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A friend of mine last night was telling me that milk, or dairy products in general are known to decrease the effectiveness of some medications.  I have always taken all of my meds (including Effexor and now Wellbutrin which my pdoc started me on 1/24) with milk because its all I really drink at home.  Has anyone else heard this about milk affecting the effectiveness of some drugs, and does anyone know if Effexor and/or Wellbutrin are effected by milk/dairy products?  If so, I will start buying juice or something to take my meds with.

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DearPS:

Haven't heard it and I have been drinking milk all my life.  It doesn't interfere with any of my 6 meds, that I can see.  Maybe you should Google it and see what the Web has to say.

olga

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I know you shouldn't take adderall with citrus.

And grapefruit seems to be a no no on a lot of things.

And i have a friend who swears peanut butter messes up her ritalin...

But the only med that I know of that you shouldn't take with milk is the antibiotic doxycycline.

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I don't know anything offhand re: Effexor or Wellbutrin interacting with milk. Never heard anything about it, and I was on Effexor for 16 years. But here are two good sites to check for interactions:

1) https://www.aidsmeds.com/cmm/DrugsNewContent.asp. How they describe this online tool: "Check My Meds allows you to take the preventive step of determining whether the drugs you are taking interact with each other, or interact with certain foods, and cause a bad reaction in your body."

2) http://www.druginteractioncenter.org/. This site is specifically for checking meds re: interactions with grapefruit juice.

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There are a number of anti-biotics which are absorbed by milk and therefore shouldnt be taken together.    Normally the instructions tell you to allow several hours between consuming them.

Off hand I haven't seen any such cautions with psych meds, but you should check yours out. You can use the the checkers or go read the full PI sheets.  There are links in the med sections.

A.M.

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I'm going to repeat what's been said about checking online. And there are some things you shouldn't take with milk -- if you want to see if a checker picks up a milk interaction enter one of the antibiotics that have already been mentioned as not playing well with milk.

Still, the bottle from the pharmacy, or the patient information, should have a notice on it. And, you can always ask your pharmacist.

Fiona

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I know you shouldn't take adderall with citrus.

<{POST_SNAPBACK}>

Or several brands of soda (phosphoric acid) - lower gastric pH tends to reduce absorption rates

for amphetamines and related compunds. The drug will still be absorbed, but the peak

concentration will be lower and more spread out.  Something to keep in mind if you feel

the prescription is overshooting the mark a bit.

And grapefruit seems to be a no no on a lot of things.

<{POST_SNAPBACK}>

A well-known enzyme inhibition (cytochrome P-450 3A4 - I just looked the specific isoenzyme

up (Science Daily has a write-up. - and it's the same enzyme Serzone and Fluvox inhibit)

And i have a friend who swears peanut butter messes up her ritalin...

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Don't know how, but that doesn't mean it can't happen.

But the only med that I know of that you shouldn't take with milk is the antibiotic doxycycline.

<{POST_SNAPBACK}>

Pretty much all of the tetracycline-related antibiotics. The calcium in the milk binds to the

drug and too much of it passes on through the digestive system untouched (many antacids

and calcium supplements are also a no-no.)

Basically, as mentioned elsewhere, these are the sorts of things covered in the PI sheets

and the warning stickers

slapped on the bottles.

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Or several brands of soda (phosphoric acid) - lower gastric pH tends to reduce absorption rates

for amphetamines and related compunds. The drug will still be absorbed, but the peak

concentration will be lower and more spread out.  Something to keep in mind if you feel

the prescription is overshooting the mark a bit.

like coke?  (is this why coke syrup helps with nausea?)

what about if you are a fast processor?  would this slow your processing speed down?

my adderall xl lasts 5 (maybe 6) hours and ir only lasts 3... i'd love to makes these last longer.... though i guess that's more of a p450 issue?

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Cyp2D6 according to the first source I checked - so yeah, combining with a

more competitive substrate or an inhibitor might give more duration.  The

source that listed Cyp2D6 as the processing enzyme also reported

that  15-55% is excreted unchanged by the kidneys, depending on

pH (low pH -> more excretion). That the kidneys can handle a good

portion of the removal might make for a reduced toxicity risk.

