Medicines - safety issues

When used correctly, medicines (including prescription, over-the-counter and complementary medicines) help keep us well. However, approximately 250,000 Australians are admitted to hospital every year because of problems associated with the use of medicines, including side effects and other reactions. It is important to make sure you take your medicines correctly.

Safety issues - side effects from medicines

A side effect is an unwanted symptom caused by medical treatment. All medicines can cause unwanted side effects.

Causes of side effects from medicines

Some of the causes of side effects from medicines include:

• not taking the dose correctly - for example, at the right time of day or with food or water
• overdose - taking more than the recommended dose
• allergies to ingredients of the medicine
• combining the medicine with alcohol or certain foods - for example, some older types of antidepressants can cause life-threatening side effects when combined with certain types of cheese and a range of other foods (and alcoholic drinks)
• taking other medicines, illicit drugs or other preparations that interact with the medicine
• taking medicines stored at home but no longer required
• taking medicines that have expired
• taking medicines prescribed for someone else.

Make sure your doctor, pharmacist and other health professionals know about every medicine you take, including non-prescription and complementary medicines such as vitamin, mineral and herbal supplements. Mixing medicines can cause side effects.

Some conditions make side effects from medicines more likely

Always be guided by your doctor. It may not be advisable to take certain medicines if you:

• drink alcohol
• are pregnant, breastfeeding or trying to conceive
• are very young or elderly
• are known to be allergic to particular medicines
• have a stomach condition
• have kidney, liver or cardiac (heart and blood vessel) disease.

Safety issues - ask about your medicines

When your doctor prescribes a medicine, or if you are buying an over-the-counter preparation from your pharmacy, questions to ask include:

• What is the appropriate dosage - how much should I take; how often should I take it and at what times of the day?
• Should I take the medicine on a full or empty stomach?
• Do I need to swallow the pills whole or can they be crushed or chewed?
• What should I do if I miss a dose?
• For how long should I take the medicine?
• Are there problems with taking the medicine if I have a particular condition?
• What are the possible side effects, such as drowsiness, and how can I manage these?
• What are the signs and symptoms of serious reactions that I need to watch out for?
• Are there potential interactions with other medicines I take or may take?
• Can I have a Consumer Medicine Information leaflet?

Complementary medicines and safety issues

If you take any complementary medicines (including vitamins, minerals and herbal supplements, as well as bush medicines), general safety suggestions include:

• Tell your doctor and other health professionals about any supplements you are taking. Many herbal preparations are as powerful as pharmaceutical drugs and may cause side effects on their own or if used in combination with other medicines or in certain conditions.
• Unlike pharmaceutical drugs, the strength of herbal preparations may not be clear. Make sure you seek advice from a suitably qualified professional.
• Don't self-diagnose. See a health professional for diagnosis and treatment if you think you need to take supplements.
• Taking 'mega doses' of vitamins or minerals can be hazardous. Only use the recommended dose.
• Use all supplements strictly as directed or according to your health professional's recommendations.

Taking your medicines safely

General suggestions on how to take your medicines safely include:

• If you are not certain that you can remember the dosage instructions, write them down, ask your pharmacist to write them down or ask your doctor or pharmacist about a dose administration aid (such as a dosette box). This is particularly important if you are taking more than one medicine.
• If your prescription medicines are crucial for your health and wellbeing, consider carrying a list of your medicines and their dosage instructions with you in case of an emergency or if you are admitted to hospital.
• Ask your doctor or pharmacist for a Consumer Medicine Information leaflet for each medicine you take.
• Read the Consumer Medicine Information leaflet and all the labels on the container or packaging carefully before you use the medicine. They will tell you about your medicine and how to take it. Do this with every medicine.
• Regularly clear out your medicine cabinet and dispose of any medicine that is past its use-by date or that you no longer use. Return expired or leftover medicines to your local pharmacy for disposal.

Storing your medicines safely

To store your medicines safely:

• Keep your medicines in their original containers.
• Don't remove the labels from containers or packaging - they include expiry dates and important instructions on how to store your medicine.
• Store medicines out of direct sunlight in a cool, dry place.
• Some medicines need to be refrigerated - if you leave them out of the fridge by accident or they freeze, check with your pharmacist whether they should be thrown out or used within a certain time.

Safety issues - medicines and children

Children see adults taking tablets and, given the opportunity, may take those tablets themselves. Safety suggestions include:

• Ask your pharmacist to package your medicines in childproof containers, if possible.
• Keep medicines locked in cupboards out of children's sight and reach.
• Only remove a medicine from its packaging when you are ready to take it - do not leave it lying around for a child to pick up and take.
• If your handbag contains medicines, make sure to keep your bag out of children's reach.
• Try to avoid taking tablets in front of your children, as they may want to imitate you.

Where to get help

• In an emergency, always call triple zero (000)
• Your GP (doctor)
• Your pharmacist
• Victorian Poisons Information Centre (24 hours, 7 days) Tel. 13 11 26 - for poisoning, suspected poisoning, poisoning prevention advice and if you have made a mistake with your medicine or have overdosed
• NPS MedicineWise - Medicine finder.