Taking medicines safely

Medicines can be confusing. We are told that they can cure an illness or improve our symptoms, but that they can be dangerous if taken incorrectly. The key to dealing with medicines effectively is to understand them.

When you pick up prescribed medicines, the pharmacist should explain each one to you, what they are for and how they should be taken. Always check the strength of the medicine - some formulations, especially liquid medicines, come in different strengths. Remember, if you have any questions, talk to your pharmacist.

Use the medicines as directed on the label. Your medicine should have instructions for taking it either on a label or on the box or bottle. Always follow these instructions and never give more than the recommended dose. Sharing medicines can be dangerous. When they are prescribed, the doctor takes into account the patient’s symptoms and general health.

Even though a friend or relative may have the same symptoms, they may have other factors that make the medicine unsuitable or even dangerous. Medicines should only be taken by the person for whom they were prescribed.

You should have been told whether to give the medicine with or after food or on an empty stomach. This is important because the amount of food in the stomach affects how well the medicine is absorbed. Some medicines can irritate the stomach lining so it is best to take them with or after food to reduce the risk of irritation.

Most tablets or capsules are best taken with a glass of water, preferably while sitting or standing. Some medicines interact with certain foods or drinks. For instance, some medicines should not be taken with milk as this can reduce how well they are absorbed. Other medicines, for instance, should not be taken with grapefruit juice. If you are unsure, please ask the pharmacist.

If you are taking several doses each day, it can be difficult to work out when to take them. With most medicines, you do not have to wake up during the night to take a dose, so you can spread out the doses throughout the day. If you are not sure of the times to give medicine, talk it over with the pharmacist.

Some medicines interact with other medicines. This can happen in various ways: one medicine might stop another from working so well, whereas others can increase the effect of another medicine. You should always tell the pharmacist about all your child’s medicines, including those bought over the counter, herbal and complementary medicines and other prescribed medicines.

When your pharmacist knows about all of your child’s medicines, he or she can work out if they are likely to interact. If there is a chance of an interaction, you might need to alter the schedule of doses so that the two medicines are not taken at the same time. Alternatively, your child might need to be prescribed another medicine altogether. If you are concerned about medicines interacting, please discuss this with your doctor or pharmacist.

Medicine doses are worked out by age, that is, whether a child or an adult will take it. When prescribing medicines for children, their height and weight is taken into consideration as well. You may see a medicine dose described as mg/m², which is referring to a child’s ‘surface area’. This is calculated from a child’s height and weight, so the dose might be increased as a child grows.

This is particularly true of medicines that are taken on a long-term basis as their effectiveness might reduce over time if the dose remains the same. If your child is prescribed a long-term medicine, your doctor may ask you to weigh and measure your child regularly and may change the dose accordingly.

This is the name often given to herbal or homeopathic medicines. These are different to mainstream medicines in that they are not subject to the same rigorous testing and there is some debate about whether they are effective and if so, how they work. One important point to remember is that although you can buy a vast range of alternative and complementary medicines over the counter, they can still have as harmful an effect if taken improperly as mainstream medicines can.

For instance, certain vitamins can be harmful if taken at too high a dose and others are not recommended for children at all. Some alternative and complementary medicines, such as St John's Wort, can interact with prescribed medicines.

Whether you decide to take alternative and complementary medicines or not, it is important that you tell your doctor and pharmacist about all medicines you are taking. They will be able to advise about possible interactions.

• Always keep medicines out of sight and reach of children.
• Some medicines need to be kept in the fridge, but most at room temperature, away from direct sunlight and heat sources, such as radiators or fires. The label should give storage instructions but check with your pharmacist if you are unsure.
• A locked medicine cabinet on the wall is often the safest place to store medicines. Most people keep their medicine cabinet in the bathroom, where it can be hot and steamy, and it could be better placed elsewhere in the home.
• Always keep medicines in their original packaging. It can be dangerous to ‘decant’ medicines into another container as it will be unlabelled, which could be dangerous if different medicines get mixed up and taken at the wrong time. Some medicines do not work as well once they have be removed from the packaging, such as tablets or capsules that come in blister packs. As well as showing the name of the medicine, the packaging usually protects it as well. Keep the patient information leaflet that comes in the package as well - this tells you important information about the medicine such as side effects and storage instructions.
• If you have trouble opening childproof containers, ask your pharmacist about optional devices for opening them. If you store medicines out of sight and reach of children, you might not need a childproof container.

• Medicines are expensive so do not ask for more than you need. It can also be risky to keep too many medicines at home. It is not advisable to ask for a bigger supply to save for another occasion as some medicines have a short expiry date.
• If your doctor decides to stop treatment with a medicine or change to a different one, return any unused liquids, tablets or capsules to the pharmacist. Do not flush them down the toilet or throw them away.
• Do not hoard medicines if they are no longer required. It is a good idea to check your medicine cabinet on a regular basis, returning any unused or unwanted medicines to the pharmacist for disposal.

Your pharmacist should always be your first port of call if you have any questions about medicines. Most community pharmacies have a quiet room where you can talk to a pharmacist in private and many keep a selection of health information leaflets as well.

If your child is a patient at Great Ormond Street Hospital (GOSH) and you would like to know more about his or her medicines, please call Pharmacy Medicines Informationon 020 7829 8608 (Monday to Friday from 9am to 5pm). Please note that we might not be able to give advice to parents of children not currently being treated at GOSH.

If your child is not a patient at GOSH, please contact the hospital looking after your child or your family doctor (GP).