Americans love to plug and play. Reading instructions takes time and is incompatible with our fast paced life.

Does anyone bother to read the instruction booklet that comes with a cell phone? Most people just want to hit the buttons and talk.

When it comes to prescriptions, all most folks want to do is pop the pills. Reading the stickers on the bottle may seem like a waste of time.

Even if you want to be a conscientious consumer and take your medicine correctly, the label that is stuck on your prescription medicine container can be awfully hard to read. You might need a magnifying glass to make out the small print.

A recent study of prescription drug containers found that the warnings and instructions, which might be considered among the most important information on the label, were in the smallest type (Archives of Internal Medicine, Sept. 10, 2007).

The warning stickers were often slapped on the bottle haphazardly in a different direction from the rest of the label, making them hard to read.

The researchers had doctors in four different cities write identical prescriptions for Lipitor, Fosamax, Bactrim and ibuprofen. They were filled in six different pharmacies in each city.

There was a huge variability between pharmacies, especially with regard to warnings and instructions. For example, only 14 of the 24 bottles of the osteoporosis drug Fosamax had directions that the patient should not lie down for at least 30 minutes after swallowing the pills. This instruction is critical for preventing serious injury to the esophagus.

In the case of the pain reliever ibuprofen, only 15 percent of the bottles cautioned patients to avoid aspirin. Fewer than a third warned that this drug can cause drowsiness or dizziness. A medication guide required by the FDA gives more information on the safe use of ibuprofen, but not a single prescription for this anti-inflammatory drug included it.

It should be obvious that a small pill bottle is not the optimum way to transmit critical information about the correct use of medicine. The researchers observe that patients should be counseled more completely by doctors or pharmacists, but in practice this rarely occurs.

One way to get this essential data is to ask for it. Have your physician and pharmacist fill out a detailed checklist for each medicine you take. We have created a Drug Safety Questionnaire you can give to your health professionals to organize this information. It is available for free at
Over-the-counter medications also pose a problem. Although the FDA specifies warning information for many nonprescription drugs, it too is frequently hard to read. Perhaps that’s why a previous study found that very few consumers—less than 20 percent—actually read the instructions on the labels of OTC pain relievers like ibuprofen or naproxen (Journal of Rheumatology, Nov. 2005). As a result, nearly half of those questioned took too high a dose of these medications.

It’s time for people to take their medicine seriously. Over a million medication errors occur each year, leading to serious illness, disability and death. Clear and complete information could save lives.

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  1. Miriam Murdock

    One more point about Fosamax in addition to not lying down for at least 30 minutes after taking Fosamax; you must also, after at least 30 minutes, EAT SOME FOOD before lying down, to prevent serious damage to your esophagus.
    I have taken Fosamax for years & happily find that it has strengthened my fingernails & made my teeth less prone to decay.

  2. Sheila Anne

    I just read the article about too small print on prescription bottle lables. AMEN to that! I have to get out reading glasses to be able to read the scant/scarce warnings provided.
    Another point in your article was that ibuprofen and aspirin should not be taken together (I have heard this warning for years) yet one very famous brand of pain reliever (in different versions of migraine relief, back pain relief, etc.) is a combination of these pain relievers plus caffeine! Some might have a slightly different version, but it seems to me that IF this combination of pain relievers IS warned against, WHY can they be bought together in a pill?

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