Common pill combos can put you at risk

If you take...

A quinolone antibiotic

Such as ciprofloxacin (Cipro), ofloxacin (Floxin), or levofloxacin (Levaquin) to treat a urinary tract infection, traveler's diarrhea, or other problem

Possible conflict: Over-the-counter antacids containing calcium, magnesium, or aluminum, like Tums, Rolaids, Maalox, or Mylanta

Why: Quinolone antibiotics have an unhealthy attraction to the metals in common antacids. Magnesium, aluminum, and (to a lesser extent) calcium quickly glom on to the germ killers, rendering them much less effective. Protect yourself: You don't have to put up with a sour stomach while you're battling an infection. Simply wait an hour or two after taking your antibiotic before reaching for the antacid.

If you take...

A common cholesterol drug

Specifically lovastatin (Mevacor), simvastatin (Zocor), or atorvastatin (Lipitor) Possible conflicts: Macrolide antibiotics, such as clarithromycin (Biaxin) or Erythromycin Azole antifungals taken orally, such as the prescription drugs ketoconazole (Nizoral) and itraconazole (Sporanox)

Why: Some antibiotics and antifungals can block enzymes that help break down these specific cholesterol drugs. As a result, you may end up with 4 to 10 times more cholesterol medication in your blood than your doctor intended--enough to greatly increase your risk of muscle or kidney damage.

Protect yourself: You can simply take a break from Mevacor or Zocor if you need one of these specific antibiotics or antifungals, Horn says. (Once your infection clears up and you're off those drugs, you can safely go back to your cholesterol medication.) Or your doctor may be able to prescribe a different remedy for your infection.

If you take...

A corticosteroid for asthma, hay fever, or other allergies such as budesonide (Pulmicort, Rhinocort) or prednisone (Liquid Pred)

Possible conflicts: Antibiotics Antifungals Antidepressants A calcium channel blocker for blood pressure--specifically diltiazem (Cardizem) or verapamil hydrochloride (Calan)

Why: When you take a corticosteroid--whether in a pill or via inhaler--you depend on certain enzymes in your body to break the drug down after it's done the job. But recent studies suggest that a number of other medicines can block the action of these enzymes, potentially leading to a corticosteroid overdose, Horn says. That can cause Cushing's syndrome, in which you can gain weight in your upper body and develop hypertension, bruising, weakness, depression, acne, and excess hair growth.

Protect yourself: The risk is greater if you're taking the corticosteroid in pill form (inhalers deliver a lower dose) or if you add a pill to your inhaler regimen, as people sometimes do for an allergy flare-up. Ask your doctor if any of your other medications could potentially slow the breakdown of the drug. Cushing's syndrome is reversible, but you don't want to suffer any longer than necessary.

One safety valve: It takes time for corticosteroids to build up to toxic levels, so a short course of an antibiotic or antifungal shouldn't cause trouble.

If you take...

An over-the-counter stimulant laxative Such as Senokot or Dulcolax

Possible conflicts: Blood pressure medications Antiseizure drugs, such as phenytoin (Dilantin) Antibiotics The blood thinner warfarin (Coumadin) The heart medicine digoxin (Lanoxin)

Why: Many medications need plenty of time to be properly absorbed, but stimulant laxatives can rush them through your system. The result: You may not get the benefit of a crucial prescription.

Protect yourself: Talk with your doctor before adding a stimulant laxative to your routine. Generally, you can stay on the safe side by taking it at least 2 hours before or after any other medications.

If you take…

The blood thinner warfarin (Coumadin)

Possible conflicts: NSAIDs (including aspirin and ibuprofen) Antibiotics--specifically metronidazole (Flagyl), trimethoprim/sulfamethoxazole (Bactrim), or quinolone antibiotics such as ciprofloxacin (Cipro) Antiseizure drugs

Why: Some of these meds multiply the effects of warfarin, greatly increasing the risk of uncontrolled internal bleeding.

The reason: NSAIDs keep platelets from sticking together, which--like warfarin--interferes with the clotting of blood. And certain antibiotics slow the enzyme that breaks down warfarin, also raising the risk of increased bleeding. On the other hand, antiseizure drugs can speed the breakdown of warfarin: Your blood can get too thick, causing a dangerous clot.

Protect yourself: Interactions involving warfarin are relatively common and can be very serious. If you're on warfarin, don't take any other medication unless your doctor says it's okay.

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