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Tag: prescription

  • Combining supplements with prescription drugs may cause treatment failure – Experts

    Combining supplements with prescription drugs may cause treatment failure – Experts

    Angela Onwuzoo

    Pharmacists and physicians have said it is dangerous to indiscriminately take prescription drugs alongside dietary supplements without seeking advice or counselling from qualified healthcare personnel.

    They noted that supplements contain certain ingredients, which though, are micronutrients, could interfere with drugs and lead to treatment failure.

    The experts warned patients suffering from chronic health conditions such as diabetes, hypertension, and cardiovascular diseases, not to take supplements without discussing it with their doctor or a pharmacist.

    This, they said was imperative to avoid adverse reactions, which could lead to organ failure and prolonged healing time, especially when used for long.

    Speaking exclusively with Reportr Door Healthwise, a pharmacist, Dr. Samuel Adekola, said that taking supplements is not bad, but the choice of which to use is very critical and of major concern to medical professionals.

    The one-time past National President, Association of Community Pharmacists, Nigeria, said, “This is one of the biggest burdens of pharmacists.  Many hospitals don’t know about micronutrients.

    “That is the truth and that is why they are not prescribed in the hospital.  Community pharmacists are supposed to help the population with the choice of supplements to use.

    “People should endeavour to seek counsel from pharmacists on the choice of appropriate micronutrients or supplements to use.  This is because there are tendencies for what is known as food-food interaction, food-drug interaction, and drug-drug interaction to take place. Wrong usage of supplements could lead to treatment failure and toxicity in the body.

    “Dietary supplements are widely used and they include vitamins, minerals, and other less familiar substances—such as amino acids, botanicals, and botanical-derived ingredients. Evidence has shown that many Nigerians take some form of dietary supplements alongside prescription medications.”

    The United States Food and Drug Administration says mixing medications and dietary supplements can endanger one’s health

    FDA states that dietary supplements may contain ingredients that can have strong effects on the body and recommended that patients speak with health care professionals before taking them.

    “Combining dietary supplements and medications could have dangerous and even life-threatening effects. For example, drugs for HIV/AIDS, heart disease, depression, treatments for organ transplants, and birth control pills are less effective. Depending on the medication involved, the results can be serious”, FDA warned.

    Dr. Adekola affirmed that supplements are good, but that they should be a complement to medications.

    “Some micronutrients could be useful in persons on antihypertensive medication. Supplements can counter the side effects of certain drugs, for example, diabetes drugs. The long-term usage of these drugs has some other deleterious effects on the body and you can’t stop using them. Also, supplements help to address dangerous metabolites. There would be a need for them to consistently be on supplements”, he said.

    However, giving further insights into risks associated with the indiscriminate use of supplements alongside prescription drugs, Dr. Adekola, said, “They are at risk of food-food interaction, food-drug interaction, and drug-drug interaction consequences.

    “The first one is about therapeutic failure. You know that therapeutic drugs are taken to elicit healing purposes. Unfortunately, if the supplements are not used rationally, they can affect the absorption of drugs and prolong healing processes because you are getting suboptimal dosage. And the reason you are getting suboptimal dosage is that something has hindered the absorption, and in this case, it is the supplement.”

    Supplements, the expert further, said could as well decrease the absorption of certain drugs.

    “Prolonged use of supplements with medication can lead to toxicity and organ failure. The supplements may interact with the main drugs to hinder absorption. This leads to under-absorption or over-absorption.  It will either give you treatment failure or exposes you to the risk of toxicity

    “On drug-drug interaction, when you now use them with some other drugs that either compete for their absorption, maybe they have the same part wave of absorption, it may lead to treatment failure. We must emphasise that the choice of supplements to use must be advised or decided by a competent healthcare professional,” Dr.  Adekola said.

    In the same vein, a Consultant Physician and Cardiologist, Dr. John Asekhame, told Reportr Door Healthwise that taking supplements with prescription medication should be done with a doctor’s knowledge and recommendation.

    The physician, who works with Providence Multi-Specialty Hospital, Abuja, said dietary supplements on their own are harmless, but that some medications can react to them.

    “Supplements may make you have an adverse reaction to prescription medications. They may have side effects, though it depends on the composition of the particular supplements,” Asekhame added.

    In a 2019 study published by an online journal, PubMed Central, the researchers said one in every two people that combined supplements with prescription drugs stand the risk of potential interaction.

    According to them, “Specifically, older people and the population with a higher educational level represent a profile at risk of a potential interaction between medications and nutritional supplements.

