The risk of diarrhea
Not many people choose milk to wash down pills. However, there are some milk lovers who can´t resist. Calcium ,which is present in milk and dairy products, lowers the absorbtion of some antibiotics, especially tetracyclines. They should never be washed down by milk. Milk can also enhance the effect of some laxatives. It might have rather serious consequences.


Trickiness of grapefruit juice
A lot of people drink grapefruit juice for breakfast. This is also a typical time to take pills. However, grapefruit juice blocks metabolism of many important pills in the liver and thus increases their effectiveness. It does so with pills against high blood pressure, high cholesterole, pills used in psychiatry, hormones in tablest (estrogens), hormonal contraception, pills against allergies, pills used after organ transplants and many others. Other juices including citrus juices do not have this effect.
Orange juice should not be consumed together with pills against stomach acidity (antacids), which include aluminium. It enhances the absorbtion of aluminium, which is not wanted. At the same time it increases stomach acidity, which breaks down antibiotics in a greater way. On the other hand, juices which contain vitamin C increase the absorbtion of supplements with iron, which prevent anaemia and therefore insufficient oxygenation of tissues. These types of pills should be washed down with such juices to enhance their effect. There are even some expensive drugs which are recommended to be taken with grapefruit juice to ensure maximum effect. However, such recommendations should stay in the hands of the doctors.

Competition with nerves
Drinks containing caffeine are tricky. They include coffee, some kinds of black teas and soft drinks such colas.These drinks increase the effect of theophyllines. These pills are often used to treat chronic inflamation of bronchial tubes and lung asthma.The combination of above mentioned drinks and drugs can lead to higher level of nervousness, shaking, insomnia, headache and heart palpitation. Patients wo drink more than six cups of coffee a day can have medical problems even if they don´t use coffee to wash down their pills. You should also be cautious when it comes to St. John´s wort. It decreases the effect of many medications including female contraception.

The question of life
Washing down  pills with alcohol is an adrenalin sport rather than a medical treatment. Even a small amount of alcohol can drastically change the effect of medications. It is especially true for treatment of mental illnesses such as depression, insomnia, also antibiotics, pills against allergies and pills for blood dilution. Alcohol can dramatically enhance their effect. Among one hundred most prescribed pills there are fifty percent which react with alcohol. Therefore pills should never be taken with alcohol and you should in fact not consume alcohol when taking any pills.

Safe bet
The best option is to use minimally 200 ml of clean cold water or mineral water to wash down pills. Do not use mineral water with high amount of sodium, which decreases the effect of medications against high blood pressure and could prevent successful treatment of heart attack. Magnesium and potassium are on the other hand very profitable. They can be very beneficial, because some diuretics used for heart attack treatment decreases the level of these minerals in the body. It is not recommended to use carbonated drinks. They increases stomach acidity and can destroy many substances before they have chance to be absorbed.

Lenka Bicanová editorka FN