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Should I tell my doctor what 'alternative' products I use?
A huge proportion of the population takes some form of complementary or "alternative" medicine, regularly or from time to time. Health professionals recognise this is a growing trend and are happy to talk to you about their safe use.
It is always important that you tell your doctor and pharmacist about all other non-prescription medicines you may be taking. These may include over-the-counter preparations (eg, antacids for stomach acid, aspirin or paracetamol-containing products for pain), alternative or complementary medicines and other supplements (eg, vitamins or alternative health products). These can have a bearing on how effectively your prescription medicines work and what side effects might occur.
Many "natural products" - including some foods - can also affect how well prescription medicines work and may increase the side effects. Such products can influence how a medicine is absorbed or eliminated from the body - thus affecting the amount that gets into or remains in your system. They may counteract or enhance the effect of the medicine prescribed by your doctor.
These interactions between medicines and other products are often difficult to predict because ingredients are often not listed, and all of the effects of alternative medicines and dietary supplements may not be known (they are not studied as well as conventional medicines). But many interactions have been shown and some are very important. So, make a list of what over-the-counter and complementary or alternative medicines you use and take it along when you next visit your doctor or pharmacist. (It may help to refer to our Over-the-Counter Medicines Guide). Remember to include any:
- Over-the-counter pharmacy/supermarket medicines
- Vitamins and supplements
- Complementary medicines or traditional medicines
- Particular foods you consume in quantity (eg, garlic, grapefruit, liquorice)
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The Over-the-Counter Medicines Guide summarises some of the possible interactions with complementary medicines. An example is St John's Wort, which is widely used to relieve symptoms of mild depression. However, it is known to interfere with the way a number of other medicines work, including the oral contraceptive pill.
Foods are also important. Grapefruit and grapefruit juice can increase the degree to which some drugs accumulate in your bloodstream, which can increase their effects to levels above those desired. Eaten in quantity, liquorice can also affect the actions of a number of important medicines.
Registered pharmaceutical medicines and complementary medicines
When pharmaceutical medicines are registered for use by the government their composition, dose, actions, uses and known side effects are listed in MIMS New Ethicals, New Zealand doctors' and pharmacists' directory of available drugs. Similar details are also available on www.medsafe.govt.nz - the website of the New Zealand Medicines and Medical Devices Safety Authority.
The evidence for the safe and effective use, and side effects, of registered medicines has come from large international studies, and their safety is monitored in New Zealand on an ongoing basis by the Centre for Adverse Reactions Monitoring (CARM) at the University of Otago.
Complementary medicines, natural products and dietary supplements are not regulated or monitored in the same way. At the moment, they are classified as foods and are subject to foods legislation. There is no requirement for studies of their actions and effects to have been performed, and these products are not permitted to carry any therapeutic claims.
Original material provided by everybody and reviewed March 2006.
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