Medication Safety

Overview

What Is It?

The first and most important step to use medications properly is to educate yourself about the specific drugs you and your family are taking and the conditions they are intended to treat.

Women typically are the safekeepers and managers of their families' health. Women often purchase their families' medications, take their children and sometimes their parents to medical appointments and frequently make most of the family health care decisions. If this describes your role, there is much to know about how to keep yourself and your family safe when using medication.

Chances are you have a cabinet full of medications—from over-the-counter (OTC) decongestants to prescription drugs you take for a variety of reasons. You may also have some herbal supplements, vitamins and minerals—even some expired medications and perhaps some prescription drugs you no longer use.

The U.S. Food and Drug Administration (FDA) has the final say as to whether a medication will be available by prescription only or OTC. The FDA establishes guidelines for use, which are required to appear on all labeling instructions, but the proper use of these drugs depends on you. Herbal products are regulated only as dietary supplements, but nonetheless, they must be treated as medications because they may have side effects or may interact with prescription medications. Therefore, they should be used as you would any other medication: carefully, correctly, with your physician's knowledge and with periodic review.

The first and most important step to use medications properly is to educate yourself about the specific drugs you and your family are taking and the conditions they are intended to treat. Here are basic guidelines for keeping you and your family safe while using medications safely and effectively.

• Always keep an updated list of all the medications (prescription, over-the-counter, herbal, supplements) you (or those you care for) take. Also list medications you are allergic to with an explanation of what happens when you take the medicine. Make this list available to all health care providers.
• Take all medications and supplements only as directed. Read and follow instructions on the label. Make sure the instructions include specific directions for taking the medication.
• Ask questions about your medications if you don't understand how to use it until you fully understand the answer.
• Take the correct amount of a medication. Do not take more or less than the label indicates. When giving over-the-counter medications, herbal agents or supplements to children, do not give adult doses or guess at the dose you should give them. Instead, read the directions carefully or ask your pharmacist or health care professional.
• Do not take medicine in the dark or without the benefit of wearing your glasses to read the label correctly.
• Do not use or share medications prescribed for someone else.
• Be aware that medications can interact with each other—even OTC and herbal medications. In addition, certain foods, like grapefruit and drinks (particularly alcohol), can interact with medications. Discuss all the medications you are taking with your health care professional or pharmacist to determine if any potential problems exist between the medications you are taking. Make sure to check all labels on your medication and read any safety information that comes with it.
• Never keep old medications and never self-medicate with prescription drugs when you think you know the nature of the problem.

Dispose of all expired medications properly and look through your medicine cabinet from time to time to make sure nothing in there has expired. The FDA offers the following guidelines for proper disposal of medications:

• Follow any specific instructions for disposal that are printed on the medication label or patient information. Do not flush the medication down the toilet unless the instructions specifically tell you to do so.
• If no instructions are included on the label or patient information, throw the medication into your household trash. But first, do the following:
  • Take the medication out of its original container and mix it with something undesirable, such as kitty litter or coffee grounds. This will make the medication less appealing to children, pets or anyone who may go through your trash.
  • Place the medication in an empty can, sealable bag or other type of container to prevent it from leaking or breaking out of a garbage bag.

Discussing Medication With Your Health Care Professional

When two or more drugs, herbal agents or supplements are mixed in the body, they may interact with each other and produce uncomfortable or even dangerous side effects. Your health care professional needs to know what medications and agents you take so he or she can help you avoid possible adverse drug interactions. This includes any prescription or OTC medications, supplements, herbal remedies or vitamins and minerals, even if it seems as minor as aspirin or sleep aids and even if you only take them occasionally. Make sure you mention, also, if you use birth control pills or other methods of hormonal contraception such as long-acting shots or implants. Even certain foods and drinks can interact with medications.

Some common examples of dangerous drug interactions include:

• blood-thinning medications (anticoagulants), such as warfarin, combined with aspirin.
• Anticoagulants also interact strongly with alcohol and certain foods.
• antacids combined with certain drugs for Parkinson's disease
• antacids combined with some heart disease medications

Remember, not all drug combinations are bad. High blood pressure, for example, is often treated with several drugs used in combination. Unless supervised by a health care professional, however, taking a mixture of drugs can be dangerous.

