Health

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 PUNCH 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 PUNCH 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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