We are seeing an increasing number of queries asking whether it is safe to take certain vitamins, minerals, herbal medicines or supplements with prescription medicine. The NHS is time pressured and these queries do tend to be quite lengthy.
We therefore gratefully request that our patients follow the advice below:
1. Read the ‘patient information leaflet’ that comes in the pack with every medicine dispensed from a community pharmacy. If you have not had this leaflet, please speak with your community pharmacist.
2. In the patient information leaflet, look for the section ‘Other medicines and your tablets’. This will tell you what has been found to interact with the tablet. If the supplement you are thinking of buying is listed in this section, do not buy or take the supplement.
3. In the patient information leaflet, look for the section ‘Food, Drink and Alcohol’. This section is not always present. If there are substances mentioned here, we would recommend you do not take supplements with your prescribed medication.
4. Medscape offer a free online interaction checker. Although this is aimed at healthcare professionals, you may find it helpful to have a look. The website is https://reference.medscape.com/drug-interactionchecker
5. We recommend that our patients stick to the NHS guidance levels for vitamins and minerals, unless they have been otherwise advised by a qualified specialist. This is available at: https://www.nhs.uk/conditions/vitamins-and-minerals/
6. You may further wish to consult a private nutritionist or herbalist for tailored advice. Remember to ask them what their qualifications and check that they have joined the voluntary register for their area of practice. More information is available at https://www.nhs.uk/conditions/complementary-and-alternative-medicine/. You should also ask them what reference sources they plan to consult when they answer your query.
7. Please remember that interactions with herbal medicines and supplements are frequently underreported, and the area is also less well regulated compared to prescribed medication. There is still a lot which is unknown. If you start taking a herbal medicine or supplement and develop a side effect, notice that your prescribed medication seems to work less well, or have any other concern, it is very important to report it. You can report this via the NHS Yellow Card scheme at: https://yellowcard.mhra.gov.uk/
The NHS has recently granted clinicians free access to Stockley’s Medical and Herbal Interactions, which is a world class resource. Therefore, if you have followed all the steps above and wish to speak with our pharmacist regarding a specific query, you are welcome to contact the practice. Please state what steps you have already taken to answer your question, and what specific issue you still need guidance for. Please also be aware that we do prioritise our work according to clinical urgency, therefore please allow up to four weeks for your query to be answered. Of course we will always aim to answer in a timely manner, dependent on workload.
Amy Khoo – Clinical Pharmacist