Medication Dosage and Use
I’ve been prescribed narcotics because of chronic pain, and the bottle says I should avoid operating heavy machinery and driving when I take them. Can you tell me why? Is there anything else I should avoid, like herbal supplements?
Narcotic pain medications (also known as opioids) tend to make people dizzy and drowsy. That is why people taking them are warned not to do things that could be dangerous if you were not 100% alert. Many people who use narcotic medications for chronic pain report that these side effects lessen or go away after a few days or weeks on the medication. However, even if you feel alert, driving might not be safe or legal in your area. Consult your health care team about whether you should restrict your activities while taking narcotics.
You should avoid other things that can make you sleepy or dizzy while taking this medication. Sleeping pills, tranquilizers, muscle relaxants, antihistamines, and even alcohol can make the side effects worse. Even if you usually do not have these side effects, you can get them when you add another medication or alcohol to your routine. Also remember that even over-the-counter medications and herbal supplements might cause these problems when taken with narcotic medications.
In particular, the herbal supplements kava and valerian should not be used with narcotic medications. Kava is typically used as a pain reliever, muscle relaxant, anti-anxiety treatment, or anticonvulsant. Valerian has similar uses as a mild sleep aid, pain reliever, and muscle relaxant. Both of these supplements can intensify the drowsiness and dizziness of narcotic medications.
Tell your doctor about all medications and herbal supplements you take, including over-the-counter medications and vitamins. Read the labels of your medications and consult your health care team if you have concerns. If you have any side effects, be sure to tell your doctor—you might just need a different dose of the medication.
Three days ago, my daughter was prescribed an antibiotic for an ear infection. She is very small for her age, and I’m hesitant to give her the whole dose because I don’t think the healthcare provider considered her weight when determining the dose. I’ve been breaking the pill in half and she seems better. Did I do the right thing?
In a word, no. Antibiotics work by killing the bacteria that cause infection. If you take less than was prescribed, all the bacteria might not be killed. The surviving bacteria can become resistant to the drug, and it might not work the next time your daughter needs it. With antibiotics, it is very important to take the full dose and finish all the medication exactly as prescribed. Also, breaking pills can sometimes be dangerous.
Health care professionals are taught to consider both age and weight when prescribing medication. However, if you feel the doctor might have made a mistake, you should call the doctor’s office or ask your pharmacist to make sure that the dosage is in a safe and effective range. Pharmacists are a great source of information about medication safety.
It is good for you to be aware of the potential drawbacks of your child’s medications, but you must also be open with your child’s health care team about your concerns. If you don’t feel comfortable giving a drug to your child, please discuss those concerns with the medical team so that you can decide on a safe course of action.
I have a difficult time swallowing large pills, and in the past, I’ve crushed the pills up and mixed them into food to make them easier to take. Are there any medications that I shouldn’t do this with?
You should be very cautious about crushing pills. Many pills have a special timed-release coating that allows small doses of the medication to be absorbed over time as the coatings dissolve. Crushing a pill destroys its coating, and releases a much larger dose all at once, which can lead to dangerous side effects or even death.
Talk to your pharmacist about whether your medications are available in a different form. Your doctor might be able to change the prescription to a liquid, or to several smaller pills that are easier to take. If you have to use a large pill, ask your doctor or pharmacist if it is safe to crush it or dissolve it in food. To be safe, it’s important to ask about every medication, and even for refills if the pill changes from one manufacturer to another.