What medicines should not be taken with milk?🥛🥛🥛

Milk is a great natural nutritional supplement. It is also a drink that many people drink every day. Although drinking milk has many benefits for people, it will affect the absorption of drugs when it is taken with many drugs at the same time. It may even interact with those drugs and make them less effective. One of the main reasons is that milk can form a thin film on the surface of gastric mucosa and drugs. When the film is digested and absorbed, the drug may miss its optimal absorption period. As a result, drug absorption and efficacy are reduced. In addition, milk can also produce physical or chemical reactions with some drugs. It may adversely affect medicines. Milk contains substances such as iron, calcium, phosphorus, protein, fat and multivitamins. They react chemically with some drugs and form insoluble salts or stable chromium compounds. This can make it difficult for the body to absorb the medicine and can even lead to gallstones or kidney stones. Some drugs are listed below for specific explanation:

1. Preparations containing iron, zinc or calcium.

Calcium, zinc, or iron preparations such as calcium lactate, calcium gluconate, zinc gluconate, ferrous gluconate, ferrous fumarate, and ferrous succinate can form clots with the protein in milk. In addition to reducing the absorption of drugs and reducing the peak plasma concentration of drugs, this clot will also increase the burden on the gastrointestinal tract. Iron can also be precipitated by phosphorus in milk and affect its absorption. Iron is absorbed mainly in the duodenum and proximal jejunum in the form of ferrous ions. Calcium ions in milk compete with iron for absorption in the duodenum. It reduces iron absorption and effectiveness. Therefore, when patients take calcium, zinc or iron preparations, they should be separated from milk for 1 to 2 hours.

2. Antacids and gastric mucosal protective agents.

Aluminum hydroxide, bismuth potassium citrate, calcium carbonate, magnesium hydroxide, sodium bicarbonate, etc. are clinically commonly used antacids and gastric mucosal protective agents containing metal ions. The above-mentioned drugs containing metal ions also form clots with proteins in milk. It will reduce the efficacy of drugs and increase the burden on the gastrointestinal tract, but also affect the body's absorption of nutrients in milk. In addition, when sodium bicarbonate is taken together with milk, milk-alkali syndrome can occur.

3. Most antibacterial drugs.

Almost all quinolones such as ciprofloxacin, levofloxacin, and norfloxacin will be combined into insoluble chelates by metal ions in milk. These chelates will affect the absorption of antibacterial drugs, reduce their antibacterial effect, and make the drug less effective or even completely ineffective. Therefore, most antibacterial drugs should not be taken together with milk.

4. Drugs for the treatment of cardiovascular diseases.

Drink a lot of milk while taking digoxin, digitoxin and other drugs for the treatment of chronic heart failure. The toxicity of these drugs will be increased by the calcium ions in the milk. When patients with severe hypertension take antihypertensive drugs, if they take milk or milk products at the same time, their blood pressure may rise sharply. In severe cases, the patient's blood pressure will continue to rise, and even hypertensive crisis will occur.

5. Anti-Parkinson's disease drugs.

Milk should not be taken together with anti-Parkinson's disease drugs such as carbidopa and levodopa. These drugs need a carrier to help them move in the body when they are absorbed in the small intestine. The aromatic amino acids contained in protein in milk will compete with them for the same carrier system and affect their absorption.

6. Antidepressants.

Monoamine oxidase inhibitors in antidepressants should not be taken with milk. When monoamine oxidase is inhibited, tyramine, which is rich in milk, will accumulate in the body in large quantities. It can cause cardiac arrhythmia, sudden increase in blood pressure, and severe cases can lead to cerebral hemorrhage and even death.

7. Constipation medicine.

The stimulant laxative bisacodyl is used to treat acute, chronic, and habitual constipation. The enteric coating of bisacodyl is prematurely dissolved by the milk, making it irritating to the stomach and duodenum. Therefore, milk should not be consumed for 2 hours before or after taking this medicine.

8. Other drugs.

Calcium and bone metabolism regulators such as alendronate sodium, ibandronate sodium, anticancer drugs such as estramustine, etc. should not be taken together with milk.

Unless instructed by a doctor, it is best to take the medicine with water, not milk, tea, etc.

Read More

How to choose external medicine for skin disease?🙌🙌🙌

Whenever the seasons change, many people will have some skin problems
(such as skin allergies, eczema, tinea manuum, tinea pedis, etc.). There are many different types of ointments available at community pharmacies for skin inflammation. Many patients don't know what are the uses and differences of these ointments? This article will introduce the relevant knowledge of topical ointments commonly found in community pharmacies.

What are the common skin diseases?

1. Infectious skin diseases:

Infectious skin diseases: When patients are infected by fungi and suffer from skin diseases, then patients should choose ointments containing antifungal drug ingredients. Econazole, ketoconazole, and miconazole are commonly used antifungal ingredients in ointments. If the patient has pustules on the skin, it is likely due to a bacterial infection. Therefore, patients should choose ointments containing antibacterial ingredients, such as mupirocin ointment, chlortetracycline ointment and erythromycin ointment.

