Prescription Medications and interactions, side effects, danger, metabolism and review of benefits and risks
December 1 2017 by
Ray Sahelian, M.D.

Many patients are placed on prescription medications and doctors rarely take the time to review the long list that can accumulate over time to see if they are all necessary and whether dosages need to be adjusted or certain drugs eliminated. Many people taking prescription or over-the-counter medications may not fully understand how and why to take them. If you are one of the 7 out of 10 Americans taking prescription medications, ask your doctor to make sure if you really need all of them. 

Those who use a prescription drug take four, on average, and many also take over-the-counter drugs, vitamins and other dietary supplements. Many of those pills may be unnecessary and might do more harm than good.

What are the potential side effects with long term use?
What condition is this medication for, and what is it supposed to do? Do I still need it? Can I take it less frequently or in a lower amount?
How long should this medication be taken?
What are the special instructions for this medication -- time of day it should be taken, how often, with food or water?
Can this prescription medication interact with other drugs I'm taking?
Will these medications interfere with some of the natural supplements I am taking?

2017
Some prescription meds could impair the ability to drive. In addition to sedatives and narcotics, some antihistamines, some antidepressants, some blood pressure meds, muscle relaxants and even stimulants -- may negatively influence driving ability.

2016
Taking one of the most-prescribed medications in the world -- proton pump inhibitors -- might dramatically increase a person's risk for kidney failure and kidney disease. The study was released April 2016 in the Journal of the American Society of Nephrology. Doctors prescribe proton pump inhibitors, also known as PPIs, to help people who suffer from regular heart burn, ulcers, gastroesophageal reflux disease or acid reflux. They are sold under the names Prevacid, Prilosec, Nexium, Protonix, Aciphex and others.

Infants and children given psychiatric drugs without testing
Many doctors worry that these drugs are used despite no published research into their effectiveness and potential risks for children so young.

Danger of prescription medications
FP Essent. 2015. Adverse Effects of Common Drugs: Adults. Although drugs can be an essential and lifesaving component of the care of adult patients, their use frequently is accompanied by adverse effects and life-threatening adverse drug reactions that can result in significant disability and mortality. The potential for drug-related severe morbidity and mortality is compounded during periods of hospitalization, when high-risk drugs such as anticoagulants or insulin are used, and when care in an intensive care unit is required. Patient factors in adults that can increase the risk of drug harms include immunosuppression, cognitive impairment, depression, alcoholism and other substance abuse disorders, chronic kidney disease, hepatic dysfunction, coagulopathies, limited English proficiency, institutional/nursing home care, and underinsurance or lack of insurance. Physician factors that can increase the risk of drug harms include inappropriate prescribing of drugs (including to pregnant and breastfeeding women), failure to appropriately discontinue/deprescribe drugs, insufficient drug reconciliation, failure to coordinate care among multiple prescribing clinicians, and failure to elicit and incorporate into health histories and clinical decision-making the widespread use of nonprescription drugs, herbal products, and dietary supplements.

In a 2015 article in the journal BMJ, an expert argues that the benefits of psychiatric drugs have been exaggerated and the negatives downplayed due to poor trial design. Every year in the West, more than half a million people over age 65 die from the use of psychiatric drugs and the benefits would need to be “colossal” to justify these “immensely harmful” treatments, according to Peter Gøtzsche, MD, professor and director of the Nordic Cochrane Centre, Denmark.

Reports of deaths or injuries related to prescription medications more than doubled between 1998 and 2005 in the United States, with painkillers and immune-system boosters accounting for most of the side effects.
   More than half of all prescription drugs cause adverse effects — some of them serious or fatal — that aren't detected until after the Food and Drug Administration has approved them, sometimes many years later.

More and more Americans are landing in the hospital due to poisoning by powerful prescription painkillers, sedatives and tranquilizers. City-living middle-aged women seem particularly vulnerable. Opioids -- examples include morphine, methadone, OxyContin and the active ingredient in Percocet -- are powerful narcotic painkillers that can be habit-forming. Some examples of sedatives or tranquilizers include Valium, Xanax, and Ativan. American Journal of Preventive Medicine, April 2010.

