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Boggio Family of Pharmacies

Boggios: A healthy choice for your whole life

Category Archives: Allergies

Grapefruit and grapefruit juice are an excellent source of many nutrients that contribute to a healthy diet. Grapefruit is a good source of vitamin C, fiber, and the pink and red hues contain the beneficial antioxidant lycopene, thought to have a role in preventing various diseases such as cancer and heart disease. Studies have shown that grapefruit helps lower cholesterol, and there is evidence that the seeds have antioxidant properties.

However, there are compounds in grapefruit called furanocoumarins that can interfere with the way your body metabolizes certain medications. This can lead to dangerously high levels of medication in the body and may increase the risk of rare but serious or life-threatening side effects such as slowed heart rate and muscle deterioration. For a few medications, it can lead to decreased effectiveness because these medications need to be metabolized in order to become active. Don’t take these interactions lightly, as some can cause potentially dangerous health problems.

Both grapefruit juice (either fresh or frozen) and the fruit itself can affect certain medications and the effects have been seen with as little as one 8-ounce (250 mL) glass of grapefruit juice. The effects of grapefruit juice on medications can last up to 3 days, so taking them at different times of day will not help. Naturally sweet orange juice has not been shown to affect medications the way grapefruit juice does, but tangelos (which are related to grapefruit), lime juice, andSeville(sour) oranges may affect medications.

Many medications may be affected by grapefruit juice, including medications for:

Allergies Fexofenadine (Allegra)
Anticoagulation Dabigatran (Pradax)
Anxiety/Sleep Buspirone (BuSpar), Diazepam (Valium), Triazolam (Halcion), Alprazolam (Xanax), Clonazepam (Rivotril)
Arrhythmia Amiodarone (Cordarone)
Blood Pressure Amlodipine (Norvasc), Felodipine (Renedil, Plendil), Nifedipine (Adalat)
Cholesterol Simvastatin (Zocor), lovastatin (Mevacor), atorvastatin (Lipitor)
Depression Sertraline (Zoloft)
HIV Saquinavir (Invirase, Fortovase), indinavir (Crixivan)
Seizures/Epilepsy Carbamazepine (Tegretol, Mazepine), Clonazepam (Rivotril)
Sexual Dysfunction Sildenafil (Viagra), Taldafil (Cialis)
Transplants/Autoimmune Diseases Cyclosporine (Neoral, Sandimmune), tacrolimus (Prograf, Advagraf), sirolimus (Rapamune)

This is not a complete list; grapefruit juice may affect medications for conditions other than those listed here. Also, if you are taking any natural health products, check the labels to see if they contain grapefruit, tangelo, Seville orange, or lime juice. Avoid these fruits and juices until your doctor or pharmacist has told you it’s safe to have them.

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Allergic rhinitis can affect up to 30% of the population.  The two most common forms are seasonal allergic rhinitis (hayfever) and perennial allergic rhinitis (caused by dust mites, animal dander, and mold spores).  Symptoms from these allergies include nasal blockage, itching, and sneezing, and can also involve the eyes throat and ears.

These types of allergies can be more than annoying.  The first steps to take involve avoiding the allergy.  Air conditioning reduces pollen exposure.  Removing pets from the home, and dust avoidance can reduce exposure as much as 60%.  It is also important to change not only your pillowcase but your actual pillow on a regular basis. There are also a number of pharmalogical options available.

The over the counter medications include 1st and 2nd generation antihistamines.  These medications will help with a runny nose, itching, and eye symptoms.  First generation antihistamines are very helpful with hives and itching.  An example would be Benadryl.  This type of medication does cause drowsiness and it is usually recommended to be taken only at bedtime.  Second generation antihistamines like Claritin, Aerius, and Reactine, do not cause drowsiness and do help with symptom control.  They work quickly and can be taken on an as needed basis.  In general they do not help with nasal congestion, and for that it is best to take an oral decongestant.

Pseudoephedrine is the main ingredient in the decongestant products available.   Some patients should speak to their doctor first before they take a decongestant.  They should be avoided in patients receiving MAO inhibitors, and used with caution in patients with hypertension, hyperthyroidism, or ischemic heart disease.  Topical decongestants like Otrivin should probably be avoided for patients who require long term therapy.  Prolonged use of these products can cause rebound congestion and require the patient to continue using them for relief of their symptoms.

For many people they need to take an antihistamine/decongestant combination pill to control their symptoms.  These types of medications cut down on the number of pills a patient needs to take and there are a number available on the market.

If symptoms are still a problem there are prescription steroid nasal sprays.  There are a number of these available.  Some are covered by drug plans and some are not.  It is best to call your plan first before you get your prescription to see which ones your drug plan covers.  Nasal sprays are generally well tolerated, have little systemic absorption, and are effective for symptom control.

For more serious allergy problems oral prednisone can be used.  Patients whose symptoms do not resolve can also undergo Immunotherapy.  This can involve desensitization or allergy shots.

Allergies can be difficult to deal with but there are a wide variety of treatments available.  Talk to your community pharmacist about which option is best for you.

An anaphylactic reaction is the most serious form of an allergy. It is estimated about 2% of the population have this type of allergy. People who have these types of allergies when exposed to the allergen get hives, swelling of the tongue, closing of their airway, a drop in blood pressure, and if untreated can die from the reaction.

Peanut and nut allergies seem much more prevalent now than they did twenty years ago.  If you are a caregiver, or teacher of a child with this type of allergy it is very important to be familiar with an EpiPen and how to use it.  An EpiPen is to be administered at the first sign of anaphylactic reaction and it involves giving an automatic injection in the individual’s thigh to deliver epinephrine.  This medication can reverse the symptoms mentioned above.  If you have to give an individual an Epi injection they should still be taken to hospital as soon as possible, one shot may not be enough and they need to be monitored for further respiratory and blood pressure complications.

If you, or someone you know, has this type of allergy please come into the pharmacy where we can show you how to use the EpiPen.  Being prepared ahead of time is the best way to make sure you can do what is necessary in a crisis situation.There are new EpiPens on the market that have different colour coding that make them easier to use.  You can buy an EpiPen without a prescription and it may be handy to have one just in case.  People can develop allergies later in life, and may not even know they have this type of life threatening condition until they are exposed to an allergen.

One thing to take note of when you buy an EpiPen is the expiry date.  Epipens also come in two different strengths.  There is an EpiPen Jr. for children 15-30 kg  (33lbs-66lbs), and an adult pen for individuals 30kg (66lbs) and up.  Most people, even  children, require the adult pen, but it is based on weight so you need to make sure you have the appropriate pen.  Consult your doctor for your child if they are less than 15kg or 33lbs.  If your child is below this weight and they are having an allergic reaction it is best to call 911 or go straight to the ER.  You can administer some liquid Benadryl based on their weight on the way to the hospital.

Please be sensitive to people who have these allergies.  Anaphylaxis is a life threatening condition and it is up to all of us to protect the most vulnerable people in our community.  It is a scary prospect to send your child to school if they have one of these types of allergies.  If we are all aware of what to do in case of this type of emergency everyone will benefit from a safer environment.