Take migraine drugs with antidepressants. New research has found that mixing triptans (Imitrex, Frova) with SSRIs (Paxil, Prozac, Celexa) or SNRIs (Cymbalta, Effexor) can cause serotonin syndrome—high levels of the brain neurotransmitter, which can be life threatening without immediate medical attention. Symptoms include rapid heartbeat, fever, diarrhea, nausea, shivering, uncoordinated movements, hallucinations, and mental confusion. Luckily, the odds of this happening are very slim, says John Horn, a professor of pharmacy at the University of Washington: "You and your doctor may decide that the pros of taking both medications outweigh the possible cons." Other treatments for depression that have minimal effect on serotonin levels (some tricyclic medications, for example) may also be recommended, he adds.
Mix aspirin and ibuprofen. If you're taking a low-dose (or baby) aspirin for heart health, the benefits may be blocked if you pop a couple of ibuprofen to relieve pain. "This is really a concern for people who use both medications chronically," says Horn. To avoid the canceling out effect, the FDA advises taking ibuprofen at least eight hours before or 30 minutes after the aspirin. If you're using delayed-release ("safety coated") aspirin, wait at least two hours before swallowing the ibuprofen, says Horn. You also might consider acetaminophen (Tylenol), which doesn't appear to interfere with aspirin, or simply a higher dose of aspirin itself.
Use black cohosh. Regulatory agencies in Europe, Great Britain, Australia, and Canada are warning that the herb—taken to treat menopausal symptoms—may cause liver disorders such as hepatitis in some people. A 2004 panel at the National Institutes of Health reviewed the safety of black cohosh and concluded that there is reason for concern, but further investigation is necessary to determine if the connection is real. In the meantime, you should use the herb only under the supervision of a health professional, and stop immediately if you notice fatigue, loss of appetite, yellowing of skin and eyes, dark urine, nausea, or vomiting.