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What kind of mistakes are you at risk for? According to eye-opening research by the Institute of Medicine, from the moment your doctor writes a prescription, any of a number of things can go wrong -- often in the hospital, but not always. A pharmacist misreads the physician's scrawl. A doctor, unaware of research about when a drug shouldn't be used, prescribes it for you anyway. A patient forgets to tell a doctor about an herbal remedy she's taking, resulting in a dangerous drug interaction. "Mistakes can be made with something as common as birth control pills or allergy medication," says Jim Jirjis, MD, director of primary care at Vanderbilt University Medical Center in Nashville. These mess-ups may not be life-threatening, but they can have very serious side effects.
Experts say women are at special risk. Until recently, most medicines were tested primarily on men, under the assumption that the two sexes would process them the same way. "We now know that women respond differently to many medications," says Rosaly Correa-de-Araujo, MD, PhD, director of Women's Health and Gender-Based Research at the Agency for Healthcare Research and Quality in the U.S. Department of Health and Human Services. "Women have a lower body weight, a higher proportion of fat, smaller organs, and a slower rate of metabolism, as well as different hormone levels. All of these factors affect the way a medication is metabolized, absorbed, and eliminated by the body." In addition, during the menstrual cycle, water retention frequently occurs, which can lead to dilution of a medication. As a result, even if you, your doctor and your pharmacist get everything right, you still might need to readjust the dosage of your medication.
Which isn't to say you should flush all your prescriptions down the toilet. What you need to do is educate yourself. "There are many things women can do to protect themselves," says Dr. Correa-de-Araujo. For starters, pay close attention to your body's response to a new medication and tell your doctor if you notice anything she didn't tell you to expect. For instance, is the drug less effective during your period? If so, you may need a different dosage.
Most of us think of over-the-counter (OTC) drugs as harmless -- who hasn't at one time or another popped more than the recommended number of Tylenol or Advil? "But none of them are perfectly safe," says Dr. Wertheimer, who reviewed OTC drug usage for the Institute of Medicine report. "OTC preparations, as well as vitamin and herbal supplements, can be dangerous when taken in combination with certain other drugs," says Wertheimer. Consult your doctor if you're worried about the common mismatches outlined below.
|If you take…||Don’t take…||Why?|
|NSAIDs like Advil or Aleve||Antacids or H2 antagonists (diagnosed for acid reflux)||Together, these drugs can cause serious gastrointestinal bleeding.|
|Calcium supplements||Aspirin, erythromycin (an antibiotic) or bisacodyl (for stomach ailments)||The mix can irritate the lining of your stomach, possibly resulting in ulceration.|
|Allergy meds (RX or OTC) like Benadryl||Sleeping aids like Lunesta or Ambien||
Both kinds of drugs cause drowsiness; combined, they could result in unconsciousness.
|Acetaminophen, such as Tylenol||Painkillers like Percocet, Vicodin or Lortab, or cough/cold medicines like Tylenol Cold||Many painkillers and cough/cold medicines also contain acetaminophen, so you could be double-dosing.|
Originally published in FITNESS magazine, November 2006.