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Your pain medication: Don't mix and match

Written by: Roanne Weisman
Published: January 29, 2010
Reviewed by: Kevin Zacharoff, MD, January 2010

Your pain medication: Don't mix and match

When you take prescription pain medication, what happens to it? Some people may think that the medication finds its way to a special “pain medicine” compartment in the body, which then sends it out to where the pain is.

This is actually not what happens. When you take medications some of the organs in your body become sort of a “processing plant”.  These include your stomach and intestines, (also called your gastrointestinal (GI) system), and your liver or kidneys. Even if a substance or medication enters your body through the skin or by injection, rather than through your mouth, your body must still “process” it before it can be used.

During this “processing” everything that goes into your body is mixed together, and they can all affect each other. There are no separate compartments for foods, medicines, and liquids. Therefore, the medication you take for pain can be affected by what you eat or drink, and any other medications that you have been taking. Even the vitamins you took with breakfast or the herbal tea or coffee you had at lunch can affect the way your body processes and reacts to medications.

A peek into your body as a processing plant

Everything that goes into your body passes through this plant before it leaves your body.
The GI system, where it often starts, does far more than transport food and medicine. The system also helps to break everything down into microscopic pieces, called molecules. Food is broken down into the molecules your body needs to live: proteins, carbohydrates, fats, vitamins, minerals, and water. Medicine is also broken down into molecules, and the GI system then delivers these molecules directly into your bloodstream, which carries them to every cell, tissue, and organ in your body. 

Connected to the GI system are several "accessory" organs that produce digestive juices, enzymes, and acids that help break down your food and medicines.  Two very important organs are the liver and the kidney. The liver serves two functions; it helps to further breakdown these molecules, and it also filters out those that are not used.  The nutrients and medicine your body does not use are broken down and discarded as stool. The kidneys help the liver process and filter substances out of the blood, and dispose of them in the form of urine.

Imagine a prescription pain medication traveling through this long, crowded processing plant inside your body, and it will give you a better idea of why it is important NOT to “mix and match” without the expert knowledge of your health care provider to guide you safely.

Track and tell

The key here is not to stop eating, drinking or taking other medication, but to track what you are doing, or plan to do, and to be sure to tell your healthcare provider about it. Why is this important? Because when medications are mixed together—either with other medications or with alcohol, coffee, herbal or vitamin supplements, or even certain foods—changes can occur, and some of them can be unexpected:

  • Your prescription pain medication can become less effective because another substance “cancels it out”
  • You can have a stronger response to the medicine, even serious side effects which can be dangerous, if another substance you are taking adds to or magnifies the effect your medication is meant to achieve

What to watch out for

When you take prescription pain medications, such as an opioid (narcotic), it is very important to keep track of everything else that goes into your body, and to check with your health care provider (and your pharmacist) to find out what bad interactions may occur. Here is a partial list of what you should discuss:

  • Name all of the prescription medicines that you may be taking for any other condition
  • Name all of the over-the-counter medicines you take, including ibuprofen, acetaminophen, aspirin, anything for stomach upset, or non-steroidal anti-inflammatories
  • Describe how you use alcohol (which is a drug), even it is only one glass of wine or a beer each day
  • Describe your use of any kind of tobacco (which contains the drug nicotine)
  • Name the medicines that you use, but don’t take by mouth, such as:
    • Those delivered through a patch on your skin
    • Medicines delivered by injection
  • List foods you often consume, like chocolate or cheese, if you worry that they may make your medications less effective
    List any herbal supplements or drinks that you take
  • Describe if you are using or have used any illicit (not legal) substances or “street drugs” like marijuana or cocaine

The human body is amazingly efficient processing plant, but like any other machine, you need to maintain it properly to keep it working right.