Health
6 Benefits of Butterbur herb and side effects
6 Benefits of Butterbur Herb and side effects.
Seasonal allergies are often accompanied by a flurry of unpleasant symptoms. Sneezing, sniffling and itchy eyes are just some of the annoying side effects that come with the season.
If you’re like most, you’ve probably desperately reached for antihistamines to find quick relief from your allergies only to experience additional symptoms like drowsiness, dry mouth, or nausea.
Fortunately, there are natural allergy remedies, like the herb butterbur, that can help prevent symptoms without the unpleasant side effects.
Butterbur herb is good for more than just allergy season. It can be used year-round to relieve inflammation, prevent migraines, reduce asthma symptoms, and even protect the brain and heart from damage.
In the past, it was also used as a traditional treatment to help heal wounds, reduce symptoms of urinary tract infection, and fight fevers.
Available in a convenient capsule form, adding butterbur herb to your medicine cabinet can have a huge impact on your health and may even reduce your need for other medications.
Benefits of Butterbur Herb
1.- treats seasonal allergies
Allergic rhinitis, also known as hay fever or seasonal allergies, is an allergic response that produces symptoms such as sneezing and itchy eyes.
Although traditional treatment includes medications such as antihistamines, steroids, and decongestants, the herb butterbur can be an effective natural alternative to help reduce symptoms.
In one study, butterbur extract was shown to be significantly more effective in treating hay fever than placebo in a randomized, double-blind, placebo-controlled, parallel-group comparison.
In another study, the effects of butterbur were compared to cetirizine, also known as Zyrtec, a drug used to treat seasonal allergies. Not only was butterbur as effective as cetirizine in improving symptoms, but it also produced fewer negative side effects, such as drowsiness and fatigue.
For those who suffer from seasonal allergies, butterbur can be a great option to help lessen symptoms and avoid the adverse side effects that can occur with traditional medications.
2.- Relieves migraines
If you’ve ever suffered from migraines, you’re probably all too familiar with the long list of migraine symptoms that come with them.
Throbbing pain, sensitivity to light and sound, dizziness, nausea, and vomiting are all common side effects when you have a migraine.
Fortunately, many natural remedies can help lessen symptoms. Butterbur herb extract has been shown to help naturally treat migraines.
In one study, the benefits of butterbur cut migraine frequency by 48 percent over a four-month treatment period. Another trial found similar results, showing that the herb decreased the number of migraines by 47 percent and was significantly more effective than a placebo.
Additional research focused only on children and adolescents who took butterbur and found that migraine frequency was reduced by 63 percent, and 91 percent still felt improvements four months after treatment.
If you suffer from frequent migraines, butterbur can be a great natural remedy to have on hand. You may also want to consider other natural remedies, such as feverfew, which have been shown to provide migraine relief as well.
3.- Reduces asthma symptoms
Asthma is a common problem throughout the world, affecting approximately 300 million people and accounting for 250,000 premature deaths each year.
Some evidence shows that the benefits of butterbur herb could be used in combination with traditional treatment to help improve asthma symptoms.
One study measured the effects of butterbur in 80 participants with asthma for four months. Not only did the severity, duration, and number of asthma attacks decrease, but symptoms also improved, and 40 percent of participants reduced their use of asthma medications.
An animal study also showed that butterbur has potent anti-inflammatory properties that can help treat asthma.
Using butterbur, alone or with other asthma treatments, might help reduce asthma symptoms and severity while reducing the number of asthma attacks.
4.- Protects the brain
Interestingly, there is some evidence showing that butterbur might help keep your brain healthy and protect against oxidative damage.
Oxidative damage is caused by the buildup of damaging free radicals, compounds that form as a result of factors such as stress, pollution, and a poor diet. If antioxidants don’t neutralize free radicals, they can cause cell damage and even lead to chronic disease.
An animal study showed that the herb butterbur has a protective effect on the brain. It was able to prevent damage to the brain even after a neurotoxin was administered.
The herb butterbur also contains a plant compound called kaempferol, which is also found in foods such as broccoli, Brussels sprouts, spinach, apples, and green tea. Kaempferol boasts a long list of health benefits and has even been shown to prevent oxidative damage to the brain.
