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Warning about mixing prescription drugs not always given

Reprinted from The Atlanta Journal / Constitution, Monday, August 19, 1996

Study: Warning about mixing prescription drugs not always given

Washington - More than half of 245 pharmacies tested in a magazine study failed to warn consumers against the dangers of mixing prescription drugs.

"The disappointing results of this study should serve as a wake-up call to the entire industry," the U.S. News & World Report study quoted Thorir Bjornsson of Jefferson Medical College in Philadelphia as saying. The study appears in the magazine's edition that hits newsstands today.

The investigation found that well over half of the pharmacists surveyed did not warn consumers when presented with prescriptions for drugs that, when taken together, can be at best risky and at worst deadly.

The authors of the study, done in cooperation with Georgetown University School of Medicine, asked seven physician-pharmacologists to write prescriptions for three drug combinations that cause reactions of varying degrees of familiarity and severity.

A pharmacist was considered to have warned the patient if he counseled him, offered to call the doctor or refused to fill the prescriptions.

Among the findings:

• About one-third of pharmacists did not alert consumers to the potentially severe interaction between Hismanal, a common antihistamine, and Nizoral, an often-prescribed antifungal drug. The Hismanal-Nizoral mix can cause irregular heartbeat, cardiac arrest and sudden death.
• Only four out of 17 pharmacies warned of acute interaction between oral contraceptives and Rimactane, an antibiotic used to treat tuberculosis, which diminishes the effect of birth-control drugs and can render them ineffective.
• Consumers' chances of being alerted to potentially dangerous drug interactions varied among the cities surveyed. In Denver, more than half the pharmacists tested dispensed Hismanal-Nizoral without verbal warnings. In suburban New York, 40 percent did. In Indianapolis, all but three of 20 pharmacists surveyed refused to fill the prescriptions and the three who filled them issued strong warnings against taking the two drugs together.
• Fewer than half the pharmacies surveyed included written warnings with the drugs after filling the prescriptions and what warnings there were varied -: considerably in usefulness and reliability. A minority offered; detailed information about the interactions; more often, the warnings counseled patients to "talk with your physician if you are taking other medications."
• Although independent drugstores represented half the total pharmacies tested, they accounted for nearly two-thirds of the pharmacies that failed to warn consumers of the most dangerous of the three drug interactions. While pharmacies in low- and lower-middle-income neighborhoods represented less than half the survey sample, they accounted for nearly two-thirds of the pharmacies that failed to warn consumers of the most dangerous interactions.

Modified December 25, 2002