It's laid out nicely at IUPUI, with references even. It looks like Wellbutrin would pack a one-two punch - it competitively

inhibits 2D6 as well as affecting NA/DA transport and reuptake.  Your doctor

would really want to reduce the Adderall dosage with that combo.  In my case

there seemed to be only a 1 hour difference between Adderall XL and IR while

I was on WB, so the generic made more sense.

i'm sorry, i'm really retarded at the whole processing thing.

all i know is that i'm such a bizarre processor i almost had my chromosomes tested last year.

i just went on 150 wellbutrin xl.  i'm also on 200mg celebrex wich is also listed as a 2D6 inhibitor.

and added in a second 10mg ir dose.  i do 30mg xl at 8 am, 10mg ir at 1, and 10mg ir at 4.  my last class ends at 7 and when i get home i'm completley brain dead.

you seem to get this more than i do.  when i take the adderall xl i get a RUSH about an hour later (hear pounding) and then it subsides. 

does this mean anything at all?

i once tried to figure this all out, made and excel chart (using that link even) but i just don't get things like that.  (i'm more of a big concept history girl.)

lemme know if anything i said means anything.

i see my pdoc again soon.

oh, and i'm also titrating up on lyrica.  that mean anything?

GAH

*feels retarded and just wants to be able to concentrate through a whole day, and hates that she's fucking retarded in her 4-7 class because it's a seminar and shit.*

penny

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*feels retarded and just wants to be able to concentrate through a whole day, and hates that she's fucking retarded in her 4-7 class because it's a seminar and shit.*

<{POST_SNAPBACK}>

Totally OT. Just remembering back to those lengthy seminars. The only thing that got me through these were chocolate-covered espresso beans. Hmmm. Caffeine and chocolate. And so discreet! ;)
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*feels retarded and just wants to be able to concentrate through a whole day, and hates that she's fucking retarded in her 4-7 class because it's a seminar and shit.*

Totally OT. Just remembering back to those lengthy seminars. The only thing that got me through these were chocolate-covered espresso beans. Hmmm. Caffeine and chocolate. And so discreet! ;)

omg SUCH a good idea

i have GERD tho and can't drink coffee... wonder if i could eat those???

hrm. 

once, when i was about 7, my friend and i ate a POUND of chocolate covered espresso beans.  when we were still up at 6 am and my dad saw the empty package, he made us swear to never do it again, and also asked my friend to maybe not tell her mom about it as it might bother her....

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omg SUCH a good idea

i have GERD tho and can't drink coffee... wonder if i could eat those???

hrm. 

once, when i was about 7, my friend and i ate a POUND of chocolate covered espresso beans.  when we were still up at 6 am and my dad saw the empty package, he made us swear to never do it again, and also asked my friend to maybe not tell her mom about it as it might bother her....

<{POST_SNAPBACK}>

I have GERD, quit all my stimulants, didn't do anything for the GERD, went back on all the stimulants (Rx and otherwise), dealt with it, and God knows the condition of my esophagus now.

And you thought you were OT... A couple of years ago, when I was still in college, a friend and I (both German majors) found this article in the Cleveland Plain Dealer titled 'GERD Linked with Pregnancy'.  Incidentally, we had a very popular German lecturer who went by Gerd (short for Gerhard).  So we cut out the article and duct taped it to his office door one evening when he wasn't there.

(He thought it was hilarious, btw.)

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i'm sorry, i'm really retarded at the whole processing thing.

all i know is that i'm such a bizarre processor i almost had my chromosomes tested last year.

<{POST_SNAPBACK}>

Heh. If I *really* knew what I was doing I'd be cured, eh?

It seems to be a hot topic because there is a demonstrated genetic component,

as well as demonstrated medication and environmental components to the

liver enzyme systems.  If it's ever figured out there'd be less risk of over/under-

medication for all sorts of pharmaceuticals. Remember: dead patients don't

buy any more of your products and their families have lawyers.

That's also why some older family practitioners out in BFE can have as good a

track record or better than your Harvard Grad , fresh from school with all

the latest theories. The old stick-in-the-mud may have been dealing with the

same (often scarily-interrelated) families for decades. S/he already KNOWS

Patient X has the same med reactions/complaints as Cousin Y and is very

likely to come down with Z by age W.

Anyhoo, we're all different in Ways That Count.

i just went on 150 wellbutrin xl.  i'm also on 200mg celebrex which is also listed as a 2D6 inhibitor.

<{POST_SNAPBACK}>

But, and this also depends on your urine pH, the body can divert amphetamine

straight to the kidneys. So for SOME things the body has a backup. It makes

sense when you look at how many plants contain similar chemicals intended

to turn anything that dares to eat them into prey.  Amphetamine is one of the

larger group of phenethylamines, which includes things like mescaline: eat it,

hallucinate, and some other critter has you for dinner while you're incapacitated.

And being a phenethylamine I wouldn't be surprised if monoamine oxidase B

goes after it as well.

I haven't needed Celebrex, but my guess is that as the WB metabolite levels

stabilize you'll have a somewhat better duration of effect from the Adderall.

and added in a second 10mg ir dose.  i do 30mg xl at 8 am, 10mg ir at 1, and 10mg ir at 4.  my last class ends at 7 and when i get home i'm completley brain dead.

