Some websites that sell medicine can be not state-licensed pharmacies or aren't pharmacies at all; or may give a diagnosis that is not correct and sell medicine that is not right for you or your condition; or won't protect your personal information. The medicines that sold online can be fake (counterfeit or 'copycat' medicines); can be too strong or too weak, or have dangerous ingredients, or have expired (are out-of-date), or haven't been approved or checked for safety and effectiveness, can be made using non-safe standards, or not safe to use with other medicine or products you use. Make sure the site requires a prescription and has a pharmacist available for questions.
If you take several different medicines, see more than one doctor, or have certain health conditions, you and your doctors need to be aware of all the medicines you take. Doing so will help you to avoid potential problems such as drug interactions. Drug interactions may make your drug less effective, cause unexpected side effects, or increase the action of a particular drug. Some drug interactions can even be harmful to you. Reading the label every time you use a nonprescription or prescription drug and taking the time to learn about drug interactions may be critical to your health. You can reduce the risk of potentially harmful drug interactions and side effects with a little bit of knowledge and common sense. Early in a drug's development, companies conduct research to detect or predict potential interactions between drugs. Experts evaluate the drug-interaction studies as part of assessing a drug's safety. When a drug is taken orally, it usually travels from the stomach to the liver, where it can be metabolized-the process of breaking down and removing chemicals from the body. Enzymes are complex proteins that act as catalysts in starting or speeding up chemical reactions. They cause a specific chemical change in other substances without being changed themselves. The most important enzymes in the liver that metabolize drugs are called the cytochrome P450 family of enzymes. These enzymes break down drugs when they pass through the liver or small intestine. It used to be that the only way to test for drug interactions was in people. Now drug companies can take five test tubes with the five major pathways for metabolism and put their drugs in to see whether it's metabolized by CYP450. This allows to generate a list of possible interactions based on their findings. Researchers say there are several important variables that affect individual differences in how drugs are metabolized, including race, gender, age, and health conditions. For example, people with kidney or liver disease don't eliminate drugs from their system as well as people who are healthy. Very young children and older people have slower drug metabolism than others, and women may metabolize drugs differently than men in some cases. Health professionals also use computer systems with drug-interaction screening software, electronic prescribing, and other technology. Mark Langdorf, M.D., chair of the department of emergency medicine at the University of California, Irvine, says, "In a busy emergency room, you have to quickly find out what a patient is taking and how those drugs could interact with other treatments." But it is good way -- consumers remind doctors of everything they take when they are prescribed a new medication. So a patient might say: "Now remember, I'm also taking birth control pills. Is there a risk of interaction with this new medicine?" Examples of food with tyramine are cheese and soy sauce. Grapefruit juice should not be taken with certain blood pressure-lowering drugs or cyclosporine for the prevention of organ transplant rejection. Alcohol should not be taken with pain relievers such as Tylenol (acetaminophen) or ibuprofen because of the increased risk of liver damage or stomach bleeding.
Before using any medicine--as with many things that you do every day--you should think through the benefits and the risks in order to make the best choice for you. There are several types of risks from medicine use: a) The possibility of a harmful interaction between the medicine and a food, beverage, dietary supplement (including vitamins and herbals), or another medicine. Combinations of any of these products could increase the chance that there may be interactions. b) The chance that the medicine may not work as expected. c) The possibility that the medicine may cause additional problems. To obtain the benefits of riding in a car, you think through the risks. You consider the condition of your car and the road, for instance, before deciding to make that trip to the store. The same is true before using any medicine. Every choice to take a medicine involves thinking through the helpful effects as well as the possible unwanted effects. The benefit and risk decision is sometimes difficult to make. The best choice depends on your particular situation. You must decide what risks you can and will accept in order to get the benefits you want. You need keep an up-to-date, written list of ALL of the medicines (prescription and over-the-counter) and dietary supplements, including vitamins and herbals, that you use--even those you only use occasionally. Important things is tell to your doctor about any allergies or sensitivities that you may have. Tell about anything that could affect your ability to take medicines, such as difficulty swallowing or remembering to take them. Before use a medicine make sure you understand the directions; ask your doctor if you have questions or concerns. Always double check that you have the right medicine. Ask your doctor always if there are interactions with any other medicines or dietary supplements (including vitamins or herbal supplements), beverages, or foods. Use the same pharmacy for all of your medicine needs, whenever possible. Ask your doctor if there is anything you can do to minimize side effects, such as eating before you take a medicine to reduce stomach upset. You always have to pay attention to how you are feeling; note any changes. Write down the changes so that you can remember to tell your doctor, pharmacist, or other health care professional.
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