Some can be deadly

Nearly two million Americans are hurt every year by the medication mistakes of others, such as being given the wrong drug or the wrong dose. But this total includes only the errors that are caused by doctors or in hospitals. It doesn’t include the mistakes that many of us make on our own, such as forgetting to take a pill or accidentally double dosing.

Thankfully, most of these errors are not fatal, but they can be. Common mistakes—and how to avoid them…

MISTAKE: Taking two different products with the same ingredient. Suppose that you normally take acetaminophen several times a day to reduce pain from arthritis. Each dose contains 325 milligrams (mg). Then you get a cold. So you take an over-the-counter cold remedy such as NyQuil. Many cold medications contain about 650 mg of acetaminophen per dose.

You could wind up getting 2,500 mg of acetaminophen from several doses of the cold remedy…in addition to the acetaminophen that you’re taking for arthritis. You could exceed the maximum safe dose of 4,000 mg a day without even knowing it.

Self-protection: Always read labels. Don’t take any medication without knowing what it contains. Many have more than one active ingredient. If a new medication contains an ingredient that you’re already taking, ask your doctor or pharmacist if the combined dose is safe.

Also, drugs can have similar actions even if the active ingredients are different. Some antidepressants, for example, lower blood pressure as a side effect. Your pressure could drop too low if you’re also taking medication for hypertension. Again, never take any combination of drugs without consulting your doctor first.

MISTAKE: Assuming two doses are better than one. Many people think that more is better. For example, if one dose of a painkiller gives some relief, they tell themselves that a double dose will be even more effective.

Not true. For example, you’ll get the same relief from 400 mg of ibuprofen (the usual adult dose for mild-to-moderate pain), taken every four to six hours, as you would from one dose of 800 mg—with less risk for side effects.

Most of the common painkillers, such as aspirin and ibuprofen, take time to work. You might not notice much improvement in the first hour or two. After that, the medication gets more effective as it changes your body’s chemistry. Be patient.

Self-protection: Take the recommended dose for at least a few days. If your problem still isn’t under control, ask your doctor if you should take a higher dose—or if another painkiller might be more effective.

MISTAKE: Missing a dose. Everyone forgets to take medication sometimes. It rarely matters, particularly if a drug is used for treating a long-term condition such as hypertension or high cholesterol. Just take your next scheduled dose.

Exception: Medication that you need for an acute problem, such as an infection. If you’re taking an antibiotic four times daily and you miss the morning dose, you usually can take a double dose at lunchtime, then return to the normal schedule.

But check with your doctor or pharmacist because doubling up is dangerous with some medications. Examples: Patients taking Coumadin, a blood thinner, could experience excessive bleeding if they take a double dose. With blood pressure drugs, you could suffer from hypotension, pressure that falls too low.

Self-protection: When you get a new prescription, ask your doctor or pharmacist what to do if you miss a dose. The rules are different depending on the medication.

MISTAKE: Using a regular spoon to measure medications. People routinely use kitchen spoons to measure their liquid medications. Don’t do it. A study in Annals of Internal Medicine found that participants who used kitchen spoons to measure medications wound up taking either too much or too little.

Self-protection: Some liquid or powder medications are packaged with a measuring device, such as a graduated cap. These devices are far more accurate than a kitchen spoon. Or you can buy dosing syringes or other appropriate measuring devices at pharmacies.

MISTAKE: Unsafe splitting. In an effort to save money, many patients ask their doctors to prescribe a higher-strength pill, which they split in two to get the correct dose.

This isn’t necessarily a bad idea. The cost of a 5-mg dose usually is about the same as you would pay for 10 mg. You’ll probably get the right dose if the pill is scored for easy cutting. But if it is not scored for cutting and you cut it anyway, you could get uneven doses.

Self-protection: To split tablets that are hard, very small or have an unusual shape, use a pill splitter, available at pharmacies. They have sharp blades and are designed to hold pills in the correct position when cut.

Never split or separate capsules—and don’t split medications that have a time-release mechanism. Breaking the coating could cause the medication to be absorbed too quickly—or even, in some cases, not absorbed at all.

MISTAKE: Buying or taking the wrong drug. This happens more often than you might think. Name confusion is among the most common types of drug errors. The US Pharmacopeia, an organization that sets drug standards, estimates that more than 1,400 commonly used medications have names that are so similar that people often confuse them.

Examples: It would be easy to confuse the osteoporosis medication Fosamax with Flomax (used to treat an enlarged prostate gland). Are you supposed to take Lamictal to prevent seizures or Lamisil to treat a fungal infection? Even names that don’t sound alike, such as Avandia and Coumadin, may look similar on handwritten prescriptions.

Self-protection: Know the correct name of every drug that you’re taking and why you’re taking it. Never take pills in a dark room.

Helpful: When your doctor is writing a prescription, ask him/her to jot a note on the prescription saying what the drug is for. If the prescription is for Coumadin, for example, the note might read “to thin the blood.” The pharmacist will be less likely to make a mistake. Also, confirm with the pharmacist what the drug is for when you pick up your prescription.