Bleeding disorders

NSAIDs –pose the risk of bleeding when used inappropriately especially when used people with bleeding disorders..

Diabetes mellitus

Oral decongestants can raise your blood sugar. While safe to take, adjustments to diabetic medication may be needed in some circumstances when taking oral decongestant. A safe option that will not affect blood sugar levels is a saline nasal spray, which can provide relief from a stuffy nose

Cough: Cough syrups typically contain a good amount of sugar, so sugar-free cough syrups are the safest option for those with diabetes.


Heart disease

NSAIDs: Ibuprofen, Advil, Motrin, Aleve, Toradol, Celebrex. These medicines hold fluid and cause swelling when taken for people with heart failure, caution needed. They also can harm your kidneys.



High blood pressure

Decongestants such as those that contain pseudoephedrine. Decongestants relieve nasal stuffiness by narrowing blood vessels and reducing swelling in the nose. This narrowing can affect other blood vessels as well, which can increase blood pressure.

Pain medicines (NSAIDs), such as ibuprofen and naproxen.

  • Cold and influenza medicines. These often contain decongestants and NSAIDs.
  • Some antacids and other stomach medicines. Many of these are high in  sodium, which can raise blood pressure. So be sure to read labels carefully to check for sodium content.


Kidney/ Liver problems

Kidney: NSAIDs such as ibuprofen and naproxen. These medicines hold fluid and cause swelling and can also harm the kidneys

Liver: Non-prescription pain relievers such as acetaminophen (paracetamol), aspirin, ibuprofen and naproxen can damage your liver, especially if taken frequently or combined with alcohol.




Psychiatric problems

St. John’s wort is a common herbal supplement for depression. The combination of St. John’s Wort with antidepressants (SSRI’s) can cause serotonin toxicity.

Tyramine- Should be careful when when eating foods with Tyramine commonly found in aged meats, cheeses, and beer. If taken together, it may cause an unsafe rise in blood pressure

Asmatics 

Cough suppressants such as codeine, pholcodine and dextromethorphan.

NSAIDs (such as ibuprofen and aspirin) can cause an asthmatic attack in certain people with asthma. The attack may be severe and sometimes life-threatening.

Theophylline: Due to theophylline’s narrow therapeutic index, patients prescribed theophylline (or aminophylline) should avoid taking products containing theophylline such as Do-Do Chesteze which may cause theophylline toxicity




Enlarged Prostate

NSAIDs may decrease the risk of an enlarged prostate, but aggravate urinary symptoms as they inhibit the production of prostaglandins worsening urinary symptoms.

First generation antihistamine such as Chlorphenamine, Promethazine, Cinnarizine, Meclozine, Triprolidine, Diphenhydramine, buclizineas they don’t allow the prostate and bladder to relax correctly and thereby slow or inhibit urine flow. Second generation medicines such as Loratadine or cetirizine show less of this symptoms so would be the better choice

Decongestants both topical and oral decongestants (Phenylephrine, Pseudoephedrine, Ephedrine) carry a warning against use by men with BPH. Phenylephrine, may constrict the prostatic capsule and lead to urinary retention which in the longterm may cause bladder stones. Using mechanical dilators for men with BPH to dilate the nostrils


Glaucoma

Antihistamines that contains drugs such as diphenhydramine put patients with narrow angles at risk others include:

·     Chlorphenamine (e.g. Piriton), Diphenhydramine (e.g. Benylin Chesty Coughs [Original]), Promethazine hydrochloride (e.g. Sominex), Promethazine teoclate (e.g. Avomine), Buclizine (e.g. Migraleve Pink)

Anticholinergics: Hyoscine hydrobromide (e.g. Kwells), Hyoscine butylbromide (e.g. Buscopan IBS Relief)

Corticosteroids: Beclometasone (e.g. Beconase Hayfever Nasal Spray), Fluticasone (e.g. Pirinase Hayfever Nasal Spray), Triamcinolone (e.g. Nasacort Allergy Nasal Spray)


Ephedrine can result in acute angle-closure glaucoma attacks in patients with preexisting narrow angles. Some cold medications contain ephedrine for managing congestion.