Is Your Pharmacist Smart?

There are a lot of things you should ask your pharmacist, but advice on which medication (including OTC) to take is not one of them. They SHOULD know more about drug interaction than your doctor, but they may not be up on how herbs and supplements interact with prescription and over the counter medications.

Consumer Reports wants you to know . . .

How much does your druggist know?

Last reviewed: April 2011
Illustration of pharmacist scratching his head




Illustration by Jason Schneider







An undercover investigation byConsumer Reports suggests that some pharmacists are uninformed aboutpotentially harmful interactions between over-the-counter supplements and prescription drugs.

We sent shoppers to 20 pharmacies in five states to ask the pharmacist or an assistant whether it was permissible to take atorvastatin (Lipitor), a widely used cholesterol-lowering drug, along withred yeast rice, a dietary supplement that is touted as a natural way to reduce cholesterol. Red yeast rice is a rice extract fermented with a strain of red yeast, and laboratory evidence has shown that it contains a substance essentially identical to the cholesterol-lowering drug lovastatin. Consumer Reports has recommended against using it. Moreover, taken together, the two might raise the risk of side effects such as muscle aches and pains and a rare muscle disease that could result in kidney failure. Over time, it might cause liver damage as well.

Twelve of 20 times, shoppers got incorrect or fuzzy advice, sometimes even after the druggist consulted an online medical database. In two cases, a pharmacist said taking both medications was a good idea. One of those pharmacists, in Albany, N.Y., revealed that he and his wife used red yeast rice and said he recommended it to all his customers who take a cholesterol-lowering product. A pharmacist-technician at a Safeway in Richland, Wash., was clearly bothered by our shopper’s questions and directed her to a health-food store for advice. Other pharmacists seemed unfamiliar with the supplement, shrugged, or gave wishy-washy answers.

The responses suggest that many pharmacists might not know enough about supplements, which aren’t subject to the kind of federal regulations that drugs are.

Orly Avitzur, M.D., a board-certified neurologist and Consumer Reports medical adviser, said she wasn’t surprised by the results of our investigation or convinced that physicians know more than pharmacists about dietary supplements. “When more physicians have electronic medical records with fully functioning medication modules, drug and supplement interactions will be flagged automatically, and we hope these problems can be avoided,” she said.

How to avoid medicine missteps

Bad advice is just one reason behind medicine mistakes. You might miss a dose or take it with food or drink instead of on an empty stomach. Other reasons include confusion between similar-sounding medications, poor handwriting on prescriptions, and incomplete information about your allergies. To make sure you get the right medicine in the right dose:

Give the pharmacy your complete history

Include a list of drugs, vitamins, and other dietary supplements you’re taking and information about medical conditions, allergies, and adverse reactions. Some drugstores let you create a secure profile online that you can update with new information.

Understand how to take medicine

Does it matter whether it’s in the morning or at bedtime; or before, during, or after a meal? Can you crush or chew it? Should you avoid any foods, beverages, other drugs or supplements, or activities while on the medicine?

Ask what happens if you miss a dose or take too much. If too much time passes, do you double up or wait? If you suspect an overdose, should you go to the hospital?

Know the side effects

Do any problems warrant immediate attention?

Ask whether you can stop once you feel better

With some drugs, notably antibiotics, if you cut the regimen short, the bacteria might survive and cause the infection to recur.

Know the time frame

Does “three times a day” mean during waking hours or during a 24-hour period?

Store medications properly

In general, select a cool, dry place away from direct sunlight. A bathroom medicine cabinet isn’t ideal because of moisture and heat, which can cause some drugs to break down. If you store pills above a sink, they could fall down the drain. Keep refrigerated medications out of the door because of temperature variations.

Remove roadblocks

Sometimes, difficulty opening the bottle, illegible instructions, and bad taste are reasons people don’t take their drugs. Ask for an easy-open bottle, large-print labels, or special flavoring.

The one area where you SHOULD ask your pharmacist for advice is in choosing a Medicare Part D prescription drug plan.

In looking for affordable Medicare supplement plans, consider Georgia Insurance Shop, the leading resource for information on health coverage in Georgia.

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