Compounds found in butterbur may help keep your brain healthy and prevent degenerative brain disorders such as dementia and Alzheimer’s disease.
5.- Promotes heart health
The herb butterbur is full of health-promoting compounds and antioxidants that can help improve your heart health and reduce certain risk factors for heart disease.
In an animal study, butterbur supplementation was shown to decrease total cholesterol, bad LDL cholesterol, and oxidative stress in mice. Another animal study also found that it improved cholesterol concentrations and even reduced body weight and fat accumulation.
The kaempferol found in this herb may also benefit heart health. Several studies have shown that it can protect against heart damage caused by heart attacks.
6.- Reduces inflammation
Although inflammation is a normal response of the immune system, more and more emerging research shows that chronic inflammation may be at the root of many diseases. Inflammation is thought to contribute to diseases like obesity, cancer, diabetes, and heart disease.
The herb butterbur contains powerful anti-inflammatory properties and has been shown to prevent the buildup of inflammatory cells in the body. Kaempferol, one of the components found in butterbur, also contains anti-inflammatory properties.
An animal study showed that kaempferol reduced levels of inflammatory markers and reduced oxidative stress in mice.
According to these studies, pairing butterbur with a balanced diet and healthy lifestyle may help decrease inflammation and prevent chronic disease.
How To Use Butterbur Herb
The herb butterbur is most commonly found as a supplement in capsule form and is widely available at most natural health stores, drug stores, and online retailers.
It is also found in some natural medicines, such as Petadolex. Petadolex is a medicine containing butterbur that is used to promote blood flow and prevent migraines.
Most studies show that butterbur is most effective when given in doses of 50 to 75 milligrams twice daily. You may want to start with a smaller amount and gradually increase your intake to assess tolerance.
Be aware that some butterbur-containing products may also contain pyrrolizidine alkaloids (PAs), a type of chemical that can cause liver damage and other adverse side effects. If you have liver problems, avoid raw butterbur and look for butterbur-free products to avoid this harmful chemical.
Also, be sure to look for a trusted brand with minimal ingredients to ensure you’re getting the best quality possible.
The butterbur plant in dried form or extract can also be used to make an allergy-fighting tea.
Butterbur Herb Side Effects and Precautions
Although generally safe and well-tolerated, some people may want to avoid butterbur.
Some people may be allergic to this herb. Butterfly allergies are more common in those who are also sensitive to other plants in the same family, such as ragweed, daisies, marigolds, and chrysanthemums. If you experience symptoms such as hives, itching, or swelling of the throat, you should stop using immediately and talk to your doctor.
If you are pregnant or nursing, the use of butterbur is not recommended as its effects have not yet been studied. Also, although it is safe and effective for children, it should only be given to children under the supervision of a healthcare professional.
You should also make sure to only use products labeled certified PA-free to avoid liver damage and other negative effects. Consuming raw, unprocessed butterbur is not recommended for those with liver problems in particular, as these harmful chemicals have not been removed.
Common side effects of butterbur include headache, diarrhea, fatigue, belching, and itchy eyes.
As always, if you experience negative side effects, you may want to lower the dosage or discontinue use and consult with your doctor.
Final Thoughts on Butterbur Herb Benefits
The butterbur herb has a long history of being used as a medicinal herb, treating everything from the plague to fevers and wounds.
Several recent studies have shown that it can effectively treat migraines, reduce seasonal allergy symptoms, protect the heart and brain, relieve inflammation, and lessen the severity of asthma.
It’s easy to add butterbur into your daily routine whether you’re using a supplement once or twice a day or brewing an occasional cup of butterbur tea.
Use alone or with other natural remedies in conjunction with a healthy lifestyle to help improve certain conditions and move toward better health.
Health
Benefits of bay leaves and side effects
Table of Contents
Health
Serious side effects of metoprolol
- Discover the serious side effects of metoprolol.
- How does this medication work? What are its effects?
