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Weekend House Call

Aired September 20, 2003 - 08:29   ET


ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Good morning, and welcome to Weekend House Call. If you have a cough, cold, headache or heartburn, you usually go to a pharmacy and buy something over the counter, OTC, for relief. There are over 100,000 different OTC drugs on the market today. When you're making your purchase, do you read the label carefully, follow the directions, and ask questions of your pharmacist? A new survey of more than 1,000 people shows most Americans don't.
The heartburn medication known as the little purple pill went over the counter this week. The Food and Drug Administration only approved Prilosec OTC after its maker, Procter & Gamble, conducted studies to prove patients could understand and follow the instructions on the label. But a survey carried out for the government shows most Americans don't do a good job of reading drug labels or following the directions.

The FDA says misuse of over the counter, or OTC, drugs caused 178,000 hospitalizations last year. Surgeon General Richard Carmona warns mixing drugs can be dangerous. Fifty-one percent of those polled have taken an OTC medicine and a prescription drug simultaneously.


DR. RICHARD CARMONA, SURGEON GENERAL: Many over-the-counter products share the same active ingredient. So you can hurt yourself by doubling or tripling up on different medications.

COHEN (voice-over): Equally troubling, many patients don't tell their doctors if their taking herbal remedies or dietary supplements at home.

DR. STEVEN LANSKY, EMORY UNIV. HOSPITAL: They don't consider them at all similar to medications. And therefore, when asked, a lot of times they just don't think about these products that they may be using.

COHEN: Almost half surveyed say they have sometimes taken more than the recommended doze of a nonprescription medication. And 35 percent say they've taken the next dose sooner than directed.

So here are simple steps to follow to ensure you're using OTC drugs the right way. Read the label. Every time you buy or use a nonprescription medicine, pay special attention to the ingredients and directions for use and the warnings. Take only the recommended dose as stated on the label. Also, talk to your pharmacist or doctor before combining an OTC medicine with a prescription medicine or before taking more than one OTC remedy at the same time.

And keep a record of all the OTC medicines, prescription drugs, dietary supplements or herbal remedies you take. Share this record with your health care provider at each visit.


COHEN: There are more than 5 billion over-the-counter drugs sold each year. While it's great that you can get medication without seeing a doctor, it's important to make sure to read the label and follow directions. Now, we have with us a box of nighttime cold and flu capsules. Turn it around and you'll see that on the back, there's a drug fact label that's very similar to the nutrition labels that you see on food. And they can be found on most drugs that were made after May 2002.

If you check it out, the label is divided into sections. The first always lists the active ingredient, which is the chemical compound that actually brings you the relief. Now, the uses are also listed. This section tells you the symptoms this medicine is approved to treat.

The next section deals with warnings. It tells you what other medications, food or situations, like driving, to avoid while taking the medicine. The next section lists direction, the daily dosage and frequency of the dosage is listed here. And you should follow it strictly. It's not just how much you take but how often you take the drug that's important. Other information on how to store the medicine and its inactive ingredients is also included.

We want to answer your questions about taking non-prescription drugs safely. Call us at 1-800-807-2620 or send your question via e- mail to

We're joined today by Lisa Chavis from Tampa, Florida. She's a registered pharmacist and author of the book "Ask Your Pharmacist." Thanks for joining us this morning.


COHEN: We've gotten so many calls, Lisa, and e-mails on this topic. Our first e-mail is from Illinois. And it's very interesting because many people will take a prescription medication and then think nothing of taking an over-the-counter one, as well. But she had a bad drug interaction.

She writes, "I'm sure I'm not the only person who has allergies and motion sickness. I didn't it a second thought when I took a long trip during allergy season, to take OTC motion sickness tablets along with my prescription anti-histamine. When I felt queasy, I took another motion sickness pill. I became violently ill and later learned from a pharmacist that both of the pills had similar ingredients and that I was actually, starting to overdose. Please let people know about this situation." COHEN: Now, Lisa, you're a registered pharmacist. How often does this kind of thing happen?

CHAVIS: Unfortunately, it happens too often. And interactions between over-the-counter and prescription drugs can be quite serious. It's very important that whenever you get an over-the-counter medicine, you talk with your pharmacist, you talk with your doctor; let them know what other medications that you're taking at the same time. They'll be able to make sure that there's not going to be an interaction, that you're not having medical duplication of the medicines.

