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Thread: AAS and drug interactions: the "if I use X drug with steroids, is it bad?" thread.

  1. #1
    Steroidal.com Writer/Mod Dan C's Avatar
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    AAS and drug interactions: the "if I use X drug with steroids, is it bad?" thread.

    If your question sounds like this: "Is it safe to use [insert drug name here] during my cycle? Is it bad? WILL I DIE!?", then you have come to the right place.

    One of the most common questions received both in person as well as in the anabolic steroid using community in general is whether or not X, Y, or Z drug will negatively interact with anabolic steroids if that person happens to be on a cycle at the time. anabolic steroid use without a doctor's prescription in the United States is considered a criminal act, and it is for this reason that many individuals keep their anabolic steroid use a secret and never mention it to their doctor. Although anabolic steroid use in other Western countries like Canada and the UK is legal, most users in those countries also will not divulge their anabolic steroid use to their physicians. This causes an issue, because if your doctor does not know what you are administering to yourself on a regular basis, it might very well cause potential problems when/if you are prescribed a medication for the treatment of something, whatever it might be. Drug interactions can be serious, and although to some of us who understand pharmacology might find questions like "will antibiotics be a problem during my cycle?" might sound laughably stupid,for many others who are lay persons in this area of knowledge it isn't so easy to understand and it is a valid concern. I am going to provide a list of some common drugs that are asked about concerning their use during a cycle.

    anabolic steroids are actually one of the few classes of drug that exhibits very little negative direct interaction with other drugs and substances. Remember that anabolic steroids are simply synthetic versions of hormones (Testosterone and other androgens) that you ALREADY have in your body and that your body manufactures, albeit in much smaller quantities.

    Disclaimer: It is understood that if there is a drug you are using that you are concerned with anabolic steroids, that it is prescribed by a doctor for valid medical purposes. There is to be NO RECREATIONAL DRUG USE DISCUSSION ON THIS FORUM. I am not a doctor (yet), and the information contained here is for informational and educational purposes only, and is not intended to replace the advice of a qualified physician. If you are using anabolic steroids, YOU SHOULD TELL YOUR DOCTOR. If you are concerned about any particular drug interactions with anabolic steroids and are unsure or in doubt, YOU SHOULD TELL YOUR DOCTOR.

    List of drugs and their interactions with anabolic steroids (in alphabetical order):

    Adderall (Dextroamphetamine): No direct negative interactions with anabolic steroids. Scroll down to 'stimulants' to read more about the possible effects/interactions with AAS in terms of the stimulant aspect of Adderall. Adderall has been granted its own separate entry here because of my findings have unveiled to me an important correlation between Estrogen and amphetamines. Yes, that's right, Estrogen levels actually influence the effect of Adderall's (amphetamine's) dopaminergic effects. It has been discovered that increased Estrogen levels lead to an increased response intensity to the dopaminergic activity from amphetamines, which would explain why when women take Adderall, they experience an intensity of effect that is far greater than what men who use Adderall experience. One study on rats discovered that 30 minutes after a single treatment with a physiological dose of Estrogen, there is enhanced amphetamine-induced behavior and increased amphetamine-induced striatal dopamine detected during microdialysis(1). The same study discovered that both the peak response and the duration of the response from amphetamines are greater in Estrogen-primed animals treated with Estrogen or progesterone 30 minutes prior to the administration of amphetamine, than in all other groups. Another study, this time on human females, involved 2 groups women: one being pre-treated with Estradiol patches before 10mg amphetamine administration, and one group that received placebo Estrogen patches pre-treatment(2). The study determined that Estradiol pre-treatment increased the magnitude of the effects of amphetamines on the test subjects' subjective ratings of 'pleasant stimulation' and decreased ratings of 'want more'. Lastly, one more study on human females administered 15mg amphetamines during the follicular phase of their menstrual cycle (typically a period when Estrogen levels rise while Progesterone remains low) and then during the luteal phase (when Estrogen and Progesterone are both high) determined that the responses to amphetamines were related to levels of Estrogen, where higher levels of Estrogen were associated with greater amphetamine-induced increases in "Euphoria" and "Energy and Intellectual Efficiency"(3). SO, what does this mean for the anabolic steroid user? Simple: it means that if you are using aromatizable AAS without an aromatase inhibitor, expect your Adderall to be a heck of a lot more intense/effective due to high Estrogen levels. On the flipside, if you are using an AI during cycle or during PCT, and you find that your Adderall for some reason isn't working as well as it normally does, well, now you know why!! Excessively low Estrogen levels will diminish the effects of amphetamines on the CNS.

    Antibiotics: No direct negative interactions with anabolic steroids. Very safe combination. However, there exist many different types of antibiotics and although the vast majority are known to have no interaction at all with anabolic steroids, some might interfere superficially (for example, some antibiotics are known to cause excessively dry skin and this may or may not conflict with the increased oily skin commonly caused by the androgenic effects of anabolic steroids).

