Prescription Drugs: The Heath Ledger Effect

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Combining drugs can turn deadly. One drug may alter another's breakdown rate or amplify its effects. "Even if some of the desired effects—such as pain relief—are synergistic, all drugs have negative side effects too. And synergistic side effects can be deadly," says Ellen Unterwald, Ph.D., director of the center for substance abuse at Temple University school of medicine.

Her advice: avoid mixing meds without a doctor's approval, and be especially careful with the toxic twosomes below.

Opioids (OxyContin, Vicodin, Percocet)

Sleep Aids: Sleep aids slow your central nervous system, potentially compounding the same effect of opioids. This could lead to oversedation, coma, or respiratory depression, which makes breathing difficult or impossible.

Antianxiety Medications: Both of these drug types suppress your central nervous system, potentially causing it to shut down.

Alcohol: Yet another case of two drugs acting on the same pathway: This duo dangerously suppresses your central nervous system. Plus, alcohol may speed up slow-release opioids, spiking doses to a potentially lethal level.

Celebrex: The arthritis drug Celebrex may interfere with an enzyme that clears opioids from your system. This could raise your opioid levels dangerously high.

Alcohol

Aspirin/NSAIDs: They all decrease blood clotting, so the combination may lead to gastrointestinal bleeding.

Acetaminophen: Alcohol may accelerate the breakdown of acetaminophen, raising levels of the drug's liver-damaging by-products.

NSAIDs

Celebrex: Celebrex is a prescription NSAID (nonsteroidal anti-inflammatory drug), so the combination could raise your risk of gastrointestinal bleeding and ulceration.

Acetaminophen(Tylenol)

Vicodin/Percocet : Vicodin contains both hydrocodone and acetaminophen; similarly, Percocet is a blend of oxycodone and acetaminophen. That means adding over-the-counter acetaminophen to either drug could result in "Tylenol toxicity," or severe liver damage.

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