Medication and Digestion

According to the National Digestive Diseases Information Clearinghouse (NDDIC), a number of medicines, though often safe when taken as directed, can have an adverse affect on the digestive system. Below, you'll find some of the more common ones.

For more information read about "Medicine Safety" "Your Medicine Cabinet" "Drug Interaction Precautions" "Heartburn" "GERD"

Please remember that medications are given in broad categories and this list is not inclusive, so if you have specific questions about medication you might be taking - or if you suspect your medicine is causing stomach or other problems - always check with your doctor before taking any action.

Acetaminophen

Acetaminophen relieves fever and pain by blocking pain centers in the central nervous system. (Read about "Nervous System") A well known brand of acetaminophen is Tylenol.

NDDIC says large doses of acetaminophen (and even small doses when taken with alcohol) can cause severe liver injury. (Read about "The Liver")

Antacids

Antacids relieve heartburn (Read about "Heartburn"), acid indigestion (Read about "Indigestion"), sour stomach and symptoms of peptic ulcer. (Read about "Peptic Ulcers") They work by neutralizing stomach acid. Aluminum hydroxide antacids include Alu-Tab and Amphojel; calcium carbonate antacids include Tums, Alka Mints and Rolaids Calcium Rich; magnesium antacids include Mylanta and Maalox.

NDDIC says antacids that contain aluminum can lead to constipation; (Read about "Constipation") and magnesium-containing antacids can have the effect of laxatives and cause diarrhea if overused. (Read about "Diarrhea")

Antibiotics

Antibiotics (Read about "Antibiotics") destroy or block the growth of bacteria that cause infection. (Read about "Microorganisms") Hundreds of antibiotics are available, including penicillins, clindamycin, cephalosporins, tetracyclines, quinolones and sulfa drugs.

NDDIC says diarrhea is often caused by antibiotics, which affect the bacteria that live normally in the large intestine. (Read about "Diarrhea")

Anticholinergics

This class of medicines affects the nerve cells or nerve fibers (Read about "Nervous System") and includes drugs for depression, anxiety and nervousness. (Read about "Depressive Illnesses" "Anxiety")

Examples of anticholinergics include propantheline and dicyclomine. Examples of antidepressants include amitriptyline and nortriptyline. Medicines for relieving the symptoms of Parkinson's disease (Read about "Parkinson's Disease") also are in this category. Examples include levodopa and carbidopa and levodopa combination.

NDDIC says this class of medicines can increase the likelihood of backup or reflux of the highly acidic contents of the stomach into the esophagus. (Read about "Gastroesophageal Reflux Disease")

Anticonvulsants

These medicines control epilepsy (Read about "Epilepsy") and other types of seizure disorders. (Read about "Seizures") They act by lessening overactive nerve impulses in the brain. (Read about "The Brain") Examples of this class of medicines include phenytoin and valproic acid.

NDDIC says this class of medicines has the potential to cause liver disorders.

Antihypertensives

Antihypertensives lower high blood pressure. (Read about "Hypertension: High Blood Pressure") They act by relaxing blood vessels, which makes blood flow more easily. Examples of antihypertensives include methyldopa and clonidine hydrochloride.

NDDIC says this class of medicines can cause constipation. (Read about "Constipation")

Antituberculins

These drugs for tuberculosis (Read about "Tuberculosis") limit the growth of bacteria or prevent tuberculosis from developing in people who have a positive tuberculin skin test.

NDDIC says this class of medicines has the potential to cause liver disorders.

Bisphosphonates

Bisphosphonates are a class of drugs which help to strengthen bones. They can be used to prevent and treat osteoporosis. (Read about "Osteoporosis")

When taken orally, bisphosphonates should be taken with a full glass of water at least 30 minutes before eating a meal, and you should not lie down for at least 30 minutes after taking the medication, to avoid irritating your esophagus.

Calcium channel blockers

These medicines for angina (Read about "Angina") (chest pain) and high blood pressure affect the movement of calcium into the cells of the heart and blood vessels, relax blood vessels, and increase the flow of blood and oxygen to the heart. Examples of calcium channel blockers include diltiazem, nifedipine and verapamil.

NDDIC says calcium channel blockers can increase the likelihood of backup or reflux of the highly acidic contents of the stomach into the esophagus. A common side effect of these drugs is constipation. (Read about "Constipation")

Chlorpromazine

This tranquilizer relieves anxiety or agitation. (Read about "Anxiety") Examples of brand names include Thorazine and Ormazine.

