It turns out that your favorite pharmacist may not be giving you the advice about bad drug combinations she/he should be. This article from The Consumerist(an off-shoot of Consumer Reports) talks about a Chicago Tribune investigation showed that pharmacists warned of harmful interactions just slightly over half the time-114 in 223 tests. Far too many relied on the “Do you have any questions about this prescription?” checkbox, even when there were clear problems that the pharmacist should be warning the customer about.
I think from now on I’ll just check “yes” on that little box, just to make sure.
Note that Over The Counter medicines like cough, allergy medicine, etc. can interact with prescription drugs. (READ those labels!)
And a medical professional would need a COMPLETE LIST of all medications you are taking - including OTC, alcohol, and illegal drugs.
So basically tell your doctor about every drug you take - have them enter it into their computer. They should get a pop-up warning if two will interact.
How about three? or eight or nine? I have to take a handful of pills every day, and NOBODY knows how they all interact. Just because medication A is safe with B or C or D, etc., individually, doesn’t mean it’s safe with all of them in combination. I don’t know how many of my physical problems are actually side effects of all the meds I’m taking, and there’s no way to find out.
The days of people using one doctor for all their ills are pretty much gone. I’m in pretty good health and still have a PCP, a dermatologist and an orthopedist that can and do prescribe drugs. One has to make sure ALL of one’s doctors and pharmacists have a complete list of ALL one’s medications - easier said than done. And then there is the issue brought up by panache.
I prefer to rely on the pharmacist rather than try to have all the doctors completely in sync on all meds I’m taking.
Pharmacists are not glorified pull-pushers: they’re the experts on drug dosages and interactions. That’s their expertise .
We go to a small local pharmacy where they know us, and where their primary purpose is to dispense medications. We don’t go to a grocery or department store that happens to have a pharmacy tucked away in the back.
The drug store we go to has a complete log on their computer of all the medications that members of Clan Piper are taking. More than once, they’ve caught an issue that the medico didn’t.
People don’t seem to get that while doctors of course know about drugs and their effects, the pharmacists are the experts about drugs. I take full advantage of their expertise, rather than look on them as glorified pill-counters.
Disclosure: Piper Dad was a druggist (the preferred term in our multi-generation family of druggists) and I worked in his store in high school. It was not uncommon to hear him on the phone with the doctors, clarifying the dosage or drug interaction of a prescription that a client had just got from the doctor. The doctors were always glad to have his feedback, as far as I could tell, and would change the details of prescription if he recommended it.
According to the article I linked to in the OP,
Be careful about more than just harmful drug interactions with each other. One of the medications I take interacts very poorly with, of all things, grapefruit juice. It would cause the level of that medication to be increased in my system by about 400%, which could prove fatal.
ETA: The medication is Latuda, in case this information would be helpful to anyone reading this thread.
Do you know that nobody knows or do you just assume that nobody knows? Sure, there’s an infinite combination of meds people can take (and multiply that by all the ways people can react to just about anything), but I’d wager that unless there’s something really odd going on with you, the combination of meds that you’re on is common enough that plenty of people are on them and if they interact with each other a statistically significant number of people would have reported it such that it would be in all the databases. Also, FTR, I understand what you’re saying. A and C can be taken together as well as B and C, it’s all three that can cause a problem. I have a feeling that we’ve advanced enough that everyone involved in getting the meds to you have made beyond comparing one to one, but maybe I’m wrong, I guess I’ve never really thought about it.
Very true, that’s one of the reasons, whenever possible, I try to stay within the same group. All my doctors (finally) use the Epic system. It’s nice to talk to the first nurse and instead of trying to rattle off all my meds, she can run through and update the list. Much easier that way. Sometimes, the day before and appointment, they’ll send me an email to do some of the pre-interview stuff then, including looking over my med list. I can also go online and print that list out or even pull it up on my phone if I need to.
Someone once posted here that it’s only white grapefruit, but most people just say ‘grapefruit’ and run with it. But that’s the only time I’ve ever heard that. Either way, it’s amazing how much grapefruit has fallen out of favor in the last 10-15 years because of that. At my store we’ve been selling less and less grapefruit to the point that it’s almost none. I have a friend that owns a large beverage company, he distributes juice all over the country. He mentioned that he was pulling grapefruit juice out of his lineup because it’s become so unpopular, citing meds as the reason people don’t drink it anymore.
This isn’t at all unusual. One of the meds I take, atorvastatin (Lipitor) is fairly common, and reacts poorly with grapefruit juice. And the furanocoumarins in the juice may remain active in the body for up to several days.
I’ve had screw-ups from the big stores, good catches from the independent I go to.
Well you can also “do it yourself”!
Search google.com for the words…
drug interaction checker
(Just be sure to enter everything including alcohol and illegal drugs.)
Are you asking about the side effects panache is referring to? Nobody knows. It isn’t an assumption for anyone. I’m taking three different meds, and I started experiencing what MIGHT be a side effect (the list for each med on its own is probably taller than I am). I talked about it with a number of my doctors, and it was always the same. “Well, that might be a side effect of Med A, or it could be Med B interacting with Med A, but every patient is different, so I can’t say with any certainty. If it is really bothering you, we can try something else…”
That isn’t taking into account if you missed a day, if you took any recreational drugs, drank any alcohol.
With that many factors and that many meds, there is no way to tell what is a side effect and what isn’t.