Contents
What we drink with drugs is of great importance, increases the effectiveness of therapy and allows us to avoid side effects. We explain why we should not replace boiled, cooled water, juice, coffee, tea or any other drink …
If water, how much and how much?
In leaflets attached to medicinal products, we often find information that the medicine should be washed down with a sufficient amount of fluid. However, it is not known what kind of liquid it should be and whether the use of “any” liquid will not pose a threat to human health and the success of the therapy itself. The truth is, however, that what we drink with drugs is of great importance, because it increases the effectiveness of treatment and allows you to avoid side effects.
Experts have been repeating for years that the best and safest choice is boiled, cooled down water. The degree of utilization of medicinal substances also depends on the amount of fluid with which the drug is sipped. This is especially true for drugs that contain substances that are poorly soluble in water. In such cases, an increased volume of water is required [1].
Taking into account that in practice we do not always know whether a given drug is well or poorly soluble, the general rule is that oral medications should be washed down with a glass (200-250 ml) of still, cooled down and low in minerals water.
Despite this, we still sometimes reach for a different drink or not drink the medicine at all. Let’s see what the threat is …
Why not tea or coffee?
Very often we take medications right after breakfast and instinctively, without even thinking about it, wash down the tablets with a cup of coffee or tea. Why is this a bad idea? Caffeine, which can also be found in carbonated drinks of the Cola type, significantly affects the pharmacokinetics of many drugs, causing their weakened or increased effect. For example, drinking some medications with coffee may lead to heart rhythm disturbances, insomnia, anxiety, headaches and muscle cramps [2].
Caffeine can also increase the effect of some painkillers – in order to avoid synergistic effects, a 2-hour interval between taking the drug and drinking a drink with caffeine is necessary.
Coffee may also slightly reduce the beneficial effects of statins on the heart. A cup of a small black cup should also not be washed down with iron preparations.
When it comes to tea, just like coffee, it contains tannins that can reduce the absorption of active substances in some medications, so tea can reduce the effect of some medications by up to 90%!
The tannins contained in tea bind with iron and prevent its proper absorption, which may result in the treatment being ineffective.
Why not milk and milk drinks?
The answer is simple – calcium ions contained in milk, kefir or yogurt we like so much form insoluble salts with some drugs, which reduces their absorption, and when used in therapy and washed down with milk, they may not have a therapeutic effect. On the other hand, consumption of some antibiotics together with calcium-rich drinks may reduce their concentration in the blood by up to 50%, which may indicate a weakened antibacterial effect.
Therefore, although it is recommended to drink yoghurt and kefir during antibiotic therapy, they should be consumed two hours before or one hour after taking the antibiotic.
Why not herbs?
Although herbal infusions are healthy and support the treatment of many ailments, drinking them with medications may end badly for us. St. John’s wort extracts can affect the metabolism of drugs and reverse their effects – for example, they reduce the effectiveness of contraceptives. On the other hand, medicinal plants containing polysaccharides will weaken the effects of other drugs, whether plant or synthetic, by reducing their absorption in the gastrointestinal tract. Such raw materials include marshmallow root, flax seeds and plantain.
Reducing the bioavailability of the drug may also be associated with the simultaneous administration of herbal raw materials rich in tannins. Like polysaccharides, they are macromolecular compounds that will interfere with the absorption of simultaneously taken medicinal preparations. Tannins have the property of binding substances to their surface, which leads to the complexation of numerous active ingredients. This mainly applies to minerals such as iron and zinc that are consumed at the same time. Large amounts of tannins can be found in raw materials such as cinquefoil rhizome, green tea leaf, raspberry leaf and turnip greens. In order to avoid this type of interaction, tannin and polysaccharide herbs should be used at least two hours apart from the administration of another drug [3].
Also, laxative herbs, which cause an accelerated intestinal transit, contribute to the reduction of the absorption of concomitantly consumed preparations. The raw materials that may intensify this type of interactions include senna leaf, buckthorn bark and slaughtering root.
Why not juices?
Many of us mix juices with drugs to mask their unpleasant taste. This is especially true for children and the elderly. However, it should be remembered that fruit juices, especially citrus juices, not only change the pH in the gastrointestinal tract, which interferes with drug absorption, but also affects their metabolism.
Drinking the drug with grapefruit juice leads to inhibition of the activity of enzymes that are responsible for the metabolism of certain groups of drugs, which in turn causes that the active substance of the drug does not undergo biotransformation, and thus its blood level increases, resulting in excessive drug action and toxic effects.
Thus, taking medication with grapefruit juice may lead to cardiac arrhythmias, it may also cause an excessive reduction in blood pressure, and, consequently, headaches and dizziness.
Medicines should not be mixed with cranberry juice, which increases the effect of the blood-thinning agent, leading to dangerous bleeding.
In order to avoid interactions between the juices and the drug, experts advise to keep an interval of at least 4 hours.
Why not alcohol?
Percents and medications are an extremely dangerous duo that can lead to nausea, vomiting, fainting, loss of coordination, but also to much more serious consequences such as internal bleeding, heart problems, liver damage, and difficulty breathing. Moreover, alcohol can reduce the effectiveness of the drug or make it toxic to the body. When taken even in small amounts, it can also increase the side effects of medications.
[1] Jachowicz R. Practical pharmacy, PWZL 2010: 452-456 [2] Zdrojewicz Z., Grześkowiak K., Łukasiewicz M. Is drinking coffee healthy, Medycyna Rodzinna 3/2016; 19 (3): 138-145 [3] https://opieka-farmaceutyczna.eu/artykul/interactions-pomiedzy-ziolami-a-lekami-farmaceutyczne, (accessed: 27.09.2021/XNUMX/XNUMX)