Medicines
Evidence-based reviews of medicines and drug classes: what works and what is marketing.
This section covers individual medicines and pharmacological classes through the lens of evidence-based medicine: clinical trials, systematic reviews, current international society guidelines, and Russian Ministry of Health clinical recommendations. Every article answers three questions: which indications have proven efficacy, which uses rely on outdated or low-quality evidence, and what alternatives current guidelines recommend. Drugs with marketing-driven indications unsupported by independent RCTs are flagged separately – many such drugs are sold for decades in Russia and the CIS while their clinical use is limited or absent in Europe and the United States.
- Featured#drug-interactions#grapefruit#cyp3a4
Grapefruit juice and medications: what not to combine and why
A single glass of grapefruit juice can raise blood levels of certain medications 2–5 times and hold them there for up to 72 hours. At risk: statins, calcium channel blockers, post-transplant immunosuppressants, several targeted oncology drugs, some antiarrhythmics, and select psychotropics. Class-by-class breakdown sourced from international guidelines.
- #ibuprofen#paracetamol#nsaid
Ibuprofen vs. paracetamol: how they differ and when to pick which one
Paracetamol is safer on the stomach and kidneys but riskier on the liver; ibuprofen treats inflammation but raises GI risk, strains the kidneys, and conflicts with anticoagulants. The article covers: what to pick for fever, headache, dental, muscular, dysmenorrhea, and post-op pain; when to combine the two; who should avoid each; and what not to mix with either, based on NICE NG143/NG226, Cochrane, AAP, FDA, and EMA.
- #lactancia#anticoncepcion#cerazette
Contraception during breastfeeding: what works, what to postpone
Short answer: progestin-only pills (Cerazette, desogestrel 75 mcg), IUDs (copper and Mirena), Nexplanon implant and condoms are compatible with breastfeeding from day one. Combined oral contraceptives are postponed for 6 weeks to 6 months. Plan B (LNG 1500) – compatible with no pause; EllaOne (ulipristal) needs 24-hour nursing pause.
- #lactancia#antibioticos#amoxicilina
Antibiotics during breastfeeding: what is compatible and what to avoid
Short answer: penicillins, cephalosporins, macrolides (azithromycin, clarithromycin), nitrofurantoin and most mastitis regimens are compatible with continued breastfeeding. Short tetracycline courses are acceptable; most fluoroquinolones are acceptable but warrant a pediatrician check. We break down each class, dosing, mastitis and UTI strategies per AEMPS, AAP 2024 and e-lactancia.