COHEN: Now, so often these peop -- these days, people are taking not just prescriptions, not just over-the-counter. But Lisa, I'm sure you know this herbs and supplements that you can buy in health food stores. And that can create interactions, as well.

We have a call from Dean in Florida on this very topic. Dean, go ahead with your question for our pharmacist.

DEAN, CALLER: Yes. Good morning, folks. With the limited regulations the FDA has on dietary and energy supplements, whether it's ephedrine or caffeine, what can parents do to actually educate themselves when it comes to combining other drugs? And also, one other question; there are so many drugs that look exactly alike and even put out by the same company. How can we actually tell the difference when the same company puts out identical drugs?

COHEN: So Lisa, I think Dean is asking you a question about if you suspect that your child might be taking something with ephedra, should you also worry about what prescriptions your child might be taking?

CHAVIS: Absolutely. Even if your child is taking something with ephedra, it certainly -- you know, there are dangerous associated with this over-the-counter product. So it's something to talk to your child about and find out, you know, the reason that they are taking it.

Herbal products do not have the FDA warnings on them that non- prescription OTC items do. So it is pretty much a consumer on your own having to figure out, you know, what could cause an interaction, what could cause a problem with one or the other.

COHEN: And doctors, when they go to medical school, are they given a good education about herbs and supplements and whether or not they'll mix with medicines?

CHAVIS: Unfortunately not. Some medical schools have just started having one course on herbals because so many Americans are using herbs in addition to their prescription drugs.

COHEN: OK. We have an e-mail now from Brenda in California who also has a question about her child.

She says, "I have an 11 year old son who is five feet-four inches." Big boy. "And weighs almost 200 pounds. When administering OTC drugs, like Tylenol or allergy medicine, should I go by his weight, which is that of an adult, or by his age?"

I know many parents have asked themselves these questions -- this question. What do you think, Lisa?

CHAVIS: Absolutely go by the weight. Children's hospitals, pediatricians all use weight-based dosage for children. It's very important, especially if you have an older child who is low, you know, has a lower body weight. You certainly don't want to give them too much medication; it can be a very big danger for them.

COHEN: Lisa, many people just take just plain old vitamins, like a multivitamin, whether it's a child or an adult. Can those interact with prescription medicines or over-the-counter medicines?

CHAVIS: They certainly can. They certainly can. There are certain antibiotics that vitamins interfere with. They'll decrease the absorption so you're not getting the full effect of your antibiotic. Always speak with your pharmacist, you know, speak with your doctor, you know, about anything that you're taking over-the- counter along with your prescription medicines.

COHEN: Right. At the beginning of every doctor visit, they say what are you taking, what are you currently taking? I think most people just think of prescriptions, they don't think of something as vitamins that it's important to say that, as well.

CHAVIS: Right. Those are absolutely just as important.

COHEN: We have a call now from Kathy in Ohio.

Kathy, go ahead with your question for Lisa.

KATHY, CALLER: Good morning. I was wondering if you could please tell me why on the label of a lot of over-the-counter medicines for cold or sinus, indicate you shouldn't take them if you have thyroid disease?

CHAVIS: That's a good question, Kathy. The -- usually it's the decongestant part of the cold medicine can cause spikes in blood pressure, can cause spikes in thyroid. It can cause dangers with your particular condition. It's something that you would want to talk to your doctor about, depending on how you're controlled. If you -- if it's, you know, a high thyroid condition, a low thyroid condition, all of those are going to be dependent on what over-the-counter medications you can take.

COHEN: We've got to take a quick break now. When we come back, taking over-the-counter medications and antibiotics correctly. Can they mix? Now, Many doctors have stopped prescribing them as much. When is it OK to ask for them? We'll talk about it and answer your questions. Call us at 1-800-807-2620 or e-mail us Stay with us.

(COMMERCIAL BREAK) COHEN: Did you know that that little purple pill is now pink? Prilosec OTC still comes in purple packages, but the pills in the new over-the-counter brand are pink instead of purple. It's the color of the magnesium salt used to make the tablets.

This WEEKEND HOUSE CALL, and we're talking about taking medicines wisely. Call us with your questions at 1-800-807-2620 or e-mail your questions to While we're getting your calls lined up, let's check our "Daily Dose Health" quiz. How many prescription drugs does an average senior citizen take? We'll have the answer in 30 seconds. Stay with us.


