Prevent Dangerous Drug Interactions

January 23, 2017 (Updated: August 16, 2018)
Lily Moran

There are 10,000,000 chemical reactions taking place in every cell of your body, every second. And there are trillions of cells in your body. Adding one drug to that mix complicates things, but that’s what drug trials are for—to ferret out those issues. But when you add a second drug, everything becomes vastly more complicated—and potentially more dangerous. Most people think that we’ve got a good handle on drug interactions, that we know how things mix. And the truth is, we know a lot about some dangerous combinations. But even with that knowledge, you could be in danger. Not just because there are some drug interactions we haven’t discovered yet. But also because the safeguards we use against mixing dangerous drugs fail with alarming frequency. Today, let’s talk about how safe you really are—and four things you should do to protect yourself.

Don’t Trust Your Pharmacist

The Chicago Tribune just published a multi-year trial of several local pharmacies. Reporters went in asking for drug combinations known to cause serious issues.

And sometimes, the pharmacist would tell them they couldn’t take those drugs together and try to find an alternative. But, 49% of the time, the pharmacy sent the reporter away with a dangerous cocktail in hand, and no warning about potential harm.

Different pharmacies had different results. Small local pharmacies did worst, with a 72% fail rate. CVS—which just took over Target pharmacies—was almost as bad, at 63% failure.

But even the best-performing drugstore, Walgreen’s, failed to prevent a toxic chemical mix 30% of the time. That’s simply too high.

And while the exposé has prompted all of the pharmacies to promise to update and improve their internal checks against this sort of mistake, I’m not holding my breath. Your medical records might be digital and, in theory, easier to access, but so far, the results of this improved data haven’t been all that stellar.

Don’t Trust Your Drugs, Either

Of course, even if our nation’s pharmacists get on the ball, that’s just protection from the adverse effects that we know about. There are plenty we don’t recognize yet—either because the drugs haven’t existed side by side for long, or because what’s fine in one person’s body can be deadly in someone else.

We have a rule at my office. If someone comes in with a host of unexplained problems, we try to get them off all their medications at once. And, more often than not, that solves the problem.

We really are guinea pigs for medicine. It’s too difficult to test all drug interactions in the lab, so it happens in the general public instead. Sometimes with very bad results.

I had one patient, a man in his early 70s, whose cardiologist had given him an array of drugs to fix atrial fibrillation—an irregular heartbeat. With all those drugs, he’d developed a variety of maladies—all of which went away when I took him off that potent cocktail.

Of course, his atrial fibrillation could have easily been fixed with an electro-conversion treatment that only takes two minutes. But sometimes, it’s not easy to stop taking or replace drugs. Some require time to ween off of them—stopping “cold turkey” can sometimes do more harm than good. And that’s when you need a trusted, interested doctor you can discuss alternatives with.

But that’s only a step you take after a problem develops.

Obviously, it’s better to stop problems before they start. Which is why I’m giving you four rules to ensure you won’t face the same problems.

Rule #1: Be Your Own Advocate

Only you truly know what’s going on inside your body. If something is going amiss with a drug, you’re the first—and often last—line of defense.

But also, only you are completely interested in your own care. Your doctor is seeing multiple people every hour, and just can’t devote the same amount of time you can.

So, when you are prescribed a medication, do your own research on it. Use a website like drugs.com and find out what combinations are a no-go. Other prescription medicines, yes—but also any over-the-counter medicines, supplements, or even foods.

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Some cholesterol drugs like Lipitor, for instance, shouldn’t be taken with grapefruit. Grapefruit can slow down the rate at which these drugs are processed by your liver, which can lead to a dangerous buildup of the drug in your system.

That’s something your doctor or pharmacist should tell you, but it doesn’t always happen.

There’s no replacement for doing the research yourself. When you get the prescription, read the box, the insert, and, if they have it, the little pamphlet stapled to the bag, even if you have to break out a magnifying glass. Don’t just trust that you’ll be told everything you need to know—since we know, too often, you won’t be.

Rule #2: Use One Pharmacy

It’s bad enough that pharmacies will hand out dangerous drug combinations fairly frequently.

But at least pharmacies are working to stop that sort of thing from happening, and have systems in place that try to prevent dangerous combos.

But different pharmacies don’t talk to each other. So if you get your prescriptions from different places—say, some are from your local drugstore, but others are filled at a hospital pharmacy—there’s no protective system in place at all.

That’s why, very simply, you should get all your drugs from one pharmacy. They don’t have a perfect record of safety—but it’s better having a rickety safety net than nothing at all.

Rule #3: Ask Everyone

Doctors and pharmacists are busy people, and sometimes they’ll forget to go over drug interactions or to give you important information.

That’s why, every time you’re prescribed medicine, you should ask about it.

Make sure your doctor knows everything else you’re taking, including supplements and over-the-counter medicines, and ask if your new combinations are safe. And don’t just ask your GP, but every doctor you talk to.

Do the same of your pharmacist. You might just remind someone to make a check they forgot—and, in so doing, spare yourself a nasty surprise.

Rule #4: Cut It Out

If you find yourself feeling poorly when you take a new drug or drugs—and they aren’t regular side effects you knew were coming—stop taking those meds and talk to your doctor.

If the medicine is vital for a condition you have, get an alternative as soon as you can. If it’s something that isn’t immediately life-or-death, let your doctor know that you’re having a bad effect, you’ve stopped the medication, and you need something different.

Too often, we think of prescriptions as necessities. Some are, but many only help on the fringes. You don’t want to damage your health taking drugs that aren’t absolutely vital.

Americans in general are terribly over-prescribed. And, because of that, dangerous drug combinations are a rising problem. Inform yourself about every drug you take, and be your own advocate to prevent mistakes, and stop problem interactions as soon as they start.

We probably won’t see a 100% safe pharmaceutical industry in our lifetime. But, for now, erect your own watchtower, and look out for signs of trouble. You’ll be more effective than the alternatives—and, sometimes, you’ll be the only one doing it. It’s well worth the time it takes to do your homework.

References

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