Ages and Stages: Special Medication Considerations for Women

When it comes to medication safety, pregnancy and breast-feeding require special consideration. So, too, do other stages of a woman's life and the lives of those she cares for. For example, some women find that hormonal fluctuations may affect how certain medications work or increase their need for medication. Headaches experienced premenstrually, for instance, may increase a woman's use of pain relievers. Using medication for children requires careful supervision. Age may also affect how medication works by affecting how it is absorbed. Also, as people age, they tend to use more medication for different conditions; drug interactions may become an issue. All these "life-stage" issues are important to be aware of and discuss with a health care professional.

Women who are considering pregnancy, are pregnant or are nursing should follow the basic guidelines for using medications safely, with a few additional precautions:

• If you are pregnant or trying to become pregnant, it's imperative that you let your health care professional know, because some drugs are dangerous to an unborn baby.
• If there is a possibility that you could become pregnant, ask about any potential side effects to you or your fetus from medications that you might be prescribed.
• If you are nursing, be sure to ask your health care professional if any drug or medication he or she is prescribing or recommending is safe for the nursing baby.
• Some drugs, including common antibiotics, as well as certain herbal remedies, can cause birth control pills to become ineffective, requiring that you use a second form of birth control. Be sure to ask your health care professional about this possibility so you won't be surprised by an unplanned pregnancy.
• Some drugs affect fertility, so be sure to tell your health care professional if you are trying to become pregnant.

Medication In-Hand

Before you leave your health care professional's office, make sure you know what the prescription is for and how it should be taken. You should also understand if there are major or common side effects. Then you can double-check these facts at the pharmacy. Make sure you can read the label at the pharmacy. Very often the information sheet provided with a prescription provides an exhaustive list of every side effect ever reported even though some may be very rare. If you are confused by the information provided, you should ask for help from your health care provider's office or from the pharmacist who gave you the medicine. In fact, you should always discuss with a pharmacist any questions or concerns you have when you purchase prescription or nonprescription medications, herbal agents or supplements.

If you believe you are experiencing side effects after you begin taking medications, contact your health care professional. Don't try to adjust your dosage, either to minimize side effects or save money. Finding just the right dosage is a fine science that requires teamwork between you and your health care team. It's also important not to stop taking a medication because you feel better without first consulting your health care practitioner.

If you or someone in your care is taking a lot of medication, consider asking your primary health care professional, the specialist who has prescribed the majority of your medications or your pharmacist to conduct a "brown-bag checkup" for you. This is a safety measure to ensure all the medications you are taking won't cause any potential problems and don't need to be adjusted to meet changing health needs. Here's how it works:

• Gather all prescription medications, over-the-counter drugs, herbal or natural products and vitamins or minerals you use, place them in a bag and take them to your health care professional and your pharmacist.
• Your health care professional will review all of them to ensure they are the same as those listed on your medical record; your pharmacist will double-check them against your pharmacy profile.
• They will screen them for potential duplication of therapies, side effects or interactions.
• They will ask you how you take each medication to ensure you fully understand the instructions.

Discussing Medications With Your Pharmacist

No other health professionals have as much training in prescription and OTC drugs as pharmacists. Be sure to tell your pharmacist about any prescription drugs you are taking, whether you purchased them at the same or a different pharmacy or by mail order. You should also mention any OTC medications or supplements you use.

If you are pregnant, nursing or plan to become pregnant, tell your pharmacist.

Before you leave the pharmacy, go over the dosing instructions with your pharmacist. Make sure you can read and understand the instructions. For example, if the instructions say, "take 5 mL," make sure you know what 5 mL is and use a special liquid dropper or oral syringe to make sure you take the right amount. Also ask your pharmacist what the concentration of the original prescription was supposed to be. For instance, your doctor should have written: 250 mg per 5 mL. Double-check that the concentration is correct.

If the bottle says, "take three times a day," find out if you need to take the medication at meal time, at three equally spaced times during a 24-hour period or at three equally spaced times during your waking hours. Most medications don't require you to take them in the middle of the night, but you should double-check to make sure.

