A man taking a common pill (Image: Getty)
Health experts have issued a warning to Brits who take multiple medications following findings that half are unaware of the potentially harmful side effects. Data from TakingCare reveals that half of Brits are unaware of the side effects of the medicine combinations they take, with common medications for conditions such as high blood pressure, heart problems and blood sugar control all being identified as having potentially life-threatening side effects.
With the average 70-year-old in the UK taking around eight medications a day, elderly people are at increased risk of facing severe side effects. Lauren Frake, Elderly Care Expert at TakingCare has teamed up with Peter Thnoia, Prescribing Pharmacist and the Chief Product and Innovation Officer at PillTime, to issue guidance on the common medicine combinations that could have deadly side effects for the elderly population.
Furosemide/indapamide and metformin – severe dehydration and low blood pressure
“Medication used for heart conditions such as heart failure or high blood pressure, for example furosemide or indapamide, can cause rapid drops in blood pressure and require the patient to maintain a steady water intake,” Peter explains. “For example, if an elderly person taking one of these medications finds themselves sweating more than normal, they may quickly reach a state where their blood pressure is very low and which will drastically increase their chance of a fall. These types of tablets are taken by around 30% of our patients at PillTime.”
Lauren said: “More than 40% of elderly falls recorded by TakingCare are from people who take medication for a heart condition, likely linked to the potential side effects of some of their medication, which can involve an increased risk of falling.”
“This, combined with the fact that a person’s risk of having a fall drastically increases once they enter the 70+ age bracket, creates the perfect storm for older people who take multiple heart condition medications, as they are more likely to get dehydrated, dizzy and consequently have an accident. Our research shows that a person’s health can severely deteriorate after they’ve had a fall, so accident prevention is key here.”
Peter said: “Type 2 Diabetes medication metformin can also cause a condition called Lactic acidosis in cases where a patient becomes dehydrated. This can lead to them feeling exhausted, weak, experiencing a burning feeling in their muscles, as well as nausea, and cramps.”
“It would be safe to say that an elderly person taking both metformin and furosemide are at increased risk if they become dehydrated, placing them more at risk of a fall.”
Antihistamines (Hay fever medication) and sedatives or benzodiazepines – dangerous drowsiness
As hay fever patients have suffered numerous ‘pollen bombs’ this summer, Peter said: “Lots of the active ingredients of hay fever medication belong to a group of medicines called antihistamines,” Peter explains. “These are very effective in reducing symptoms of hay fever, however they are known to cause drowsiness – some more than others.
“If someone is maybe not as steady on their feet and also taking another medication which has a sedative effect, alongside hay fever medication, they could quickly become at risk of a fall.
“Benzodiazepines such as temazepam, loprazolam, lormetazepam, diazepam and nitrazepam, which are typically prescribed to reduce anxiety and promote calmness, relaxation and sleep all include drowsiness and confusion as one of their potential side effects, so taking antihistamines in conjunction with these medications should also be handled carefully.”
Lauren said: “Hay fever medication is an easy go-to to help relieve symptoms during the summer months. However, the increased risk of drowsiness, combined with other medications that have a similar effect isn’t to be underestimated.
“Patients should also be careful driving whilst taking multiple medications with a sedative-effect, as the effect could be very dangerous.”
Oral decongestants (pseudoephedrine) and antidepressants – irritability, delayed reactions and confusion
Peter highlights that antidepressants, which, according to the NHS are taken by 8.6million people in the UK, can also interact with common over-the-counter medicines and have potentially risky results.
He said: “Selective serotonin reuptake inhibitors (SSRIs), which are used to treat depression and anxiety, can also cause drowsiness, confusion and slowing of reactions. Fluoxetine is a very well-known SSRI. Other SSRIs include citalopram (Cipramil), escitalopram (Cipralex), paroxetine (Seroxat) and sertraline (Lustral).
“Another medication found in cold and flu products will interact with some antidepressants. For example, taking a selective SSRI antidepressant and an oral decongestant (such as pseudoephedrine or phenylephrine) can cause irritability, insomnia and affect blood pressure. If someone is unaware to look out for these they can display very odd behaviour that can be alarming for the individual and those around them.”
Lauren said: “Our experience with elderly people shows that people who experience confusion and delayed reactions are at a higher risk to themselves. This can mean they will put themselves in unnecessary risk because they haven’t understood their surroundings, or in more severe cases, they may neglect an injury or wound, which can lead to dangerous consequences. This could be even riskier for those with Dementia or Alzheimer’s.
“Emergency alarm services will help to monitor patients who take multiple medications, and response teams will be on the lookout for common side effects, and it’s important that family members are also aware of potential side effects and the signs to look out for.
“For example, patients who are suffering from sudden confusion as a result of their medication may be unnaturally irritable and perhaps even aggressive. They will likely have changes in their personality, may have rambled speech and seem easily distracted from conversation.
“Special care should be taken around people who are expressing these symptoms, as they may be at risk of an accident, so ensure the home space has been checked for any trip hazards or poor lighting in stairwells. It may sound simple, but a quick check to make sure corners of rugs are taped down and that there are non-slip mats in the bathroom areas and kitchens can make all the difference for preventing accidents at home.
“Whilst an increased risk of falling may be alarming to the families of patients who are unaware of this information, the key takeaway is that there are simple preventative measures that can be put in place to reduce the risk of patients having a fall. By taking simple preventative steps early on, both patients and their families and ensure that elderly people can live independently and safely at home for longer.”