Each year in the U.S., there are nearly 100,000 emergency hospitalizations for adverse drug events in adults 65 and older. Of the thousands of medicines available to older adults, the blood thinner warfarin, insulin, oral anti-platelets such as aspirin, and oral diabetes drugs lead the list.

New
2015 -- The U.S. Food and Drug Administration approved Praluent, the first of a powerful new class of injected, cholesterol-lowering drugs. Praluent (alirocumab) sharply cuts levels of LDL ("bad") cholesterol, and is one of a group of newly developed drugs called PCSK9 inhibitors.

List
The following are some prescription medication discussed on this web site and other web sites. We have no association with any pharmaceutical drug company and present both the benefit and side effects.

Acyclovir is generic for the prescription medication Zovirax for the treatment of herpes viral infection
Adenosine is generic for the drug Adenocard used in cardioversion.
Albuterol sulfate is available as ProAir HFA (albuterol sulfate) Inhalation Aerosol
Alendronate sodium) is a bisphosphonate that acts as a specific inhibitor of osteoclast-mediated bone resorption. Bisphosphonates are synthetic analogs of pyrophosphate that bind to the hydroxyapatite found in bone. Fosamax is made by Merck.
Alfuzosin hydrochloride is generic for Uroxatral, a prescription medication that works as an alpha blocker.
Alprostadil topical cream is generic for Alprox-TD and used for impotence, formerly an injection, Caverjet, Muse
Alprazolam is generic for Xanax used to reduce anxiety
Anagrelide is generic for the prescription medication Agrylin
Anastrozole is generic for Arimidex, Anastrozole is an aromatase inhibitor for breast cancer prevention
Aripiprazole is generic for the drug Abilify used in schizophrenia
Atorvastatin is generic for Lipitor, a class of medications called HMG-CoA reductase inhibitors (statins). Atorvastatin works by slowing the production of cholesterol in the body.
Atomoxetine also known as Strattera is the first non-stimulant medication approved for the treatment of attention-deficit/hyperactivity disorder in children
Azelaic acid is a cream used in rosacea and acne.
Buproprion is a prescription medication used for depression and smoking cessation and known as Wellbutrin
Cephalexin is generic for Keflex, a cephalosporin antibiotic made by Eli Lilly.
Cetuximab is a monoclonal antibody and generic for Erbitux, used to treat colorectal cancer
Citalopram is generic for Celexa.

Testimonial
I have suffered for years from anxiety, depression and ADD. I am a 52 year old woman and have tried several different anti-depressants and add medicines over the past 10 years. I always have to discontinue my use because of side-effects. I have been taking 10 mg of Celexa for 6 weeks. I am feeling better than I felt in a long time. I have much less anxiety and am smiling again. The problem is that everytime I find a pill that takes away my anxiety and depression it usually effects my thinking/concentration and vision. This pill has given me memory loss (slight amnesia) and I am at a loss for words and cannot seem to express myself (I am happy but feel stupid). I hope you can suggest a supplement that I might take to improve my memory and concentration and take away this side-effect, so I can continue taking Celexa. I would like to continue this med but the side-effects are too strong. I also have the side-effect of blurred vision.

