Dear Doctor Column, August 8, 2005

Tips to Avoid Drug Interactions, Medication Mistakes

Question:

I'm 62 years old and have recently been prescribed several drugs for two health problems I'm having. I'm not accustomed to taking so much medicine and want to be sure not to overdose or have other problems related to taking several pills daily. Any advice?

Answer:

The average older adult uses between two and six prescription medications and between one and three over-the-counter (OTC) medications regularly. Taking more than one medication puts you at risk for unexpected drug interactions. The result could mean your medications are not working as intended, or interactions could cause dangerous side effects.

Drug interactions fall into three broad categories:

1. Drug-drug interactions occur when two or more drugs react with each other. This drug-drug interaction may cause you to experience an unexpected side effect. For example, while both drugs to help you sleep and some antihistamines can slow reaction times making it dangerous to drive or operate machinery, taking them together dramatically increases this effect.

2. Drug-food/beverage interactions result from drugs reacting with foods or beverages. For example, mixing alcohol with some drugs, such as antihistamines, may cause you to feel tired or slow your reactions.

3. Drug-condition interactions may occur when an existing medical condition makes certain drugs potentially harmful. For example, if you have high blood pressure you could experience an unwanted increase in blood pressure if you take a nasal decongestant.

Before taking a drug, ask your doctor or pharmacist the following questions:

• Can I take it with other drugs?
• Should I avoid certain foods, beverages or other products?
• What are possible drug interaction signs I should know about?
• How will the drug work in my body?
• Is there more information available about the drug or my condition (on the Internet or in health and medical literature)?

Fortunately, drug interactions and medication mistakes are largely preventable:

• Make your doctors aware of the drugs you are taking.
  

All of your physicians should know which medications you currently take, including prescription and OTC drugs, as well as dietary supplements and vitamins. At least 40% of Americans take medication prescribed by two or more health care providers, increasing their risk of drug interaction or duplication. Bring all medications and supplements to your appointment so the doctor can check what you are taking.

• Fill prescriptions at the same pharmacy.
  

Drug interactions are less likely to occur if the pharmacist can see your entire medication profile. Keep a list of all medications you take and carry a copy with you.

• Get smart about side effects.
  

Read the fine print on drug labels and make note of potential side effects and risks. Also, check active ingredients, which are important since many drugs contain the same ones.

• Stick to a medication schedule.
  

Get in the habit of taking medications at the same time every day. This will ensure you will not forget and that you will have a constant amount of medication in your bloodstream.

• Take medications with a full glass of water, unless prescribed otherwise.
  

What you drink with pills can change how they act in your body. For example, grapefruit juice can increase the potency of some medications.

Remember, the drug label will tell you what the drug is used for, how to take the drug, and how to reduce the risk of drug interactions and unwanted side effects.

If you still have questions after reading the drug product label, ask your doctor or pharmacist for more information.