COHEN: Checking the "Daily Dose Health" quiz, we asked how many prescription drugs does an average senior citizen take? The answer, five or six. So if you add aspirin, cold medicines or herbal supplements to that, you could be taking over 10 medications. That's why it's important to talk to your doctor or pharmacist to make sure that adding OTC to your prescribed regimen is safe.

You're watching WEEKEND HOUSE CALL and we're talking about taking prescription and non-prescription medicines responsibly.

Now, antibiotics used to be prescribed all the time for kids, but a new study shows that doctors have cut back on handing out prescriptions to both kids and adults. Now the government wants to get the message out to parents, it's asking moms and dads to stop pestering pediatricians for antibiotics when their child just has a run of the mill cold.

Lisa Chavis, a registered pharmacist, joins us from Tampa.

Lisa, we have Michelle on the phone from Ohio and she has a question about antibiotics.

Michelle, welcome to our show, go ahead with your question.

MICHELLE, CALLER: Good morning. Most of the time when I to the doctor for severe cold symptoms, I receive a prescription for antibiotics. And my question is, how often does this happen and what kinds of problems can result with overuse of antibiotics when they are not needed?

CHAVIS: That's a good question, Michelle. Antibiotic overuse can cause quite a few problems. You develop a resistance to bacterial infections, if it's for you or your child. What may happen is the next time you get sick, you may get an antibiotic but bacteria have developed resistance and you may not get well as quickly. This condition may last a little longer.

As far as how often this happens, quite often. I read recently that I think it's 40 percent of the antibiotic prescriptions that are written are written needlessly. So that's quite a few antibiotics that are out there that don't need to be written.

COHEN: Forty percent is a very high number. I mean, should you question your doctor and say doctor; do you really think I need these?

CHAVIS: There's an incredible power in a prescription when someone gets a little white slip of paper, they automatically feel like they're going to get better. It's amazing, someone brings it in and they know that's going to make them feel better.

And there's a lost pressure on physicians to write for an antibiotic. I think part of this campaign is to stop parents and adults from actually asking for them and demanding an antibiotic every time they go in to see a doctor. In just -- you know, in just sore throats these alone, only 10 percent are caused by a bacteria that antibiotics can even do anything about.

COHEN: Now, antibiotics, of course, are by prescription but we have a lot of questions about over-the-counter drugs as well. This one is from Sally in Texas.

She writes, "I've taken Benadryl nightly for several years for allergy and sleeping purposes. Is there any long-term effect or hazard associated with long-term use of this drug? Is it a carcinogen?"

Lisa, what do you think?

CHAVIS: It's not a carcinogen. But as far as long-term, what happens is when you take a medication for over several weeks, several months at a time, your body becomes tolerant for it. That means that it's not actually going to work at the same level. You're going to require more of the medication to get the same effect. So long-term, it is something to think about if you're using it as a sleep aid, possibly talking to your doctor about something that might be more effective for you.

COHEN: Can you get addicted to over-the-counter drugs?

CHAVIS: Certainly, certainly.

COHEN: Because I think most people probably don't think that. They think it's got to be prescription.

CHAVIS: Mm-hmm.

COHEN: Well, we've a phone call from Catherine in South Carolina.

Catherine, welcome to WEEKEND HOUSE CALL, and go ahead with your question.

CATHERINE, CALLER: Hi, thank you. I have been prescribed Fosamax for the past two years osteoporosis, and was wondering, the instructions say to drink water for two hours and not eat anything until then. My physician says it's OK after 30 minutes. And I wondered also, is there a new drug out for osteoporosis?

CHAVIS: Yes, as far as the Fosamax, taking the medication, it is usually OK within 30 minutes as long as you're taking it with water, a full glass the water, eight ounces is what they recommend.

And yes, there are several new drugs out. There are, gosh, I can't think of the name of right it off the top of my head. But there's a new drug by injection, and there is another drug that's in the R&D pipeline that probably should be out early next year.

COHEN: We now have an e-mail from Gail in Louisiana. She wants to know, which over-the-counter pain reliever for headaches, et cetera, will not affect one's liver?

Lisa, we hear a lot about acetaminophen, which is in Tylenol and other things, can sometimes affect the liver. Is that right?

CHAVIS: That's absolutely right, especially when combined with alcohol even just one to two drinks a day of alcohol, the Tylenol liver toxicity is a noted problem.

As far as over-the-counter pain relievers, none of them are completely safe. Even aspirin can cause severe stomach bleeding. There isn't anything -- even though it's an over-the-counter, doesn't mean that it's completely 100 percent safe. Read the warning labels carefully on the back because there is in even in aspirin is not 100 percent safe.

