People’s Pharmacy | Rx roulette: Double check for drug interactions
When your doctor writes a prescription, she is supposed to know everything else you are taking and check that the new medication won’t interact. Long ago, doctors and pharmacists had to look the combination up in a big book like the PDR (Physicians Desk Reference) or some other print resource. Today, interaction warnings are computerized.
In theory, that should make checking for incompatibilities much easier. But it is still far from seamless. Many physicians and pharmacists complain about “alert fatigue.”
We heard a while ago from a healthcare provider. She gets frustrated with excessive alerts the computer presents: “The number of alerts is mind-boggling. If a patient is allergic to anything, I get an alert for every medication I prescribe. And I have to go through a rigmarole to get to the reason for the alert to see if it is relevant or not. I don’t need to know about a wool allergy.
“Drug-drug interactions are more serious, but the alerts look identical to non-relevant alerts. For years, I have been asking the software provider to improve this, to no avail.
“I tell patients about common OTC interactions, like don’t take a cold medication with DM on the label. The cough suppressant dextromethorphan (DM) interacts badly with antidepressants like SSRIs or SNRIs.
“If someone has migraines, I warn them about common migraine meds even if they aren’t taking them at the time of the appointment. I also upload information about serotonin syndrome to their portal account to make sure they have that information.
“Patients need to be more active in their care. They often message me between appointments to ask about interactions with a new medication they started with another provider. Please ask the provider who wrote the scrip for the new medication about this during the appointment. Or, if you forget, ask the pharmacist when you pick up the new medication. Don’t ask the provider whom you haven’t seen for months!
“Patients often fail to tell me what OTC medications, vitamins, supplements, herbals, birth control, inhalers, creams, eye drops or recreational drugs like nicotine or alcohol they use. I ask repeatedly about these because this stuff is important! Prescribers need to know what is going into your body. Please compile a list with dosage and type (extended release, etc.) so we can add it to the software. I promise I won’t judge you for taking St. John’s wort. I just need to know.
“I myself bring such a list to every appointment with my providers. You can also take a picture of your medications. I take photos of my medication bottles all lined up and send it to my husband. I also send him an updated list of medical diagnoses. If there were an emergency where I can’t speak for myself, he would have it right there on his phone.
“My brother-in-law took a picture of his 89-year-old mother’s medications when he visited her last summer. That sure came in handy when I had to take her to the emergency room while we were traveling! She only had her pills in a pill organizer, so there were no labels to identify them.”
Doctors and pharmacists are so busy these days that they could easily miss an important interaction. That’s why we always encourage patients to be their own advocates. Drug interaction checkers can be found at Drugs.com, DrugBank.com and Medscape.com.
Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. In their column, they answer letters from readers. Write to them via their Web site: www.peoplespharmacy.com. Their newest book is Top Screwups Doctors Make and How to Avoid Them (Crown).
This story was originally published June 26, 2025 at 10:56 PM with the headline "People’s Pharmacy | Rx roulette: Double check for drug interactions."