Pharmacist Gina Harper, clinical coordinator of pharmacy services for UCHealth Poudre Valley Hospital, discussed in a UCHealth online posting reasons why patients would be wise to periodically review the prescriptions they are taking. Because, she says, while medicines “are meant to help us live longer and healthier, still there are dangerous and costly consequences to taking medications incorrectly or mixing certain drugs and supplements.”

She considers a scenario in which someone may have been prescribed a new medication or, alternately, been on the same medication for years, and now adds a vitamin or a supplement or another over-the-counter medication for a new symptom. This potentially poses risks, such as adverse interactions. For instance, some nonprescription meds and supplements may cause a prescribed med to act differently, either weakening its effectiveness or, in a different direction, allowing its concentration to rise to unsafe levels in the user’s body.

“These are all important reasons to have your list of prescriptions, over-the-counter medications and supplements reviewed by a health care professional,” Harper advises. She adds: “It is important for everyone to remember that medications should be used at the smallest dose for the shortest amount of time. And another mantra: more is not always better.” Harper regularly performs medication reviews and says the primary reason to have your list of medications assessed is to try and pare down or reduce the amount of medicine you are taking, when that is medically possible.

Some Medicare plans cover prescription reviews

Some people on Medicare drug plans can automatically get a medication review. says plans with Medicare drug coverage “must” offer Medication Therapy Management (MTM) services to help members if they meet certain requirements or are in a Drug Management Program. “If you qualify,” Medicare states, “you can get these services at no cost to help you understand your medications and take them safely.”

MTM services usually include a discussion with a pharmacist or health care provider to review your medications. These services may vary by plan. Medicare explains that through the MTM, you may get:

  • A comprehensive review of your medications and the reasons why you take them.
  • A written summary of your medication review with your doctor or pharmacist.
  • A Recommended To-Do List and Medication List to help you make the best use of your medications.

Medicare says: “Bring your Medication List with you to your yearly wellness visit or anytime you talk with your doctors, pharmacists, and other health care providers. Also, take your Medication List with you if you go to the hospital or emergency room.” And: “If you take many medications for more than one chronic health condition, contact your drug plan to see if you’re eligible for a Medication Therapy Management program.”

Getting back to the UCHealth posting on this subject, here are some of the key points made:

Who should do a prescription review if you live in Colorado?

Doctors or pharmacists are qualified to do them. One advantage of having your physician do a review is he or she can make any changes in prescribed meds that might be warranted. To assist in this process, patients are advised to write down the prescriptions, over-the-counter drugs and vitamins or supplements they take, making sure they include the dosage sizes and frequency for all of them.

What are common mistakes Coloradans make with supplements?

There are at least three potential mistakes. 1) Taking several supplements with overlapping ingredients, giving you too much of a “good thing.” Read supplement ingredients lists carefully to help avoid this. 2)

Continuing a supplement when it is no longer needed, such as when the reason you started it no longer exists. 3) Taking a supplement that interferes with a prescription.Some supplements, for instance, might increase your risk of bleeding or affect how your body metabolizes a drug you’ve been prescribed. Myriad other adverse interactions are possible.

What are issues with over-the-counter medications for Coloradans?

A key one is the old standby aspirin. There are new recommendations for daily dosage, including that

older adults who are not at an elevated risk for heart attack or stroke should not be taking a daily baby aspirin, partly due to bleeding risk. Also, when treating pain relief, note that nonsteroidal anti-inflammatory drugs (NSAIDs) like Aleve or Motrin can worsen blood pressure. Sleep aids can raise concerns. Harper notes that “Medicines like Tylenol PM have diphenhydramine, which is a big no-no for adults over the age of 65. Diphenhydramine hides in many over-the-country sleep aids” and “is directly tied to increased risk of falling, memory loss and urine retention.” Long-term use of gastric reflux medicine, often used to allay heartburn or treat ulcer symptoms, can impair your ability to absorb other vitamins. This is not an exhaustive list, but it serves to show why OTC meds need to be part of your prescription review.

What are some concerns Coloradans may have with prescribed medications?

“Therapy for life” is one phenomenon Harper points to—starting a drug and never stopping it—even if a patient never gets better on that drug. “Maybe it should be removed or replaced,” Harper says, “especially if there are side effects, like weight gain, that could lead to other issues like high blood pressure or diabetes.”

Treating the side effects of prescription medications. “When a medicine has side effects that cause that person to take additional drugs to solve the new issues,” Harper says, “it’s time for them to return to their doctor to ask whether a different care plan is appropriate.”

Drug reluctance. Some people don’t take their medication because they fear the side effects. If you have such concerns, Harper says, talk with your doctor about your treatment plans to address your concerns and understand your risks. She adds that if people don’t know WHY they’re given a certain prescription, “It’s always a good idea to ask questions” because “if you don’t understand why you need to take something, you’re less likely to comply with it, which … may cause more problems.”

Candor in communicating. By all means, Harper says, be honest with your doctor about your prescription medication compliance, or non-compliance. Otherwise in some situations, your doctor might actually add another drug or increase a dosage in the belief that a current prescription is not working well enough. Be honest as well about any side effects you are experiencing or problems you have with being able to afford your prescriptions, because there might be other options available to you.

Don’t stop a drug “cold turkey.”

Lastly, Harper says if you do have issues with a prescribed drug, talk to your doctor about your reasons. Get as clear an understanding as possible about why the drug is recommended, and what other options you might have. Harper says do NOT stop taking a prescribed medication “cold turkey.” This can have serious consequences and imperil your health and life. In many cases, even when you and your doctor agree on discontinuing a drug, a gradual tapering off is required to avoid adverse reactions that can occur when abruptly stopping a drug.