Paul's Heart

Life As A Dad, And A Survivor

Understanding Drug Interactions

I got an unusual phone call the other day.  It was from my pharmacist.  She wanted to make me aware of two medicines that I was having renewed, they could cause a potential problem.

Unfortunately, while typically I write about my experiences based on the world of cancer, there are literally millions of people, either currently or in the past, having dealt with Covid19, need to be aware of the medicines and potential interactions.

Up until around 2008, all I had really taken was a prescription for my thyroid, damaged from my radiation therapy for Hodgkin’s Lymphoma, something for my high cholesterol, and to help with my blood pressure.  In 2008, that all changed.  To date, I now take nine different medications, all related to the late effect issues that I deal with.  In twelve years, this is the first time I had heard from a pharmacist personally though.

I have a large number of doctors that I deal with, and I trust them with the medicines I need to take.  I trust them to be aware of any interactions between the medications, and to weigh the benefits and risks.

In 2019, I had to have yet another procedure, the second on my heart.  But unlike the open heart surgery I had in 2008, this procedure was going to involve a stent (ironically for an artery that they knew about in 2008 with the other surgery, just did not fix it).  Because of the stent, I would need to take more than the baby aspirin I took from my open heart surgery.  I was prescribed an actual blood thinner.

Later in the year, I saw a different cardiologist, who noted on my record, the list of medications that I took, and noticed a medicine I take for gastrointestinal issues.  He was concerned.  As he stated, there is a likelihood that that medicine and the blood thinner interaction could actually negate the benefit of the blood thinner.  I would need to change the medicine I took for my stomach.

There was only one problem with that.  No other medicines are able to handle the issue I deal with for my stomach.  We are talking quality of life at this point.  Not to mention the fact, not being able to take this medicine would also increase risks of complications with my GI system, and likely lead to aspiration pneumonia (I have written other posts on this).

Then the suggestion, was to try a newer blood thinner.  The problem with that, the cost was enormous and unaffordable.

As a consensus made among all of my doctors, 95% of us, including me, agreed that I would continue on the path that I had been for the last year.  And that was the last I had heard of it, until the phone call from the pharmacist.

I want to be clear.  I completely am so appreciative for a pharmacist who does so much more than just fills prescriptions.  This is the first time in my life, I have ever had a pharmacist even tell me of a potential conflict.  Up until then, if you wanted to find out about conflicts, you went to the web site drugs.com for the potential issues.

Now, with Covid19, and the treatments for it, things get really complicated for me, but not necessarily a cakewalk for someone who has never had cancer.  You still need to have that awareness.

One of the early popular drugs thought to be helpful, now disproven, when combined with an antibiotic, could cause cardiac issues.  The use of steroids?  Not when you have a known heart condition.  Treating someone like me who has a history of a drug called Bleomycin (for my chemo) with oxygen, a huge no-no.  I have spent decades being aware of the medicines I need to stay alive, or save it.  Even foods you eat can impact a medicine you need such as grapefruit.  Certain statin drugs (for cholesterol) actually have their effects reduced by grapefruit.  If you take a medicine for your thyroid, they tell you not to take any other medicines with it, because the drug will affect the absorption of any other medications.  I have learned way more than I have ever wanted to about medicine and prescriptions.

It would be just so much easier not to have to take any of them.

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