<{POST_SNAPBACK}>

You put in a full day at work and school, have ongoing refractory pain issues,

and you wonder why you're tired at the end of the day?  You SHOULD be

zonked once the adderall fades and the intellectual stimulation (which will

keep an ADDer going long after she should have crashed) halts.

Unless you're one of the really compliant folks, by now you've figured that

doubling up the Adderall to just keep going when you're tired can

backfire. (If I'm tired and making a long drive late in the day, caffeine + sugar

is my best bet all around, followed by adrafinil [Provigil would be better, maybe.

Alas... no prescription])

you seem to get this more than i do.  when i take the adderall xl i get a

RUSH about an hour later (hear pounding) and then it subsides. 

does this mean anything at all?

<{POST_SNAPBACK}>

It may mean that overnight the NA/DA levels taper down enough for you to

really notice the adrenergic effects as your frontal lobes come back online.

Or, you might be better off with a slightly lower initial dose - less early

cardiovascular wear and tear might ease up the body load.

i once tried to figure this all out, made and excel chart (using that link even)

but i just don't get things like that.  (i'm more of a big concept history girl.)

lemme know if anything i said means anything.

i see my pdoc again soon.

oh, and i'm also titrating up on lyrica.  that mean anything?

GAH

<{POST_SNAPBACK}>

That you *really* ache?

Seriously though, I saw on one of the online med info pages that Lyrica can

cause drowsiness. Wellbutrin certainly can. Even the Adderall can help you

get to bed by breaking the "just one more web page/post/level/page/chapter..."

syndrome.

What if you swapped your 8AM and 1PM doses ?  The XL is supposed to be

50% immediate, 50% delayed, so you'd only be going down 5mg  initially

and that might cut down on the cardio rush you mentioned.

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That's also why some older family practitioners out in BFE can have as good a

track record or better than your Harvard Grad ™, fresh from school with all

the latest theories. The old stick-in-the-mud may have been dealing with the

same (often scarily-interrelated) families for decades. S/he already KNOWS

Patient X has the same med reactions/complaints as Cousin Y and is very

likely to come down with Z by age W.

that kinda a scary notion. 

what bothers me about fancy pants doctors is that i've had them blatantly ignore my "but my cousin took that and...." and then i ... and it just annoys me.  1st cousins are fairly genetically simmilar... bah.

Anyhoo, we're all different in Ways That Count.
point.  i should watch sesame street more in the morning.  instills such life lessons... and i did it once last month and was happy all day.  maybe it's an AD?  (not to imply that what you said was childish... it just reminded me of those life lessons you should remember)

You put in a full day at work and school, have ongoing refractory pain issues,

and you wonder why you're tired at the end of the day?  You SHOULD be

zonked once the adderall fades and the intellectual stimulation (which will

keep an ADDer going long after she should have crashed) halts.

speaking of life lessons...

i know i probably shouldn't be in grad school right now.  i should probably take another year off and sleep.  maybe go back on antibiotics in case i have lyme.

i'm expecting too much of myself and my medication and it's not that bright.  push push push and that's how i ended up with chronic fatigue in my mid 20s in the first fuckign place and here i am, doing it again, only now i'm sick and forcing myself to read 1000+ pages a week and grade papers and jesus. 

ok this is pathetic and now i'm crying.

and why am i so fucking driven that i've made myself fucking sick?  because i know i'm insane and half of my family is batshit and on dissability and i don't want fuckers like bobby to think i'm a failure at life so i must push and push and be perfect and really it's insanley stupid that i'm doing this to myself.  i really do love school but i'm really stupid for pushing this hard.

 

That you *really* ache?
haha.  yes, le sigh.  and it's supposed to maybe help with anxiety and i'd like to get off the xanax...

Seriously though, I saw on one of the online med info pages that Lyrica can

cause drowsiness. Wellbutrin certainly can. Even the Adderall can help you

get to bed by breaking the "just one more web page/post/level/page/chapter..."

syndrome.

see, these are all actually good things.  the more sleep i get the less i ache, the less i ache the deeper the sleep and the less i ache and the less brain fog i have.  it's just very hard for me to say ok, it's bed time even if x,y and z are not done because i need sleep more than x,y and z need to be done. period.

What if you swapped your 8AM and 1PM doses ?  The XL is supposed to be

50% immediate, 50% delayed, so you'd only be going down 5mg  initially

and that might cut down on the cardio rush you mentioned.

hmm. i shall try tomorrow.

thank you for your thoughtful reply. sorry i emotionally blew up it just kinda happened, heh.  common sense is hard sometimes...

happy friday! yay weekend.

thank you , really, a lot.

penny

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