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Drug interactions are an integral part of any pharmacotherapy. The medications taken affect not only the human body, but also each other's actions. Alcohol and some food ingredients should be added to this. Combining them can be really dangerous. How can it affect high blood pressure?

In Poland, arterial hypertension affects approx.32% of people . This problem mainly affects the elderly, who often treat several ailments at the same time. This, in turn, results in a large number of medications taken and, consequently, a high risk of interactions between them.

However, while combinations of medications recommended by a doctor and used chronically are not generally a source of side effects, they may occur in the case of acute use by such peopleover-the-counter medications. The most dangerous in this respect areanti-inflammatory, analgesic and antipyretic drugs- very often used without reading the leaflet and careful reflection on their impact on chronic drugs.

Drug interactions: OTC drugs

The most popular group of drugs with anti-inflammatory, analgesic and antipyretic properties are the so-called NSAIDs ( non-steroidal anti-inflammatory drugs ). These include active substances such as:

  • acetylsalicylic acid,
  • ibuprofen,
  • dexketoprofen,
  • naproxen,
  • diclofenac,
  • metamizol (also known as pyralgina).

In turn, paracetamol is the drug with "only" analgesic and antipyretic properties. Their use in the simultaneous pharmacotherapy of hypertension should be cautious for the simple reason -they reduce the effect ofantihypertensive drugs.

How to tell if there is any interaction in a hypertensive patient who has taken one of the drugs mentioned? The patient should be alerted by the following symptoms:

  • swelling around the ankles,
  • deterioration of well-being,
  • tinnitus,
  • hot flow,
  • headaches.

Most often, however, the increase in pressure is not felt by the patient. Therefore, they should be checked regularly while taking anti-inflammatory and analgesic drugs.

So how should patients with hypertension behave when somethingdo they hurt or have a fever? In the first place, you should try treatment with a drugthe lowest risk of side effects . In practice, this usually means starting analgesic treatment with paracetamol or acetylsalicylic acid at the lowest effective dose.

If this treatment is unsuccessful, other NSAIDs can be used in the order in which their potency increases:

(paracetamol ->acetylsalicylic acid ->ibuprofen ->naproxen ->diclofenac ->dexketoprofen ->metamizol).

If none of them bring relief, the choice of drugs from the so-called2nd stage of the analgesic ladder , i.e. a combination of paracetamol with a weak opioid and, optionally, an adjuvant. This group includes over-the-counter medicines containing paracetamol and codeine, and additionally supplemented with caffeine, which is the adjuvant mentioned.

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Hypertension medications and alcohol

Many people believe that high blood pressure excludes the possibility of drinking alcohol, which interacts with drugs used in this ailment. This is not entirely true. Small amounts of alcohol-containing beverages do not alter the effects of antihypertensive medications. Such a combination usuallydoes not endanger the he alth and lifeof the patient.

However, it must be remembered that alcohol can affect the amount of blood pressure itself. Immediately after consumption, it will be slightlylower- this effect lasts for approx.8 hours . Immediately followed by thephase of blood pressure increase . Therefore, people planning to consume alcohol in the evening should not give up taking medications for hypertension, because they will most likely experience an increase in blood pressure the next morning.

Of course, not every amount of alcohol is safe in the case of antihypertensive medications. Its abuse will lead to the occurrence of quite dangerous side effects:

  • dizziness,
  • faint,
  • sleepiness,
  • arrhythmia.

People taking drugs such as quinapril, doxazosin, clonidine, losartan or enalapril should be especially careful.

Beware of cholesterol-lowering drugs!

The effects can be much more seriousalcohol abuse with simultaneous use of drugs forelevated cholesterol levels , often included in the treatment of hypertension. If you take them, you should absolutely not reach for drinks containing alcohol.

Use of drugs such as:

  • lovastatyna,
  • rosuvastatin,
  • atorvastatin,
  • simvastatin,
  • pravastatin

can increase the activity of liver enzymes up to three times. For those who consume large amounts of alcohol, it will result in irreversibleliver damage .

Interactions of antihypertensive drugs with food

Taking care of a proper diet is an important element supporting the pharmacotherapy of hypertension. However, controlling the amount of calories, carbohydrates and fats you eat is not enough. There are often individual ingredients in foods that can interfere with how medicines work. The consequences of the interactions prosecuted in this way are often difficult to predict, and therefore very dangerous.

People with high blood pressure who takemetoprolol, propranolol or bisoprololshould not combine these drugs withhigh-fat meals . These types of food may increase their absorption rate, leading to a slow heart rate, arrhythmias, drop in blood pressure and heart failure. High fat meals will also increase the absorption of antidepressants such asamitriptyline, clomipramine, imipramine . As a result, the concentration of drugs in the blood will increase and their side effects will increase.

Perhaps the most dangerous dietary component for people using any pharmacotherapy is grapefruit and grapefruit juice. It contains ingredientsthat slow down the metabolism of many pharmaceuticals , which in turn leads to a dangerous increase in their blood levels.

Currently known43 medicationswith which he interacts dangerous. These are preparationscardiology, oncology, statinsorimmunosuppressive . Taking one tablet of any of these drugs with grapefruit juice may have the same effect as taking5-10 lozenges . The effects of this may vary and depend on the type of medication:

  • stomach bleeding,
  • breathing difficulties,
  • kidney damage,
  • heart rhythm disturbance,
  • and even death.

People usingamlodipine, felodipine, nifedipine, nitredypineandverapamilshould be especially careful. These drugs interact with the grapefruit juice thatreduces their metabolism. This leads to a drop in pressure, facial flushing, and headache. Also, sedative and hypnotic drugs, such asmidazolam and diazepam , should not be used in conjunction with grapefruit juice as this may result in respiratory and circulatory depression.

The same interaction takes place when grapefruit juice is used concomitantly with the anticonvulsant drug -carbamazepine . As you can see, any type of active substance introduced into the body (and these are all drugs) can change its action when combined with others.

That's why it's worth to interactask doctors and pharmacists , but most of all carefullyread leafletsmedications.

Apart from grapefruit juice, other citrus fruits can also interact with medications:pomelo or bitter orange . You can eat a sweet orange that does not cause interaction without fear.

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Which medications reduce the effects of antihypertensive drugs?

It has been shown that the reduction of antihypertensive effect by non-steroidal anti-inflammatory drugs (e.g. aspirin, ibuprofen) is higher with beta-blockers (e.g. bisoprolol, metoprolol) and angiotensin converting enzyme inhibitors (e.g. ramipril, enalapril), lower for diuretics (e.g. furosemide, spirinol), while calcium antagonists seem to be neutral (e.g. amlodipine, nitredypine). Clinical trials show an average increase in blood pressure in people treated with NSAIDs of about 5 mmHg.

The article was published in the monthly "Zdrowie"

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