While you're at the pharmacy, ask the pharmacist to open the bottle to see what the medication looks like. The pharmacist can help make sure the medication looks right. You should also look. If you've taken the medication before, does it look the same? If not, be sure to ask your pharmacist about it to ensure he or she didn't dispense the wrong drug. Sometimes the same drug may look different if it came from a different manufacturer. Also ask your pharmacist what the medication will do for you and make sure his or her answer makes sense. If you are filling a prescription to treat an infection, for example, but the pharmacist says the drug is for asthma, you'll know a mistake has been made. How could such a situation occur? Many prescription drugs have very similar sounding and looking names within one or two letters of each other.

A side effect is an effect other than that which a medication is intended to produce. Known side effects are listed in the labeling and the consumer information sheets. It is important to make sure you receive this information and read it very carefully and get help interpreting it if needed. An adverse reaction—as opposed to a side effect—is a harmful, unexpected and unintended response to a drug.

Ask your pharmacist or physician about any potential side effects or adverse reactions to the medication, as well as what you should do in case you experience any of them. Also ask the following:

• Are there side effects I should simply tolerate while continuing to take the medication? (Some side effects only occur when you start the medication, and then go away.)
• What side effects should make me stop taking the medication?
• When should I call my pharmacist or health care professional?
• When should I seek treatment immediately?

Ask your pharmacist what foods to eat or not eat with each drug; some drugs shouldn't be taken with certain foods. Some foods can make medications more or less powerful or interfere with your body's ability to absorb them. For example, drinking grapefruit juice while taking certain medications may increase blood levels of these drugs. Other drugs should be taken with a full glass of water. Finally, ask your pharmacist how you should store the medication; some drugs need to be refrigerated.

Ask your pharmacist about OTC medications as well as prescription drugs. Remember, just because a medication is available over the counter doesn't mean it is safe under every circumstance for every person. For example, many decongestants can raise blood pressure and be dangerous for those who already have high blood pressure. Your pharmacist can tell you when and how to take the medication and if it should alleviate the symptoms you are trying to treat. He or she also can look up your prescription drug record to make sure the OTC product won't have adverse interactions with any of the other medications you take. Try to use one pharmacy for all of your prescriptions so there is a complete drug record in one place.

Sometimes medications produce delayed, subtle or slowly evolving side effects or adverse reactions. When this occurs, it may even lead you to believe you are developing a new illness. So your awareness when taking medication must be continually maintained, and you should always discus with your health care provider any such symptoms or concerns.

Medication Safety in a Hospital

In spite of sophisticated computer ordering and dispensing systems, medication errors do occur in hospitals. Again, women need to be proactive in their health care and in their care of family members. You can take the following steps to reduce the risk of medication errors in the hospital:

• Take a specific list of prescription and OTC drugs you take and their dosages with you to the hospital so the health care professionals there can know what you are taking. (It's best to bring the actual medications; you can have a family member or friend take them home after the health care professional has seen them.) Also tell your health care professional about any illegal drugs you use, making sure he or she knows that the information is confidential.
• Make sure to tell your health care professionals about any allergies you have, even if the allergy is not to a specific medication but to a food, such as shellfish or peanuts, and the type of reaction you experience. Some tests use dyes or solutions that may have non-medicinal ingredients to which you are allergic, and some medicines may use ingredients to which you are allergic, such as eggs. Double-check with hospital personnel before you have any test or procedure that requires dyes or medications.
• Ask the person bringing your medication the name of each medication and the reasons you are taking it. Then, each time you are given a drug, make sure the hospital employee checks your identification. You can do this in a friendly and nonconfrontational way. If you don't remember your health care professional telling you about the specific medication, you need to ask questions to help ensure a mistake isn't being made.
• When you or a family member is ready to go home, have the health care professional or hospital pharmacist go over each medication with you, just as you would in a health care professional's office or pharmacy.

Ensuring Medication Safety at Home

Women need to remember drugs and medications affect people differently. What may work for your partner or friend may not work in the same way for you. Never take another person's prescription medications.

It's easy to make a mistake when you are busy or overseeing medication for more than one family member. Make sure instructions for each medication and family member are written down so you don't have to worry about remembering every detail. Ask your health care professional to write out a medications schedule you can sign when you take your medication. If you receive any conflicting or confusing information or instructions, contact your health care professional for clarification.

