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For more information, visit the Ohio Department of Aging web site at: http://www.state.oh.

and Ohio State University Extension’s “Aging in Ohio” web site at:

Adverse Drug-Drug and Food-Drug

Medication Interactions
■ frequent falls
B ecause older adults often take more
medications than younger adults, the
incidence of adverse drug reactions does
■ depression

increase with age. Adverse drug reactions, ■ weakness or tremors

however, frequently go unnoticed or are ■ excess drowsiness or dizziness
misdiagnosed in older people for the ■ agitation or anxiety
following reasons:
■ decreased sexual behavior
■ Drug reactions sometimes mimic signs
or symptoms of disease (e.g., demen- If a problem develops shortly after a
tia). person begins taking medication it is wise
to alert a physician immediately. Some-
■ Symptoms of a drug reaction are times it takes time for an adverse reaction
thought to be caused by an existing to occur, making it less likely the problem
medical condition or the onset of a new will be associated with taking medication.
health problem.
■ Physical reactions to medication, such
as fatigue, falling, or weight loss, may Drug-Drug Interactions
be mistakenly labeled as “normal” Another type of adverse drug reaction
aging. is a drug-drug interaction. A drug-drug
There are many physical signs that interaction occurs when the effect of one
may be attributed to an adverse drug drug is altered by the presence of another
reaction. These include: drug in the body. For example:
■ fatigue ■ One drug might reduce or increase the
effects of another drug.
■ constipation or diarrhea
■ Two drugs taken together may produce
■ confusion
a new and dangerous interaction.
■ incontinence
SS-129-97-R02—page 2

■ Two similar drugs taken together may also interact with prescription medication.
produce an effect that is greater than Some examples of this type of interaction
would be expected from taking just one include:
■ Aspirin can significantly increase the
Prescription drugs can interact with effect of blood thinning drugs (antico-
each other, for example: agulants), thus increasing the risk of
■ Mixing antidiabetic medication (e.g., excessive bleeding.
oral hypoglycemics) and beta blockers ■ Antacids can cause blood-thinning
(e.g., Inderal) can result the decreased drugs (anticoagulants) to be absorbed
response of the antidiabetic drug and too slowly.
increased frequency and severity of
low blood sugar episodes. ■ Antacids can interfere with drug ab-
■ Mixing antidiarrheal medication
sorption of antibiotics (i.e., tetracy-
(e.g., Lomotil) and tranquilizers (e.g., cline), thereby reducing the effective-
Transxene, Valium), sedatives (e.g., ness of the drug in fighting infection.
Dalmane, Quaalude), or sleeping pills ■ Antihistamines, often used for aller-
(e.g., Amytal, Nembutal, Seconal) can gies and colds, can increase the seda-
result in an increased effect of tranquil- tive effects of barbiturates, tranquiliz-
izers, sedatives, or sleeping pills. ers, and some prescription pain reliev-
■ Mixing antihypertensive medication ers.
(e.g., Reserpine, Aldoril, Combipres) ■ Decongestants in cold and cough
and digitalis (e.g., Lanoxin) can result medications can interact with diuretics
in abnormal heart rhythms. or “water” pills to aggravate high blood
■ Mixing anticoagulants (e.g., pressure.
Coumadin, Warfarin) and sleeping
■ Iron supplements taken with antibiot-
pills (e.g., Nembutal, Amytal, Seconal)
ics can reduce or stop the ability of the
can result in decreased effectiveness of
antibiotics to fight infection. (The
the anticoagulant medication.
chemicals in the supplement and the
In addition to prescription medica- antibiotic bind together in the stomach,
tions, over-the-counter medications can instead of being absorbed into the
interact with each other. Some examples bloodstream.)
■ Salt substitutes can interact with
■ Taking a cough medication with alco- “water” pills or blood pressure medica-
hol at the same time as an antihista- tion to increase blood potassium levels.
mine medication can increase drowsi- This can result in symptoms of nausea,
ness and decrease alertness. vomiting, muscle cramp diarrhea,
■ Mineral oil taken with fat-soluble muscle weakness, and cardiac arrest.
vitamins (A, D, E, K) can decrease the
These are just a few of the many
absorption of the vitamins.
interactions that can occur when multiple
In addition to interacting with each medications are taken together. Check
other, over-the-counter medications can with your doctor or pharmacist to make
SS-129-97-R02—page 3

sure your medications do not have the Check with your pharmacist on how food
potential to interact. can affect your specific medications.

Drug and Food Interactions Factors Affecting the Extent of

When drugs and certain foods are Interaction Between Foods and Drugs
taken at the same time they can interact in The impact of food-drug interactions
ways that diminish the effectiveness of the will depend on a variety of intervening
ingested drug or reduce the absorption of factors. For example:
food nutrients. Additionally, vitamin and
herbal supplements taken with prescribed ■ The dosage of the drug.
medication can result in adverse reactions. ■ A person’s age, size, and state of
Some examples of how foods and health.
drugs can interact include: ■ When the food is eaten and when the
■ Food can speed up or slow down the medication is taken.
action of a medication. Avoidance of drug interactions does
■ Impaired absorption of vitamins and not necessarily mean avoiding drugs or
minerals in the body. foods. In the case of Tetracycline and dairy
■ Stimulation or suppression of the
products, these should simply be taken at
appetite. different times, rather than eliminating one
or the other from the diet. Having good
■ Drugs may alter how nutrients are used information about the medications you
in the body. take and timing your medications around
■ Herbs may interact with anesthesia, your food intake can help to avoid drug
beta-blockers, and anticoagulants. interaction problems.
Foods containing active substances
that work against certain medications can
produce unexpected or adverse effects. If
you are taking medication, the food you Senior Series Volume 2, The Center
eat or the supplements you take could on Rural Elderly, University of Missouri
cause the medication to work incorrectly. System.

Adapted by: Paula M. Taliaferro, MGS, The Central Ohio Area Agency on Aging.
Revised by: Christine A. Price, Ph.D., Extension State Specialist, Gerontology with assis-
tance from Drs. Sereana Dresbach and Bella Mehta (July 2001).

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