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[bobf <bobford79 AT yahoo.com>]

This article is in today's Washington Post and cerns not only danger with 
mixing medications, but also supplements and over the counter meds.  I have 
had more than one of the reactions in the article myself (blood thinner, 
aspirin, & something else, & the doc forgot to tell me, at first,  to quit 
taking niacin -- which I had taken for years-- when I started statins).  
Soemone well educated on plants and supplements like Roxanne or Susan Jane 
probably know  all of this stuff, but it is hard for me to keep up with 
allpossible interactions.........................

------------------------------------------------------------------------
Millions of older Americans use risky drug combos
 
 
By LINDSEY TANNER

The Associated Press 
Wednesday, December 24, 2008; 6:24 AM 

CHICAGO -- At least 2 million older Americans are taking a combination of 
drugs or supplements that can be a risky mix _ from blood thinners and 
cholesterol pills to aspirin and ginkgo capsules _ a new study warns. 

Among older men, the numbers are particularly alarming _ one in 10 are taking 
potentially harmful combinations, according to the study. 

The results aren't always disastrous, but older people are more vulnerable to 
side effects and drug-to-drug interactions. And patients need to know that 
just because lots of medicines and supplements don't require prescriptions 
doesn't mean they're harmless. Nor are some of these safe to take when you're 
prescribed other medications. 

Experts say the take-home advice is to ask about any side effects of 
prescription drugs, and tell your doctor before taking other medicines. 


The report showing just how many older people are using risky combinations 
comes from a study of nearly 3,000 interviews with people aged 57 to 85. The 
research, funded by the National Institutes of Health and University of 
Chicago, appears in Wednesday's Journal of the American Medical Association. 

It's well-known that as people age, their medication use goes up. But the 
study highlights the potential problems with some sobering statistics. 

Ninety-one percent in this age group use at least one medication, often for 
heart disease and related problems. That translates to more than 50 million 
people. More than half use at least five remedies, including prescriptions, 
over-the-counter medicines or supplements. 

Virtually every medicine can have side effects, and with so many being used 
by so many older adults, the potential for harm is high. 

For example, warfarin, a potent prescription clot-fighting drug, was often 
taken with aspirin. Both increase the risk of bleeding, so the odds are even 
higher when both drugs are taken. The researchers said these risks also occur 
when warfarin is taken with garlic pills, which some studies have suggested 
can benefit the heart and help prevent blood clots. 

Signs of bleeding problems include bruising easily, hard-to-stop bleeding 
from the gums or from cuts and blood in the urine. 

Other commonly used and risky combinations included: 

_Aspirin taken with over-the-counter ginkgo supplements, increasing chances 
for excess bleeding. 
 
_Lisinopril, a blood pressure drug, taken with potassium, which combined can 
cause abnormal heart rhythms. Potassium is often prescribed to restore low 
levels of this important mineral caused by certain blood pressure drugs. 

_Prescription cholesterol drugs called statins taken with over-the-counter 
niacin, a type of vitamin B that also lowers cholesterol. This combination 
increases risks for muscle damage. 

"Patients need to know that while medications are often beneficial, they're 
not always safe," said lead author Dima Qato, a University of Chicago 
pharmacist. "If they need to self-medicate with over-the-counter or dietary 
supplements, they should definitely consult with their physicians or 
pharmacists." 

The study relied on data from in-person interviews with 2,976 adults 
questioned about which medications they routinely used. The nationally 
representative survey was done between June 2005 and March 2006, and results 
were extrapolated to the general population. 

The researchers assessed how many people routinely used at least two 
medications of any type known to have dangerous or even fatal interactions. 
The number totaled at least one in 25, corresponding to 2.2 million 
nationwide. 


Those interviewed weren't asked if they'd ever had a bad reaction from taking 
those combinations. And the study didn't assess whether patients were taking 
medications inappropriately. 

Dr. Jerry Gurwitz, chief of the geriatric medicine division at University of 
Massachusetts Medical School, said taking multiple medications, despite 
possible bad interactions, isn't necessarily a bad idea as long as patients 
are in close contact with their doctor. 

"There are definitely many instances where if they're monitored carefully and 
there's good reason for using them, that they could be used safely," said 
Gurwitz, who wasn't involved in the study. 

Prescription drugs were the most commonly used and nearly one-third used at 
least five prescription drugs. 

Michael Cohen, a pharmacist and president of the Institute for Safe 
Medication Practices, called the study an important snapshot of medication 
use in older Americans. But as someone who takes at least five medications 
himself, Cohen said the widespread prevalence isn't surprising. 

Cohen said his group recently launched a new Web 
site,http://www.consumermedsafety.orgthat will allow consumers to enter names 
of their medications to check for any potentially dangerous interactions. 






http://www.washingtonpost.com/wp-dyn/content/article/2008/12/24/AR2008122400608.html?hpid=sec-health