Beverages and Elixirs (Part 1)

    Many of you may have encountered the issue of feeling that a prescribed drug is not working effectively or experiencing undesirable side effects despite following all the instructions, keeping the medication away from sunlight and moisture, and maintaining the right temperature. Today, I'd like to address one possible reason behind such problems: drug interactions.

    Drug interactions, also known as drug-drug interactions, occur when two or more medications interact with each other in ways that can counteract their effects, enhance their effects, or lead to additional side effects. This interaction can sometimes result in toxicity or produce unexpected outcomes that affect the overall treatment.

    Moreover, drugs can also interact with the food and drinks we consume, leading to what is called drug-food interactions. For instance, some medications may not work as intended if taken with certain foods or beverages. You might have seen labels on medicine containers advising against taking them with milk or antacids because these substances can directly interact with the drugs, reducing their absorption or effectiveness.

    Certain medications, particularly those sensitive to stomach acid, have a protective coating designed to break down in the small intestine, ensuring their efficacy. When such drugs are taken with milk, the milk's acidity can interfere with the protective coating, causing the drug to deteriorate prematurely and not treat the condition effectively. It is crucial to be aware of hidden sources of milk in various drinks, such as coffee with milk, pearl milk tea, yogurt smoothies, and soy-based beverages, as they can have the same problematic effect.

    For some people, avoiding drugs that interact with milk is manageable, but for others, it can be a significant challenge, especially if they are coffee addicts who prefer their coffee with milk. In such cases, there are two options: switching to black coffee or adjusting the timing of medication and coffee consumption to be at least two hours apart. However, it's essential to ensure that the medication can be taken on an empty stomach to avoid any issues.

    In addition to milk or milk-containing beverages, other drinks, such as soft drinks, fruit juices, and alcoholic beverages, can also interact with medications. These interactions will be discussed in more detail in the next week's discussion.

    In summary, being aware of drug interactions and drug-food interactions is crucial for optimizing the effectiveness of medications and avoiding unwanted side effects. If you have concerns or questions about how your medications might interact with food or drinks, it's best to consult your healthcare provider or pharmacist for personalized advice.

Assoc. Prof. Dr. Nattada Areepiam and Asst. Prof. Dr. Bodin Tiwasuwan

Faculty of Pharmacy Chulalongkorn University