Published July 24, 2014 (revised March 19, 2015; December 31, 2024)
When it comes to medicines, you may already know how essential it is to exactly follow the instructions provided by your healthcare provider or directions on over-the-counter (OTC) Drug Facts labels. But you may be overlooking some habits or beliefs that can keep you from getting the full benefit of your medicines or cause you to risk your health and safety. See if any of these common medicine missteps apply to you.
Misstep #1: Keeping medicines in your bathroom medicine cabinet. The irony of a "medicine cabinet" is that it is the worst place to keep medicines because the heat and humidity from bathing can break down the medicines and make them less effective. Medicines should be kept in a cool, dry, and secure area, up, away, and out of reach of children.
Misstep #2: Basing a child's dose of an OTC medicine on the child's age, not weight. Children metabolize (break down and absorb) medicine differently based on their weight, not age. So, weight-based dosing is more accurate than age-based dosing. This is especially important for children who are overweight or underweight for their age. Your child may be in the upper percentiles for weight for his age and need more medicine than a child on the thinner side. Always ask your child's doctor or pharmacist about the proper dose of an OTC medicine if your child's weight is higher or lower than what's listed for the corresponding age category on the label. Your child's doctor should factor in your child's weight when prescribing medicines.
Misstep #3: Taking daily low-dose aspirin at the same time you take daily ibuprofen or naproxen. Low-dose aspirin (81 mg) can help protect the heart from clots because it reduces the clumping of platelets that can block an artery. This effect happens because aspirin sticks to an enzyme called cyclooxygenase. However, ibuprofen and naproxen also stick to cyclooxygenase. If they get to the enzyme first, there is no room left for the aspirin to adhere. If you only take ibuprofen or naproxen occasionally, it does not cause a problem. But if you take them regularly, take your aspirin at least 30 minutes before or 8 hours after taking ibuprofen or naproxen.
Misstep #4: Taking your vitamins in the morning and then skipping breakfast. Vitamins are classified as either water-soluble (vitamins B and C) or fat-soluble (vitamins A, D, E, and K). Fat-soluble vitamins require dietary fat from a meal to be absorbed properly in the body. The dietary fat carries the fat-soluble vitamins through the intestine, into the bloodstream, and to the liver where they are both stored until needed. Without dietary fat, the vitamin would not reach the liver. So, if you take your multivitamin in the morning and tend to skip breakfast (or eat a totally non-fat breakfast), eat a few raw almonds (or other fat-containing snack) afterwards to ensure proper absorption.
Misstep #5: Taking St. John's wort when relying on birth-control pills or contraceptive implants to prevent pregnancy. St. John's wort is a common herbal mood-boosting medicine. But the herbal can increase the breakdown of estrogen, which is found in many brands of contraceptives, and allow breakthrough bleeding and unintended pregnancies. Women using a hormonal contraceptive should not take St. John's wort or should use a back-up form of birth control.
Misstep #6: Taking too much medicine. Overdoses of medicine are the number one cause of medication-related deaths in the United States according to the US Food and Drug Administration (FDA). The most deadly overdoses have occurred with prescription drugs that are often abused, such as Percocet (oxycodone and acetaminophen), Xanax (alprazolam),and Adderall (dextroamphetamine and amphetamine). But overdoses of OTC medicines have also been linked to deaths. Medicines should be taken only as directed on the prescription or package label, unless specifically recommended otherwise by your healthcare provider.
Misstep #7: Confusing medicines with one another. Medicines frequently have look- or sound-alike names that are easy to mix up. Frequently confused medicines include:
Be sure medicines are clearly labeled, and separate the storage of those with names that look or sound alike. Reading the leaflet that comes with prescription medicine, or reading the Drug Facts label on OTC medicines, can help detect a mix-up because most look- and sound-alike medicines are used for different purposes. If the usual purpose of the medicine doesn’t apply to you, have the pharmacy check that the medicine matches the prescription. If a prescribing mix-up seems possible, you or the pharmacist should also call your healthcare provider to verify that the prescribed medicine was the one actually intended
Misstep #8 : Medicines interacting with one another. Some medicines should never be taken together because they can interact with each other in ways that alter their effects. These interactions can be dangerous, even deadly on rare occasions. The potential for a serious interaction is heightened for older people, who frequently take 5 or more prescription medicines daily, often ordered by different doctors. It is important to keep a current list of all your prescription and OTC medicines. Review the list with every doctor at each visit, and provide it to your pharmacist. Pharmacy computers will often detect medicines that interact and alert the pharmacist, who can then call your doctor to discuss a possible prescription change.
Misstep #9: Food and drug interactions. Similar to drugs interacting with each other, certain foods or beverages can prevent some medicines from working appropriately. For example, grapefruit juice affects how certain medicines are absorbed in the body or changed so they can be eliminated. Allegra (fexofenadine) interacts with not only grapefruit juice but also with apples and orange juice. Or mixing antihistamines, acetaminophen, or non-steroidal anti-inflammatory drugs with alcohol can cause extra drowsiness or liver damage.
Misstep #10: Wrong route of administration. According to the FDA, 16% of medicine errors in the home involve taking the medicine by the wrong route of administration. For example, a person may swallow a tablet whole instead of letting it dissolve under the tongue as directed. Or someone may put ear drops in the eye, or swallow a liquid product intended to be applied to the skin. Again, it is important to read and follow the directions on all prescription and OTC medicine labels
