Read the fine print for medication interaction with all prescription drugs

by JD Meyer

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Asthma Drug Interactions and More

Do you read the fine print on prescription drug descriptions? I’m talking about those tiny, folded pieces of paper inside the box with your medications, not just what’s printed on the outside of the box. I just started reading them, and I was unpleasantly surprised. I have weak lungs starting with occasional bronchitis as a child, asthma by 28, and emphysema by 46. If you have chronic bronchitis and emphysema, then you graduate to Chronic Obstructive Pulmonary Disorder (COPD).

Unfortunately, I’m one of the millions of Americans who doesn’t have health insurance although I work but not as often as I’d like. For starters, I always keep albuterol for my nebulizer and hopefully an albuterol rescue inhaler. I’ve had a nebulizer since I was 37, should you be keeping score. At least in East Texas, nebulizer albuterol is really cheap--$3.99 for a box full of vials. Cheap medicine for lung illness is rare enough to be an oxymoron!

Everybody in the U.S.A. who has ever wheezed should know there is one company that makes the only two over-the-counter drugs for asthma-related illness: Primatene, an inhaler for quick relief and tablets for long-lasting help. But did you know that you’re not supposed to mix albuterol and Primatene tablets because of ephedrine in the Primatene tablets? Finally, I decided to read the fine print on the nebulizer albuterol description. I’m sure that I’ve mixed those drugs before in the past, thinking they were a good combination, and just figured my continued problems were the sign of a tough flare-up of COPD.

A really wonderful medicine for those with bronchitis is the expectorant, guaifenesin, and it’s the leading component of Mucinex and a host of generic medicines. Be sure to drink plenty of water with this drug. For that matter, drink lots of water if you have chest congestion in general. It will thin the secretions in your lungs so you can spit them out.

Here’s another unpleasant surprise: don’t mix Symbicort, the short, fuscia-and-white inhaler with Advair, the purple disk, and a leading inflammation control drug. Symbicort is an inhaler that’s part lung dilator and anti-inflammatory but not a rescue inhaler. It’s easier to find than regular albuterol rescue inhalers but costs more, roughly $40 versus $24. Back when I was on health insurance with a full-time teaching job, our clinic doctor said that if I stayed on expensive Advair (roughly $165/disk), I’d have my asthma under control. (It hadn’t evolved to emphysema at that time). However, I just applied for financial assistance with such medicine at PATH (People Attempting To Help), a local social service agency in Tyler..

Now that you know that I don’t have enough Advair, what happens to me without anti-inflammation drugs? I get sick, go to the doctor or emergency room, and later receive Prednisone, a water-based steroid. Fortunately, that is also cheap in East Texas like nebulizer albuterol--again only $3.99 for a pill bottle--but Prednisone can’t be refilled once the crisis is over. Take your Prednisone after eating, but take your antibiotic before eating. This is one notice that you’ll see on your pill bottle.

What does the medication description tell us about Prednisone? Long-term use can lead to osteoporosis (brittle bones) and cataracts. I had the beginnings of a cataract back in Fall 2008. Isn’t it surprising that a drug that reduces inflammation in your lungs or wherever can make your bones fragile? Here’s something else surprising about prednisone. I forgot to tell my doctor during my asthma attack of two weeks ago that I severely sprained my foot over a month before. My question was, “Would the prednisone go to both areas and short-change my fragile lungs?" Two different doctors at two different places said, “No"--including last night's emergency room.

To conclude, read the fine print on medication interaction for asthma, bronchitis, and emphysema or whatever drugs. You might get an extra source of income explaining medicine interactions for those who don’t read particularly well. On the other hand, if you’re like me, you may be in for some unpleasant surprises. I bet that I’ve only scratched the surface in this area of lung illness drug interactions. Drink plenty of water and stop smoking, even ultra light cigarettes.

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