ZAMBIA officially recorded its first cases of Covid-19 on March 18, 2020.  A year on, we together with the rest of the world been fighting against this powerful enemy and a year on the battle still rages.

A year on, so many loved ones have gone and yet still a year on, so many drugs have come. A year on, no real consensus on what the real cure is and a year on, people are still taking anything and everything and anyhow.

I remember being so shocked by a cocktail of drugs someone once showed me they were taking for Covid-19. I was like “what, you mean you are taking all these?,” “yes  was the reply,” “and who told you?” I continued in shock.  “I bought them from the drug store.  “Did you have a Doctor’s prescription for all these?” I asked, “no, I was recommended by some colleagues,” was the answer.

I further learnt their colleague who advised them was advised by someone who themselves were advised by someone else and the list of advisors went on like a chain.

 Sadly, so many other people are still doing the same. Pharmacies are booming in business having doubled or even tripled some of the prices due to demand which keeps going up.

And most of these are self-prescribed Over The Counter (OTC) drugs following instructions from “advisors” who can be anyone nowadays especially in this time of need. But just how safe is this?

 Today, I want to enlighten and warn on the dangers of drug interactions which I think most people may not be aware of or just choose to ignore.


To begin with whatever substance, we put in our bodies that wasn’t meant to be in there in the first place has a potential to cause harm.

It doesn’t matter how commonly used or safe the drug may seem to be, always remember it is a stranger to the body, no wonder drugs fall under substances called “xenobiotics,” “xeno” for “foreign” which I think most of us are familiar from the word “xenophobia” the fear of strangers while “biotics” means “life.”

Not even herbal medications are exempted from this truth, as a matter of fact the word “drug” comes from the “French” word “drogue” which means “dry herb” signifying that drugs had their origins from herbs.

When we take a drug whatever route, either by mouth, injection, as a topical application on the skin, a suppository etc, they all end up changing the body’s physiology in one way or another. And the body also does something to the drug, absorbing part of it and clearing the rest as weakened toxins especially if the liver and kidneys are functioning normally.


Drug-drug interactions occur when two or more drugs – prescription and/or OTC react with each other.  Some drug interactions can make the drug you take less effective.

And some combinations of drugs can be dangerous. For example, mixing a drug you take to help you sleep (a sedative) and a drug you take for allergies (an antihistamine) can slow your reactions and make driving a car or operating machinery dangerous.

The key factor behind most adverse reactions is Cytochrome P450.  Please never mind the name Cytochrome P450, it just has to do with the wavelength these proteins have when exposed to a certain light, cyto-cell and chrome-colour..

Basically these are a family of enzymes/proteins that work on most drugs when they get into the body. They can either weaken a drug, thus make it less poisonous or activate it for it to work.

For instance they activate drugs called “prodrugs” like clopidogrel, a drug on demand nowadays as it is used to prevent clot formation, without its activation it will be useless.  However, some drugs can also either weaken or strengthen the activity of cytochrome p450.For example  the antidepressant phenelzine weakens it.

 The case of 18-year-old Libby Zion

In short, if one takes two or more drugs at the same time that interact differently with cytochrome P450, then they are in for a game of Russian roulette.

For instance, if someone took clopidogrel and phenelzine at the same time, then the effects of clopidogrel will be compromised as phenelzine will weaken cytochrome P450 which should activate clopidogrel to its active form.

This may not be a lethal combination but there is a documented case that led to the death of Libby Zion in 1984 in New York, USA.

The cause of her death is believed to have been a lethal condition known as “serotonin syndrome” allegedly caused by the interaction of phenelzine she was taking at home for her depression and pethidine she was given at the hospital. She was only 18 and a law has been made in her honour.


Natural occurring compounds found in common foods may also affect Cytochrome P450.  For example bioactive compounds found in grape fruit juice weaken these enzymes leading to increased to bioavailability and strong possibility of overdosing of some drugs.

Because of this, avoiding grapefruit juice and fresh grapefruits entirely while on drugs is usually advised.  And almost always alcohol is not recommended when taking most drugs.


Ultimately the choice is yours, you can take everything or anything you want but at least as you do that especially if your intentions are good.

By good I mean not to intentionally overdose to commit suicide, which unfortunately has become common among especially female college students. something that needs urgent attention.

Please remember you can reduce the risk of harmful drug interactions and side effects by understanding the drugs that you take.

Please every time you use a drug, take the time to learn about possible drug interactions and read the drug label. And please talk to your health care providers about all the drugs that you take.

Discuss all OTC and prescription drugs, dietary supplements, vitamins, botanicals, minerals and herbals you take, as well as the foods you eat.

Before taking any drug, please ask the following questions;

• Can I take it with other drugs?

• What are the possible side effects and what to do if I experience them?

• Should I avoid certain foods, beverages or other products?

It is true the long-awaited medical breakthrough has delayed or has not yet been approved and the desperation is real but we must remember we are actually doing more harm than good when we mix different drugs that shouldn’t mixed.

That is why it is not to good self-prescribe, leave that to trained and authorised professionals: Doctors, Clinical Officers, Pharmacists etc.






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