    “Older people are also more likely to use both drugs and supplements because of a higher potential to get sick.

    “This is an important issue from a public health perspective, as there are population groups, such as the older population that are high consumers of these two kinds of health products.

    “This study is one of the first to examine factors associated with specific medication-dietary supplement interactions.”

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  • Experts warn against taking hypertension drugs without doctor’s prescription

    Experts warn against taking hypertension drugs without doctor’s prescription

    Angela Onwuzoo 

    Medical experts have cautioned Nigerians against taking hypertension medications without getting a prescription from a doctor.

    According to the experts, it is dangerous for people diagnosed with hypertension to take drugs that are not prescribed for them.

    The physicians also said it is risky for people to ignore their medications when diagnosed with hypertension.

    The experts stated this during separate interviews with Reportr Door HealthWise, stressing that people suffering from hypertension should only take medicines prescribed for them by their doctors.

    Dr. Michael Ajala, a Consultant Pathologist, told our correspondent that hypertensive patients should avoid taking herbs and supplements because some of them have addictive properties.

    Dr. Ajala, who is the Chief Executive Officer of Help Diagnostics and Checkup Services, Lagos, said those diagnosed with hypertension must avoid self-medication.

    The pathologist said, “Don’t share drugs with friends and family members.”

    “When you are taking antihypertensive drugs, don’t take herbs and supplements.”

    “When you are taking antihypertensive drugs, please don’t take herbs or some other supplements because some of these things have addictive actions that may be damaging and that will be bad for the health status of whoever is taking them.

    “There are a lot of them on the internet, but the question is, have they been tried in proper trials? Some of them will even claim that they are NAFDAC-approved when they are not”.

    The Mayo Clinic says herbal supplements aren’t necessarily safe just because they’re natural.

    It warned that people should avoid supplements that may interfere with blood pressure medication.

    “Check with your doctor before taking any herbal supplements.” “You may need to avoid supplements that raise your blood pressure or interfere with your blood pressure medications,” the clinic cautioned.

    The Ajala noted that high blood pressure affects many organs of the body and causes impaired vision.

    The physician added, “It is very dangerous for people to go and buy antihypertensive drugs without a doctor’s prescription because they saw their friends taking them.

    “Doctors make you do some tests; based on these tests, apart from the blood pressure measurement, they then offer a solution in the drugs.”

    “So, you don’t take drugs that are not prescribed for you, especially for hypertension, as they can kill just like that.”

    “There is nothing like my friend is taking it, so I can take it,” he said.

    Dr. Ajala also said that skipping hypertensive drugs has a lot of disadvantages, warning that it causes a lot of cardiovascular damage.

    He urged Nigerians to have regular blood pressure checks and work with their doctor when diagnosed with hypertension.

    A general physician, Dr. Oyinkansola Taiwo, said hypertension is a public health problem that should not be handled with kid gloves.

    “Hypertension is a public health problem that we need to spend our time tackling.”

    “For hypertension, awareness is key.” We have to let our people know that hypertension is something that can be managed. We have to let them know that once they start using their medication, that is not the end.

    “Most people that we see, once they start using their medication, then they stop using it.”

    She also counseled people with hypertension to reduce salt in their diet and avoid energy drinks.

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  • Why Nigerians should stop taking supplements without prescription —Pharmacists

    Why Nigerians should stop taking supplements without prescription —Pharmacists

    Tony Ademiluyi

    Pharmacists have cautioned Nigerians against taking dietary supplements without the prescription of a health expert, noting that self-medicating on supplements could be dangerous to health.

    According to the drug experts, unknown to many people, some dietary supplements should not be taken by persons who are taking certain medications for some health conditions. 

    Certain dietary supplements, they added, should also not be taken by some people living with or managing some health conditions, because the interactions of the supplements with the medications for those health conditions could be lethal and injurious to health.

    Speaking with our correspondent, the pharmacists, a Nigerian-American, practising in the United States, Dr. Patience Abeeb, and Unoaku Ifudu, Territory Lead with Field Intelligence — a pharmaceutical supply chain company based in Abuja, urged Nigerians to seek and get prescriptions before deciding to purchase dietary supplements.

    Speaking with Reportr Door HealthWise, Dr. Abeeb explained that a dietary supplement basically contains ingredients intended to add further nutritional value to supplement a regular diet. 

    Dietary supplements, she said, could be a vitamin, herb, mineral, botanical or amino acid.

