Americans take way too many medications. They mix and match with barely a second thought.

Researchers found that 81 percent of older adults took prescribed drugs. More than half “used 5 or more prescription medications, over-the-counter medications, or dietary supplements” (Journal of the American Medical Association, Dec. 24/31, 2008).

Some combinations are potentially dangerous, if not lethal. We often hear from readers of this column concerned about their relatives:

“My mother is 85 and under the care of an internist, a cardiologist and a neurologist. She has almost no energy and is quite depressed. She takes: Aldactone, atenolol, Crestor, Diovan, hydrochlorothiazide, Lexapro, Miacalcin, Neurontin, Nexium, Nitro-Dur, Norvasc, Plavix, Rhinocort, Synthroid and tramadol. In addition, she takes Aleve for arthritis pain and aspirin twice a day as needed.”

Counting the OTC pain relievers, this woman is taking 17 different drugs. Some combinations could be life threatening. Taking aspirin, Aleve and Plavix together could increase the risk of hemorrhage, including bleeding ulcers. Perhaps that is why the internist prescribed the acid-suppressing drug Nexium. The trouble is, Nexium and similar medicines may undo the vascular benefits of Plavix.

Aleve can increase drowsiness resulting from Neurontin and reduce the effectiveness of atenolol to lower blood pressure. There are other potential interactions, but the point is that three specialists each prescribed medicines that may not play well together.

This is not an isolated case. Many elderly people have several health conditions and see a range of experts.
Another woman was worried about her sister who is taking two antidepressants: Prozac (fluoxetine) and Zoloft (sertraline) plus a sleeping pill (Ambien). In addition, she takes Tegretol (carbamazepine), atenolol, Lipitor, Zantac and several more drugs for high blood pressure and diabetes. Is it any wonder that this woman is drowsy, weak, unsteady on her feet and has breathing problems?

One of the findings of the recent study is that older adults often add over-the-counter drugs and dietary supplements to their prescription medications. They might not realize that pain relievers like aspirin or Aleve can cause mischief with prescribed medications.

Some years ago we heard from a retired judge who took enalapril to control his blood pressure. It worked well until he started taking coated aspirin for back pain. Then his blood pressure soared to over 210/90.

Physicians and pharmacists are so busy these days that they may not take time to look up every possible drug interaction. That is why people have to look out for themselves and each other.

We include a Drug Safety Questionnaire in our Guide to Drugs and Older People. This can prompt a conversation about incompatible drug combinations with both the doctor and pharmacist.

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  1. Grannyvee
    Tennessee
    Reply

    I am taking the following prescriptions: Anastrozole, Zetia, Clopidogrel Bisulfate, Pantoprazole Sod, Losartan, Sertraline Aspirin 81 mg. One tablet each day. I have terrible fatigue and weekness. Have fainted twice this year. I get light headed frequently. Might any of these medications be causing my problem?

    I also take the following supplements: B 12, Folic Acid, D3, Magnesium Citrate.

  2. John
    Texas
    Reply

    Well what are the consequences for the Dr. and the pharmacist if I die b/c of their neglect? Is there a self help forum somewhere that can help. Drs. and druggists are human and some don’t give a damn.

  3. Tova
    Reply

    Doctors are too busy to look up interactions ????
    Really?
    That’s their job, but I did it for my cardiologist today and the arrogant SOB got crappy towards me and told me to just take the atenolol even though my heart is FINE.
    I tried to let him know I’m not doing well with this and every and all side effects are awful and I have them all!
    He didnt care. He actually got up and walked out and said see ya in a year!

  4. WJG
    Reply

    Many people do not realize that Motrin can deplete the sodium in the body as a possible side effect. I had this occur a few years ago with near fatal results yet this possible side effect is barely mentioned.
    I am also having quite an experience with Aleve at the moment. I have high blood pressure which is controlled normally, but after several days on Aleve my BP has soared so now I have quit hoping it will normalize as the medication works out of my system.
    PEOPLE’S PHARMACY RESPONSE: PROBABLY MOST DOCTORS ARE NOT AWARE OF HYPONATREMIA (SODIUM DEPLETION) AS A SIDE EFFECT OF IBUPROFEN. HERE’S THE FIRST MENTION WE COULD FIND, BUT THERE ARE NOT MANY OTHERS: http://www.ncbi.nlm.nih.gov/pubmed/7209292

  5. JCD
    Reply

    I’m taking 6 different meds,
    Protonix, Isosorbide, Furescimide, Metprolol, Warfarin, and Crestor. I know that they are affecting me adversely, but my doctor seems too busy to sit with me and discuss this. Who can I turn to, to discuss this?
    PEOPLE’S PHARMACY RESPONSE: IT IS THE DOCTOR’S RESPONSIBILITY TO MAKE TIME TO DISCUSS THIS WITH YOU. MAKE AN APPOINTMENT WITH THE DOCTOR OR WITH THE PHARMACIST.

  6. Aurica
    Reply

    My husband is 92. He is taking Prozac plus several other meds for heart and blood pressure. He is easily agitated, angry, verbally abusive and a few times has thrown things. I was told Prozac can cause this condition.

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