9 Ways to Avoid Dangerous Drug Interactions

August 4, 2017
Drug interactions are more common than you may realize and can lead to unwanted – or even dangerous – side effects. These may include:
  • Dizziness
  • Confusion
  • Excess fatigue
  • Nausea/vomiting/diarrhea
  • Change in heart rate
  • Just not feeling “right”
  • New symptoms that arise within days (or weeks) of starting a drug 
Although elderly people are at increased risk of adverse drug interactions because they typically take more medications on average than younger people, medication interactions can happen to anyone.
Any time you notice a new or unusual symptom, particularly around the time a new medication is started, it’s a good idea to see your doctor. Many medications take a day or two to start causing interaction symptoms, and some (such as aspirin) may take a week or longer.

Below are tips to reduce the risk of a drug interaction. Use these strategies at home, at the pharmacy, and at the doctor’s office to help prevent complications such as hemorrhage, dizziness leading to falls, or even death from drug errors.

Unexpected Sources of Trouble

When it comes to interactions, we often think of drugs as only those that are prescribed for us. However, there are other seemingly-safe substances that can contribute to a drug interaction and should be mentioned to your health care provider:
  • Home remedies, herbs and supplements, including vitamins
  • Over-the-counter (OTC) drugs such as pain relievers, allergy and cold medicines, heartburn drugs, sleep aids and more
  • Antibiotics or other medicine prescribed for a short-term illness
  • Medical marijuana, CBD products or illegal drugs
  • Ointments, eye drops and nasal sprays
  • Alcohol including wine, beer and liquor
  • Certain foods, like grapefruit, can also interact with some medicines
It’s fairly common for antibiotics, blood thinners and behavioral drugs (like those used at times for people diagnosed with dementia) to trigger interactions. When these are combined with other medications, individuals are at increased risk for bleeding (which may show up as excessive bruising), falls and other problems.
When you go to the doctor, bring a list of all the medications you’re currently taking, including prescriptions, herbs and supplements, home remedies, ointments, eyedrops, and OTC drugs. Any and all of these types of drugs can cause other medications not to work, or to work too well, which can leave your loved one at risk.

9 Tips to Dangerous Drug Interactions

Here are nine tips we share with clients and caregivers to reduce the risk of a drug interaction. Use these strategies at home, at the pharmacy and at the doctor’s office to help prevent complications.
  1. Ask questions about your prescriptions: When you or your loved one is prescribed a new medication, ask what it’s for. If it’s meant to treat a symptom caused by another medication, keep asking questions. Sometimes there may be an alternative that doesn’t cause troublesome side effects.
  2. Don’t share medications: Everyone’s medical needs are totally different, even if your loved one is diagnosed with the same condition as a friend. The medication the friend was prescribed may be too high (or too low) of a dose for your loved one or may interact with other medications.
  3. Don’t take leftover medications. Discard them safely: “Leftover” medications may be expired and may not work as intended. It’s important to discard them properly. Pills flushed down the toilet can cause pollution issues and medications tossed in the trash can be accessed by kids, pets or individuals with drug addictions. Instead, ask the pharmacy if they have a medication-disposal event, especially for items such as needles and catheters that can’t be safely tossed in the trash. You may also consider crushing pills, dissolving them in water and mixing this with cat litter before throwing it in the trash.
  4. Don’t change dosages on your own: This includes taking too much OTC medication, changing the dosage yourself or not properly taking the drugs a doctor has prescribed. If a drug isn’t working as expected, talk to the doctor before changing the dose or stopping the medication. It can be dangerous to stop some medicines, especially anti-seizure drugs. On the other hand, medications like antibiotics may not reach full effectiveness if you don’t take the entire amount of medicine that was prescribed.
  5. Read the labels on OTC drugs: Many drug labels list warnings for potential drug interactions. If you have questions about a drug, ask the pharmacist or call your primary care provider’s (PCP) office. Some pharmacists can access your electronic medical record (EMR) through their database for more specific recommendations, just like your PCP can.
  6. Tell your doctor about at-home remedies. Clients and caregivers often share that they’re trying home remedies for their ailments, and we urge them to check in with their doctors. The doctor and the pharmacist won’t think the at-home treatment is silly, but they will help determine if it could affect your other medications or cause problems.
  7. Use one pharmacy and medical center whenever possible: EMRs that store all your prescriptions can help reduce some of this risk, but not all hospitals and pharmacies use them. And EMRs don’t account for OTC medications or supplements unless you share the information with your doctor or pharmacist.
  8. Use a medication organizer. This helps reduce the likelihood of forgetting to take the right medicines at the right time, as well as reduce the possibility of taking too much medication or taking it too frequently. Supplements can go into the organizer along with your prescriptions. Some organizers have timers that beep to remind you – or you can use a mobile app to set reminders.
  9. Ask the pharmacist to use labels with larger print. Many pharmacies have this option. It can help prevent dangerous errors due to instructions that are too small to read.

How Home Health Nurses Can Help

During our first visit with a new client, a BrightStar Care Registered Nurse will review in detail all the medications the client takes to check for potential drug interactions. We check it again every 60 to 90 days, depending on the client’s level of care. This helps us monitor how medications affect the client every day. For example, if a person takes blood thinners, excessive bleeding or bruising may indicate that a condition has changed or something else is wrong. We’ll also help you understand the doctor’s orders about a certain drug and what each drug does if you have questions.
Related reading: Improving Patient Safety at Home
As a family caregiver, you are your loved one’s best advocate. If you’re concerned about the number of drugs your loved one is on, whether they’re taking them properly or about possible interactions with OTC drugs or supplements, let your home health nurse know any time.
You, your loved one, the doctor, the pharmacist and your home health nurse are on the same team. We can all work together to make sure medications are taken safely and effectively.