    The Philadelphia-based pharmacist said, “Before you take any dietary supplement, it is important you discuss it with your healthcare professional. You must inform your healthcare provider about all the dietary supplements and medications you are currently taking. You should also include the dosages and how many times a day you take them. This is important.

    “If you are thinking of adding any dietary supplement to your daily routine, call your healthcare professional first, and let him/her know what other supplements and medications you are taking. 

    “Also, tell your healthcare professional if your health status has changed, particularly if you are breastfeeding, or have had recent illnesses or surgery”.

    She warned that combining dietary supplements and medications could have dangerous or even life-threatening effects. 

    “For example, some drugs for heart diseases, depression, treatments for organ transplants, and birth control are less effective when taken with some herbal supplements. The results of such combinations can be serious.

    “In addition, warfarin (a prescription blood thinner), and gingko biloba (a herbal supplement) can thin the blood. Taking these products together may increase the potential for bleeding. 

    “Don’t assume natural means safe. It is not”.

    She also cautioned parents against giving their children dietary supplements without first talking to health experts.

    She said, “Children, in particular, could be harmed by taking supplements and medicines at the same time. Children’s metabolisms are unique, and at different ages, they metabolise substances at different rates. 

    “Therefore, for children, ingesting dietary supplements together with other medications makes adverse effects a real possibility”.

    The pharmacist also urges caution in the use of dietary supplements while pregnant and breastfeeding.

    She said, “If you are pregnant or breastfeeding, it is advisable to first discuss any dietary supplements you intend to take with your health care professional”.

    Also speaking with our correspondent, Unoaku Ifudu corroborated Dr. Abeeb’s admonition on the need for Nigerians to seek a doctor’s prescription before taking dietary supplements.

    She said: “I wouldn’t even advise anyone to take supplements without a doctor’s prescription. There are various classes of supplements but then generally, the ones I am talking about are the ones sold in pharmacies. They are often purchased based on the recommendations of friends or colleagues who have suffered health challenges that are claimed the supplement can heal. There is no consideration for the fact that not all body systems are the same. 

    “You might actually be harming yourself while taking the supplement your friend told you about. Some dietary supplements contain neurotoxins and substances that could harm certain organs in your body. Most of them are meant to be taken in moderation, yet some people may take an overdose of it.”

    She also stressed the need for Nigerians to know that supplements can interact with food and other drugs.

    She said, “There are certain medications that shouldn’t be taken with supplements and some foods as there is what we call food-drug interaction and drug-drug interaction. Supplements can interact with food and other drugs to cause adverse effects in the body. 

    “For instance, if someone is hypertensive, he or she isn’t advised to take a dietary supplement that has sodium. It is not advisable. 

    “In pharmacy school, I studied pharmacognosy which made me understand that some of these natural products came from the source without its being synthesised. Some of them actually have medicinal value but the challenge is with the dosage which may make the patients take an overdose and worsen their heart health”.

    She stressed further that Nigerians who are desirous of taking dietary supplements should discuss first with their physician or pharmacist who will counsel them on the appropriate ones as well as the right dosage.

    According to a recent study published by Premier Health — an online health information platform, dietary supplements may interfere with prescription medications. 

    The chemical interactions of dietary supplements may be dangerous or minor, but they can weaken medications and make them less potent, the article said.

    In another study published by Single Care — another online health information platform, the authors said medications could interact with dietary supplements and worsen the efficacy or the side effects of the medications. The authors of the study advised that dietary supplements should be taken with a doctor’s prescription.

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  • FG warns against buying antibiotics without prescription

    FG warns against buying antibiotics without prescription

    Lara Adejoro

    The Federal Government has warned Nigerians against buying antibiotics over the counter, saying it accelerates antimicrobial resistance and leads to avoidable deaths.

    The FG made this known on Friday at a press briefing to commemorate World Antimicrobial Awareness Week with the theme ‘Preventing Antimicrobial Resistance Together’.

    The government said the consequences of AMR can affect both human and animal health.

    It noted that AMR is one of the top 10 global public health threats facing humanity and has inhibited the effective treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.

    AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spreading to others.

    The Reportr Door reports that the WAAW is celebrated from November 18 to 24 November every year.

    Speaking at the briefing, the Chair, Nigeria Antimicrobial Resistance Coordination Committee, Dr. Tochi Okwor said buying antibiotics without prescription fuels antimicrobial resistance.

    She said, “The dangers of buying antibiotics over the counter are many. You are not sure if the antibiotics you are buying is the right one for what is wrong with you. For you to be sure of the antibiotics to take, your sample has to be taken in the lab and it is in the lab that the organism causing the infection is known.