    Aspirin: No direct negative interactions with anabolic steroids. Very safe. Many anabolic steroid using bodybuilders and athletes resort to Aspirin to alleviate some of the cardiovascular effects of anabolic steroids due to the blood thinning effect in order to reduce heightened blood pressure or to alleviate significantly increased hematocrit levels. This is not advice, however, to go ahead and start doing that. That is simply an example used to describe the safety of this drug combination.

    Benzodiazepines (Diazepam, Clonazepam, Oxazepam, Nitrazepam, Temazepam, etc.): No direct negative interactions with anabolic steroids. However, some clinical evidence suggests that some anabolic steroids seem to interact with the peripheral benzodiazepine receptors (PBRs), inhibiting them. One particular study on rats demonstrated that Stanozolol (Winstrol) inhibited the PBR up to 75% and 17beta-Testosterone Cypionate inhibited the PBR up to 40%, while the administration of 17alpha-methyltestosterone and Nortestosterone Decanoate did not demonstrate any significant inhibition of the PBR-specific ligand(4). Although the study does not make any conclusions about what result this might have on the effect of benzodiazepines in the body, it suggests that the use of certain anabolic steroids might reduce the effectiveness of different benzodiazepines due to the inhibition of the benzodiazepine receptors. However, anecdotal evidence would suggest that people who are prescribed benzodiazepines while on a cycle of anabolic steroids do not report any significant reduction in effectiveness. Even if some anabolic steroids do seem to inhibit the PBR, the fact that different benzodiazepine drugs exist with different strengths of activity would mean that various benzodiazepines might not be affected by this effect, and still bind quite strongly to the PBR despite any inhibition caused by AAS. For example, the PBR is actually Diazepam's secondary binding site, not its primary one(5). Furthermore (and this is going slightly off-topic here), the PBR controls many different functions in the human body and is not yet completely understood, but because benzodiazepines bind to the PBR and cause CNS depression (thus enabling the user to sleep), it might very well be possible that the 'Trensomnia' that is caused by Trenbolone might actually be due to Trenbolone possibly expressing strong inhibition of the PBR. The result would then of course be an inhibition of depressive effects on the CNS, thus disrupting sleep patterns. However, this is all currently my own speculation based on what I know and have discovered thus far about AAS-PBR interaction.

    Beta Blockers (Propranolol, Sotalol, Timolol, Bucindolol Acebutolol, etc.): No direct negative interactions with anabolic steroids.

    Marijuana (THC): No direct negative interactions with anabolic steroids. At all. This is all I am going to say about this.

    Opiates (Oxycodone, Hydrocodone, Morphine, Codeine, etc.): No direct negative interactions with anabolic steroids. Be careful that whatever opiate you are prescribed might contain acetaminophen in it (Percocets are combination of 5mg Oxycodone with 325mg of acetaminophen (Tylenol), for example. If acetaminophen is included, this will be an issue if oral C17-alpha alkylated compounds are used. For more information on this, read further about Tylenol (acetaminophen).

    Stimulants (Amphetamines, Ritalin, Ephedrine, Clenbuterol, *******, etc.): No direct negative interactions with anabolic steroids. However, many of these drugs are known to increase blood pressure and heart rate. If using anabolic steroids in supraphysiological bodybuilding doses, it is common knowledge that blood pressure (and in some instances, heart rate) is increased during a cycle. Therefore, the use of stimulants might not be a good idea, especially if one already possesses any cardiovascular and/or blood pressure related complications. Some stimulants have more of an effect on the cardiovascular system than others, and some individuals respond in a more negative manner than others to various stimulants. Many individuals have utilized stimulants during anabolic steroid cycles with no problems, but at the end of the day: approach this combination with caution.

    SSRIs - Selective Serotonin Reuptake Inhibitors (Lorazepam, Prozac, Dapoxetine, Zoloft, etc.): No direct negative interactions with anabolic steroids. Beware, however, that upon the cessation of anabolic steroids during the PCT period, negative psychological feelings may arise (aka 'PCT depression', 'PCT blues', etc.) and that SSRI use during this period might possibly result in unwarranted negative psychological effects (mood swings or worsening depression).

    Tylenol (Acetaminophen): Fairly safe during anabolic steroid use, though it is advised to avoid heavy acetaminophen use during the course of an anabolic steroid cycle that includes oral C17-alpha alkylated compounds. The increased liver stress can indeed cause issues. The occasional therapeutic recommended doses of acetaminophen for any intermittent pain related issues (headaches, injuries, etc.) should not be a problem, even with oral anabolic steroid use. High dose acetaminophen use is a problem during oral anabolic steroid use. Chronic long-term acetaminophen use during oral anabolic steroid use is also a problem and should be avoided. During a cycle of injectable-only compounds it is even less of an issue. No direct negative interactions exist.


    *I will add more to this list as time goes on and as more drug interaction questions are asked here. Feel free to ask or mention any that should be added to this list.

