Apologies if this is a well repeated question, but not sure how to search for old posts where l’m sure there is an answer! Does anyone know of a good site where one can search for drug interactions? Have tried the pharmacy which is okay if you can get them to answer the phone and I won’t start on problems with trying to get through to the surgery! have a cold which normally is no problem as I would dose up on cold meds like Night Nurse, Benylin and nasal sprays. Mainly for night when paracetamol (that I know is safe to take) isn’t enough. I don’t think Bisoprolol is a problem, it’s just the Apixaban that I’m concerned about as I’m sure I read certain interactions can cause bleeding. Any advice would be gratefully appreciated. Many thanks.
Mixing medications : Apologies if this... - Atrial Fibrillati...
Mixing medications
Hello, further to your question. I understand it can be frustrating trying to contact the GP for an immediate appointment, therefore I would urge you to persevere with contacting the pharmacist, are you able to pop into your local pharmacy, or visit Boots? The assistant may be able to help, or check with the on-duty pharmacist on your behalf. It really is best to check in advance to ensure they are not interacting with any other prescribed medication.
Okay, I understand, thank you.
Personally I would always check online for myself as well. On two occasions a doctor has attempted to prescribe something which I knew was inadvisable with my existing medication. On both occasions, (once at A&E, and once with the GP, ) I have told them of the contraindication and they have agreed with me and thanked me for my input.
Good thinking and yes I have received some brilliant help from some of the answers here regarding just that. Thanks for your comment.
Most "cold remedies " contain drugs which can be highly pro arrhythmic so best to avoid.
Didn’t know that, so thanks.
Any cold medication contains phenylephrine or sudafedrinewhich are vasoconstricters and meant for congestion are potentially dangerous. Cough medications contains an expectorant and dextromethforatham are OK.
Best etheral
You could download the Merck app from the app store on Android or equivalent on IOS and much detailed information about all drugs as well as medical conditions is available. Best etheral
Great replies- many thanks
Hi R010.
Yes I could give you a few but we are no longer allowed to post links without admins approval.
Google 'drug interaction checker' and you should find the answer to your question.
Paul
I’ll try that, thank you.
No advice, just my take, I’m on Apixaban and Bisoprolol for PAF and take nothing more than paracetamol since.
Link to NHS medications A-Z : nhs.uk/medicines/
Each drug has a link to taking with other meds
Hope this helps but follow admin’s advice.
Looked previously on NHS site, but didn’t see that, thank you.
Nothing beats advice from a professional. One of their tomes is the British National Formulary which is available as a free phone app. It is not as detailed as some other online searches which I hesitate to share
Never heard of them, so many thanks
Brilliant, thanks. Don’t know why I couldn’t find these sites!!
I always use Drugs.com
Thanks
Brilliant site. Very comprehensive.
Search web for "webmd drug checker"
or just seatch for "drug checker" there are a number of them
Very logical, good thinking 🤔
Drugs.com allows you to search for known interactions.
Cold remedies really are waste of money. They don’t do much. My husband is currently off work and unwell with a cold virus and he has only taken two paracetamol because he was feeling uncomfortably achey. The last time I had a cold I took absolutely nothing, no supplements, no medicines other than my usual vitamin D that I take anyway. Colds get better of their own accord regardless of what you do. It’s a good idea to keep well hydrated with water, tea, or whatever you feel like drinking (but not alcohol!) Ginger and lemon makes a nice drink if you have any, and even better if you have someone to make it for you. So far I’ve not caught my husband’s virus though he’s coughed all over the place indoors so maybe this is the calm before the storm. He’s quite poorly with it so if you’re going through the same I certainly sympathise.
I agree with Autumn Leaves - don't waste your money 'dosing up' when you have a cold. Let your body sort it out without all that chemical interference; just take paracetamol for aches if necessary, and maybe a little Vicks or similar to assist nasal breathing when sleeping.
As I mentioned on another reply, it turns out that there is very little I can take so agree it’s just paracetamol and bed. Feeling pretty sorry for myself - very achy and chesty, but just glad it’s not Covid!! Horrible viruses going around at the moment. Hope your husband feels better soon.
My husband had a very rough few days but he’s back at work now. As you describe, he felt very achey. I’m thankful it wasn’t Covid either. Not to keen on going through all that again!