- Metoprolol belongs to the class of medications called beta-blockers. Metoprolol is used to treat high blood pressure and prevent symptoms of certain types of angina ( chest pain). It is also used to reduce the risk of death immediately after a heart attack. It works by reducing the needs of the heart during exercise.
- People who have had a heart attack take metoprolol to avoid having another heart attack. Metoprolol is often used in combination with other drugs that lower high blood pressure, such as diuretics (pills that increase urine output), when just one agent is not enough to control blood pressure.
- This medicine is available under various brand names or in different formulations, or both. A specific brand of this medication may not be available in all forms and may not have been approved for all of the conditions discussed here. Also, some forms of this medicine may not be used for all of the conditions mentioned in this article.
- Your doctor may have suggested this medication for a condition that is not listed in this Medication Information article. If you have not yet discussed this with your doctor, or if you are not sure why you are taking this medicine, consult your doctor. Do not stop taking this medicine without consulting your doctor first.
- Do not give this medicine to anyone, even someone who has the same symptoms as yours. This medicine could harm people for whom it was not prescribed.
- What forms does this medication come in?
- Apo-Metoprolol
- 25 mg
- Each white, oval, scored tablet, engraved “ME” over “25” on one side and “APO” on the other, contains 25 mg of metoprolol tartrate. Nonmedicinal ingredients: colloidal silica dioxide, croscarmellose sodium, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.
- 50 mg
- Each white, round, scored tablet, engraved “APO” over “M50”, contains 50 mg of metoprolol tartrate. Nonmedicinal ingredients: colloidal silica dioxide, croscarmellose sodium, lactose, magnesium stearate, and microcrystalline cellulose.
- 100 mg
- Each white, round, scored tablet, debossed with “APO” over “M100”, contains 100 mg of metoprolol tartrate. Nonmedicinal ingredients: colloidal silica dioxide, croscarmellose sodium, lactose, magnesium stearate, and microcrystalline cellulose.
- Apo-Metoprolol (Type L)
- 50 mg
- Each pink, capsule-shaped, coated tablet, scored on one side and engraved “50” on the other, contains 50 mg of metoprolol. Nonmedicinal ingredients: carnauba wax, colloidal silica dioxide, croscarmellose sodium, D&C aluminum lake red No. 30, sun yellow aluminum lake, hydroxypropyl methylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350, and sodium dioxide. titanium.
- 100 mg
- Each blue, capsule-shaped, coated tablet, scored on one side and engraved “100” on the other, contains 100 mg of metoprolol. Nonmedicinal ingredients: carnauba wax, colloidal silica dioxide, croscarmellose sodium, hydroxypropylmethylcellulose, indigotin aluminum lake (AD & C blue # 2), lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol 3350, and titanium dioxide.
- How should this medication be used?
- The usual maintenance dose of metoprolol ranges from 100 mg to 200 mg per day, however, this dose may be increased to 400 mg per day as needed to achieve symptom control. Immediate-release tablets are taken in 2 divided doses while slow-release tablets are taken once a day.
- This medication should be taken soon after a meal, but try to take it at the same time every day.
- Several factors can be taken into account in determining the dose a person needs: their weight, their health, and whether they are taking other medications. If your doctor has recommended a dose other than those listed here, do not change the way you are taking the medicine without consulting your doctor.
- This medicine must be taken exactly as your doctor has told you. If you miss a dose, take the medicine as soon as you notice the missed dose and resume treatment as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your usual dosing schedule. Do not use a double dose to make up for a missed dose. If you are unsure of what to do after missing a dose, ask your doctor or pharmacist for advice.
- Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
- Do not dispose of medicines in the wastewater (eg not in the sink or in the toilet bowl) or with the household garbage. Ask your pharmacist how to dispose of unused or expired medicines.
- In which cases is this medication not recommended?
- Do not use this medicine under the following circumstances:
- a condition such as right ventricular failure caused by high blood pressure in the lungs;
- is allergic to metoprolol or any of the ingredients of the medication
- are allergic to other beta-blockers;
- anesthesia caused by an agent having a depressant effect on the myocardium (eg ether);
- a history of heart attack accompanied by:
- a heart rate of fewer than 45 beats per minute,
- severe heart block
- very low blood pressure
- moderate or severe heart failure.