When you or a family member starts taking a new medication, watch for any side effects or adverse reactions. Some adverse reactions result from being allergic to a drug and can be so dangerous you should stop taking the medication and seek emergency medical treatment immediately. Serious adverse reactions and side effects include:

• hives
• difficulty breathing or swallowing
• convulsions and loss of consciousness

These can be the signs of anaphylaxis or anaphylactic shock—a sudden and sometimes deadly drop in blood pressure. Anaphylactic shock can potentially stop the heart or lead to complete closure of air passages, causing death by suffocation. So call 911 if you experience any of these symptoms.

Other non-life-threatening side effects are reasons to call your health care professional and your pharmacist. These side effects may be minor or common. If they don't bother you too much, the positive effects of the drug may outweigh them, in which case your health care professional may have you continue taking the medication. In other cases, your health care professional may want you to stop taking the medication or try a different dose or different drug. Keep track of any reactions and make sure your pharmacist enters the information into your file. Also be sure to mention the reactions to any health care professionals you see.

If you discontinue your medication because of uncomfortable side effects, notify your health care professional. Also, don't try to adjust the dose without telling him or her. For example, abruptly stopping certain medications can cause serious consequences such as extreme changes in blood pressure or heart rate. If you experience minor side effects and are advised to continue taking the medication, be careful in treating the side effect. Make sure the medication you take—such as an antacid for minor stomach upset—will not interact or interfere with any of the medications you take.

Keep your medications in their original packaging with the full instructions. In the case of OTCs, be sure to read the label and informational insert carefully to note any warnings or possible side effects, especially if you have a health condition such as diabetes, thyroid disease, high blood pressure or heart disease. If the condition for which you are taking OTCs doesn't get better—for example, if you have indigestion or pain for several days—you should contact your health care professional. Indigestion is a symptom that could be harmless, but it can also be a warning sign of a heart attack or other heart-related problem in women. Persistent indigestion and other gastrointestinal discomfort may also be a symptom of ovarian cancer. Any persistent symptom should be discussed with a health care professional.

It's also not wise to take an OTC for a condition you are experiencing for the first time. In such a case you may be guessing at what you have. For example, you should talk with or see a health care professional the first time you get a yeast infection, rather than trying to treat it yourself, to make sure your symptoms truly are associated with a yeast infection and not another condition.

Some other tips for safe and effective medication use include:

• Read the label every time you take the medication to prevent mistakes. This is especially crucial if you take more than one drug. Also, you might find that some OTCs have different directions from the last time you purchased them.
• Don't chew, crush or break any capsules or tablets or mix with a liquid unless instructed. Your body could absorb some long-acting medications too quickly if you chew or crush them. Other medications may be ineffective or could make you sick.
• If your health care professional prescribes a medication that only comes in one dosage that can be safely split and you only need one-half the dose, purchase a pill cutter or ask the pharmacist to split the pills. Pill cutters are inexpensive items that you can buy at your local drugstore. They make cutting pills easier, more even, and you won't lose the other half of the pill when it flies onto the floor!
• If a tablet or capsule is too difficult to swallow, ask if a liquid or dissolvable form is available. Or try these pill-swallowing techniques:
  • Take a deep breath before you swallow, which can help suppress your gag reflex.
  • Place the pill on the back of your throat, drink some water, tilt your chin down toward your chest and swallow.
  • Alternatively, place the pill on the tip of your tongue, drink some water, tilt your head back and swallow.
• If you are taking a liquid medication or giving one to your child, be sure to use the correct measuring cup or spoon. Some medications come with marked cups—keep them together with the medication and don't use the cup or dropper for a different medication. Also, don't use regular household spoons, which can vary greatly in size. Use an actual measuring spoon. Your best bet is to get a medicine spoon—or an oral syringe—at the pharmacy (often they are free) to be sure you measure the correct dose. Do not use a hypodermic syringe to draw the medicine up.
• Use a memory aid to help you take your medications at the correct times. For example, if you have to take your medication in the morning on an empty stomach, you might remember to take it when you brush your teeth every morning. If you take medications for long-term or chronic ailments, it may be beneficial to use an inexpensive medicine dispenser that you fill each week. You may also choose to track medications by marking a daily calendar or keeping a chart or log, either on paper or electronically.
• Forgetting to take your medication is not uncommon. Whether or not you should take a missed dose depends on the drug. In some cases, it may be appropriate to take the missed dose as soon as you remember. In other cases, it may be too close to the time you need to take your next dose. If you didn't get enough information on what to do in this situation from a drug-information sheet or from your pharmacist, call him or her for advice.
• Don't stop or change your dose for any reason—even if you are feeling better—without first talking it over with your health care professional. Otherwise he or she won't have all the information necessary to continue treating you effectively, and your care will be compromised.
• Keep medications in their original containers (except when using a medication dispenser) so you'll know what they are and how to take them. Keep medications out of direct sunlight and away from moisture. Also, be sure to store medications where children can't see or reach them. If you have children or children visit your home, you should keep your medications in a locked box or cabinet. Do not store your medications with household chemicals or cleaners, and don't store them in the same place you keep pets' medications. Also, don't store tubes of ointments or creams near your toothpaste—a mistake when grabbing quickly could range from unpleasant to serious.
• If you have difficulty opening your medications because they have child-resistant caps, you can ask your health care professional and pharmacist for a non-child-resistant cap. This should only be done if there are no children in the home or children (or grandchildren) visiting the home, and the prescription should be kept in the medicine cabinet. If you use child-resistant caps, make sure you tighten them when you're finished taking your medicine or a child could still get into your medication.
• Be sure to throw away any leftover prescription medications you are no longer taking. Also, monitor prescription and OTC "use by" dates and throw away expired ones; some drugs become toxic after the due date, while others simply lose their potency.

