Forum: Knowing your pharmacist can save your life

Quick — name every prescription drug you take and all your vitamins and supplements and the dosage for each.
Do you know about possible side effects and interactions these drugs, vitamins and supplements may have with one another?
Judging by responses from a room full of senior women at the George G. Young Community Center in Jamesport last Friday, the answer is probably not.
That’s what prompted Rite-Aid pharmacist Elizabeth Hyland, who works in both the Riverhead and Mattituck stores, to talk about the dangers of mixing various prescriptions and supplements and the importance of establishing a relationship with your pharmacist as well as your doctor.
“I know my people,” said Ms. Hyland, explaining that it’s her job to be sure patients get the right medication in the right dosage and that they clearly understand when and how they should take it. It’s also her job to ensure that patients understand possible side effects and are alerted to watch for them.
The mix of medications an individual takes can also be an important issue, she said. Today, she acknowledged, it’s increasingly difficult for a local pharmacist to get the big picture for any one patient, because so many use mail-order drug services.
If you get most of your maintenance drugs through a mail-order company, but have an immediate need for an antibiotic or other one-time prescription, the pharmacist you see locally needs to know what else you’re taking, Ms. Hyland explained.
You’re probably trusting your doctor to tell you about drug interactions, she said, and you may think the information that comes with your prescriptions includes everything you need to know. But it may not be enough, she cautioned.
The pharmacists working for the companies that fill your mail-order prescriptions don’t know what vitamins and supplements you might be taking, she pointed out, so they can’t render advice about possible interactions.
For example, Ms. Hyland cautioned, vitamins A, D, E and K can accumulate in your body and an overdose can be dangerous. They can all can be helpful to your health, but only if the dosage is correct, she said.
Do you take Coumadin to prevent blood clots? If so, you likely know that aspirin is contra-indicated because the combination of the two can cause dangerous bleeding. But did you know that many antibiotics also shouldn’t be taken with Coumadin? Your doctor may have advised you to discontinue Coumadin while you’re taking an antibiotic. But if not, a pharmacist who knows your medical history can be the next line of protection.
Too often, Ms. Hyland said, she sees patients who haven’t been warned of possible interactions or have been given too large a dose of a medication for their specific circumstances.
“Somewhere along the line, somebody didn’t tell somebody something,” she said.
If you’re diabetic and take an over-the-counter cold medication — many of which have hidden sugars and/or alcohol — you could easily find your blood sugar level out of control.
You probably think of Tylenol as a benign pill. But an overdose can affect your liver, Ms. Hyland said. If your doctor puts you on a prescription painkiller, it likely contains Tylenol along with other ingredients. If you add your own Tylenol to the prescription, you may be in danger, she said.
Similarly, over-the-counter Motrin can affect your blood pressure.
And did you know that as you age your kidney function diminishes? This means that a medication may not be flushed from your system as quickly as with a younger patient, so your dosage should be lower to avoid a toxic buildup, the pharmacist said.
Ms. Hyland and her staff are another line of protection for patients, able to call doctors and question prescriptions they suspect might harm the patient, she said.
They can also intervene when they realize a prescription may be much too expensive for the customer.
“The doctor isn’t paying for your medication,” she said, and may not be aware that the prescription is beyond what you can afford — even if you have insurance. She can suggest a less expensive alternative and clear it with your doctor.
Ms. Hyland also warned seniors to beware of coupons from drug manufacturers who may offer a free one-month’s supply of a medication. Your pharmacist can do a test claim to determine whether your insurance company covers the drug and how much it’s going to cost you if you want to continue to take it after the free offer expires.
Concerned about generics? Don’t be, Ms. Hyland counseled. Most are perfectly good alternatives to brand name drugs and can save you money. What’s more, your pharmacist can tell whether generics are reliable or “flimsy.” She estimated that 90 percent of the time, generic substitutes are viable and economical options.
What’s your responsibility as a patient? Make sure the prescribing doctor knows all of the prescriptions and over-the-counter medications, vitamins and supplements you take. And don’t forget to share that information — and your medical history — with your pharmacist as well.
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