- slow heartbeat caused by problems with the heart rhythm;
- severe heart block;
- cardiogenic shock;
- significant circulatory disorders;
- proven heart failure;
- the presence of asthma or other obstructive airway conditions (only when it comes to metoprolol in intravenous form);
- a disorder referred to as “sinus dysfunction syndrome”;
- have untreated pheochromocytoma (a tumor of the adrenal glands).
- What are the possible side effects of metoprolol
- Many medications can cause side effects. A side effect is an unwanted response to a drug when taken in normal doses. It can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
- At least 1% of people taking this medicine reported the following side effects. Many of these side effects can be managed and a few may go away on their own over time.
- Consult your doctor if you experience these side effects and if they are serious or bothersome. Your pharmacist may be able to give you advice on what to do if these side effects appear:
- changes in libido or sexual ability;
- constipation;
- diarrhea;
- pain or discomfort in the abdomen;
- dizziness or light-headedness when changing from sitting or lying down to standin
- fatigue or unusual weakness brought on by activity;
- fatigue;
- headaches;
- nausea;
- hair loss;
- weight gain;
- dreams giving a powerful sensation;
- dry mouth;
- increased sensitivity of the skin to solar radiation;
- increased sweating;
- sleep disturbances;
- vomitings.
- Most of the side effects listed below do not happen very often, but they could cause serious problems if you do not see your doctor or receive medical attention.
- Check with your doctor as soon as possible if any of the following side effects occur:
- slow heartbeat (especially less than 40 beats per minute);
- hearing changes;
- confusion;
- difficulty breathing or wheezing;
- back or joint pain;
- chest pain;
- hallucinations (the perception of phenomena that do not exist);
- tingling in the arms and legs.
- a feeling of coldness in the hands and feet;
- signs of depression (eg, lack of concentration, weight fluctuations, trouble sleeping, indifference to many activities, thoughts of suicide);
- signs of certain heart problems (e.g., increased or irregular heartbeat or pulse, chest pain, difficulty breathing, excessive fatigue, swelling of the feet, ankles, or part lower legs);
- signs of certain kidney problems (eg increased or reduced urine production, itching, nausea, vomiting, rash);
- signs of a bleeding disorder (e.g. unusual nosebleeds, bruising, blood in urine, cough with bloody sputum, bleeding gums, cuts that keep bleeding) ;
- signs of liver problems (eg, nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools );
- a flare-up of psoriasis (eg, red spots the size of a pinhead on the skin; red, scaly, or crusty skin);
- a feeling of numbness or tingling in the extremities;
- symptoms of low blood pressure (eg, dizziness, fatigue);
- vision changes (eg blurred vision, dry eye, eye pain).
- Stop taking the drug and seek immediate medical attention if there is a response such as :
- coldness, discoloration, or pain in the fingers or toes;
- symptoms of a serious allergic reaction (such as swelling of the face or swelling of the throat, hives, or difficulty breathing).
- Some people may experience side effects other than those listed. See your doctor if you notice any symptom that worries you while you are using this medicine.
- Are there other precautions or warnings?
- Before using any medication, be sure to tell your doctor about any medical conditions or allergies you may have, the medications you are using, and any other important facts about your health. Women should mention if they are pregnant or breastfeeding. These factors could influence how you should use this medicine.
- Respiratory disorders: In general, people with asthma, and certain other lung problems, should generally avoid taking beta-blockers such as metoprolol, as they can cause breathing difficulties. If you have breathing problems, and your doctor has prescribed metoprolol for you, it is probably in lower doses, and they will monitor you regularly while you are using this medicine. If you have breathing problems, talk to your doctor about how this medicine may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether medical supervision is needed. specific.
- Severe allergies: If you have allergies severe enough to cause anaphylaxis (a severe allergic reaction in which swelling of the face, lips, and throat makes it very difficult to breathe), talk to your doctor about what to do next. take if you have an allergic reaction. the use of metoprolol may make it more difficult to treat severe allergic reactions with epinephrine.
