding. It is best not to use it.
Children: Melatonin is POSSIBLY SAFE when taken by mouth as a single dose. It is POSSIBLY UNSAFE when taken by mouth or injected into the body in multiple doses in the short-term. Because of its effects on other hormones, melatonin might interfere with development during adolescence.
Bleeding disorders: Melatonin might make bleeding worse in people with bleeding disorders.
Depression: Melatonin can make symptoms of depression worse.
Diabetes: Melatonin might increase blood sugar in people with diabetes. Monitor your blood sugar carefully, if you have diabetes and take melatonin.
High blood pressure: Melatonin can raise blood pressure in people who are taking certain medications to control blood pressure. Avoid using it.
Seizure disorders: Using melatonin might increase the risk of having a seizure.
Transplant recipients: Melatonin can increase immune function and might interfere with immunosuppressive therapy used by people receiving transplants.
Blood Tests That Require Fasting
Some blood tests will require you to fast completely beforehand. In these cases, your medical practitioner will instruct you not to eat or drink anything, except water, in the hours leading up to the test. It is important that while fasting you continue to drink water as this will help keep your body and your blood hydrated and thus, easy to obtain a blood sample.
Not eating before some blood tests are carried out is crucial to making sure that the results of the blood test are correct and accurate. The core ingredients such as protein, vitamins and so forth, that essentially all of our food and drink are made of can have an effect on the reading of the levels of your blood which could have a fundamental effect on the results meaning a wrongful diagnosis or extra testing may come about as a result of this.
You will not have to do this for every blood test, not all blood tests need a fasting element before they are commenced. Blood tests that will likely require the need to fast for include
- Renal function panel
- Lipoprotein panel
Dependant on what test you are having will determine how long you need to withhold food for. Most blood tests that require a fasting element will expect the patients not to have anything but clear water for eight to nine hours before and leading up to the blood being taken. In terms of some blood tests, the patient will be required to not consume anything for a longer period, which is usually up to twelve hours.
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What To Know About Aspirin
Before recommending a daily aspirin, doctors weigh the potential benefits against the risks, which, according to the Mayo Clinic, include:
- Bleeding stroke, caused by a burst blood vessel.
- Bleedingin your digestive tract .
The AHA advises against taking a daily aspirin without talking with your doctor first. Your doctor can weigh your individual risks and benefits and make a recommendation.
Dr. Yang says he typically recommends low-dose aspirin commonly sold in 81 milligram dosage for patients who take daily aspirin therapy. “It is just as effective as regular-strength aspirin in terms of reducing the risk of heart attack and stroke,” he says. “We don’t usually recommend higher-strength aspirin because it may increase the risk of bleeding, which we’re trying to avoid.”
For pain relief, you can also take ibuprofen, another over-the-counter medication, while taking a statin, says Dr. Yang. But, “similar to aspirin, it is a nonsteroidal anti-inflammatory medication and so, if taken in excess, can increase the risk of bleeding, can increase your blood pressure it can sometimes cause kidney damage.”
When To See Your Doctor
Check in with your doctor whenever you have concerns about your general health. If you have any of the risk factors for high cholesterol, a quick blood test can reveal a lot and allow your doctor to take action. Sometimes lifestyles changes are enough to whip your numbers back into shape. Your doctor can also prescribe statin drugs to lower your cholesterol if necessary.
Trouble sleeping is another issue you may want to bring to your healthcare providers attention. Even an additional hour of sleep each night can shift your numbers, so try to head to bed a bit earlier tonight. Relaxation techniques like yoga and meditation are great for unwinding before bedtime. If these home methods dont help, your doctor can point you in the right direction or possibly prescribe medication.
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Other Supplements Vitamins And Herbal Remedies Not To Ingest And Why
I know many people may take herbal supplements. Some can be very good for you, but many are contraindicated with anesthesia or surgery in general. Since these supplements are over-the-counter and generally safe to use, some patients might forget to disclose their consumption to their surgeon and anesthesiologist. Many of these are contraindicated and can severely hurt you when used in conjunction with anesthesia, other medications, or while undergoing surgery. Furthermore, just because these products are derived from plants and are considered natural, many medications and drugs are actually considered dangerous. Please keep this important point in mind: while you may be embarrassed to disclose your use of medications for weight loss, sexual performance, or depression, dont be. Nothing is embarrassing when it comes to safety. This is your life be truthful with us!
