Medical Drugs and Dentistry

Your 73 year old aunt who is taking Coumadin calls you at home with a little discomfort after dental treatment earlier that day. Do you prescribe Advil, Tylenol, or Vicodin? Which antibiotic (Erythromycin, Biaxin, or Zithromax) would you prescribe for your patient who is allergic to Penicillin; but who is taking medication to reduce his cholesterol levels? Many of our patients are on new medications developed with in the past few years. These newer drugs may have drug interactions with older, more traditional medication. Dentists should be familiar with the possible drug interactions involving drugs used in dentistry.

Coumadin--Therapeutic doses of Tylenol may enhance the anticoagulant effect of Coumadin resulting in prolonged bleeding.

Cholesterol Drugs--The anticholesterol drugs Lipitor, Mevacor, and Zocor may interact with Erythromycin and the related drug Biaxin.

Antihistamines--Because of the risk of cardiac complications, Biaxin must not be administered with the non sedating antihistamine Hismanal. Plasma levels of another more common antihistamine Claritin are increased by Erythromycin.

Viagra--Plasma concentrations of Viagra are increased by Erythromycin and Biaxin, but not Zithromax.

Osteoporosis--Evista is used to prevent osteoporosis in post-menopausal women. NSAIDs should be used carefully in those patients taking Evista.

Propulsid--Propulsid, a drug used to treat gastrointestinal reflux disease, has been associated with fatal cardiac arrhythmias. Drugs which inhibit its metabolism are contraindicated. These drugs include, Erythromycin, Biaxin and Nizoral.