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Duration of treatment with atorvastatin is unlikely to increase the risk of muscle-related side effects as most occur within the first year of treatment, after which the risk is not increased further. [64] The known cardiovascular benefits of atorvastatin over time outweigh the low risk of muscle-related side effects. [65] [64]
If the combination of two drugs in combination therapy has an effect lower than the sum of the effects of the two drugs acting independently, also known as antagonistic effect, the drugs will seldom be prescribed together in the same therapy. Drug or chemical combinations with additive effects can cause adverse effects.
The most important adverse side effects are muscle problems, an increased risk of diabetes mellitus, and increased liver enzymes in the blood due to liver damage. [ 5 ] [ 65 ] Over 5 years of treatment statins result in 75 cases of diabetes, 7.5 cases of bleeding stroke , and 5 cases of muscle damage per 10,000 people treated. [ 34 ]
When two drugs affect each other, it is a drug–drug interaction (DDI). The risk of a DDI increases with the number of drugs used. [1] A large share of elderly people regularly use five or more medications or supplements, with a significant risk of side-effects from drug–drug interactions. [2] Drug interactions can be of three kinds:
[86] [87] As with other NSAIDs, ibuprofen may be useful in the treatment of severe orthostatic hypotension (low blood pressure when standing up). [88] NSAIDs are of unclear utility in the prevention and treatment of Alzheimer's disease. [89] [90] Ibuprofen has been associated with a lower risk of Parkinson's disease and may delay or prevent it.
The risk and rate of gastric adverse effects is different depending on the type of NSAID medication a person is taking. Indomethacin, ketoprofen, and piroxicam use appear to lead to the highest rate of gastric adverse effects, while ibuprofen (lower doses) and diclofenac appear to have lower rates. [17]
The first published report on grapefruit drug interactions was in 1991 in the Lancet entitled "Interactions of Citrus Juices with Felodipine and Nifedipine", and was the first reported food-drug interaction clinically. The effects of grapefruit last from 3–7 days, with the greatest effects when juice is taken an hour previous to ...
Interactions with other drugs, food and drink, and other factors may increase or decrease the effect of certain analgesics and alter their half-life. Because some listed analgesics are prodrugs or have active metabolites , individual variation in liver enzymes (e.g., CYP2D6 enzyme) may result in significantly altered effects.
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