Taking medicine at the first sign of discomfort or sickness has become second nature for many of us. But there’s a catch: misuse these medications, and they can quickly go from being helpful to harmful.
Pharmacist Themba Muhlarhi of South Africa’s pioneering courier pharmacy, Medipost Pharmacy, highlights this vital yet often overlooked aspect of medication safety, cautioning the public to avert potential hazards before they arise.
“Understanding contraindications isn’t just the domain of healthcare professionals – it is essential for everyone taking medication. It is not just about popping a pill; it’s about ensuring that what should be a remedy doesn’t become a risk,” he warns.
The global implications are staggering. Medication-related errors and contraindications contribute to significant health risks affecting millions worldwide. According to the National Centre for Biotechnology Information in the United States (NCBI), such errors are responsible for up to 41.3% of hospital admissions and 22% of readmissions after discharge globally.
“Greater public awareness of appropriate medication use and the risks of contraindications is crucial for reducing these alarming statistics while empowering people to make safer health decisions in South Africa,” Muhlarhi says.
Understanding contraindications
Contraindications are listed in medication package inserts and describe where certain medications should not be used because they could cause harm. These can range from food and medicine interactions to more complex medication and disease interactions. There are two types: absolute, which is life-threatening and must be avoided, and relative, which requires caution and professional advice.
“For example, taking warfarin with aspirin, both blood thinners, should only be done under medical guidance. Isotretinoin, a strong acne medication, should never be used during pregnancy due to the risk of congenital disabilities. Such risks mean that medications should be prescribed carefully and with professional supervision,” explains Muhlarhi.
Staying informed and safe
“You play a key role in your health journey, and as pharmacy professionals, we are here to support you,” he says.
Tips to help you manage your medication safely:
- Read patient information leaflets: Always check the “cautions and contraindications” section in the leaflets that come with your medication for essential information.
- Consult with professionals: Ask your pharmacist about potential interactions, especially when buying unfamiliar over-the-counter (OTC) medicines. “At Medipost Pharmacy, our pharmacy team is just a phone call away, ready to assist you in all 11 official languages, ensuring you have the clinical support you need,” assures Muhlarhi.
Over-the-counter medications and contraindications
“If you have a stuffy nose, you might reach for an over-the-counter [OTC] oral decongestant. But be careful, as these medicines might not be safe for everyone. Before you take them, especially if you have any health conditions, it is important to talk to your pharmacist or doctor,” he says.
You should be extra cautious if you:
- are taking other medications
- have diabetes
- have high blood pressure
- have an overactive thyroid
- are a man with an enlarged prostate
- have problems with your liver, kidneys, heart, or circulation
- have increased pressure in your eyes, known as glaucoma
When you take OTC medicines, they can sometimes interfere with the prescription medicines you are already taking. These examples explain how:
- Pseudoephedrine, found in many OTC decongestants, can raise your blood pressure. So, if you have hypertension or are taking medication for it, you should be cautious.
- Aspirin, used for pain relief or in flu medicines, shouldn’t be taken with warfarin, a blood thinner, as mixing these medicines can cause problems.
- Oral decongestants and nonsteroidal anti-inflammatory drugs (NSAIDs) are common in OTC medicines and can interact with prescription drugs. Always get advice from a pharmacist or doctor before taking them with other medications.
- NSAIDs like ibuprofen and naproxen can increase your blood pressure, possibly affecting how well your blood pressure medication works.
“Always consult a healthcare professional to ensure your OTC and prescription drugs are safe to use together,” Muhlarhi advises.
Staying safe with medications: Essential tips and advice
When talking to your doctor or pharmacist:
- Bring a list of the medications you are taking with you
- Mention any past adverse reactions to medications
- Inform them of any food or medication allergies you may have
Let your pharmacist know if you are:
- Pregnant or planning to become pregnant
- Breastfeeding
Before taking any medication, find out:
- What the medication is
- Why you’re taking it
- If it might make you sleepy or affect your concentration levels
- The right time to take it
- The correct dosage
- How long you should take it
Your lifestyle and its impact on medication
“Your daily habits can influence how your medications perform. For example, certain foods like grapefruit may interfere with medication efficacy, while smoking and alcohol use can introduce significant risks. Alcohol, when combined with acetaminophen, can be particularly harmful to your liver. It is, therefore, crucial to discuss your lifestyle with your pharmacist or doctor when beginning new medications to ensure their safe and effective use.
The role of healthcare providers
“Healthcare professionals play a key role in safeguarding your health. Pharmacists can identify potential drug interactions by reviewing your prescriptions and asking about other medications you are taking. Similarly, doctors evaluate your medical history to avoid prescribing medicines that may cause adverse reactions,” emphasises Muhlarhi.
If you suspect that you are experiencing a contraindication or adverse reaction, stop taking the medication immediately and contact your healthcare provider.
“Never start a new medication without consulting your pharmacist or doctor, especially if you’re on long-term prescriptions. Regular medication reviews with your healthcare provider ensure your treatments remain safe and effective,” advises Muhlarhi.
“Use medication-tracking apps to monitor your doses, prescriptions and potential interactions. By being aware of interactions and collaborating closely with healthcare professionals, you can confidently manage your medications and safeguard your health.”
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