Colds don't always get better on their own. My last one slipped to my lungs and became a lower respiratory infection, requiring increased use of inhalers, a week of steroids, and two weeks of antibiotics. 95% of my "common colds" morph into lung infections.
I’m sorry to hear that, Thomas. Obviously for people who are more vulnerable or have underlying conditions that make them more susceptible such as COPD or asthma, or any other condition that compromised their lung function, they need to be extra vigilant. I don’t know if OTC cold remedies are effective in preventing that type of progression but if you find them helpful then you have to do what you have to do.
I was told by a pharmacist that I should only take paracetamol and use a nasal spray. I am on Apixaban and Bisoprolol. Hope you feel better soon.
Many thanks and yes what you take is exactly what I’m now doing. There’s some nasty viruses going around at the moment and checking everything becomes such hard work!
Like several others, I use drugs.com. It's not perfect but if you set up an account you can input your standard medications so that they are saved for future use when investigating new medications and supplements. You can also differentiate between medications you are actively taking and those you are just researching. It identifies the level of potential interactions (major, moderate or minor) between your medications and those you are investigating and explains what the issues are.
The main downside is that it's a US site and it doesn't always have information on some brands of medications/supplements available in Australia (where I live). You can get around this at times by specifying active ingredients but some still come back with "interaction data not available". Anyway, I find it a useful starting point for any new medications/supplements I'm considering. If I have any concerns I ask the pharmacist or hold off doing anything until I discuss with GP or cardiologist (email his rooms if important enough)
Many thanks for that and I must admit I obviously hadn’t read the drugs.com website properly because didn’t realise I could set up an account. Very useful as it becomes very tedious checking all interactions of medication but obviously very essential.
Inside the box of every prescribed medicine should be a "Patient Information" leaflet. On this, all important information is presented in sections, one being, "Other Medicines and [THIS MEDICINE]".
The official data sheet for each approved prescription drug is viewable on the UK's NICE website under the section "BNF" (British National Formulary"). Also, the NHS website carries similar information for each approved drug.
Here's a sample for "bisoprolol":
Steve
Interesting, as when I was unsure what to take, first place I looked was the information leaflet and none of the ingredients of cold remedies were mentioned. Must admit I only checked Apixaban at the time as I wrongly assumed that was the problem one but as it turns out it’s Bisoporol that’s the issue due to reaction with cold remedies lowering BP! The make I take annoyingly says nothing about these ingredients. The NICE BNF website and drugs.com have been very useful though. Thanks for your help.
That's interesting! Some drug interaction are unusual and less common. So far as I know, bisoprolol lowers BP by a relatively small amount and the only ingredient in a cold remedy that I can think of that would add to this would be pseudoephedrine, available by a pharmacist only and which should at the point of sale be accompanied by questions about what else you are taking and advice therein.
The equivalent from a supermarket would be phenylephrine which, I think, has much less effect.
Steve
It gets very complicated as when searching the BNF site nothing in any of the cold remedies shows a problem, but use the Drugs.com site and both Diphenhydramine and Promethazine (used in 2 different medications) show as a “moderate “ risk for lowering blood pressure. As I have fairly low blood pressure anyway it’s a bit concerning. I’ll try and find out from the pharmacist. By the time I get to the bottom of all this the cold will have gone anyway. 🤪 We all get them and it’s just a learning curve for me at the moment. Once again, many thanks.
In a past life before teaching (and now semi-retirement), I had to rely on the BNF often for information and I got used to its style. The new online version seems much clearer to me but it is certainly not concise.
Diphenhydramine and promethazine are both old "first generation" (but still highly effective and widely used) antihistamines. They can cause sedation and in a cold remedy are purported to "dry up" nasal secretion - but I doubt that they do so, and the evidence must be slim. There's little that will have any effect on a cold and recent studies have cast doubt on all remedies. Decongestants certainly do provide temporary relief but at the cost of rebound congestion coming along later.
I would be surprised if either antihistamine would reduce blood pressure except as a rare reaction in specific individuals, but you might well be one of the unlucky ones. Drugs are metabolised differently in a few people owing to such things as genetics affecting liver enzymes and that can lead to unusual effects being seen.