Clonazepam is used as a medicine for seizures
Clopidogrel is a blood thinner known as Plavix and marketed by Sanofi Aventis
Clozapine is generic for Clozaril
Cytisine is available for the treatment of smoking addiction.
Dasatinib is a prescription medication and generic for Sprycel made by Bristol-Myers Squibb for leukemia
Dextroamphetamine is a stimulant drug known to produce increased wakefulness and known as Dexedrine and a few other brand names.
Donepezil is generic for the drug Aricept, used in Alzheimer's disease
Duloxetine is generic for the drug Cymbalta for depression
Dutasteride is generic for the drug Avodart used in hair loss and prostate enlargement
Enalapril is a generic for the drug
Escitalopram is generic for the drug Lexapro, a pharmaceutical drug used for depression. Escitalopram is a highly selective inhibitor of the serotonin transporter protein. It possesses a rapid onset of antidepressant activity, and is a treatment for moderate-to-severe major depressive disorder.
Esomeprazole is generic for Nexium, in a class of drugs called proton pump inhibitors
Eszopiclone is generic for Lunesta, a prescription medicine for sleep
Ezetimibe is a pharmaceutical drug whose product name is Zetia, used for cholesterol management
Etanercept is generic for Enbrel used in ankylosing spondylitis
Etoricoxib is generic for Arcoxia, a prescription medication promoted as a COX-2 inhibitor
Exelon patch is a cholinesterase inhibitor for the treatment of Alzheimer's and Parkinson's disease
Finasteride is known as Propecia for hair loss and Proscar for prostate enlargement. It can causes impotence.
    I have been taking Proscar for hair loss and I was wondering if it is okay to use an herbal sexual enhancement product whilst I am on this medication?
        A. As long as your doctor approves it should be fine. We have not had any reports of untoward reactions when finasteride or Propecia have been used together with natural libido enhancers.
Fluoxetine is generic for the drug Prozac used for depression
Gabapentin affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain. Neurotin is the product name.
Gemcitabine belongs to the group of medicines called antimetabolites.
Gentamicin is generic for Garamycin, an antibiotic of the aminoglycoside type
Herceptin has been approved in Europe for the treatment of advanced breast cancer
Idursulfase is the first product prescribed for the treatment of Hunter syndrome (Mucopolysaccharidosis II, or MPS II), a rare inherited disease which can lead to premature death. Idursulfase is known as Elaprase.
Imatinib is the generic name for Gleevec drug, made by Novartis, more info on Gleevec here.
Imiquimod is used topically to treat warts on the skin of the genital and anal areas. 
Infliximab, Remicade, is used in inflammatory medical conditions
Isotretinoin is generic for the drug Accutane made by Roche, Inc. Isotretinoin is a medicine used since 1982 for the treatment and prevention of severe acne.
Lamotrigine is an anticonvulsant medicine that is chemically unrelated to any other anticonvulsant or mood regulating medication.
Leuprolide is generic for Lupron, also known as Eligard, Lupron, and Viadur. By causing constant stimulation of the pituitary GnRH receptors, leuprolide initially causes stimulation (flare), but thereafter decreases pituitary secretion (downregulation) of gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
Levofloxacin is sold under the trade name Levaquin
Lorazepam is generic for Ativan, an anti-anxiety drug used for the management of anxiety disorders and anxiety associated with depression.
Losartan is a prescription medication sold under the trade name
Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used for osteoarthritis
Metformin is a drug used to treat type 2 diabetes mellitus.
Methotrexate is the most commonly prescribed drug for slowing the progression of rheumatoid arthritis.
Methylphenidate transdermal system, Shire, and product name Daytrana, approved by the FDA for the treatment of attention deficit hyperactivity disorder.
Metoprolol succinate is generic for Toprol prescription medication
Minocycline is in a class of medications called tetracycline
Modafinil is generic for the drug Provigil and made by the pharmaceutical company Cephalon Inc.
Olanzapine is generic for Zyprexa, used to treat schizophrenia
Orlistat is generic for the drug Xenical used for weight loss.
Paliperidone is generic for Invega drug
Pergolide is generic for the drug Permax used for Parkinson's disease, discontinued in 2007.
Permethrin is used for scabies treatment
Pimecrolimus is an pharmaceutical medication used in the treatment of atopic dermatitis