The FDA offers the following guidelines for proper disposal of medications:

• Follow any specific instructions for disposal that are printed on the medication label or patient information. Do not flush the medication down the toilet unless the instructions specifically tell you to do so.
• If no instructions are included on the label or patient information, throw the medication into your household trash. But first, do the following:
  • Take the medication out of its original container and mix it with something undesirable, such as kitty litter or coffee grounds. This will make the medication less appealing to children, pets or anyone who may go through your trash.
  • Place the medication in an empty can, sealable bag or other type of container to prevent it from leaking or breaking out of a garbage bag.

Keep a list of all the medications you use, even if you buy them all from the same pharmacy. You should record all of your personal medical information and responses to medications. Make a list of the medications, including:

• the name, the color and the imprint on each tablet or capsule
• the date of the prescription
• the dose or strength
• what it is for
• how much you take and how often
• how long you are supposed to take it
• any foods or other things to avoid
• likely side effects
• side effects you experienced
• the name and phone number of the prescriber
• the name and phone number of the pharmacy

Also list any OTC medications, vitamins, nutritional supplements or herbal products that you take regularly. Another good thing to add to the list is any medication or food allergies.

Buying Medications Or Supplements From Non-Pharmacy Sources

Everyone needs to be cautious when buying medications or supplements online or from non-pharmacy sources such as health stores or the grocery store.

While some Web sites offer great prices on prescription drugs, not all drug-dispensing sites are legitimate. You should be aware of the following when purchasing prescription drugs online:

• Purchasing medication from Web sites is risky. You may receive a contaminated or counterfeit product, a medication that has expired, the wrong product, an incorrect dose or no product at all.
• Getting a prescription drug by filling out a questionnaire without seeing a health care professional puts you at serious risk. You may end up with a drug that is unsafe for you or one that may not best treat you. Prescription drugs are regulated for a reason: They can be very dangerous if not used correctly.
• You can check the legitimacy of a U.S. drug-dispensing Web site on the VIPPS page (Verified Internet Pharmacy Practice Sites) at the National Association of Boards of Pharmacy Web site at www.nabp.net or by calling them at 847-391-4406.
• Only do business with Web sites that have an address and telephone number and that allow you direct access to a registered pharmacist to answer your questions. When you receive the medication, ask the site's pharmacist all the same questions you would ask your local drugstore pharmacist.
• Only purchase medications from Web sites that require a prescription from your doctor or other health care professional who is licensed to prescribe medications in the United States.