Steve
Thanks Steve for your comments and knowledge. It’s much appreciated. To be honest during the day I’m managing on paracetamol but this is a really nasty cold and I want the antihistamines at night for their sedative effects as I can’t sleep. I might just double check and get in phone queue for doctor!
Hi again! Thanks for the kind comments. A background in pharmaceutical comes in handy but also causes some hypochondria!
The problem with using antihistamines for sleep is that their effect lasts well into the next day, so take care if you feel drowsy or dull-headed then.
This current cold virus seems to be a particularly bad one. An elderly friend started with it on Monday and likely caught it last Friday. For one day, he was what I would call very poorly indeed - worryingly so for a 90-year-old recently bereaved, too; day two saw some small but welcome improvement, thank goodness, and now, today, he's "sinus-y" and uncomfortable but much perkier. My daughter-in-law has been rather less fortunate. Hers began ten days ago and after a small improvement, while walking to catch her bus to work on Monday (as a nurse), her legs went weak and she ached all over but pressed on; next day she was too poorly and had to call into the ward to take sick leave for, I think, the first time in her life. Her family doctor found her to have a secondary bacterial throat infection needing amoxycillin. That, fortunately, has done the trick but her doctor told her that there are a lot of these secondary infections about, so be sure yours doesn't develop into one and if so, you'll likely need antibiotics.
Steve
Actually that sounds very familiar. Mine started over a week ago and after a few days felt slightly better but then yesterday started feeling really rough and achy and my throat is worse. Also just been informed that the new variant of Covid does not always show positive on the original self test (which is what I used). Too many viruses going around at the moment. Thank goodness for retirement so at least no worries about being anywhere! If there’s no improvement I will definitely call the doctor. Once again many thanks.
Yes, that sounds wise, and you likely already are, but be sure to gulp down lots of fluid as dehydration can strike suddenly and will affect heart and kidneys. I'm not a fan of the current vogue of hydration but have seen two friends suffer with genuine dehydration as opposed to what we used to term "thirst"! 
).
Steve
Thanks for the advice and am trying but simple to forget!
Hi, pop into the pharmacy and speak to the pharmacist, to be honest they are sometimes more knowledgeable about these things than GP, it's what they do.
It's not only cold remedies, things such as pain relief creams or tablets also need to be double checked too. I have found my local chemist very helpful.
Combination of suggested websites and at last seeing a pharmacist have been useful. Turns out to be very few medicines that I can take! Warm bed and paracetamol……
There are several sites on line where you can put in the name of the pharmaceuticals you are taking and then search for harmful interactions with one, two, three or more other drugs. I used it repeatedly a few years ago when my doctor kept prescribing things for me which were contraindicated with amiodarone and also with fluoxetine and apixaban.
Thanks. Definitely going to set up an account on one of them as I can’t be doing with all this checking, especially when feeling rough and just want bed. Thank goodness for paracetamol!,
Yes as you've read here it can be tricky to take cold remedies. I've taken the odd Lemsip but usually just Paracetamol and echinacea drops which are a must have three times a day plus Vitamin C 1g up to 3 times/day. Both those do shorten a cold time, well they certainly do with me.
Yes, paracetamol for me with maybe some honey and lemon. Everything else is just too risky. It’s all a learning curve!
After my GP prescribed a drug that had a very severe interaction with another, I NOW insist that they double check before I leave the GP surgery ! I ended up with very low BP & double vision while driving at 70mph on a motorway because of the interaction! All ok now. Best wishes.
Having checked on several sites mentioned here, I find that it’s the Bisoprolol that’s the problem and not the Apixaban as I naturally have quite low BP and quite a few cold remedies cause it to drop even lower, so understand you questioning prescribed medication. It’s all so complicated!!
I agree I was already on Bisoprolol when my GP prescribed Tamsulosin for an enlarged Prostrate (BOTH known to reduce blood pressure). I'm very cautious now!
Drugs.com!! This site is continually updated, and they have the "check drug interactions" feature which has helped me many, many times over the years!!
Yes thank you. Other people have mentioned it and it looks very useful.
Go into the pharmacy and ask them. Don't ring them. I last week had to find out whether could take antihistamine with Solatol. Otherwise ask your dr. Hope this helps you.
yes, many thanks
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