COHEN: Thanks for that advice.

We'll take a quick break. Callers stand by. When we come back, when was the last time you looked inside your medicine cabinet? When a drug has expired, should you throw it out? We'll have that answer when WEEKEND HOUSE CALL continues.


COHEN: Did you know that Tylenol and Nyquil have the same active pain relief medicine? It's called acetaminophen? How often have you had a bad cold or fever and taken Tylenol and Nyquil at the same time? If you've ever done that, you've taken more than the recommended dosage of acetaminophen. That's why it's important to read the label.

This is WEEKEND HOUSE CALL, and we're talking about taking medicine responsibly. Lisa Chavis is a registered pharmacist and author of a book called "Ask Your Pharmacist."

We have a question about drug expiration dates. And Joan in Maryland, she wants to know, "My internist says that prescription drugs are safe years beyond their expiration dates. He maintains that if a pill has not turned to powder, it is safe and effective. And even after turning to powder, some may be fine. Is this true?"

Lisa, is her internist right?

CHAVIS: If he is, I have never heard of this. After an expiration date, medication begins to lose its potency. In some medications, like the antibiotic tetracycline, it can actually become toxic. So waiting past a medicine's expiration date is not a good idea. It may not produce the effect that you're looking for and may not work at all.

COHEN: Well, here's a tough question for you, OK? You've got parents of a baby. It's 2:00 in the morning. The baby spikes a fever, they go to the medicine cabinet and they want to give the Baby Tylenol or Advil and it expired two months ago. Do you give it to the baby or run out to the 24-hour store.

CHAVIS: I'd find a 24-hour store. Unfortunately, after it's past its expiration date, there is no guarantee that the medication is going to do what you need it to do. And with your child's health, you just don't want to take a chance.

COHEN: So to recap now. Here are some tips for your medicine cabinet. Clean out your medicine cabinet at least once a year. Store medicines in a cool dry place unless stated otherwise on the label. Throw away any medicines if its past the expiration date and keep all medicines in their original containers.

We have an e-mail question now from Canada. Shuba in Toronto wants to know, "What do you feel is the role of pharmacists in counseling patients regarding OTC medications?"

I guess if I go to the drugstore and I want to buy something over-the-counter, Lisa, can the pharmacy help me with that?

CHAVIS: Absolutely. We're the frontline when someone brings an over-the-counter product up to us; we're there available, all the time to answer their questions. Always, always, always ask the pharmacist. Ask about any side effects that you're concerned with, any interactions with any medications you're taking. Just any questions and all that you have about over-the-counter products. Certainly, go find your pharmacist.

COHEN: And one great thing about pharmacists is they're always there. Doctors -- if you want to talk to your doctor sometimes, you've got to wait four or five days to get him or her on the phone. CHAVIS: That's true.

COHEN: Pharmacists, he can't go anywhere, she can't go anywhere.

Well, we've got to take a quick break now. Grab a pen. We'll give you some helpful Web site addresses when we come back. You're watching WEEKEND HOUSE CALL.


COHEN: For more information on taking medicines responsibly, check out this great Web site. Go to You can also check out our Web site at seeanon -- We've got links with more information about over-the-counter drugs and antibiotics.

Welcome back to WEEKEND HOUSE CALL. We've been talking to registered pharmacist Lisa Chavis, who's been giving us all sorts of advice about prescription and over-the-counter medications.

Lisa, give us a final thought on this topic. CHAVIS: Over-the-counter products can kind of lull us. We think that because we can pick them up in the grocery store, can pick them up at a pharmacy, that they're always going to be safe. But these are medications. So whenever you're taking over-the-counter products, talk with your health care provider, your doctor, your pharmacist, let them know what else you're taking.

COHEN: Lisa, thank you for all the fine advice you've given us...

CHAVIS: Thank you.

COHEN: ... over the past half hour. Thanks for joining us.

CHAVIS: Thank you.

COHEN: That's all we have time for today, unfortunately. Make sure to watch tomorrow's WEEKEND HOUSE CALL at the same time when we talk about fall allergies. Some people actually suffer more in the fall than they do in the spring. We'll tell you what's causing the sniffles and red eyes and what you can do to treat it.

Remember, this is the place for your answers to your medical questions. Thanks for watching. I'm Elizabeth Cohen, CNN SATURDAY MORNING continues now.


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