How Much Should I Take
Because of its ability to promote sleep, melatonin should be taken before bedtime. Doctoroz.com recommends taking 0.3 to 1 milligram of melatonin an hour and a half before bedtime. The website warns that taking too much melatonin — more than 1 milligram — may have an adverse effect and end up disrupting your sleep cycle. Lack of sleep may in turn raise your blood pressure according to the American Heart Association.
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Red Yeast Rice And Niacin
If you are one of the 95 million Americans with high cholesterol, you might like the idea of taking a natural supplement to lower your levels. Two possible pills that lower cholesterol levelsred yeast rice and niacindont play well together. Doubling up doesnt increase the benefits and may be harmful to the liver, says Todd Sontag DO, a family medicine specialist with Orlando Health Physician Associates in Florida. When prescription cholesterol-lowering drugs are added to the mix, your risks can increase. Be sure youre aware of niacin flush and what you can do about this potential side effect.
Side Effects Of Melatonin Interactions
- Sleepiness and drowsiness with sedative medication the interaction between sedative medications or depressants and melatonin can lead to excessive daytime sleepiness and drowsiness. It is essential you avoid taking melatonin with medications like lorazepam, clonazepam, zolpidem, etc.
- Wakefulness with caffeine combining melatonin with caffeine may result in decreased melatonin effects. Caffeine will overpower melatonin, so instead of sleepy, one might feel more wakeful and alert.
- Increased blood sugar with diabetes medication because melatonin increases blood sugar levels, and the diabetic medication lowers it, it can completely overpower the effectiveness of diabetes medication. This can lead to some serious issues in diabetic patients, who should avoid taking melatonin with insulin, glimepiride, glipizide, rosiglitazone, etc.
- Bleeding risk with anticoagulants because melatonin slows down blood coagulation, it should be smart to avoid taking it together with medication that has the same effects. The combination of anticoagulants with melatonin may cause bleeding and bruising. Such medications include aspirin, ibuprofen, naproxen, enoxaparin, heparin, diclofenac, etc.
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Statins Are Not For Everyone
Although they are very effective in lowering cholesterol levels, statins may not be for everyone. There are some things you should let your healthcare professional know before you begin statin therapy.
This includes any medical conditions you may have or any medications you are taking. Medications are not limited to those prescribed to you by another healthcare provider but include over-the-counter and dietary or herbal supplements as well.
Additionally, if you receive medical treatment from someone other than your healthcare professional, you should let that person know that you are taking a statin.
Other Possible Melatonin Side Effects
- Melatonin and birth control effects melatonin supplements may not be safe for women trying to get pregnant. It seems that melatonin has similar effects as birth control, making it more difficult for women to reach ovulation and become pregnant. Some evidence shows that lower doses, up to 3mg are safe, but there is not enough research to prove that.
- Melatonin and bleeding disorders it is believed that regular melatonin intake can worsen the symptoms and effects of bleeding disorders. Studies show that melatonin may slow blood clotting or coagulation, which may lead to excessive bleeding and bruising.
- Melatonin and epilepsy studies and current data show that melatonin can trigger or worsen epilepsy and seizure frequency in some people. While some experts argue otherwise, some professionals do not recommend melatonin intake in people who are prone to having epileptic or other types of seizures not even small doses.
- Melatonin and transplant recipients because melatonin can increase the immune function, it might interfere with immunosuppressive therapy used by transplant recipients.
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The Effects Of Melatonin On Elevated Liver Enzymes During Statins Treatment
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.|
|First Posted : April 20, 2017Last Update Posted : April 20, 2017|
- Study Details
Introduction Statins are widely used in the treatment and prevention of lipid metabolism disorders. They are generally well tolerated but not devoid of side effects. These include, among others, muscular symptoms, arthritis, headaches, gynecomastia. Myositis and rhabdomyolysis associated with increased activity of creatinine kinase and serum creatinine levels are rare but serious adverse events of statin therapy. The risk of these complications is increased in elderly patients with chronic diseases and in alcohol abusers.
In own study melatonin was used for this purpose because previous experimental studies had demonstrated that it protected liver against harmful effects of many toxic agents as well as the consequences of ischemia-reperfusion model.
An alternative metabolic pathway includes melatonin oxidation to N-acetyl-formyl-5- methoxykynuramine and N-acetyl-5-methoxykynuramine . The kynurenine pathway of melatonin metabolism leads to formation of a series of free radical scavengers.
What Drugs And Food Should I Avoid While Taking Melatonin
Melatonin may impair your thinking or reactions. Avoid driving or operating machinery for a least 4 hours after taking melatonin. This product may also affect your sleep-wake cycle for several days if you are traveling through many different time zones.