Pioglitazone is generic for Actos diabetic drug
Posaconazole, known as Noxafil, is used to prevent fungal infections caused by certain molds and yeast-like fungus called Aspergillus and Candida.
Pramipexole, a compound from Boehringer Ingelheim research, is approved in the U.S. for the treatment of the signs and symptoms of idiopathic Parkinson's disease.
Pravastatin, is a drug used to reduce the amount of cholesterol and other fatty substances in the blood. Pravachol is in a class of medications called HMG-CoA reductase inhibitors (statins).
Pregabalin goes by the product name Lyrica, used to relieve common types of nerve pain such as diabetic nerve pain and pain after shingles.
Propranolol is generic for the drug Inderal used as a beta blocker
Quetiapine is generic for Seroquel, an antipsychotic medication by AstraZeneca
Quinapril is generic for the ACE inhibitor drug Accupril
Raloxifene is used to prevent and treat bone loss (osteoporosis) in women after menopause. Evista (raloxifene) has been proposed to be a better choice than tamoxifen (Nolvadex, and others) for prevention of breast cancer in high-risk postmenopausal women. However, new research indicates that the cardiovascular side effects of Evista may outweigh its potential benefits in breast cancer prevention.
Ramelteon is generic for Rozerem, a medicine used for insomnia relief
Ranibizumab injection, Genentech, known as Lucentis, is used for the treatment of neovascular (wet) age-related macular degeneration.
Ranitidine is generic for Zantac used for heartburn
Reboxetine, Pfizer's antidepressant reboxetine is an ineffective and potentially harmful drug and published data on it overestimates the benefits and underplays the risks. British Medical Journal, online October 12, 2010.
Rimonabant is a prescription medication used for weight loss.
Rituximab, Rituxan, has been implicated in several dozen cases of progressive multifocal leukoencephalopathy (PML) in HIV-negative patients diagnosed with hematologic malignancies or autoimmune diseases, since the drug was approved by the US Food and Drug Administration in 1997 until the end of 2008.
Ropinirole hydrochloride is an orally administered non-ergoline dopamine agonist known as Requip drug
Risedronate sodium is generic for the biphosphanates drug Actonel used for osteoporosis
Risperidone is generic for Risperidal, used as an antipsychotic
Rivastigmine, a drug prescribed for Alzheimer's dementia
Rosiglitazone maleate is generic for the drug Avandia, made by GlaxoSmithKline  and used for diabetes
Rosuvastatin is generic for Crestor, one of the statins, drugs used to lower cholesterol
Scopolamine is used for seasickness
Selegiline is used in Parkinson's disease
Sertraline is a prescription medication known as Zoloft used to treat depression
Sibutramine is known as Meridia, a weight loss drug
Simvastatin is generic for Zocor, used for cholesterol reduction
Sitagliptin is generic for Januvia, the diabetes drug by Merck, Inc
Tacrolimus is an immunosuppressive drug
Tamoxifen was sold by AstraZeneca Plc under the name Nolvadex but is now marketed by several generic drug makers.
Tamsulosin HCI is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia. Flomax is the product name.
Tegaserod maleate, known by the product name Zelnorm, was a prescription medication approved for short-term treatment of women with irritable bowel syndrome, however due to increased heart problems, it was removed from the market.
Telbivudine is a prescription medication with the brand name Tyzeka used for hepatitis B.
Teriparatide [rDNA origin] injection, Forteo medication dosage, side effects, benefits
Topiramate is generic for Topamax used in migraine prophylaxis
Torcetrapib is being studied for its role in cholesterol
Trastuzumab trade name Herceptin for breast cancer
Valproic acid  is a prescription medication with the name Valproate and product name Depakne, used for seizures
Valacyclovir is a prescription medication, brand name Valtrex, used to treat herpes zoster.
Vardenafil is generic for Levitra, an oral therapy for the treatment of erectile dysfunction.
Varenicline is effective in helping a smoker give up cigarettes successfully, see Chantix for more information
Venlafaxine is an antidepressant made by Wyeth, based in Madison, N.J. Deaths have occurred from Effexor overdose. Doctors should consider natural antidepressants such as 5-HTP or SAM-e or St. John's wort before resorting to Effexor.
Vilazodone is a first of a new class of antidepressants called indolalkylamines
Zoledronic acid is generic for Zometa and Reclast,
Zolpidem is generic for the prescription medication Ambien, a popular sleeping pill