A Note about Purchasing Drugs from Foreign Countries

Purchasing drugs from foreign countries can be a dangerous gamble with your own health. But, it can be tempting since Canada and many other countries control prices of prescription drugs, and medications you use may be significantly cheaper there. However, you expose yourself to a number of risks when you purchase medications from foreign countries, including the following:

• Foreign outlets may distribute drugs that are expired, subpotent, contaminated or counterfeit.
• Drugs that come from outside the United States may contain a wrong or contraindicated product, an incorrect dose or inadequate directions for use.
• The labeling may not be in English and, therefore, important information on side effects and drug safety may not be available.
• Medications coming from overseas may not have been packaged and stored under the appropriate conditions.
• It is illegal to import unapproved, misbranded and adulterated drugs into the United States , including foreign versions of United States-approved medications.
• Overall, individuals who purchase prescription medications from foreign countries put themselves at risk of suffering adverse events, some of which can be life threatening.

Nearly every major pharmaceutical company has created free discount drug programs for patients below certain income levels. And supplemental insurance plans that provide additional coverage for Medicare beneficiaries usually offer prescription drug coverage.

In addition, when purchasing medications or supplements, including diet or energy pills:

• Remember, some people will say anything to make a sale. Don't fall for anyone's claims of a "new cure" for a disease or condition, a quick cure-all for a wide range of ailments or undocumented case histories showing "amazing" results. If there is any new cure or medication for your disease or condition, your health care professional will tell you about it. Feel free to ask him or her about these claims. Be cautious of Web sites that use impressive-sounding terminology to disguise a lack of good science or those that claim the government, the medical profession or research scientists have conspired to suppress a product.
• Don't be taken in by claims that the medical community or government has conspired to keep a product out of your reach.
• Before you take any new medication or supplement for the first time, be sure to ask your health care professional about it.

Weight-Loss, Energy Supplements And Herbal Remedies

If you are having problems with your weight, energy level or mood, you should turn to your health care professional for help. First, you may have an underlying medical condition that requires treatment. Even if this is not the case, there are many ways in which your health care professional can help. There's no need to be embarrassed about any of these very important health issues or any other concerns you might consider addressing yourself by using supplements or herbal remedies.

While they are safe for the most part, unregulated "natural" supplements such as ephedra, also known as ma huang, can be dangerous; in fact, many of these have been linked to very serious illness and even death in some people. A risk associated with ephedra is its potential for raising blood pressure, which is a major cause of serious problems associated with this herbal supplement.

Also, if you begin taking these potentially dangerous supplements, chances are you are doing so without checking their potential impact on or adverse interactions with any other medications you use. In general, keep in mind that herbs and supplements are not regulated, and manufacturers are not required by law to back claims with thorough testing or clinical trials.

The fact is you simply shouldn't try to diagnose yourself. But the availability of these "miracle" supplements encourages some people. While some herbs or supplements can be safe, if they are not applicable to your underlying health issues, using them can be not only a waste of money, but dangerous.

Facts to Know

1. Taking certain combinations of medications can either cause dangerous side effects or affect the potency of one or more of the drugs.
2. If you don't take drugs correctly—at the right time of day or with or without food, for example—the medications may not work as well as they should. Follow instructions on the label and from your health care professional.
3. A side effect is a recognized effect other than that for which the medication was intended. Even if you take the medication correctly and carefully, medications can cause side effects, from minor to serious.
4. An adverse reaction is an unpredictable reaction to a drug (many side effects are known to be associated with a drug and are listed on label). An example of a serious adverse reaction is a drug allergy that may cause breathing difficulties, convulsions, high fever or other symptoms of anaphylactic shock, which can lead to death if not treated immediately.
5. Some common examples of dangerous drug interactions include anticoagulant medications combined with aspirin; antacids combined with certain drugs for Parkinson's disease; and antacids combined with some heart disease medications.
6. Some of the most common and innocuous drugs can have an adverse effect on an unborn or nursing baby. Be sure to tell your health care professional and pharmacist if you are pregnant, nursing or plan to become pregnant. Also, don't take any medication, supplement or herbal remedy without first clearing it with your health care professional.
7. Some medications can reduce the effectiveness of birth control pills and other hormonal methods of birth control, such as shots and implants, requiring the temporary use of another form of birth control. Be sure you ask your health care provider if any prescription or over-the-counter (OTC) drugs you're taking could affect how well your birth control works.
8. Free samples of prescription or OTC medication your health care professional may give you or provide for your child are handy, but they rarely include dosing instructions. It's easy to forget when you get home if you're to take two tablets every six hours or one tablet every four hours. Be sure to write down all dosing instructions and tape or staple them to the sample containers. Also be sure to ask about any potential side effects and interactions with any other medications you're taking. Share your drug list with your health care professional so he or she is aware of the medications you use. Because you are not filling the prescription, there is no opportunity to check via the computer for potential drug interactions as a pharmacist would do.
9. Many drugs have similar sounding or looking names, which can lead to confusion at the pharmacy. Did the health care provider write Prozac or Prilosec? The pharmacist may think she can interpret the handwriting, but the best way to avoid a potentially dangerous guess is to have your health care professional clearly write on the prescription what the drug is to be used for.
10. Drinking grapefruit juice while taking certain medications may increase blood levels of those drugs, which can be dangerous.

