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OTC Meds for people with PD


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#1 MComes RPH

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Posted 02 August 2011 - 09:34 PM

I have been getting a lot of questions about what allergy, cold, and pain medications are ok to take if you have PD. Well, here it is in one spot for you.

Allergy, Cold, and Pain Medicines For People with PD

Dextromethorphan (also known as DM in many products) is a cough suppressant used by itself or with other products to take care of multiple symptoms. People taking the MAO-B inhibitors selegiline (Eldepryl) or rasagiline (Azilect) for Parkinson’s disease should not take dextromethorphan. If you are not sure if a product contains dextromethorphan or not, please ask your pharmacist and let them know what medications you take for Parkinson’s disease. The resulting problem could be increased blood pressure which could lead to hallucinations, coma, and possibly death.
Two common decongestants, which are used to reduce a stuffy nose. Products containing Pseudoephedrine are available for purchase at the pharmacy counter only. The Federal Government limits how much a person can legally buy at one time and how often. This law was inacted because Pseudoephedrine is the main ingredient used to produce Methamphetamine. There have been a few studies that state it is ok to take
MAO-B inhibitors (rasegaline and selegiline) with Pseudoephedrine and Phenylephrine, I will caution on the side of safety. I recommend to stay away from these products not just for that reason. These decongestants can also exacerbate tremor and the feeling of agitation in a non-PD person, these side effects can be increased in a person with PD.

Guaifenesin, which is classified as an expectorant, is used by itself or in combo with other cold and cough preparations. It helps aid in the movement of mucous and phlem out of the sinuses, lungs, and throat. It can be taken by PD patients and is comparable with PD medications.
Antihistamines come in 2 categories, drowsy and non-drowsy. The non-drowsy ones go by the names Claritin, Zyrtec, and Allegra. The drowsy anti-histamines go by the names Benadryl and Clor-trimeton. Both categories are comparable in patients with PD and petients who take PD medications. In fact, the active ingredient in Benadryl, diphenhydramine, was one of the first medications used to treat tremors in PD.
Other antihistamines come in the corm of nasal sprays. These are also ok to take if you have PD or take PD meds. The main thing to remember is that these should only be used for a max of 3-5 days. Any longer and your runny nose will het worse, not better.
For pain there are about 3 choices of oral medications available over the counter. These 3 are Ibuprofen, Naproxen, and Acetaminophen. All of these medications are fine to take if you have PD but, 1 can cause problems with the breakdown of PD medication. The Ibuprofen and Naproxen cause some stomach and GI upset but, are probably the better alternative to Acetaminophen. The reason is that Acetaminophen is metabolized by the liver, as many of our PD medications are also. If taken too close together, the Acetaminophen can cause an increase in blood levels of the PD medication. This may sound good, I van take the same amout of medication and get more results! When in actuality, you will get more of the side effects and none of the benefits.
Well, there it is. I think I covered most of it. It is amazing how far science has come from the days of, "Take 2 aspirin, get a box of tissue, and drink a hot toddie." I guess I never said those won't work, did I?
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#2 Oakman

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Posted 03 August 2011 - 09:30 PM

"For pain there are about 3 choices of oral medications available over the counter. These 3 are Ibuprofen, Naproxen, and Acetaminophen."

What about aspirin?

#3 Louise

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Posted 06 August 2011 - 09:33 AM

My husband who has PD and dementia was told by the DPharm who works in the PD clinic we go to- to try to avoid allergy meds- because they can cause more confusion. Also he can not take Leviqan? or Cipro due to those drugs causing him major confusion.
Do you have a seperate list of drugs- OTC or RX that a PD patient with cognitive issues should avoid? I have learned by experience to always call the PD clinic and talk to the DPharm to get his take on side effects- before starting my husband on a new drug,etc. The average pharm. or MD (internist) has no idea that there could be a problem with some people.

Thanks, Louise

#4 MComes RPH

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Posted 07 August 2011 - 10:44 PM

Sorry, I forgot about the oldest one pain reliever in the book..Aspirin. With all the newer choices, many times we forget, as I did, about some of the older products. Aspirin is very successful at relieving pain and decreasing inflammation. It can be taken with other PD medications and is ok for PD patients to take. A few studies have even shown that aspirin and other NSAIDS (especially ibuprofen), can possibly reduce the risk of getting PD. The study did not say anything about slowing the progression of PD. Another positive to aspirin is that at a low strength (81 mg per day) it can help decrease your chances of stroke or other cardiovascular issues.
On the down side, aspirin is very hard on the stomach, which could lead to ulcers and intestinal bleeding. Even a small amount of stomach distress could lead to altered absorption and breakdown of PD medications.


"For pain there are about 3 choices of oral medications available over the counter. These 3 are Ibuprofen, Naproxen, and Acetaminophen."

What about aspirin?


Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org




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