    “How do you know the dose to take? Who monitors the dosage you take? You have to be advised on the dose to take and you have to be monitored by an expert.

    “The best way to take antibiotics is to go to the hospital, have a health worker check you and take your sample, have your result come out in a timely manner and use what we call antibiotics formulary, we have guidelines of antibiotics to prescribe according to the specific guidelines.”

    She added that the government has developed a national antimicrobial resistance action plan in 2017 to aid the monitoring of the nation’s progress in reducing AMR.

    “We have built human capacity in the area of ability to make a diagnosis. We have built human capacity, so we now have a national surveillance site for tracking antimicrobial resistance in the country and we have well-established labs that are quality assured and manned by competent well trained human resources,” Okwor added.

    She noted that available projections suggest that by 2050, AMR could cost $300 billion to over $1 trillion annually globally.

    She said in Nigeria, seven out of 10 persons in the community access antibiotics outside licensed health facilities or pharmacies while many patients in the hospitals are over-prescribed antibiotics that have a higher risk of bacterial resistance selection (above the 60 per cent target set by WHO).

    “In the animal health sector, antimicrobials are available in the open markets without restriction, hence the misuse of these products especially in food-producing animals. Residues of these antimicrobials in eggs, milk, and meat, when consumed by humans can potentially cause cancers, allergies, and mutations,” she added.

    Also, a representative of the Chief Veterinary Officer of Nigeria, Federal Ministry of Agriculture and Rural Development, Dr. James Balami said it was estimated that by 2050, 10 million worldwide deaths could result from antibiotic resistance, making it deadlier than cancer.

    Balami said, “It is estimated that about 70 per cent of antimicrobial agents sold in the world are used in the animal health sector. In 2020, about 1.8 million tons of active ingredients were imported for use in animals from eight classes of antimicrobials.

    “Most classes of antimicrobial agents used in animals are also used in humans such as tetracyclines, aminoglycosides, penicillins, macrolides, sulfonamides, fluoroquinolones among others.

    “The misuse and overuse of antibiotics in food animals predisposes to residues in animal products such as meat, milk and eggs. Residues of antimicrobials in foods are potentially allergenic, mutagenic, teratogenic or carcinogenic. Furthermore, inadequate clean water and poor biosecurity measures in livestock production increase the risk of disease introduction and spread which in turn increases the need for antimicrobials. Poor adherence to vaccination against preventable diseases also exposes terrestrial and aquatic animal species to diseases hence the need for treatment with antimicrobials. ”

    The event was organised by the Nigeria Centre for Disease Control in collaboration with other MDAs and other development partners.

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  • US relax regulations on prescription opioids

    US relax regulations on prescription opioids

    United States health officials issued new recommendations on Thursday to relax restrictions for doctors prescribing opioids for pain, despite the risk of addiction.

    The Centers for Disease Control revised principles issued in 2016 in an attempt to curb the opioid overdose epidemic in the United States.

    Unlike the previous document, the new guide refrains from setting thresholds in terms of dosage or prescription duration.

    These had led doctors to suddenly cut or drastically reduce patients’ doses. States and insurance companies were also inspired to set their own limits.

    Chronic pain patients had complained that they no longer had access to the drugs that would allow them to lead a normal life, and had warned of the increased risk of suicide in their ranks.

    The new recommendations, compiled in a 200-page report, seek a balance. One in five Americans suffers from chronic pain and “opioids can be essential medications for the management of pain, however, they carry a considerable potential risk,” the authors of the document wrote.

    The guidelines are not “a replacement for clinical judgment or individualised, person-centered care” or “intended to be applied as inflexible standards of care,” the report says.

    But it recommends caution, warning that opioids should be considered only after other pain treatments have failed, and at each step, physicians should discuss the issue with their patients.

    If they decide to use opioids, they should first prescribe the lowest effective dose and then closely monitor the effects of the treatment.

    If problems arise, physicians should also avoid abruptly terminating opioid prescriptions and should ensure appropriate care for those with complications.

    As a precautionary measure, the agency recommends that people using opioids over a prolonged period be offered Naloxone, an antidote that can save someone who is overdosing, said Christopher Jones, a senior CDC official, at a press briefing.

    Opioid prescriptions increased fourfold between 1999 and 2010 in the United States. Although the trend has reversed since 2016, they have created addictions and driven some patients to drugs like heroin and fentanyl.

    Last year, the US had a record 107,000 overdose deaths, more than 70 percent of which were from illegal synthetic opioids.

    (AFP)