girl with cold, this year's flu

It is far too easy to assume that an over-the-counter medication won’t cause any trouble. After all, you don’t even need a prescription for it. How risky could it be?

Unfortunately, the answer might be far too dangerous if it is combined with other medicines. One family wrote to us about a tragedy:

Q. My daughter passed away ten days before Christmas last year from taking OTC cold medicine with her prescription pain medication. She stopped breathing in her sleep and was long gone before anyone knew. I urge people to take great care with what they put into their bodies, especially if they are on prescribed meds. There could be a deadly drug interaction.

Doctor Failed to Check Her Symptoms:

She had been to the doctor the day before complaining about trouble breathing, and he was in such a hurry he told her she was just getting over a cold and would be OK. The autopsy showed one of her lungs was nearly twice the size of the other one and filled with fluid.

If you feel your doctor is not hearing you, MAKE yourself heard. Be persistent in communicating your problems. Our precious daughter was the light of my life. If one person can be helped by her story, I will be satisfied.

OTC Drug Interactions with Prescription Medicines:

A. As your tragic story illustrates, OTC drugs can interact with prescription medications. People don’t always realize that they should check on a possible drug interaction, since OTC products are often thought of as innocuous.

You don’t say which pain medicine your daughter was on, nor which cold medicine she took. Both prescription pain relievers and OTC cold medicines may contain acetaminophen, which could lead to an overdose of this common drug. Other dangerous interactions are also possible.

Be Persistent about Diagnosis:

Patients need to be persistent if a doctor is not addressing their health concern. A recent report from the Institute of Medicine estimates that missed or incorrect diagnoses account for one out of ten deaths in hospitals. In the outpatient setting an estimated 12 million Americans are misdiagnosed each year (New England Journal of Medicine, online, Nov. 11, 2015).

It is always prudent for a patient to ask, “What else could it be?” To help others avoid drug interactions and missed diagnoses, we offer our book, Top Screwups Doctors Make and How to Avoid Them. It contains questions to ask and actions to take to stay safe. Don’t let anyone in your family suffer a misdiagnosis or a deadly drug interaction.

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  1. Cindy B.
    Reply

    It’s unfortunately true that many OTC drugs do have negative side effects or interactions with other meds. When I had my atrial fibrillation (now thankfully fixed), I was warned not to take OTC cold formulas or even homeopathics. “What?!” said I, certain that at least homeopathics could present NO such negatives. But I dutifully set out to do some research on the topic, and my eyes were opened!

    I was mainly looking for heart stuff, but I’m sure there are other types of reactions as well; anyway, many OTC meds do in fact have the ability to exacerbate an irregular heartbeat, or even CAUSE one over time (as in the case of NSAIDS like Aleve or Advil…) Needless to say, I’ve never taken another NSAID, and now I just basically don’t trust anything — especially if it’s a “compound” targeting many different symptoms, such as in cold formulas. Better safe than sorry.

  2. Rick
    A parallel to this column's topic
    Reply

    While not dealing with OTC meds, this submission is to tell you of a parallel situation involving the youngest of our 5 children, who was tolerating bouts with seizures. She had been on a daily regimen of felbatol / felbamate for a number of years. She told us that said med kept her seizure-free for long periods of time, implying that the med was working reasonably well for her.

    About a year ago she went to our G.P. / PCP for an annual checkup, where it was discovered that her blood pressure needed some control. The PCP prescribed Lisinopril HCTZ 10-12.5 mg.

    After taking the combination for some months, she told my spouse that she had reported to the PCP that she suspected her meds combination was aggravating her weakness for seizures, when the Lisinopril was added. As my spouse relates it, the PCP told our daughter to continue with the full regimen. (In other words, he poo-pooed / ignored her concerns.)

    About mid-September of 2015, she had a car accident wherein she hit the rear end of a stopped car; I suspect that she was having a seizure while driving. (She was out of state and did not tell us of this incident, so I can only guess that’s what happened. She was not a ‘devil-may-care’ driver.)

    On October 4, 2015, she suffered yet another seizure at the house of an (out of state) acquaintance. Paramedics were called; she was rushed to the nearest hospital. (I was told she had additional seizures on the way to the hospital.)
    God called her home that night, at age 40 years 11 months.

    I agree with the Graedons. DO NOT ACCEPT a doctor’s lackadaisical attitude when you feel sure something is not right. PUSH for a better concern and answer and remedy, if one is needed. As the Graedon’s wrote, “Be persistent if doctors aren’t addressing {your / the patient’s] concerns.”

