Lugging every pill you take to your next doctor’s appointment or trip to the pharmacist might seem like overkill, but it could save your life — especially if you take multiple drugs or supplements.
In fact, regularly taking five or more medications — something many Americans do — often does more harm than good, especially if you’re not closely monitored by a health-care provider.
Here’s how to stay safe when taking multiple medications:
Have a brown-bag checkup.
At least once yearly, gather every prescription and over-the-counter drug you take, including drops and ointments, as well as every dietary supplement, vitamin, mineral or herbal remedy you use, and bring them all to your doctor or pharmacist.
During that review, often called a brown-bag checkup, the doctor or pharmacist should check to see whether any interact with each other or whether you’re unnecessarily taking different drugs to treat the same problem. If so, you may be able to eliminate one of the drugs. Also ask whether the dosage of each medication you take can be lowered or possibly even eliminated.
Fill all of your prescriptions at one pharmacy or pharmacy chain if possible. All of a chain’s outlets usually share the same electronic record-keeping system, so a pharmacist will always know which medications you take and can more easily spot potential problems.
Ask key questions.
You can reduce the chances of taking more medications than you need by asking the following questions each time you get a new prescription or your doctor recommends an OTC product.
●What is the medication for? It might seem obvious, but asking that basic question reduces the risk of taking an inappropriately prescribed drug — something that happens surprisingly often. One common example: The OTC drug ibuprofen (Advil and generic) and prescription drug celecoxib (Celebrex and generic) have similar pain-relieving actions, so they shouldn’t be taken together.
●How long should I take it? Asking this can help spot medications you regularly take that should be used only for the short term. For example, proton pump inhibitors such as omeprazole (Prilosec and generic), taken for severe heartburn, should not be taken for more than about six months because longer use increases the risk of bone fractures and can cause low blood levels of magnesium, which can trigger muscle spasms, irregular heartbeat and seizures. Asking the purpose of medications, and when you can stop them, is especially important when you are being discharged from the hospital.
●Is this similar to another drug I already take? If you see several health-care providers, some may be unaware of what others have prescribed — and may prescribe drugs similar to one you already take. For example, your primary-care physician might prescribe a diuretic (a “water pill”) to lower high blood pressure. But your neurologist might prescribe a beta blocker, which also reduces blood pressure, to prevent migraines. In that case, you might be better off with just the beta blocker because it treats both conditions.
●Can nondrug alternatives help me? In some cases, you might be able to eliminate or reduce your need for drugs by making certain lifestyle changes. For conditions such as high blood pressure, high cholesterol and Type 2 diabetes, for example, losing excess weight, exercising regularly and consuming a healthy diet can sometimes be as effective as drugs. And exercise and physical therapy can often help ease arthritis as well as back, shoulder and neck pain, allowing you to cut back on drugs such as ibuprofen and naproxen (Aleve and generic).
●Will this medication interact dangerously with other prescription drugs or OTC products I take? The more medications you use, the greater the likelihood of interactions. For example, taking the cholesterol-lowering drug simvastatin (Zocor and generic) with the blood pressure drug amlodipine or the blood thinner warfarin (Coumadin and generic) may trigger potentially deadly bleeding. The same could happen by combining aspirin with the blood thinner clopidogrel (Plavix and generic) or OTC pain drugs such as ibuprofen or naproxen.
●What side effects could this medication cause? Being aware of possible side effects can help you spot them before they cause serious harm. For example, muscle aches might be due to a cholesterol-lowering statin you take — and if allowed to continue, this side effect could progress to severe kidney damage.
Recognizing side effects can also help you avoid “prescribing cascade,” says Jerry H. Gurwitz, chief of the division of geriatric medicine at the University of Massachusetts Medical School. That happens when, instead of stopping the drug that is causing the problem, your doctor prescribes yet another medication to treat the side effect — which can lead to additional side effects or interactions. “This is a huge issue that is underappreciated,” Gurwitz says.
For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.