    REFERENCES:
    1. Rapid effects of Estrogen or progesterone on the amphetamine-induced increase in striatal dopamine are enhanced by Estrogen priming: a microdialysis study. Becker JB, Rudick CN. Psychology Department, The University of Michigan, Ann Arbor 48109, USA.
    2. Acute effects of estradiol pretreatment on the response to d-amphetamine in women. Justice AJ, de Wit H. Neuroendocrinology. 2000 Jan;71(1):51-9.
    3. Acute effects of d-amphetamine during the follicular and luteal phases of the menstrual cycle in women. Justice AJ, de Wit H. Psychopharmacology (Berl). 1999 Jul;145(1):67-75.
    4. Direct interactions of androgenic/anabolic steroids with the peripheral benzodiazepine receptor in rat brain: implications for the psychological and physiological manifestations of androgenic/anabolic steroid abuse. Masonis AE, McCarthy MP. J steroid Biochem Mol Biol. 1996 Aug;58(5-6):551-5.
    5. "Translocator protein (18kDa): new nomenclature for the peripheral-type benzodiazepine receptor based on its structure and molecular function". Papadopoulos V, Baraldi M, Guilarte TR, Knudsen TB, Lacapère JJ, Lindemann P, Norenberg MD, Nutt D, Weizman A, Zhang MR, Gavish M (August 2006). Trends Pharmacol. Sci. 27 (8): 402–9. doi:10.1016/j.tips.2006.06.005. PMID 16822554.
    Last edited by Dan C; 06-01-2013 at 01:43 AM.
    warmouth, Mini-G and OdinsOtherSon like this.
    Chief writer for Steroidal.com
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  2. #2
    VET warmouth's Avatar
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    Havent read this yet Dan, but it is an article I've been waiting on a long time! Getting into it now!

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    Administrator Admin's Avatar
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    Great read.

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    VET warmouth's Avatar
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    Awesome job with this! Here are a few commons:
    Statins?
    Birth Control?
    Muscle relaxants?
    Anti-inflammitory(diclofinac-type)?

  5. #5
    Steroidal.com Writer/Mod Dan C's Avatar
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    Good suggestions, i'll have to add those to the list after doing some research.
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    Junior Member DrBPackenwood's Avatar
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    thanks Dan

    i've been thinking about this lately and now i know.

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    antibiotics are hard on liver/kidney so I would avoid oral aas if needing to go on biotics, but its not like its an interaction that will kill you if you needed to take them the odd time. just its a bit hard on body.
    I avoid orals overall anyway though, so maybe I am overly cautious lol

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    " Marijuana (THC): No direct negative interactions with anabolic steroids. At all. This is all I am going to say about this. "

    Good to know, I am medical from spinal damage and I am much more effective as a person NOT being on OXY every day for the rest of my life... :-) ohh and I will live longer which is a plus!

  9. #9
    Founding Member Mini-G's Avatar
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    Suggestion. Common OTC drugs that do nothing should wait til the end.., common OTC drugs that can fuck us up should come first.,,

  10. #10
    Steroidal.com Writer/Mod Dan C's Avatar
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    Quote Originally Posted by Mini-G View Post
    Suggestion. Common OTC drugs that do nothing should wait til the end.., common OTC drugs that can fuck us up should come first.,,
    Everything is in alphabetical order.
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  11. #11
    Steroidal.com Writer/Mod Dan C's Avatar
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    Well, except Aspirin... I screwed that up by sticking it at the bottom of the list. I'll fix that... loll.
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    Founding Member OdinsOtherSon's Avatar
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    Great stuff Dan!! Thanks for putting this together and for the "more to come" caveat!!

  13. #13
    Steroidal.com Writer/Mod Dan C's Avatar
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    MAJOR UPDATE:

    - Moved Aspirin to the top so that it is alphabetically in order

    - Added a separate entry for ADDERALL/amphetamines. Very interesting information I've compiled there, I suggest everyone read it whether or not you are interested in that. I myself in particular was stunned when I came across the information I did, because I am prescribed Adderall for my ADD. When I discovered the effects that Estrogen (and/or a lack thereof) have on the effects of Adderall on the body, I was very surprised. I won't spoil it here, just read!

    - Added Benzodiazepines. Once again, very interesting info I compiled, analyzed, and posted there. The interaction that various AAS has with the peripheral benzodiazepine receptor (PBR) in the brain leads me to suspect this has something to do with the 'Trensomnia' everyone experiences with Trenbolone. Just speculation on my part from what I've read, but read above!
    Chief writer for Steroidal.com
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    I understand this is a very old thread, but is very informative and very important, however, lorazepam (brand name Ativan) is a benzodiazepine, NOT an SSRI. Great article. The interactions between some benzos and the peripheral benzodiazepine receptors is an extremely interesting topic. A subject that very novel research is currently being done on. No doubt much new information and knowledge will be discovered.

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