Harvard Women's Health Watch

Protect yourself from medication mix-ups

Being vigilant about what youíre taking can reduce your risk of a harmful drug reaction.

Thereís an old expression that the cure is sometimes worse than the disease. That rings true when it comes to a common problem in health care ó medication errors.

Medication mix-ups and mistakes sometimes lead to harmful drug reactions, which cause about 700,000 emergency department visits and 100,000 hospital admissions each year, according to the Agency for Healthcare Research and Quality.

Sometimes these errors happen because the patient gets the wrong drug ó or the wrong amount of the right drug, says Dr. Gordon Schiff, associate professor of medicine at Harvard Medical School and associate director of Brigham and Womenís Center for Patient Safety Research and Practice. In other instances, a medication interacts adversely with another drug that the person is taking.

In truth, medication errors are common, and they take many different forms. Your risk of experiencing an error goes up as you age, because youíre more likely to be taking multiple drugs, sometimes prescribed by different doctors.

How to avoid medication missteps

If a handful of pills is part of your daily health regimen, you might want to add a dose of vigilance to the mix. Some simple strategies can help you prevent the most common medication errors, including the following:

Error No. 1: Wrong medicine, wrong dose. One out of every 1,000 prescriptions filled is for the wrong drug or the wrong dose, says Dr. Schiff. ďBased on those numbers, it may sound like itís a relatively rare problem,Ē he says. But when you consider that American physicians write some three billion prescriptions each year, the number of these mistakes becomes far more concerning. This type of error might involve the doctor or pharmacy mixing up one drug for another with a similar name, miscalculating the dose, or writing milligrams instead of micrograms.

The fix: While a provider, not you, typically makes this type of error, you can help reduce the likelihood that it will affect you by speaking up and asking questions. Clarify the purpose of the prescription and the recommended dosage. If your daily pill looks different when you pick up a refill, check to make sure you got the right drug. If your pharmacy offers consultations with a pharmacist when you start a new medication, take advantage of the opportunity to discuss the drug and how to take it properly.

Error No. 2: Drug interaction problems. This type of error occurs when one medication youíre taking interacts badly with another, causing potentially serious side effects. Risk factors for this type of error include taking multiple medications and getting prescriptions from different providers. In some instances, itís not a medication but a food or a supplement that interacts with the drug.

The fix: To prevent a drug interaction problem, keep an updated list of your medications and share it with your doctor, says Dr. Schiff. Be sure that your list includes any supplements, herbal treatments, or over-the-counter products you take.

Error No. 3: Failing to recognize side effects and allergic reactions. ďPatients should be educated to be on the lookout for certain symptoms,Ē says Dr. Schiff. For example, if a woman is taking birth control pills, she may be at higher risk for stroke and should be told to contact her doctor if she experiences a sudden and severe headache, he says.

The fix: If your doctor doesnít bring up drug side effects, ask him or her these questions:

  • What side effects should I watch for?
  • Are there certain symptoms that should prompt me to get emergency care or to call you?

And if youíre wondering if a symptom could be a side effect of a drug youíre taking, donít hesitate to call your doctor or pharmacist and ask.

Error No. 4: Continuing to take medication you donít need or taking duplicate medications, which sometimes happens if a patient is prescribed both generic and brand name versions of the same drug.

The fix: Know why you are taking each drug and what itís intended to treat. Dr. Schiff says he wants to see clear description of what condition each medication treats added to all drug labels to help identify problems quickly. For example, if a woman sees her medicine treats gout and she hasnít suffered from an attack of gout for years, she would be more likely to ask her doctor if she still needs that medication. If she didnít have gout at all, the label would alert her that she got the wrong medication.

Error No. 5: Assuming that over-the-counter medications are always safe. ďThe most worrisome drugs are often the ones you donít worry about,Ē says Dr. Schiff. For example, acetaminophen, a common pain reliever sold under the brand name Tylenol and used in many combination remedies, is a leading cause of liver failure when taken incorrectly, says Dr. Schiff. Other common over-the-counter medications, including those for arthritis pain or stomach acid suppression, can, at times, also cause serious health risks.

The fix: Be certain when taking a medication or supplement to carefully read the label, including dosage guidelines and potential risks.

Error No. 6: Thinking pills are the best or only solution.

The fix: Ask your doctor if the medicine is necessary or if there is a nondrug alternative that might help your condition, such as physical therapy.

Speaking up about medication use can help you ensure that the medicines you take truly protect your health.

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