- Stopping the drug: People with heart disease who suddenly stop taking this drug may experience chest pain, irregular heartbeat, or a heart attack. If you have heart disease, do not stop taking this medication without consulting your doctor first. When this medication is to be stopped, it should be done gradually, under the supervision of your doctor.
- Diabetes: The signs associated with low blood sugar may be more difficult to see while you are taking metoprolol. People with diabetes may have a harder time regulating their blood sugar levels when taking this medicine. If you have diabetes, discuss with your doctor how this medication may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether medical supervision is needed. specific. You will be kept under medical supervision while taking this medicine and your doctor may need to adjust your doses of diabetes medicine.
- Dizziness or syncope: Metoprolol may cause side effects, including dizziness or fainting, soon after starting treatment. Do not drive a vehicle or do other potentially dangerous tasks until you know how this medicine works for you.
- Hyperthyroidism (high level of thyroid hormones): Metoprolol may mask the symptoms of a person with hyperthyroidism (high level of thyroid hormones).
- If you have hyperthyroidism, discuss with your doctor how this medication may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether it is appropriate to have it. specific medical surveillance. Stopping the medication suddenly could make this condition worse.
- Liver function: Liver disease or reduced liver function can cause this drug to build up in the body, causing side effects. If you have liver problems, talk to your doctor about how this medicine may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether medical supervision is needed. specific. Your doctor will monitor your liver function with regular blood tests while you are taking this medicine.
- If you notice symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain, or swelling and itching of the skin, contact your doctor immediately.
- Kidney function: Taking metoprolol may affect kidney function. Your doctor will take this into account in his monitoring and will adjust your dose as needed. If you have reduced kidney function or kidney disease, talk to your doctor about how this medicine may affect your condition, how your condition affects the administration, and how well this medicine works. , and the relevance of specific medical surveillance. If you notice swelling in your hands, feet, or face, an increase in your blood pressure, unusual muscle cramps, or a dark appearance of your urine, this medicine may be interfering with the proper function of your blood. kidneys.
- If you notice any of these symptoms, contact your doctor as soon as possible.
- Heart disease: Beta-blockers like metoprolol can worsen already present heart failure. It is essential to use metoprolol as prescribed by your doctor to reduce this risk. If you have a history of heart disease, discuss with your doctor how this medication may affect your condition, how your condition affects the administration and effectiveness of this medicine, and whether it is appropriate to use it. specific medical surveillance.
- Pheochromocytoma: This medicine may worsen the symptoms of pheochromocytoma (a tumor of the adrenal gland) if taken alone Talk to your doctor about how this medicine might affect your condition, how your condition affects your condition. administration and efficacy of this medicinal product, and the relevance of specific medical supervision.
- Surgery: If you are about to have surgery, tell all healthcare professionals who treat you that you are using metoprolol.
- Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If pregnancy occurs while you are using this medicine, contact your doctor immediately.
- Breast-feeding: This medicine passes into breast milk. If you use metoprolol while you are breastfeeding your baby may feel the effects. Check with your doctor to see if you should continue breastfeeding.
- Children: The safety and effectiveness of this medicine have not been established in children
- Seniors: Normal doses of metoprolol for adults may lower blood pressure more than expected. Lower doses may be necessary for the elderly.
- Can other agents interact with this medication?