Avoid using melatonin with other herbal/health supplements. Melatonin and many other herbal products can increase your risk of bleeding, seizures, or low blood pressure. Using certain products together can increase these risks.
Avoid coffee, tea, cola, energy drinks, or other products that contain caffeine.
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Who Shouldnt Take Melatonin
When considering all the side effects and possible melatonin interactions with certain medication, the following groups should avoid taking melatonin
- People suffering from inflammatory or autoimmune diseases,
- Pregnant or breastfeeding women,
- Ovulating women trying to get pregnant,
- People who have responsible jobs, where sleepiness and drowsiness can cause possible safety problems,
- People with epilepsy or a history of seizures,
- People with mood, behavior, or personality disorders,
- People with bleeding disorders,
How To Handle An Herbal Drug Interaction
Advice from your health care provider is your best option in preventing serious health effects from any drug interaction.
Remember that herbal supplements are not subject to FDA oversight and have not usually been tested in clinical studies to prove their effectiveness or safety.
Contact your health care provider if you discover that a possible drug interaction may occur between medications and herbal products that you use.
Do not stop taking your medication unless directed to do so by your doctor. The interaction may be insignificant and no change may be needed on the other hand, the interaction could be serious and the herbal supplement may need to be discontinued.
More questions? Visit our Top 9 Ways to Prevent a Deadly Drug Interaction slideshow and join the Drugs.com Herbal Support Group to ask questions about drug interactions, check on the latest medical news, and provide your feedback, too.
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St Johns Wort And Antidepressants
You need to be wary of over-the-counter or prescription drugs that can interact poorly with supplements, says Robert Glatter, MD, an assistant professor of emergency medicine at Northwell Health in New York City. For example, St. Johns wort may cause fever, confusion, and anxiety if its taken with other antidepressants. Antidepressants and St Johns wort both increase levels of the feel-good brain chemical serotonin. This can cause serotonin syndrome and in severe cases, it may lead to muscle rigidity and seizures, he says.
Top 10 Medications That Deplete Your Body Of Essential Nutrients
There are about 900 drugs and fixed-drug combinations used in US today. Almost 400 prescription medications can deplete specific nutrients.
We are taking prescription drugs in increasing numbers. Nearly 50 % of American adults take at least one prescription medication, and nearly 20 % take 3 or more.
But are we healthier because of it? Are these new drugs really improvements over older versions? While we hear daily of new drug miracles, more often, its the latest debacle: Baycol, a drug for lowering cholesterol, withdrawn from the market because of deaths and transplants due to severe liver damage Vioxx, for arthritis, withdrawn because of heart disease-related complications.
Among the most ignored side effects, which are quite common and can be life threatening, are nutrient depletions. Most medications will rob your body of essential nutrients.
What can You do to prevent these detrimental side effects of the prescriptions medications?
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How To Take It
There is currently no recommended dose for melatonin supplements. Different people will have different responses to its effects. Lower doses appear to work better in people who are especially sensitive. Higher doses may cause anxiety and irritability.
The best approach for any condition is to begin with very low doses of melatonin. Keep the dose close to the amount that our bodies normally produce . You should only use the lowest amount possible to achieve the desired effect. Your doctor can help you determine the most appropriate dose for your situation, including how to increase the amount, if needed.
- Always ask your child’s doctor before giving melatonin to a child. In fact, doses between 1 to 5 mg may cause seizures in this age group.
- You should work with your doctor to find the safest and most effective dose for you. The right dose for you should produce restful sleep with no daytime irritability or fatigue.
- Jet lag: 0.5 to 5 mg of melatonin 1 hour prior to bedtime at final destination has been used in several studies. Another approach that has been used is 1 to 5 mg 1 hour before bedtime for 2 days prior to departure and for 2 to 3 days upon arrival at final destination.
Fasting And Taking Medication Before A Laboratory Test
Since many blood tests require you to be fasting, while other tests do not, the general recommendation is that you should be on a fast of 8-10 hrs. Fasting means nothing to eat, drink , smoke or chew during these 8-10 hours. Furthermore, if your blood test includes Triglycerides, then you should be on a fast of 12-15 hours.
You do not have to be fasting before collection of a urine specimen, a stool specimen, a semen specimen, or a specimen for routine bacteriological culture
The best person to answer this question is your doctor. But generally speaking, it depends on the type of medication you are taking and the reason for doing the laboratory test. Here are some examples:
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