Questions to Ask

Review the following Questions to Ask about medication safety so you're prepared to discuss this important health issue with your health care professional.

1. What is the name of this drug and what is it designed to do?
2. What is the dosing schedule and how do I take it?
3. What should I do if I forget a dose?
4. What side effects should I expect?
5. When should I contact you regarding side effects?
6. 6. How long will I be on this drug, and how should I store it at home?
7. Should I take this drug on an empty stomach or with food? Is it safe to drink alcohol with this drug?
8. If it's a once-a-day dose, is it best to take it in the morning or evening?
9. Will this drug interact with any other medications or supplements I'm taking?
10. Does this replace anything else I'm taking?

Key Q&A

Organizations and Support

For information and support on Medication Safety, please see the recommended organizations and Spanish-language resources listed below.

Center for Medical Consumers
Website: https://medconsumers.wordpress.com/
Address: Center for Medical Consumers
239 Thompson Street
New York, NY 10012
Phone: 212-674-7105
Email: medconsumers@earthlink.net

Consumer Healthcare Products Association
Website: https://www.chpa-info.org
Address: 900 19th Street, NW, Suite 700
Washington, DC 20006
Phone: 202-429-9260
Fax: 202-223-6835
Email: sdibartolo@chpa-info.org

Institute for Safe Medication Practices
Website: https://www.ismp.org
Address: 200 Lakeside Drive, Suite 200
Horsham, PA 19044
Phone: 215-947-7797

National Association of Boards of Pharmacy
Website: https://nabp.pharmacy/
Address: 1600 Feehanville Drive
Mount Prospect, IL 60056
Phone: 847-391-4406
Email: custserv@nabp.net

National Council on Patient Information and Education
Website: https://www.bemedwise.org/
Address: 4915 St. Elmo Avenue, Suite 505
Bethesda, MD 20814
Phone: 301-656-8565
Email: ncpie@ncpie.info

Pharmaceutical Research and Manufacturers of America
Website: https://www.phrma.org
Address: 950 F Street, NW
Washington, DC 20004
Hotline: 202-835-3400

United States Food and Drug Administration (FDA)
Website: https://www.fda.gov
Address: 5600 Fishers Lane
Rockville, MD 20857
Phone: 1-888-INFO-FDA (1-888-463-6332)

U.S. Pharmacopeia
Website: https://www.usp.org
Address: 12601 Twinbrook Parkway
Rockville, MD 20852
Hotline: 1-800-227-8772
Phone: 301-881-0666

Spanish-language resources

FDA Brochure, Spanish Version: Buying Prescription Medicines Online: A Consumer Safety Guide
Website: https://www.fda.gov/Drugs/DrugSafety/ucm263010.htm
Address: Food and Drug Administration
10903 New Hampshire Ave.
Silver Spring, MD 20993
Hotline: 1-888-INFO-FDA (1-888-463-6332)
Phone: 1-800-422-6237 (NCI)

Medline Plus: Drug Safety
Website: https://www.nlm.nih.gov/medlineplus/spanish/drugsafety.html
Address: Customer Service
8600 Rockville Pike
Bethesda, MD 20894
Email: custserv@nlm.nih.gov