Episode 113: How to interact with drug interactions

In episode 113, Mike and James interact in a mainly positive way about what to do with the 1000s of drug interactions that are out there. They talk about the concepts of pharmacokinetic and pharmacodynamic interactions and outline which ones appear to be clinically important.

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Drugs and meals...

Great podcast on a difficult topic!
I wonder if you can say anything about drugs and their gastrointestinal absorption - maybe you've got a simple rule of thumb for that ?

Greeetings from Germany

*proud premium podcast member ;-)

the boy who cried "wolf"

"From it is derived the English idiom 'to cry wolf', meaning to give a false alarm."
Aesop, I believe. Probably originally published in the Old England Journal of Medicine.

As always, great work. And now for a serious question. We do get numb to warnings about medication. And yet most agree (and you stated) warfarin is serious.

But is it? We know that INR increases with concomitant antibiotics...but are you aware of adverse clinical outcomes (bleeding) from this? I've read recent articles that bleeding risk doesn't really go up (or go up much) when INR increases (up to 6? 9?) so are we only trying to prevent "abnormal INR" or are we actually preventing bleeding when trying to address this interaction?

And, of course, I'm still going to watch the INR...just curious.