Most common prescription medications
In 2005, doctors wrote 2.4 billion prescriptions. Of those, 118 million were for antidepressant medications. High blood pressure drugs were the next most-common with 113 million prescriptions.

Prescription medication  for dogs
Slentrol diet pill for dog by Pfizer, Inc

Over the counter medications
Acetaminophen is known as Tylenol, used as a pain medicine.

CVS pharmacy, May 2009
An association of state lawmakers has asked the U.S. Federal Trade Commission on Thursday to take another look at its approval of CVS's 2007 purchase of Caremark, saying there was evidence of "harmful and deceptive conduct." The National Legislative Association on Prescription Drug Prices alleged that pharmacy benefit managers, or PBMs, associated with CVS Caremark took rebates from manufacturers and did not pass them on to customers; suggested different, more expensive drugs and negotiated with employers and pharmacies separately, pocketing the difference. At the time of the 2007 merger, CVS was the country's largest pharmacy and Caremark was a leading PBM.

Falls in elderly
Findings from a 4-year study conducted in France suggest the risk of falling is greater among elderly men and women taking a long-acting benzodiazepine, compared with age-matched men and women not using this type of anti-anxiety medication. Dr. Annick Alperovitch, at INSERM in Paris also found a moderately increased risk of falling among elderly men and women who regularly used mood- and behavior-altering "psychotropic" medications. This is also true in those who use tranquilizers, muscle relaxants and anti-spasmodics, and some antihistamines that block nerve responses (so-called anticholinergics. BMC Geriatrics, July 23, 2009.

Generic versus prescription
The Medical Letter on Drugs and Therapeutics has looked at the scientific studies that compare brand-name and generic versions of cardiovascular drugs, antimicrobials, proton-pump inhibitors, and levothyroxine. They say: "The continuing claims of pharmaceutical manufacturers and others that generic drugs are inferior to brand-name originals still lack convincing documentation. Nevertheless, with levothyroxine and antiepileptic drugs, Medical Letter consultants recommend using one formulation (brand name or generic) consistently or, if consistency is not possible with generics, prescribing the brand name routinely."[Generic drugs revisited. Medical Letter 51:81-82, 2009]

Funding of medical organizations
December 2009 - The senior Republican on the Senate Finance Committee has asked the American Medical Association and 32 other medical groups to disclose the financial backing they receive from drug and medical device manufacturers and insurance companies. Senator Charles Grassley asked for information on the amount, source and purpose of industry funding from January 2006 to the present. The list included some of the largest and most influential medical groups including the: American Cancer Society, American Heart Association, American College of Surgeons, American Diabetes Association and American Hospital Association.

Emails
How long does it usually take for a medication to be fully metabolized from the body. I am not asking for specifics, but a range of time. Again, I know there are variables to this and I am not going to hold you as the carbon 14 test, but if you could give me some idea I would be much appreciative. Again, I appreciate your help sooo much.
    Each person is different and each medication is different. It could be as little as an hour or as long as several days.

I currently take 1/4 of a 200 mg tablet of Sam E. It makes me extremely drowsy and agitated. I have children, so feeling agitated is not something I am willing to live with (for their sake, especially). I tried 5-Htp and Tryptophan and both made me feel sick (nausea, brain zaps, shaking hands, forgetfulness, and sleepy). I tried prescription medications which also made me feel very ill. Have you heard of someone else being as sensitive to these supplements as I am? I don't want to give up on taking something because I have depression and social anxiety. I eat well, exercise, and i'm a Psychology student finishing my last year of university. I am determined to deal with this and find solutions. I am seeking advice on the Sam -E and amounts to take.
   There are those who are very sensitive to pills and do better with even lower dosages.