FDA acetaminophen advisory - part 2

July 3, 1:05 PMAtlanta Health ExaminerAnne Davis

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Double dosing?

The FDA acetaminophen advisory demonstrates problems that can occur when taking medications at higher than recommended doses. As we see from the acetaminophen advisory, higher doses are being taken when the consumer is not aware of the ingredients in the medications they are taken. Double dosing occurs when taking 2 or more medications with the same ingredient. Very often it happens when taking a prescription medication and an over-the counter one as well with the same drug.

Acetaminophen is not the only drug that is included in many common remedies taken for pain or symptoms of colds and the flu. Non Steroidal Anti-Inflamatory Drugs (NSAIDs) are another category of medications that can be taken unknowingly by double dosing. Drugs often prescribed or sold over the counters that are NSAIDs are:

1. Cox-2 Inhibitors – celecoxib (Celebrex)
2. Etodolac (Lodene)
3. Diclofenac (Voltaren, Cataflam, Voltaren-XR)
4. Ibuprofen (Advil, Motrin, Nuprin, Medaprin, Pediacare Fever,
5. Naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
6. Aspirin

Common side effects associated with NSAIDs and aspirin are gastric irritation and upsets, and the more serious gastric ulcers that can cause blood loss. Many hospital emergency room visits and admissions are due to bleeding ulcers as a result of patients unknowingly taking more than 1 NSAID.

Common Causes of Double Dosing

1. Taking a prescription and over-the counter medication that both contain an NSAID
2. Taking more than 1 prescription medication with a NSAID as can occur when seeing more than 1 physician, which is a common scenario.
3. After being discharged from a hospital and you continue taking the medication prescribed during your hospitalization and also the medication you previously used that has a different name yet contains the same ingredient. Healthcare providers, including pharmacies, do not keep every product on the market in their formulary and may give you the same medication that has a different name.

What can you do?

1. Know your medications and make sure that your healthcare provider and pharmacist are aware of every product you are taking. That includes both prescription and OTC remedies. See article on Medication Lists 
2. Read and know the ingredients of every medication you are taking.
3. Be sure and ask the doctor every time when a medication is prescribed or a sample given to you. Samples typically do not list their ingredients on the patient package, and I once discovered that I was double dosing when I checked the ingredients.
4. Double check the ingredients with your pharmacist when picking up a prescription or selecting an over-the-counter remedy. Ask if it is safe to take with the other drugs you are using.
5. Keep an updated list of your medications with you at all times, show it to all your all of your healthcare givers. Make sure you add every new product and delete those you are no longer taking.

Send me your medication questions or concerns to info@healthstarsolutions.com.

For more info on prescription and OTCs and their ingredients go to: NIH Medline or WEB MD.