Wednesday, June 23, 1999
Drugs can intensify effects of too much sun
BY SUE MacDONALD
The Cincinnati Enquirer
The very drugs and over-the-counter products you take to feel better may actually be making you sick if you're spending a lot of time in the sun or heat.
A fairly common side effect of some drugs is a “photosensitive” reaction, meaning the products can cause rashes, sunburns, skin reactions, dehydration and a risk for heat exhaustion or heat stroke because of exposure to sunlight or high temperatures.
Some fairly common products are involved — certain heart and blood pressure drugs, antibiotics, non-steroidal anti-inflammatory drugs, birth-control pills, antidepressants, herbal products and even alcoholic beverages.
“We occasionally get calls about it, and people don't have a good appreciation for the fact that there can be an interaction between the drugs they're taking and the sun or heat, with potential harm,” says Earl Siegel, co-director of the Drug & Poison Information Center (DPIC).
“Quite a few are very common, including some of the herbal products on the market,” adds Lawrence Voss, DPIC pharmacist. St. John's wort, a popular herb for mild depression, for example, can cause a mild reaction to sunlight.
The effects of summer's heat and sun play out in different ways.
Some drugs block nerve impulses and messages that tell the brain the body is hot. Some, such as antihistamines and diuretics, dry up the body's sweat, which is the body's automatic cooling system.
If the body can't sweat, it's likely to retain heat, raising the risk for heat stroke or heat exhaustion (marked by headache, dizziness, faintness, confusion, slurred speech, seizures, delirium or coma).
Some drugs and drinks increase the risk of dehydration, because they flush fluids out of the body faster than normal. These can include alcoholic beverages, caffeine drinks and a drug like furosemide (Lasix), prescribed for high blood pressure and congestive heart failure.
Other drugs can impair a person's judgment, meaning the person might not know to seek the shade or shed clothes that retain body heat. These drugs can include sedatives, pain medicines and alcoholic drinks.
Typically, reactions are included on informational inserts packaged with the drugs, but not everyone reads papers that come with their drugs or products.
Common categories of drugs that can produce reactions to sunlight and heat (including generic and brand names) include:
• Heart and blood pressure drugs: amiodarone (Cordarone); atenolol (Tenormin); hydrochlorothiazide (HcTz or HydroDIURIL); indapamide (Lozol); losartan (Cozaar/Hyzaar); metoprolol (Lopressor); nifedipine (Procardia); propranolol (Inderal).
• Antidepressants: amitriptyline (Elavil); chlordiazepoxide (Librium); doxepin (Sinequan); fluvoxamine (Luvox); imipramine (Tofranil); paroxetine (Paxil); protriptyline (Vivactil); sertraline (Zoloft), trazodone (Desyrel), and the herb St. John's wort. Others include psychiatric medicines for mood disorders, schizophrenia and Tourette's syndrome.
• Antibiotics: azithromycin (Zithromax); ciprofloxacin (Cipro); doxycycline (Vibramycin); levofloxacin (Levaquin); minocyclin (Minocin); norfloxacin (Noroxin); ofloxacin (Floxin); sparfloxacin (Zagam); sulfamethoxacole (Bactrim/Septra); sulfisoxasole (Gantrisin); tetracycline (Sumycin); trovafloxacin (Trovan).
• Nonsteroidal anti-inflammatories (NSAIDS): celecoxib (Celebrex); ibuprofen (Advil/Motrin); ketoprofen (Orudis/Actron); nabumetone (Relafen); naproxen (Naprosyn/Anaprox), and oxaprozin (Daypro).
Other fairly common drugs include terazosin (Hytrin) for enlarged prostates; pseudoephedrine, a decongestant found in Sudafed Cold/Sinus and Advil Cold/Sinus; diphenhydramine, the anti-allergy medicine in Benadryl.
Those that can cloud judgement include alprazolam (Xanax), an anti-anxiety drug; codeine, found in some prescription cough medicines, and alcoholic drinks, which dehydrate the body.
If you notice a suspicious rash, sunburn, skin reaction or find yourself severely affected by the heat, talk to your doctor or pharmacist for guidance and help. Or call the DPIC hot line at 558-5111.
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