Drug Interactions

One of the hardest things to handle in dealing with the medical world is to the relativity of treatments and the un-sureness, evasiveness, almost wishy-washy-ness of medical professionals. Studies evolve all the time, and change the recommendations for some treatments sometimes drastically, overnight – so you never quite know what you need to be on and for how long and how will affect you, really. And no one knows. It’s a risky business.

I have decided a long time ago to have no regrets! I will do what the doctors tell me to do today, with the information they have at the time. And if the information they have now will prove incorrect after studies and many years of practice, well, then, we’ll stop what we’re doing and move on with whatever health we have left. I mean, what would be the alternative, and what would be the point of regrets?!

The alternative is to do nothing, of course. Take nothing. Use our judgment when we choose our lifestyle and hope for the best. I used to take nothing for years – and I felt not so good. Sure, there is no day in my life free of pain or discomfort now, too, but overall, I feel better, more functional, I can do more and that’s why I’ll take whatever drugs they have available for now.

Long intro, I know. My point in this piece was going to be about how un-sure and relative doctors and their helpers are when they are prescribing meds. So, my heart doctor just added a blood pressure medication to my treatment, because some days (key word is “some”, here), my blood pressure is high. OK! I knew this day is coming. With my heart problems and with everyone in my family (even the non-FH folks) with high blood pressure, it was almost a no brainer. Well, I am not sure what it is, but this new medication (Diovan) makes me dizzy, out of focus, and hot in my brain (for lack of a better medical word) right after I take it. I am not sure whether it’s the medication itself (those are some of the side effects), or the fact that I take a beta blocker (Atenolol) on top of it? Or because I take Atenolol+aspirin+Diovan at the same time? Or because I take aspirin, too, with all that? I have no clue.

A google search on the drug interactions of Diovan reveals (on drugs.com) that it interacts with both aspirin and Atenolol. As for the latter – the combo of Diovan+Beta blocker+ ACE inhibitor drug is fatal, and “the mechanism is unknown”. I am not on an ACE inhibitor drug, but made me wonder.

So, I call my doctor to ask: should I be taking all these 3 together? Should I be taking the whole 40 mg pill of Diovan on top of the 100 mg of Atenolol? Should I be taking an aspirin with everything? Should I take Diovan only in the second part of the day, since my BP usually goes up at night only?

I get a call form the doctor’s PA and she is full of “if”-s and “not sure”-s. She usually is, but this is somewhat important, I am thinking – playing with my heart (literally), not to mention my liver and what goes through it!

They prescribe this triple combo to people ALL the time and they have no issues, she says. They have never seen Diovan react with ANY drug (go to drugs.com or any other site that provides this and see the list of interactions). I should take it at noon, since the BP is high at night, OR I should take half of it in the morning and half at night OR I should take it ONLY when I take my BP and it’s high – and that also means “not every day”, if my BP is not high every day. Again: which is it?!

I mention to her that it says on the bottle and in the drug’s description online that I can’t skip dosages and I have to take it daily almost at the same exact time every day – and not on and off. She concludes: “Umm… no – that’s not true”.

So, who do you trust? What do you read? Who is the authority here? My mom has a good friend that’s a pharmacist and she told me years ago she argues with doctors all the time about how meds work and react and the doctors just won’t listen. She said it’s all about the chemistry – the chemistry you put in the drugs and the chemistry in your body and how they react with each other. Doctors have a good knowledge of the anatomy of the body but chemistry – not so much, not always, it seems. So, she sees them prescribe random stuff all the time. I am not saying my doctor did, but I surely wish I knew more about why I feel like walking on a cloud half an hour after I take this thing and for about 2 hours after that.

Anyway, I am not convinced at all that this is what I should be taking, if anything for my “randomly high” BP. I am not sure what I’ll do next, but a couple of days’ break from it might clear my head. Literally.