Q. I’ve heard that ibuprofen will negate the positive effects of aspirin if the two are taken together. I read a report that says ibuprofen blocks aspirin’s effect for only two hours and that it’s safe to take ibuprofen 2 hours after aspirin to circumvent this effect. Any truth to this?
A. Several years ago a report in the New England Journal of Medicine (Dec. 20, 2001) suggested that ibuprofen could counteract the anti-clotting benefits of aspirin. A new study in the journal Clinical Pharmacology and Therapeutics (Sept. 2006) confirms that ibuprofen undermines the effectiveness of aspirin against blood clots.
In this study it did not make any difference whether the aspirin or the ibuprofen was taken first. Waiting two hours won’t solve the problem.
Q. Do you have any information regarding sugar-free gum and diarrhea? My daughter had trouble with weight loss, stomach cramps and diarrhea. Three different doctors could not diagnose the cause. Then she remembered it all started after she began chewing sugar-free gum.
A. Sugar-free gum frequently contains compounds such as maltitol, sorbitol, mannitol and xylitol. These sweeteners are not absorbed well from the digestive tract and attract water. This can lead to watery diarrhea, gas and cramps. Giving up sugar-free gum should ease your daughter’s digestive woes.
Q. My doctor has prescribed Avodart for enlarged prostate. I am interested in any adverse side effects from this new drug.
A. Avodart (dutasteride) blocks the conversion of testosterone to dihydrotestosterone (DHT). DHT stimulates the growth of prostate tissue. Researchers are studying whether this medicine might lower the risk of prostate cancer. Although most men tolerate Avodart very well, a few report reduced libido or impotence.
Q. I am very confused about when to take my medicine. The label on my blood pressure pills says to “take on an empty stomach.��? How long after a meal should I wait?
I also take Lipitor for cholesterol control and Cipro for a sinus infection. My doctor warned me about grapefruit juice and coffee but I am unclear what the problem is. Can you help?
A. Many drugs must be taken on an empty stomach to work effectively. Examples are the blood pressure pill Capoten (captopril) and the osteoporosis medicine Fosamax (alendronate). This means at least an hour before eating or two hours after a meal.
Antibiotics like Cipro (ciprofloxacin), Noroxin (norfloxacin) and Penetrex (enoxacin) can slow elimination of caffeine so that a cup of coffee provides a bigger jolt. Grapefruit can also boost the blood levels of Lipitor (atorvastatin), Mevacor (lovastatin) and Zocor (simvastatin). This may increase the risk of side effects.
For more information on how to take medications, we offer our Guides to Food, Drug and Grapefruit Interactions. Anyone who would like copies, please send $2 in check or money order with a long (no. 10) stamped (63 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. FJ-19, P. O. Box 52027, Durham, NC 27717-2027.
Q. You advise people to dispose of old mercury thermometers and replace them with electronic models. How should we discard the old ones?
A. Many communities have a household hazardous waste collection facility. If none is available, ask your pharmacist how to dispose of old mercury thermometers safely.
The People's Perspective on Medicine