For some chronic disease patients who need to take medication for a long time, taking medicine and daily diet are "complementary". Once food and medicine "clash", not only reduce the efficacy of the drug, but also may cause more serious consequences.
According to the "China Cardiovascular Health and Disease Report 2019", the number of cardiovascular diseases in China is about 330 million.
Recently, a pathology report published by an authoritative medical journal suggested that drinking goji berry tea during taking some cardiovascular drugs may trigger a poisoning reaction.
Life Times combines new research and interviews with experts to tell you why goji berry tea interacts with cardiovascular drugs and points out some contraindications to taking cardiovascular drugs.
Experts interviewed
Shi Haoqiang, deputy director of the Department of Pharmacy, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine
Hu Qin, clinical pharmacist of the Department of Pharmacy, Xiangya Hospital, Central South University
Li Hongzhu, associate researcher of Tianjin Pharmaceutical Research Institute
<h1 class="pgc-h-arrow-right" data-track="128" > cardiovascular drugs + goji berry tea, or cause poisoning</h1>
Recently, a case report published in the European Journal of The Heart warns that drinking goji berry tea may cause poisoning during the cardiovascular drugs flucanide (antiarrhythmic drugs) and warfarin (anticoagulants to prevent thrombosis and cerebral infarction).
The report describes a 75-year-old female patient who underwent mitral valve replacement (cardiovascular surgery) three years ago, postoperative oral warfarin therapy, and regular monitoring of coagulation function to keep the international normalized ratio (INR) within the target range (2.5 to 3.5).
It should be noted that INR can indicate whether there is insufficient or excessive warfarin dosage, which can both guide anticoagulant dosage and effectively avoid bleeding.
Two years ago, the patient was treated with flecainide (100 mg twice daily) for atrial premature beats.
Recently, during drinking goji berry tea (1 to 2 cups per day), patients felt dizzy, nauseous, extremely tired, and eventually went to the emergency department for syncope.
At the time of admission, flukani poisoning was diagnosed. When discharged from the hospital, the doctor reminded the patient to stop using goji berry tea.
In the above cases, the patient took goji berries, which caused two cardiovascular drug poisonings:
One is flucainide poisoning, which leads to fatal ventricular arrhythmias;
Second, an overdose of warfarin causes an increase in INR.
The reason is that goji berries will inhibit a variety of enzymes that can metabolize warfarin and flucainide drugs, which eventually leads to poisoning. Studies believe that taking goji berries in large doses (more than 6 to 12 grams) can significantly enhance the anticoagulant effect of warfarin, which is likely to lead to dangerous conditions such as subcutaneous bleeding.
<h1 class="pgc-h-arrow-right" data-track="127" > each has a "contraindicated" food for each of the four types of cardiovascular drugs</h1>
Some foods may not only affect the efficacy of cardiovascular drugs, but also aggravate the disease. When people with cardiovascular disease take the following drugs, it is important to avoid foods that affect each other.
Take statin lipid-lowering drugs
Eat less grapefruit
Lipid-lowering drugs (statins) taken with grapefruit increase liver and muscle toxicity. Statins are currently the most widely used class of lipid-lowering drugs, and the active ingredient in grapefruit will greatly increase its concentration in the blood.
Studies have found that patients with hyperlipidemia who take a piece of lovastatin with a cup of grapefruit juice have a blood concentration 10 to 15 times higher than those taken with a cup of white water.
Take antihypertensive drugs
Eat fewer bananas
Bananas can provide potassium ions that lower blood pressure, and can excrete too many sodium ions from the body, thereby reducing its vasopressor effect and reducing damage to blood vessels.
Studies have shown that eating bananas regularly can prevent high blood pressure, and eating two sticks a day can also help improve blood pressure.
However, during the period of taking blood pressure lowering drugs, especially in the stage of adjusting the dosage, it is best to eat less bananas, otherwise it may increase the side effects of the drug and cause blood pressure to be too low.
