What YOU Need to Know About the Drugs You Take

July 10, 2009

Posted by Casie Mace

Once again, drug interactions are in the spotlight. And for a good reason! A number of people are discovering that many medications, both over-the-counter and prescription, can interact with each other and result in unwanted side effects.

For example, many woman aren’t aware of the interactions that can occur between certain substances and oral contraceptives. Both St. John’s wort (an herb commonly used to treat depression and mood swings), and antibiotics can interfere with the efficacy of birth control pills, resulting in an unplanned pregnancy.

Other people are unaware of the fact that warfarin (also known under the brand name Coumadin) should never be taken with aspirin. While they act upon different mechanisms- warfarin being a vitamin K antagonist and aspirin being in the anti-platelet class of drugs along with drugs like Plavix- both cause thinning of the blood. When taken together, these drugs can lead to excess bleeding.

And in the spotlight most recently is acetaminophen. This pain and fever reducer is most commonly taken in the form of over-the-counter drugs like Tylenol and experts are now finding that too much of it can be very dangerous. What many people don’t know is that it is also in widely used prescription pain relievers such as Percocet and Vicodin. This causes people to unknowingly combine medications that contain acetaminophen in a 24 hour period- taxing the liver and possibly causing liver damage.

Lois Parker, senior pharmacist at Massachusetts General Hospital, was interviewed by both CNN and the Boston Herald and reported that dangerous drug combinations has been a concern of hers for quite some time. She stated that, in addition to many pharmaceuticals being too readily available, “there isn’t as much awareness as there needs to be.” Furthermore, the problems and consequences associated with drug interactions aren’t always apparent, causing people to continuously pop pills.

Many people build up a dangerous tolerance to painkillers and, consequently, end up taking significantly more than is safe. This, coupled with the way these and certain other drugs are metabolized, can mean devastating long term effects. Since some drugs use the same pathways for metabolism in the liver, combining them can result in decreased absorption, decreased efficacy, or worse, they can become severely toxic.

While the FDA continues its efforts to inform the public of certain interactions, there is still little public knowledge about certain harmful combinations. In fact, a 2008 study published in the Journal of the American Medical Association, found that 1 in 25 older adults (ages 57 – 84) were taking drug combinations that were potentially dangerous. Additionally, more than half of these potentially hazardous mixtures involved seemingly harmless over-the-counter medications such as Tylenol or aspirin.

So why aren’t consumers more aware of the potential side effects and dangers associated with these combinations? Is it a lack of industry knowledge? Drug company intervention? Or simply abuse on the consumer’s end? Its possibly a combination of all three. What are your thoughts?