In general there are no specific drugs that you should not take, but there are some that should be used with caution. The only exception is an anti-eplieptic drug called sodium valproate. Sodium valproate can interact with mitochondria and is best avoided in other forms of mitochondrial disease where possible. Metformin, should also be used in caution because rarely it can increase lactic acid production in the body. This can also be increased in mitochondrial disease, and so the two together could in theory lead to high levels. The same is true of an antibiotic called linezolid. Most of these drugs are not absolutely contraindicated, but there are often alternatives that could be used instead. Many other drugs may provide more benefit than risk. The best advice is to consult with your specialist when you start a new drug.
Other drugs that should be used with caution include:
- Aminoglycoside antibiotics(eg Gentamicin) – rarely problematic but must be avoided in patients carrying m.1555A>G mutations.
- Zidovudine– may cause mitochondrial depletion.
- Statins– usually well tolerated but should have blood tests to monitor muscle enzymes.