Drug safety stressed to public

By Robbie Dingeman
Advertiser Health Writer

The customer at a Mililani drug store slid her arm into the blood pressure machine's cuff and was surprised by the reading: 95/45, far below the typical 120/80.

Tom Lynch, pharmacist at the Longs Drugs at Mililani Marketplace, helped the woman figure out what was wrong: the grapefruit she was eating prevented her liver from processing her prescription medication, causing her blood pressure to drop.

"As soon as she got off the grapefruit, she was fine," Lynch said.

The woman had not noticed the dietary warning on her prescription drugs, which Lynch said is understandable in our always-in-a-rush lifestyle.

Hawai'i pharmacists and doctors are warning people this month to carefully check with a health professional to make sure they are not mixing medications with over-the-counter drugs, herbal remedies, vitamins and even some foods in potentially lethal ways.

The effort is part of a statewide "Managing Your Medications" awareness campaign this month, sponsored by HMSA and the Hawaii Pharmacists Association and paid for by various drug companies. Nationally, an educational campaign is working to help consumers be more aware of the potential problems with taking multiple medications.

Dr. Shari Kogan, medical director of geriatrics at The Queen's Medical Center, said older and frail people need to be especially careful about the mix of medications they take. Just because a medication is sold without a prescription doesn't necessarily mean it's safe in all instances, Kogan said, "especially for the elderly."

She warns of dangers from sleeping pills, pain medication and even laxatives that can interact with other medication. In addition, she worries that people will take common, nonsteroidal anti-inflammatory drugs such as Advil, Motrin, Naproxen and Aleve without realizing that they can affect people in different ways. "They can worsen high blood pressure," she said. "They can cause stomach bleeding. They can cause confusion. They can increase potency of other medications."

Kogan encourages patients to talk with their doctors about any continuing health concerns, instead of treating the symptoms themselves with off-the-shelf medicines.

Lynch finds that people don't realize that herbal remedies such as ginkgo biloba, St. John's wort or even antacids and vitamins can affect other medication. He said ginkgo thins the blood, which can intensify a reaction for someone taking a blood-thinning drug.

Lynch said most people would benefit by having one pharmacy list all of their medications and then scheduling a consultation to add other over-the-counter medications into the computer file to head off problems.

Dr. John T. Berthiaume, medical director for HMSA Pharmacy Management, said that problems with herbal remedies are growing. He said the educational program is important to prevent misuse and accidental and potentially dangerous outcomes. At the same time, he is also urging people to throw out old medication that they no longer need.

Pharmacist Miles Lahr, owner of Shoreview Pharmacy in Kapa'a, Kaua'i, said he is seeing more problems with medication with the aging population. "There's a lot more people on a lot more medications," he said. "That gives potential for more problems."

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.