- There may be an interaction between metoprolol and any of the following:
- abiraterone acetate;
- acetylcholine;
- anesthetic agents;
- alpha agonists (eg, clonidine, methyldopa);
- alcohol;
- aldesleukin;
- aliskiren;
- alpha1-blockers (eg doxazosin, prazosin, tamsulosin);
- amifostine;
- amiodarone;
- amphetamines (eg, dextroamphetamine, lisdexamfetamine);
- serotonin antagonists (antiemetic drugs; eg dolasetron, granisetron, ondansetron);
- tricyclic antidepressants (eg amitriptyline, clomipramine, desipramine, trimipramine);
- antihistamines (eg, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine, diphenhydramine);
- nonsteroidal anti-inflammatory drugs (NSAIDs) eg. ibuprofen, indomethacin, naproxen);
- antimalarials (e.g. chloroquine, hydroxychloroquine, mefloquine, quinine);
- antipsychotics (eg, chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone);
- asunaprevir;
- atomoxetine;
- other beta-blockers (eg, atenolol, pindolol, propranolol);
- azelastine;
- barbiturates (eg, butalbital, pentobarbital, phenobarbital);
- beta-agonists (anti-asthma medicines, eg salbutamol, salmeterol, formoterol);
- calcium channel blockers (eg, verapamil, diltiazem, nifedipine, amlodipine);
- angiotensin II receptor blockers (ARBs) eg. irbesartan, losartan);
- bortezomib;
- brimonidine;
- buprenorphine;
- bupropion;
- celecoxib;
- ceritinib;
- milk thistle;
- cholecalciferol;
- cimetidine;
- cinacalcet;
- clobazam;
- clotrimazole;
- cobicistat;
- cocaine;
- cyproterone;
- darifenacin;
- delavirdine;
- rye ergot derivatives (eg bromocriptine, ergotamine, methylergonovine);
- nitro derivatives (eg nitroglycerin, isosorbide dinitrate, isosorbide mononitrate);
- dextromethorphan;
- digoxin;
- dipyridamole;
- disopyramide;
- disulfiram;
- diuretics (pills to remove water; eg furosemide, hydrochlorothiazide);
- donepezil;
- doxorubicin;
- dronedarone;
- entacapone;
- epinephrine;
- grass pollen allergen extract;
- fentanyl;
- fingolimod;
- flecainide;
- floctafenine;
- galantamine;
- ginger;
- ginseng;
- guanfacine;
- imatinib;
- phosphodiesterase type 5 inhibitors (eg, sildenafil, tadalafil);
- proton pump inhibitors (eg, lansoprazole, omeprazole, rabeprazole);
- Angiotensin-Converting Enzyme Inhibitors (ACEIs) eg. captopril, ramipril);
- selective serotonin reuptake inhibitors (eg fluoxetine, paroxetine, sertraline);
- selective serotonin-norepinephrine reuptake inhibitors or SNRIs (eg, desvenlafaxine, duloxetine, venlafaxine);
- insulin;
- isoniazid;
- ketoconazole;
- lacosamide;
- lanreotide;
- levodopa;
- lidocaine;
- lomustine;
- cholesterol “statin” drugs (eg pravastatin, simvastatin);
- methacholine;
- methadone;
- methimazole;
- methoxsalen;
- methylphenidate;
- metoclopramide;
- midodrine;
- mifepristone;
- mirabegron;
- moclobemide;
- nefazodone;
- nevirapine;
- nilotinib;
- noradrenaline;
- octreotide;
- orphenadrine;
- oxybutynin;
- pasireotide;
- pazopanib;
- peginterferon alfa-2b;
- pentoxifylline;
- sodium phenylbutyrate;
- pilocarpine;
- pimozide;
- praziquantel;
- propafenone;
- quinidine;
- quinine;
- ranitidine;
- regorafenib;
- rifabutin;
- rifampin;
- rituximab;
- rivastigmine;
- ropinirole;
- sulfonylureas (eg gliclazide, glyburide, tolbutamide);
- temsirolimus;
- terbinafine;
- theophyllines (eg aminophylline, oxtriphylline, theophylline);
- ticagrelor;
- ticlopidine;
- tizanidine;
- tofacitinib;
- tolcapone;
- tranylcypromine;
- yohimbine.
- If you are taking any of the above medicines, please tell your doctor or pharmacist. In your case, your doctor may ask you to:
- stop taking any of the medications;
- replace one of the drugs with another;
- change the way you take one or both of the medicines.
- do not change anything at all.
- Interference of one medicine with another does not always mean that you stop taking one of them. Ask your doctor what to do with drug interactions.
- Drugs other than those listed above may interact with this drug. Tell your doctor everything you take, whether it is prescription or over-the-counter drugs and herbal remedies. Do not forget to mention any supplements you take. If you consume caffeine, alcohol, nicotine, or street drugs, you should tell your prescribing doctor since these substances can affect the way many drugs work
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