2017 HCHB_digital
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OTC Medicines: Precautions<br />
Drug/drug group Condition Details<br />
Influenza vaccine Acute illness Postpone vaccination<br />
Iron<br />
Gastrointestinal diseases, eg, inflammatory bowel disease, Use only under medical advice<br />
diverticulae<br />
Iron storage/iron absorption diseases, eg,<br />
Use only under medical advice<br />
haemochromatosis<br />
Repeated blood transfusions, anaemia without iron Do not give iron<br />
deficiency<br />
Laxatives Abusers Electrolyte disturbances, especially potassium loss, diarrhoea. Excessive weight loss<br />
Acute abdominal conditions, undiagnosed abdominal pain Possible complications if laxatives used<br />
(eg, possible appendicitis)<br />
Colonic atony, immobile patients, insufficient fluid/ Bulk-forming laxatives may cause intestinal obstruction or faecal impaction<br />
dehydration<br />
Dehydration (severe)<br />
Further dehydration and electrolyte imbalance with stimulant laxatives<br />
Diabetes<br />
Can affect blood sugars in poorly controlled diabetes<br />
Difficulty swallowing<br />
Avoid bulk-forming laxatives<br />
Faecal impaction or obstruction<br />
Avoid oral laxatives, risk of colonic perforation<br />
Galactose or lactose intolerance<br />
Lactulose contains galactose and lactose. Avoid<br />
Haemorrhoids, anal fissures, proctitis<br />
Avoid laxative suppositories<br />
Inflammatory bowel disease<br />
Increased adverse effects with stimulant laxatives<br />
Regular use<br />
Avoid regular use of stimulant laxatives due to changes in rectal epithelium and risk<br />
of atonic colon<br />
Levonorgestrel Breast cancer Relative contraindication (but levonorgestrel less risk than pregnancy)<br />
Severe malabsorption syndrome, eg, Crohn's disease Impaired efficacy of levonorgestrel; increased dose may be required<br />
Severe liver disease<br />
Interferes with metabolism of levonorgestrel<br />
Meningococcal vaccine Acute illness Postpone vaccination<br />
Methyl salicylate Extensive topical application, exercise, heat occlusion Increased absorption of salicyclic acid into bloodstream (can be toxic)<br />
Metoclopramide Children, young patients and elderly Increased risk of extrapyramidal reactions. Use lower dosages especially if
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