Take diuretics
Drink less coffee
Caffeine can promote kidney function, diuretic effect. If you take hydrochlorothiazide, furosemide and other diuretics with antihypertensive effects at the same time, the diuretic effect increases, which is easy to cause excessive loss of sodium ions in the body.
Take anticoagulants
Eat less leafy greens
Anticoagulants such as warfarin can inhibit vitamin K, thereby inhibiting vitamin K-dependent coagulation factors and preventing further formation of blood clots.
The order of vitamin K content in general foods is: green leafy vegetables> meat and egg milk> fruits and cereals.
Therefore, before and after taking warfarin, you should avoid eating a large number of green leafy vegetables, including leeks, spinach, asparagus, amaranth, cabbage, green bean carob, mustard greens, hollow cabbage, bean sprouts, etc.
<h1 class="pgc-h-arrow-right" data-track="70" > take cardiovascular drugs and find the best time</h1>
Body functions appear temporal rhythm in daily life, such as hormone secretion levels, blood pressure levels, changes in body temperature, etc. The same drug, taken at different times of the day, can vary greatly in efficacy and toxicity.
Coronary heart disease drugs: take in the morning after
Coronary heart disease includes asymptomatic myocardial ischemia, angina, myocardial infarction, ischemic heart failure, and sudden death, often occurring within 4 to 6 hours after waking up in the morning, with the highest incidence at 6 to 12 o'clock in the morning.
At this time, the human coronary arteries are in a state of ischemia, the level of catecholamines is high, the resistance of blood flow increases, blood pressure rises, the oxygen consumption of the myocardium increases, and the myocardial ischemia is serious. At the same time, the blood viscosity is also high, and it is easy to form blood clots.
After waking up in the morning, taking nitrates (nitroglycerin, isosorbide nitrate, isosorbide mononitrate, etc.), calcium antagonists (nifedipine, felodipine, amlodipine, verapamil, etc.), β-blockers (propranolol, metoprolol, atenolol, etc.) can effectively prevent the occurrence of coronary heart disease.
<col>
Frequency of taking the drug
Time to take
Take once a day
Take in the morning after waking up
Take 2 times a day
Take after waking up in the morning and around 3 p.m
Take 3 times a day
Take in the morning, noon and evening
Antihypertensive drugs: taken at 7 a.m. and 2 p.m
Blood pressure fluctuates, and Asian people usually show a phenomenon of "double peaks and one valley" in blood pressure, also known as "oleander hypertension".
That is, between 9:00 a.m. and 11:00 p.m. and 16:00 p.m. to 18:00 p.m., blood pressure is higher, and the lowest is 2 to 3 a.m. the next day.
<col style="width: 351px;">
Types of drugs
Antihypertensive drugs are mainly diuretics, β-blockers, calcium antagonists, ACE (captopril, benazepril, pedopril, etc.), ARB (losartan, valsartan, irbesartan, etc.) drugs
Drugs with different mechanisms of action can generally be taken at 7 a.m. and 2 p.m
Controlled and sustained-release preparations once a day
It should be taken at 7 a.m. and should not be taken before bedtime or at night
Clinically, there are many patients with "non-ilised" or "rumblic" hypertension, and before determining the time of medication, a 24-hour ambulatory blood pressure monitoring should be done to select the correct antihypertensive drugs and medication time.
Lipid-lowering drugs: used at night
Lipid-lowering drugs are more commonly used with statins. Because the peak period of liver synthesis of cholesterol is mostly at night, some statins are more effective at night or at bedtime than during the day.
Pravastatin, simvastatin, lovastatin, etc
Take at night or at bedtime
Rosuvastatin, atorvastatin, etc
It can be taken relatively fixed at one time point
Statins are generally administered once a day, and the dose is related to the variety of drugs. Contraindicated in patients with active liver disease, pregnant and lactating women.
Finally, it should be reminded that because the method of taking each drug is slightly different, the specific medication plan needs to follow the doctor's advice. ▲
Editor of this issue: Zhang Yu
Copyright notice: This article is the original of Life Times, and unauthorized reproduction is refused.