2. Allergic skin diseases:

The vast majority of dermatitis and eczema are allergic skin diseases. This type of skin disorder generally responds well to steroid therapy. Weak- or moderate-acting steroid creams are used on areas of tender or wrinkled skin such as the face, armpits, groin or vulva. Strong-acting steroid creams can be used to treat areas of thicker skin, but stronger steroid creams are usually only used for about a week. When the patient's symptoms improve, they are switched to a weaker steroid cream. Because of the thin skin in babies and children, they usually only get weak steroid creams and they should not be used for too long.

An introduction of the strength of steroid creams for topical use.

Weak-acting steroid creams:

Hydrocortisone Acetate 1.0%: Apply to the affected area 2 to 4 times a day and massage gently for a while. It can be used to treat non-infectious skin diseases, allergic skin diseases and some proliferative skin diseases, such as eczema, pruritus, dermatitis, seborrheic dermatitis, neurodermatitis. Long-term use can cause pigmentation, telangiectasia, skin atrophy and secondary infection. Occasionally, patients have allergic reactions. It is contraindicated in infectious skin diseases such as tinea corporis, jock itch, impetigo, etc.

Medium-acting steroid ointment:

Prednisolone Acetate 0.5%: Apply an appropriate amount of ointment to the affected area 2 to 3 times a day. It is suitable for allergic eczema, lichenoid pruritus, seborrheic dermatitis and contact dermatitis, etc. Long-term use can cause pigmentation, telangiectasia, skin atrophy and secondary infection. Occasionally, patients have allergic reactions. It is contraindicated in infectious skin diseases. 

Dexamethasone acetate 0.05%: It is mainly used for autoimmune inflammatory diseases and allergic diseases, such as chronic eczema, contact dermatitis, seborrheic dermatitis, neurodermatitis, localized pruritus, etc. Patients generally take a small amount of ointment and apply it to the affected area two to three times a day and rub it gently for a while.

Clobetasone Butyrate 0.05%: It is used for short-term control and treatment of dermatitis and eczema, such as allergic dermatitis, primary irritant dermatitis, atopic eczema, etc. Children over 12 years old or adults can apply an appropriate amount of the ointment to the affected area twice a day. It can be used for up to seven days.

Triamcinolone acetonide 0.025 to 0.1%: It can be used in the treatment of eczema, pruritus, seborrheic dermatitis, allergic dermatitis, neurodermatitis. Apply to the affected area 2 to 3 times a day and massage gently for a while.

Hydrocortisone Butyrate 1.0%: It can be used to treat lichenoid pruritus, seborrheic dermatitis, allergic dermatitis, allergic eczema, etc. Apply an appropriate amount of ointment to the affected area twice a day.

Fludrocortisone acetate 0.025%: It is mainly used to treat skin pruritus, eczema, psoriasis, seborrheic dermatitis, contact dermatitis, neurodermatitis, allergic dermatitis, atopic dermatitis and other skin diseases. Apply ointment topically to affected area twice daily. Long-term use may cause acne, folliculitis, perioral dermatitis, telangiectasia, skin atrophy, and possibly increased susceptibility to infection. Occasionally, patients develop allergic contact dermatitis.

Fluocinolone 0.01%: It can be used to treat psoriasis, pruritus, eczema, seborrheic dermatitis, neurodermatitis, atopic dermatitis, allergic dermatitis, contact dermatitis, etc. Apply to affected areas twice daily. Infants or children should not be given medication for too long and the amount of medication should be kept to a minimum. Long-term or large-scale use of ointment by patients can cause telangiectasia, perioral dermatitis, and skin atrophy. Patients may also have increased skin susceptibility to infection. Occasionally, patients develop reactive contact dermatitis.

Strong-acting steroid ointment:

Beclomethasone Dipropionate 0.025%: It treats inflammatory and allergic skin diseases and related conditions, including pruritus, discoid lupus erythematosus, lichen planus, psoriasis, palmar impetigo, eczema, neurodermatitis, allergies Dermatitis, contact dermatitis, etc. Apply topically to affected area two to three times daily. It should be used with caution in infants.

Mometasone furoate 0.1%: It is indicated for the treatment of pruritus, neurodermatitis, atopic dermatitis and eczema. Apply an appropriate amount of ointment to the affected area once a day.

Fluocinolone 0.025%: In addition to the above-mentioned dermatitis, it can also be used for vitiligo, psoriasis, etc. It is generally used 2 to 3 times a day.

Betamethasone 0.05%: It is indicated for the relief of itching and inflammation in children 13 years and older and adults with hormone-sensitive skin disorders. However, it is contraindicated in children 12 years and younger.

Super strong-acting steroid ointment:

Clobetasol Propionate 0.02 to 0.05%: It can be used to treat discoid lupus erythematosus, palmar impetigo, lichen planus, psoriasis, chronic eczema, neurodermatitis and other skin diseases for which topical steroid therapy is effective. It cannot be used for long-term, large-area applications.

Betamethasone 0.1%: Apply to the affected area two to four times a day and massage gently for a while.

Read More