  3. tony
    thailand
    Reply

    I have a drug intereactions checker on my smartphone. It has a stored list of my current medications. Before I take any new ones I add it to the list and then the check for intereactions

    • John
      Reply

      My wife is on a multitude of medications. we always use the drug interaction checker and find many MAJOR interactions, and some minor ones as well. When we do, we question the doctor and pharmacist, and if they are okay with the combo, we ask what side effects to look for. We also use the interaction checker if we need to use an OTC or make a change back to an older drug. I would also recommend reading user reviews. Some people obviously don’t follow directions or post side effects before giving them a chance. But if, for example, many people complain of gaining 40 lbs, it is easier to understand and compare to another drug that has many people complaining of gaining 5lbs.

    • Linda
      Eagle River, WI
      Reply

      How do you get the drug interactions checker?

      • Terry Graedon
        Reply

        You could log in to MediGuard.org, set up a (free) account and enter your drugs.

  4. Sherry
    Waxhaw, NC
    Reply

    This is why so many OTC drugs are dangerous in the hands of consumers who believe that since they are for sale on the drug store shelves, it is safe to take. Many drugs that once needed prescriptions are now OTC. Very bad move for people, great move for shareholders of drug company stocks!

  5. DrTom
    Houston
    Reply

    I appreciate the mother wanting to help others from her experience, but there is more at work here. It is extremely rare for an otherwise healthy young individual to have an entire lung “whited out.” The doctor should have listened to both lungs because in the absence of an x-ray, there would be NO breath sounds from the whited out lung.

    This is an absolutely fundamental property of using a stethoscope. If only half the lung was whited out, there should have been absent lung sounds from the parts of the lung that were whited out. This is why the doctor applies the stethoscope in numerous different places representing listening to different parts of the lung.

    Because the lung was whited out, this means that there was a SEVERE infection (or something else that is much less common). This means that she was only using one lung, so the “respiratory depression” from combining pain medication and and OTC preparation was sufficient to cause her demise but then so was the infection as a combination of all of these factors.

    Even though it will not bring her daughter back, I hope that she has looked into a malpractice case as a way of teaching others that they must NOT fail to do even the most basic clinical exam that would have shown the problem even though an x-ray was not taken. Nobody likes lawsuits, but they are sometimes helpful to show others what not to do. No jury would side with the doctor in this type of case.

  6. Virginia
    Portland, OR
    Reply

    Thank you so much for this information. I will be sharing it with my daughter and others.

    • Mon C
      Australia
      Reply

      Be PERSISTENT, even though I didn’t have OTC medicine I had a NASTY cold, Doctor thought it was bronchitis and prescribed antibiotics. I got worse, much worse, another doctor put me straight into hospital. Lung Specialist send me for Chest X-ray which came back CLEAR and he said:-” Ah well, at least there is no problem there but we keep you in hospital over the weekend and give you MORE antibiotics!”

      The next day I was worse still, so he put me on steroids, two days later I told him to take me OFF the steroids, my hands were shaking and I had more trouble breathing.
      He then ordered a CT with contrast for the next day, I was no sooner back in my room and he came and told me I was very very sick. I had Bilateral Pulmonary Embolism, both my lungs were FULL of large blood clots, an Echocardiogram showed that large clots had gone thru my heart and stretched the right Ventricle. I was then told I “should be dead” or had a massive heart attack or stroke.

      I was in hospital for 2 weeks and because the clots were idiopathic I have to be on Warfarin for the rest of my life.
      If YOU feel the Doctor’s verdict is NOT right, ask for more tests or go to another Doctor or Hospital.
      My heart goes out to the Mother who lost her beloved daughter, I would seek LEGAL ACTIONS straight away, it won’t bring the daughter back, but it might be a “wake-up” call to some “busy” doctors.

  7. Marianne
    GA
    Reply

    Somehow the message is not getting across to people not mix certain drugs. During cold season prehaps docs need to post it in large letters or have large interactive screens flashing warnings to people about not mixing prescription meds & over the counter pain med., etc. Pharmacies could help as well making it a point to read the warning to the patient when they pick of the prescription.

  8. Jean
    NC
    Reply

    My sister passed away at age 38 from taking Ceclor. She had a sinus infection that her doctor insisted this drug would address. She subsequently developed lung failure. The autopsy revealed vasculitis and drug induced Lupus. Ceclor was slowly killing her. You have to advocate for yourself and loved ones.

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