Features August 2011 Issue

10 Ways to Manage Your Meds

Medication mishaps send millions of people to doctors’ offices and emergency rooms. Here’s how to make sure you’re not among them.

Research confirms that while appropriate use of medications can help you, inappropriate use—or just plain mistakes—can be harmful. In one recent study, researchers found that 13.5 million outpatient visits during a three-year period were linked to negative effects from prescription medications. People who take multiple drugs are

particularly vulnerable to unpleasant or dangerous side effects, allergic reactions and toxicity, according to findings published May 6, 2011 in the journal Health Services Research.

Another study, published in the June 2011 issue of the American Journal of Preventive Medicine, found that overdoses of the painkiller acetaminophen (Tylenol) lead to more than 78,000 hospital emergency room visits a year. Older adults tend to overdose by accident when they take Tylenol for a headache, for example, while also taking prescription drugs, such as Vicodin or Percocet, that combine acetaminophen with an opioid.

All this underscores the importance of "knowing which medications you’re taking, and why," says Mandy Leonard, PharmD, BCPS, assistant director of Cleveland Clinic’s Drug Information Center. That includes not just prescription drugs, but over-the-counter medications and dietary supplements, as well. Here are steps you can take to be on the safe side:

1.) Write down questions—and your healthcare provider’s answers—before and during every office visit. These days, "you have to be your own advocate," says Dr. Leonard. Include in your list any concerns about symptoms such as a rash or stomach upset that may indicate a drug side effect or interaction.

2.) Make sure any newly prescribed drug is necessary (should you try lifestyle changes first?), doesn’t duplicate any other drug you’re taking, and won’t interact with other medications you’re taking.

3.) Know whether your medicines should be taken with food to avoid an upset stomach—or if you should avoid certain foods that might interfere with a drug’s effectiveness. For example, grapefruit can interfere with the the metabolism of some statin drugs used for lowering cholesterol.

4.) Read the label and the patient insert that comes with your prescription drug—but don’t stop there. "If anything isn’t clear or you have questions about potential side effects or anything else, talk to your doctor or pharmacist," Dr. Leonard advises.

5.) Be as diligent with your over-the-counter drugs and dietary supplements as you are with your prescription medications. Be aware of the active ingredients so you don’t inadvertently take more than you should.

As the aforementioned study shows, it’s easy to overdose on acetaminophen, which is found in combination painkillers, and also in cough and cold medications. For example, if you take Tylenol for a headache, plus a painkiller that contains acetaminophen to treat arthritis symptoms, you may be exceeding the recommended daily dosage.

Dietary supplements, especially herbal products, can interact with prescription drugs and dramatically affect their potency; talk with your doctor or pharmacist before taking them.

6.) Don’t split medications on your own, either to lower the dosage or save money. "Only certain drugs can be split safely," Leonard says. "Discuss them with your doctor first."

7.) Store drugs properly. "Some drugs are sensitive to humidity and should not be stored in the medicine cabinet, where heat and steam from showers can affect their potency or appearance," says Dr. Leonard. "Generally, drugs should be stored away from sunlight and direct heat. The drug’s label will tell you if it should be refrigerated."

8.) Pay attention to expiration dates. Clear out your medicine cabinet every six months and throw out any prescription or OTC medications that have expired. Also toss any medications you no longer need.

9.) Get a medication review every time you visit a healthcare provider, especially if you have more than one provider. Take a list with you that contains all the prescription drugs, OTC drugs, and supplements you’re taking. Your doctor can weed out drugs you no longer need or pinpoint potential interactions.

10.) Fill all your prescriptions at the same pharmacy so that the pharmacist can alert you to potential problems. If this isn’t possible—if you have to order some of your drugs by mail, for example—bring a list of the medications you’re currently taking to show the pharmacist before a new prescription for another drug is filled.