Medication Mistakes
Nine Common Medication Interaction Mistakes
Advances in technology have made it easier for healthcare professionals to identify potential drug interactions, but medication interactions remain an important safety concern—especially when prescription medications are combined with over-the-counter (OTC) medications, vitamins, supplements, alcohol, or certain foods.
Potential interactions can increase the risk of bleeding, kidney injury, excessive sedation, abnormal heart rhythms, or dangerous changes in blood pressure. When reviewing your medications, be sure to consider everything you take, including prescription drugs, OTC medications, vitamins, supplements, and relevant dietary factors.
Nine Common Examples
1. Duplicate ingredients
Taking Tylenol (acetaminophen) along with a cold or flu medication that also contains acetaminophen can result in excessive acetaminophen intake and serious liver injury. Always check the active ingredients on medication labels.
2. NSAIDs with blood thinners
Taking ibuprofen (Advil, Motrin) or naproxen (Aleve) with warfarin (Coumadin) can increase the risk of serious bleeding.
3. ACE inhibitors with potassium supplements
Medications such as lisinopril, when combined with potassium supplements or potassium-containing salt substitutes, can cause dangerously high potassium levels and potentially abnormal heart rhythms.
4. Certain statins with antibiotics
Clarithromycin can increase simvastatin levels and raise the risk of serious muscle injury and kidney damage. This combination is contraindicated.
5. Opioids with benzodiazepines
Combining medications such as oxycodone with alprazolam (Xanax) or diazepam (Valium) can cause profound sedation and dangerously slowed breathing.
6. SSRIs with NSAIDs
Taking antidepressants such as sertraline (Zoloft) or fluoxetine (Prozac) with ibuprofen or naproxen can increase the risk of gastrointestinal bleeding.
7. Thyroid medication with calcium or iron
Calcium and iron supplements can reduce the absorption of levothyroxine. These supplements should generally be taken at least four hours before or after levothyroxine, following the medication’s instructions.
8. Sildenafil with nitrates
Taking sildenafil (Viagra) with nitroglycerin can cause a dangerously low blood pressure and is contraindicated.
9. Digoxin with certain antibiotics
Clarithromycin can increase digoxin exposure, raising the risk of digoxin toxicity and potentially dangerous heart rhythm abnormalities.
The Bottom Line
Medication safety requires more than reviewing prescriptions alone. OTC medications, supplements, vitamins, alcohol, and dietary factors can all contribute to adverse effects or interactions.
Keep an up-to-date list of everything you take, including doses and frequency, and share it with your healthcare professionals. Ask your pharmacist to review your medications whenever something is added, discontinued, or changed.
An interaction checker can be a useful screening tool, but it does not replace individualized medical advice. Not every flagged interaction means a medication should be stopped. If a potential interaction is identified, consult your pharmacist or prescribing physician before changing your medication regimen.
Helpful resource: Drugs.com Interaction Checker
By Marcus Forman