Guidelines For Your Safety When Taking
Over The Counter And Prescription Medication
If you have excluded other methods for dealing with a perceived problem or illness and following a discussion with your doctor, pharmacist or nurse, you have been recommended to take medication, the following tips may be helpful.
All medicines have more that just the effect they are prescribed for, some of the ‘other’ effects may be worse than the original problem. Some medicines cause depression or psychological changes in some people. No one has done research to find out why this happens.
Please read the ‘Golden Rules’ on the APRIL web site. The ‘Golden Rules’ contain practical advice from well respected doctors, consultants and psychiatrists and nurses.
Taking your medicine
- Always read the instructions on the patient information leaflet carefully and thoroughly
- Some side effects may be rare but they could happen!
- Keep the leaflet for as long as you take the medication.
- .Bear in mind that not all the side effects or withdrawal reactions may be listed on the leaflet.
- The manufacturer may not be aware of all side effects that occur.
- Most adverse reactions remain unreported to the manufacturers after the drug has been licensed.
- Many doctors fail to use the official ‘Yellow Card’ reporting system, so that accurate information is unavailable.
- The leaflet may be out of date or may contain unclear information.
Patient Information Leaflets (PILs)
Since January 1999 - All drugs and medicine must be provided, by law following an EU Directive, with a ‘Patient Information Leaflet’ (PIL). If none was provided, because you were in hospital, or the pills were taken from a large container (bulk supply), you are still entitled to a PIL.
This information is available on the Internet and your pharmacist should be able to access and print a copy for you. To obtain a PIL or Summary of Product Characteristics (SPC) go to www.medicines.org.uk insert name of the drug in the search box top right of Home Page. Anyone can use this facility and there is no requirement to register first. The SPC contains more detailed information than the PIL.
Read The Instructions Carefully.
- Ask Your Pharmacist If You Are Not Sure About When And How To Take The Drugs.
Some Tips To Help You To Stay Well
1. Keep a record of times to take your medicine
You should keep a chart, or use a container with divisions to prevent over-dose
2. Most pills or capsules must be taken with a full glass of water
This helps them on the way to your stomach and helps reduce the risk, in some cases, of them burning the lining of your oesophagus and causing ulcers.
Some pills work better if taken on an empty stomach, or some must be taken with food.
3. Interactions
If you are given a new, additional medication, always check with the pharmacist that it does not interact with the other drugs or herbal remedies. This can be dangerous especially for patients taking blood-thinning drugs like Warfarin.
- Herbal Preparations
Herbal drugs may also have unwanted side effects and can interact with other products. Check the label. And tell your doctor or pharmacist if you take any herbal or complementary remedies.
- Alcohol & Medication
It is usually unwise to drink alcohol when taking some medication for the following reasons.
Alcohol changes the way the enzymes in the liver works. This may reduce the effectiveness of the medicine or may increase the risk of physical or neuro-psychiatric side effects.
Alcohol causes dehydration and depletes vitamins. Physical disease and mental depression can be the result of too much or careless use of alcohol. Following a drinking session, reflect on how you feel the following day and if your mood is low, be cautious, you may be at risk of alcohol induced depression.
APRIL has been informed about unexpected deaths and suicides of people taking antidepressants and alcohol together.
4. Dehydration / Nutrition
Keep well nourished. Normal doses of medication can become over doses in undernourished patients.
As we grow older, our kidneys and liver become less efficient at removing medicine, this leads a build up of drugs in our body, so we usually need a reduction in dosage and should never to take more than is prescribed. It is essential to drink enough water to help clear toxins from the kidneys. About 6 to 8 glasses of water is recommended for most people.
5. Withdrawal Effects
Cortico-steroids, tranquillizers including benzodiazepines, sleeping pills, SSRI, SNRI and newer antidepressants & some pain killers should be slowly reduced. Advice on withdrawal should be sought. The Pharmacist can supply a pill cutter and you can obtain liquid form of SSRI antidepressants, such as Prozac, to help to titrate the final doses and hopefully reduce the severity of withdrawal effects.
Not everyone suffers problems with withdrawal, we are all different and it is best to be cautious.
Reasons for withdrawal reactions
Cortico-steroids reduce the functioning of our own adrenal system so we have to give our body a chance to produce the cortisol naturally at a level that wont cause us to become ill. The problem with withdrawal from the SSRI kind of antidepressant or benzodiazepines is thought to be due to changes to the cells and receptors in the body caused by the drugs. It takes time for the cells to recover.
6. Adverse side-effects also known as adverse drug reactions (ADRs)
All drugs have side effects. People react differently in the way they absorb and react to drugs, medicine, alcohol, chemicals and food.
Physical ADRs
These can range from a rash, which can signal serious reactions that can damage the lungs, kidney or liver. Muscle weakness and tendon damage, can be early signs of muscle breakdown, a side effect linked to statins drugs for cholesterol (rhabdomylosis).
Even skin contact with some pills should be avoided by using a spoon to put them in your mouth. (Chlorpromazine is one such drug.)
Psychiatric neuropsychiatric and neurological ADRs.
Feeling low, depression, agitation, mood swings, loss of interest in sex or life in general, anger, paranoia, mania, psychosis, mental distress. Insomnia, memory loss, confusion, feeling suicidal.
If you develop new mental or physical symptoms after taking a new medicine, changing a dose or stopping a drug: The new symptoms may possibly be an adverse side effect, caused by the drug, change of dosage or withdrawal reaction. Check the side effects listed on the Patient Information Leaflet and see your doctor, nurse or pharmacist.
Feeling suicidal?
If you begin to feel agitated or if you feel like harming yourself, go to A & E at the nearest local hospital, or call the local mental health crisis team or call the emergency services (999 UK or 911 USA)
If you have thoughts about ending your life, remember this is a crisis and you need to feel safe, so do not stay alone. Call a family member, a friend or the Samaritans while you await help. The feelings will not be permanent and the problems you perceive will not be unsurmountable.
SAMARITANS (UK)
24hr service for anyone feeling distressed and wishing to speak to someone
Telephone - 08457 909090 (UK local call rate)
http://www.samaritans.org.uk/
Pharmacy Information (UK)
(Bethlem and Maudsley NHS Trust )
Telephone: 020 3228 2317
NB
Same drug new name
Warning - always check names the same drug may be sold as, to avoid taking medication you may have found you could not tolerate previously.
There are too many drugs, with the same properties but varied names, to list here but these are some examples:
Cyproterone Acetate and ethinlestradiol is -Dianette, Diane-35. Clairette, Ginette 35
Fluoxetine is Prozac, Sarafem, Selfemra, Rapiflux