Knowing about drugs and Pharmacy Chulalongkorn University: Drugs and Drinks (Part 2)

    Continuing our discussion from the previous session on consuming medicines with milk or milk-based drinks, today we delve into the topic of medications and other types of beverages. We'll explore whether they can be taken together and highlight important precautions to consider.

    Let's commence with beverages that warrant moderation in consumption, notably alcoholic drinks such as spirits, beer, and wine. In general, these beverages are not strictly prohibited. However, caution must be exercised when combining them with drugs that possess central nervous system depressant effects, inducing drowsiness. Examples of such medications encompass antihistamines, cold remedies, opioid pain relievers, antidepressants, and sleep aids.

    Pairing these drugs with alcoholic beverages can intensify the depressant impact on the central nervous system, posing heightened risks, particularly for some patients. It's important to recognize that this group of drugs often carries a label warning of drowsiness and advising against activities like driving. Some medications may feature additional specific warnings against concurrent consumption with alcohol.

    A common question that arises is the timing of alcohol consumption when taking medication. If one desires to consume alcoholic beverages while on medication, a rule of thumb is to allow a duration greater than four hours after the drug's action commences. For many drugs, this means it's advisable to avoid alcohol during the treatment period.

    Moreover, certain medications can lead to alcohol poisoning due to their interference with alcohol metabolism. Hence, pharmacists often advocate abstaining from alcohol for the duration of the medication regimen.

    Moving on to beverages containing caffeine—such as tea, coffee (excluding dairy), and certain cola brands—these are generally safe to consume with medications, except for those containing caffeine themselves, like the well-known migraine pain reliever, Cafergot, and its equivalents. This medication comprises both caffeine and ergotamine.

    Taking these drugs alongside other caffeine-containing beverages could lead to caffeine overdose, characterized by symptoms like restlessness, palpitations, and diarrhea—especially for individuals who are sensitive to caffeine. Additionally, for medications that cause palpitations, like bronchodilators, nasal decongestants, and thyroid hormone supplements, caution is advised when pairing them with caffeinated drinks.

    Lastly, we touch upon the category of fruit juices. While juices might seem innocuous, certain types—like grapefruit juice—can dangerously interact with medications. Grapefruit, though not a familiar fruit in Thailand, possesses a unique sweet and sour taste with a refreshing aroma. Substances within grapefruit can inhibit enzymes that metabolize specific drugs, altering their effectiveness or even causing severe side effects when consumed concurrently.

    Frequently used drugs prone to grapefruit juice interactions include certain statin cholesterol-lowering medications and immunosuppressants prescribed for organ transplant recipients. Pomegranate and mafuang juices also exhibit similar interactions. It's advisable to abstain from consuming these juices while on medication to avoid potential complications.

    In summary, when it comes to combining medications with beverages other than plain water, caution is crucial. Labels often contain warnings to guide users. Therefore, individuals taking medications should diligently read labels before consumption. If uncertainty persists about which medications can be taken with desired beverages, consulting a pharmacist for guidance is recommended. Reach out to us at @guruya for more information.

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

Faculty of Pharmacy Chulalongkorn University