PINPOINTING PITFALLS BEFORE YOU’RE INJURED

Running keeps you healthy. But even active people sometimes need medications—and when you do, telling your doctor you’re an athlete is crucial. “Exercise can affect how certain drugs work,” says Lori Mosca, M.D., director of preventive cardiology at NewYork-Presbyterian Hospital. “And certain drugs affect how you feel while exercising.” So before you pop a pill, do your homework.

Antihistamines

Treat sneezing, itchy eyes, runny nose

Why Worry? Benadryl and Tavist can cause sluggishness and slow reaction times, says Marjorie L. Slankard, M.D., of Columbia University College of Physicians and Surgeons.

What Instead? Dr. Slankard recommends Alegra, Claritin, and Zyrtec (over-the-counter) and Clarinex (prescription)—all of which have fewer side effects.

Beta-Blockers

Treat high blood pressure, heart palpitations, migraines

Why Worry? Beta-blockers may cause fatigue. And because they lower heart rate, they can make it tough for your heart to perform at its peak, making even easy runs feel challenging. That’s why Heather Gillespie, M.D., team physician for UCLA Athletics, says she’d never put a runner on beta-blockers.

What Instead? Opt for calcium-channel blockers, ACE inhibitors, and angiotension receptor blockers (ARBs).

Fluoroquinolone Antibiotics

Treat bacterial infections

Why Worry? Research shows that taking antibiotics in this family (Cipro, Levaquin, Floxin, Noroxin) triples the risk of Achilles injuries. And your Achilles may be vulnerable for months after your prescription runs out.

What Instead? “If I have an active patient, I’ll give them a different antibiotic, like penicillin,” says Dr. Gillespie.

NSAIDs

Treat pain

Why Worry? Nonsteroidal anti-inflammatory drugs (Advil, Aleve, Naproxen) can impair kidney function when taken in excess before or during a run, especially if the user becomes dehydrated, says David Nieman, Ph.D., of the North Carolina Research Center and Appalachian State University. Dr. Nieman studied participants of the 100-mile Western States Endurance Run who used ibuprofen to manage discomfort. After the race, he measured participants’ muscle soreness and found that the pill-poppers felt just as achy as those who hadn’t medicated.

What Instead? If you need to pop something before you hit the road, you probably need a rest day. Running through pain could lead to injury. Postrun, Dr. Gillespie recommends acetaminophen (Tylenol), which has fewer side effects.

Tricyclic Antidepressants

Treat depression

Why Worry? Tricyclics (Endep, Sinequan) cause increased heart rate, which can make you tire faster on a run. They can also cause lightheadedness and delay electrical conduction in the heart, which can lead to an irregular heartbeat.

What Instead? In some cases, regular exercise can be enough of a mood-booster to reduce reliance on these drugs. If not, selective serotonin reuptake inhibitors (Prozac, Paxil, Zoloft) have fewer side effects. “They still increase heart rate a bit,” says Dr. Gillespie. “But they’re better for active people.”