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Very unfairly, some of us experience multiple long-term health conditions at the same time. Often this also means taking many different medications every day to...
Very unfairly, some of us experience multiple long-term health conditions at the same time. Often this also means taking many different medications every day to manage these conditions. Now on the one hand we are fortunate in modern medicine to have so many medicines at our disposal and each one targets a specific symptom or disease. However, this presents a new medical challenge as many of these medicines can affect the way another medicine works. This could increase your risk of side effects or make other treatments less effective. Here at Meds for Less we believe that having a better understanding of how medicines or treatments interact can support you to safely and effectively manage medical treatment for several long-term health conditions.
Polypharmacy is the term clinicians use to describe the situation when a one patient is using five or more medications every day. Sometimes, if there are several long-term health conditions to manage, taking more than five medicines a day may be the optimal treatment for that patient’s quality of life. In other cases, patients may be taking more medicines than they need or taking medicines that are no longer suitable for them. Problematic polypharmacy does not only have to be from a medical perspective, social factors are equally important to consider. This would include thinking about how manageable a treatment is for example: Is the person able to take the medication three times a day? Does this person have carers to help make sure medication is taken on time and consistently? Are there any cognitive or memory concerns that could affect whether someone is able to take the medicines exactly as prescribed?
Drug interactions can happen for many reasons. There are key questions to think about regarding how drugs work: How is it absorbed, distributed around the body, broken down, and then eventually cleared from the body? Usually, drug interactions happen because some drugs affect how the body processes another drug. Some common factors that increase the likelihood of a drug interaction include:
There are actually multiple ways that medications can interact. Some examples include:
Being able to spot the warning signs of medicine interactions can help prevent serious side effects. Some physical symptoms that should prompt you to consult your healthcare provider include:
The best thing to do to reduce the risk of medication interactions is to have regular medication reviews with a suitably trained clinician. Aside from that, some practical steps you can take to safely manage treatment with multiple medicines include:
It is very important to keep an up-to-date list of medications you are taking. You can write it in your notes or on a piece of paper in your wallet, whatever works best for you. Most people will at some point have to move between General Practice to the specialist clinic or have to use the Emergency department in a new region in England (or abroad). Unfortunately, the more changes there are, the more likely there may be mistakes. This could be mistakes in transferring information, outdated information, or the health records may not be accessible at all. Hence, having your own record can help reduce the risks of mistakes in prescribing or introducing any new treatment.
Before you are started on any new medication, your doctor will check on official clinical guidelines to assess if any of your medications could interact with this new medication. A pharmacist can also be involved in checking over potential dangerous medication interactions and advising on forms or brands. If you have any concerns about interactions when starting a new medicine, please consult your healthcare provider for advice.
Doctors and Pharmacists are the two main clinicians who manage medication safety. They are trained on understanding the mechanisms of drugs, how they affect the body biochemically, and the possible interactions between drugs. Thus, pharmacists and doctors work closely together to assess treatment regimes, adjust doses, and assess prescriptions; this process helps to explore optimal solutions for the patient.
Just because over-the-counter medicines can be bought at a supermarket, does not mean that they do not carry any risks. The same goes for herbal remedies, people often assume that because they are natural, there are no risks involved. Non-prescription medications can still be very dangerous, especially if you are already taking other Medications for Chronic Conditions. For example:
| Medication type | How can this lead to drug interactions? | What you should tell your doctor/ healthcare professional |
| Prescription Medicines | Prescription medication can contain strong active ingredients that can affect how the body processes medicines. A common example is the effect on the liver’s function. | The drug name, the dose, how often and when you take it, and how long you have been taking it. |
| Over-the-counter medicines | Over-the-counter medications can increase the risk of prescription drugs or interact in other ways. An example might be the increase in bleeding risk if you are already using a blood thinning prescription medication. | Inform the doctor of any over the counter medication you take from allergy medication to paracetamol/ ibuprofen. |
| Herbal Remedies | Some compounds in herbal remedies can affect how a drug is processed by the body. Even supplements like vitamins or minerals may affect other medications. | No matter how natural and harmless they may seem, you should tell your doctor about all the supplements and herbal remedies you are taking. |
After a change in medication/dose/treatment regime, if you experience any new symptoms you should seek medical advice promptly. This is especially important if you have new symptoms that persist or any other concerning symptoms (e.g unexplained bruising). For severe symptoms however, you should get emergency medical attention. Some examples of dangerous effects of drug interactions include: