7 Medication Myths Pharmacists Can Debunk

Misinformed patients may be inadvertently harming themselves with medications.

Misinformed patients may be inadvertently harming themselves with medications.

The Cleveland Clinic recently outlined 7 myths relating to both OTC and prescription drugs, and then described how to debunk them.

It is helpful for pharmacists to know the most common medication misconceptions so that they can preempt any problems.

Myth No. 1: If pain or discomfort persists or worsens, it’s okay to take more than the prescribed dose.

The recommended or prescribed dose of an OTC or prescription drug is not an arbitrarily conceived amount. Not heeding it could have dangerous consequences that may include accidental overdose or liver damage.

Acetaminophen, for example, is an analgesic commonly found in both Rx and OTC medications to relieve pain and fever, but it is also associated with liberal dosing among patients.

In 2011, the FDA asked manufacturers of prescription combination medicines to limit the amount of acetaminophen to a maximum of 325 mg per tablet, capsule, or other dosage unit in an effort to reduce the incidence of liver failure associated with high doses.

Although those guidelines do not apply to OTC medications, the maximum daily dose for single-ingredient Extra Strength Tylenol products in the United States was lowered from 8 pills per day (4000 mg) to 6 pills per day (3000 mg).

Pharmacists should strive to be resources for information about the safety risks associated with taking more medication than recommended or prescribed.

Myth No. 2: Once patients feel better, it is no longer necessary for them to take their prescribed medication.

Patients who do not fully understand the importance of medication adherence may be less likely to see their regimen through to the end of its prescribed course.

A 2013 survey from the National Community Pharmacists Association revealed that the most common forms of medication nonadherence included failing to refill a new prescription (20%) and taking a lower dose than instructed (22%).

Meanwhile, some of the most common reasons for nonadherence were forgetting to take the medication (42%) and believing that the medication was not needed anymore (16%).

Contrary to patients’ popular belief, the absence of obvious symptoms does not necessarily mean that the bacteria or virus that caused the illness in the first place has been completely eliminated.

Some medications are dosed to be tapered over time, and pharmacists should emphasize that premature drug termination could be associated with adverse effects.

The proton pump inhibitors omeprazole (Prilosec) and esomeprazole (Nexium), for example, suppress the production of stomach acid, so stopping them early could cause the stomach to rebound and overproduce acid.

Myth No. 3: Natural supplements are safer than their prescribed counterparts.

Patients often confuse the term “natural” with “healthy”—a trend seen in nutrition as well as pharmaceuticals.

In light of this, patients should be reminded that the FDA standards for natural supplements are much weaker than the standards for approved drugs.

Potential adverse side effects may not even be listed on a natural supplement’s label, and there is also potential for supplements to dangerously interact with certain medications.

Melatonin and coenzyme Q10 supplements, for instance, can decrease the anticoagulant effects of warfarin, and supplements such as cinnamon, chromium, and whey protein can exacerbate the effects of hypoglycemic drugs.

Pharmacists should take time to educate their patients about these and other potential drug-supplement interactions.

Myth No. 4: Antibiotics are the right remedy for all acute infections.

As many as 1 in 10 health care providers prescribe antibiotics for almost every patient they see with a cold or bronchitis—despite the fact that antibiotics can only treat bacterial infections such as strep throat, not infections caused by viruses such as acute respiratory infections.

Patients commonly request antibiotics, but they should be made aware that taking them unnecessarily could cause the treatment to lose its strength and ability to effectively treat bacterial infections going forward.

This misconception among patients and some health providers contributes to the overuse and inappropriate use of antibiotics, which is exacerbating antibiotic resistance.

Antibiotic resistance constitutes one of the most challenging problems in modern health care.

Myth No. 5: Health care professionals don’t need to know what vitamins patients take.

Nearly 63% of US adults take 1 or more vitamins or dietary supplements, and many perceive them to be risk-free and “natural” without any potential for adverse effects, results from a 2012 survey revealed.

Health care professionals should make sure they are asking patients about any vitamins they may be taking, so that they can warn these patients about potential drug-vitamin interactions.

Examples of vitamins with the potential for serious interactions include vitamins A and E, which increase the effects of anticoagulation and should therefore be closely monitored when taking warfarin, and magnesium, which can decrease antibiotic absorption and should be dosed separately by 2 hours before or 6 hours after taking an antibiotic.

Myth No. 6: Medications are best stored in the bathroom or near the kitchen sink.

Many patients believe that storing their medications in a convenient and often-visited place will help them remember to take them, but they should know that medications are almost always best stored in a dry place away from heat, direct light, or any source of dampness.

Some OTC products simply lose their potency when they are exposed to hot, humid environments. For instance, heat and moisture cause aspirin tablets to break down into acetic acid and salicylic acid, which can cause stomach irritation.

Pharmacists should also advise families to take careful precautions to improve medication safety in their homes.

Myth No. 7: It doesn’t matter how a pill is ingested.

The Cleveland Clinic advises patients to take their oral medications with a full 8 oz glass of water to avoid throat irritation and other potential consequences.

Taking pills with any other liquid—in particular, alcohol—can interfere with the manner in which the body absorbs the medication.

To add another layer of complexity, some medications must be taken with food, while others may have strange or even dangerous interactions with certain foods that patients may not be aware of.

Pharmacists should take time to describe drug administration instructions to patients and counsel them to follow them closely.