Safe handling of medications

An example is St John's Wort (also known as Hypericum perforatum), a complementary medicine sometimes suggested to help relieve symptoms of depression. It has been shown to interact with a wide range of medications. Examples of medications that can be less effective when taken at the same time as St John's Wort include:

• Contraceptives;
• Warfarin (a blood-thinning medication);
• HIV medications, and;
• Some epilepsy medications, including phenytoin and carbamazepine.

St John's Wort can also increase the risk of side effects with:

• All antidepressant medications;
• Some migraine medications (for example sumatriptan), and;
• Clopidogrel (a blood-thinning medication).

To reduce your risk of experiencing medication interactions, you can:

• Let all your health professionals know about all the medications you are taking (including herbs and complementary medicines);
• Ask before you take anything new. Your doctor or pharmacist will be able to advise whether it may interact with your existing medications;
• Follow any instructions your health professionals give you, particularly about consuming foods or other drugs, and;
• Learn about your medications and any common interactions that may occur with them.

Taking multiple medications

If you take multiple medications, it can be more difficult to keep track of what you are taking, but it is very important to do so.

In some cases, health professionals prescribe different medications in combination, specifically so they can work together. If you do not take them as prescribed, it may mean your treatment is less effective, or you may experience serious side effects.

You can help to manage medications by:

• Being informed about your medications including their names, what they look like, why you are taking them and when you should take them;
• Keeping a list of your medications and their details handy. This is particularly helpful when seeing different health professionals, or when going to hospital;
• Organizing your medications. You can use an organizer that covers different times of the day and week, or ask your pharmacist to supply your medications in a dosage system, and;
• Seeing your doctor regularly so you can review the medications you take.

Pregnancy and breastfeeding

Pregnancy is a time when women may need to be particularly careful about the medications they take. This includes non-prescription and complementary medicines.

Medications can cause problems during pregnancy when they:

• Pass from the mother's bloodstream through the placenta and affect the baby's development;
• Damage the placenta and prevent the developing baby from getting adequate nutrition, and;
• Bring on premature labor.

Some medications can also pass from the mother to baby via breastfeeding.

Many medications can be taken safely during pregnancy and when breastfeeding. In some cases, pregnant or breastfeeding women may have serious medical conditions that need to be treated so that they and their babies stay well. Your doctor can discuss medication options and any risks they may pose. In some cases, alternative medications or different doses may be recommended.

Many medications can be used safely whilst breastfeeding. 

Following instructions with medications

For medications to be effective, you may need to follow special instructions when taking them, so make sure you're clear about any instructions your health professional gives you.

For medications taken in oral form:

• You may need to take them with food so they do not irritate your stomach;
• You may need to take them on an empty stomach so they are absorbed correctly;
• You may need to break or crush the tablet in order to take it, or;
• Breaking or crushing the tablet may mean the medication will no longer be effective.

Some medications may require special applicators or procedures in order to be effective. For example, many asthma medications require the use of inhalers and, in some cases, spacers, in order to deliver the medication correctly into the lungs. People who need to use eye drops may need to follow special procedures to make sure the eye drops remain in the eyes and do not drain away into the nasal passages.

Many asthma medications are delivered into lungs via an inhaler. 

If you are at all unclear on how to take your medications, you can ask your doctor or pharmacist. Even if you have been taking them for a long time, it is easy to forget exactly how you should be doing it. Having a quick refresher on what you need to do can help ensure your medications are as effective as possible.

It is also important to follow your doctor's instructions on how long you should take your medications.

Stopping medications early or suddenly can:

• Mean the treatment may not be as effective as it should be;
• Put you at risk of a relapse of your condition, and;
• Sometimes cause dangerous or unpleasant side effects.

If you are concerned about taking a medication in any way, you can always discuss it with your doctor. In some cases, they may be able to recommend an alternative medication or treatment and give you guidance on how to most safely stop taking medications.

Taking out-of-date medications, or medications prescribed for someone else, can lead to serious health problems.

Storing and disposing of medications safely

Some medications can deteriorate if not stored correctly.

To make sure your medications are as effective as possible:

• Store in a cool, dry place. Avoid storing them in the bathroom (where it is hot and damp), or the car (which can heat up);
• Store in the refrigerator, (if instructed to do so), and;
• Store medicines in their original containers with the labels, so that expiry dates and instructions are always with them.

It is also important to store medications securely, ideally in a high, locked cupboard to prevent children from accidentally taking them. Even if you do not have children living in your house, children may visit you and gain access to medications from places such as handbags or kitchen shelving. If you have out-of-date medications or medications you no longer need, you can safely dispose of them by taking them back to your pharmacist.

Buying medications

Medicine bought over the Internet from foreign sources, from storefront businesses that offer to buy foreign medicine for you, or during trips outside the United States, may not be safe or effective. These medicines may present health risks and the US Food and Drug Administration (FDA) cannot ensure the safety of medicine from these sources. The FDA cannot help you if you have problems with medicine you get from outside US regulation and oversight.

Medications can be expensive and it may be tempting to buy them from overseas or via the internet. However, it is important to be aware that overseas businesses may not be required to follow regulations such as those that ensure the safety of medications in the US. In some cases, medications bought from overseas may be ineffective or dangerous.

It is also necessary to follow all relevant US laws whenever you are importing medications into the country (which includes buying them over the internet).

If you buy medications online:

• Ask your doctor or another health professional whether the medication is safe and appropriate for you before you make a purchase;
• Buy medications from sites within the US;
• Make sure the website has contact details so you can speak to someone if you need help, and;
• Buy medications from sites that require a valid prescription.

If you are on multiple regular medications, your pharmacist is a very important source of information and can advise regarding safely taking your medications and reinforcing medical information. Having a regular pharmacist can be as important as having a regular doctor.

Further references

Buying Medicine from Outside the United States