NDDIC says this drug has the potential to cause liver disorders.

Colchicine

This medicine eases the inflammation from gout and prevents attacks from recurring. (Read about gout in "Gout")

NDDIC says colchicine is a common cause of drug-induced diarrhea. (Read about "Diarrhea")

Iron

Iron is a mineral the body needs to produce red blood cells. Iron supplements are used to treat iron deficiency or iron-deficiency anemia. (Read about "Vitamins & Minerals" "Anemia")

NDDIC says iron can lead to constipation. (Read about "Constipation")

Laxatives

Many forms of laxatives are available for relieving constipation. (Read about "Constipation") Common brand names of laxatives include Phillips' Milk of Magnesia, Citroma, Epsom salts, Correctol and ExLax.

NDDIC says the abuse of laxatives may result in damage to the nerves and muscles of the colon and cause diarrhea. (Read about "Nervous System" "Diarrhea")

Nitrates

These drugs for angina (chest pain) relax blood vessels and increase the flow of blood to the heart. Examples of generic names include isosorbide dinitrate and nitroglycerin.

NDDIC says this class of medicine can cause esophageal reflux. (Read about "Gastroesophageal Reflux Disease")

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These drugs block the body's production of prostaglandins, substances that mediate pain and inflammation. NSAIDs relieve the pain from chronic and acute inflammatory conditions, including arthritis and other rheumatic conditions (Read about "Arthritis and Rheumatic Diseases"), and pain associated with injuries, bursitis, tendinitis (Read about "Tendinitis and Bursitis") and dental problems. NSAIDs also relieve pain associated with noninflammatory conditions. Generic and brand names of NSAIDs include aspirin, ibuprofen (Advil, Nuprin and Motrin), tolmetin, naproxen and piroxicam.

NDDIC says NSAIDs can irritate the stomach by weakening the ability of the lining to resist acid made in the stomach, and sometimes this irritation may lead to inflammation of the stomach lining (gastritis), ulcers, bleeding or perforation of the lining. (Read about "Gastrointestinal Bleeding" "Gastritis")

According to NDDIC, older people are especially at risk for irritation from NSAIDs because they are more likely to take regularly pain medicines for arthritis and other chronic conditions. Also at risk are individuals with a history of peptic ulcers (Read about "Peptic Ulcers") and related complications or gastritis. These individuals should tell their doctor about any of these previous conditions. Special medicines may be needed to protect the stomach lining.

Potassium chloride

Potassium is a vital element in the body. Potassium supplements help prevent and treat potassium deficiency in people taking diuretics.

NDDIC says this medicine can cause ulcers if it becomes lodged in the esophagus when swallowed.

Quinidine

This medicine often is used to correct irregular heartbeat. (Read about "Arrhythmia")

NDDIC says this medicine can cause ulcers if it becomes lodged in the esophagus when swallowed.

Theophylline

This medicine eases breathing difficulties associated with emphysema, bronchitis (Read about emphysema and bronchitis in "Chronic Obstructive Pulmonary Disease"), and bronchial asthma. (Read about "Asthma") The medicine works by relaxing the muscles of the respiratory tract (Read about "Respiratory System"), which allows an easier flow of air into the lungs.

NDDIC says this medicine can lead to esophageal reflux. Theophylline can also cause irritability, restlessness and can precipitate cardiac arrhythmia. (Read about "Arrhythmia") It's suggested that people taking it have periodic blood levels checked.

Vitamins

Vitamins serve as nutritional supplements in people with poor diets, in people recovering from surgery, or in people with special health problems. (Read about "Vitamins & Minerals")

NDDIC says some vitamins, including vitamin A and niacin, have the potential to cause liver disease when taken in high doses. Others, such as vitamin C and iron, can cause ulcers if they become lodged in the esophagus when swallowed.

Talk with your doctor

Again, this list is not inclusive and the information is general in nature. Simply because a class of medicine is not on this list, that doesn't mean it can't cause potential problems. Anyone with any questions about their medication and potential side effects should consult with their doctor and pharmacist.

Used with permission of the National Institute of Diabetes, Digestive, and Kidney Diseases of the National Institutes of Health.

Related Information:

    Digestive System

    Children & Prescriptions