Dangerous Medication Combinations: When Can Prescribing Errors Cause Harm?

Taking several medicines at the same time is common, particularly among older people and those living with diabetes, asthma, heart disease or kidney problems. In many cases, this is entirely appropriate. Different medicines may control separate conditions, prevent a stroke or heart attack, or substantially improve a person’s quality of life.

The difficulty arises when one medicine alters the effect of another, aggravates an existing condition or adds to a shared side effect. The consequences can include dizziness, falls, internal bleeding, breathing difficulties, dangerously low blood sugar, kidney injury or an abnormal heart rhythm.

According to the NHS Specialist Pharmacy Service guidance on polypharmacy, 8.4 million patients regularly take five or more medicines. It also reports that one in five hospital admissions among patients aged over 65 results from adverse drug effects.

Those figures do not mean that taking several medicines is itself unsafe or negligent. They do, however, demonstrate why accurate prescribing, medication reconciliation, monitoring and regular medication reviews matter.

If after reading this material you require more information please read our article on: Medication Error Claims: Can You Sue a Doctor or Pharmacist?

Important medical warning: This article provides general information. It is not personal medical advice or a complete medication-interaction checker. Do not stop, start, skip or change the dose or timing of prescribed medicine because it appears in this guide. Some of the combinations discussed below are routinely and beneficially prescribed under clinical supervision. Ask a GP, prescribing clinician or pharmacist to review your exact medicines, doses and medical conditions. If somebody is unconscious, is not breathing normally, has severe breathing difficulties, shows signs of a stroke or heart attack, or has heavy bleeding that will not stop, call 999. For urgent concerns that are not immediately life-threatening, contact NHS 111.

What is a medication interaction?

A medication interaction involves more than two tablets chemically “clashing”. There are three common ways in which harm can arise.

Medicine-to-medicine interaction: one medicine changes the level or effect of another. For example, an antibiotic may increase the concentration of another drug in the bloodstream.
Medicine-to-condition interaction: a medicine prescribed for one health problem may worsen another condition. Certain beta blockers, for example, can aggravate asthma in some patients.
Additive or cumulative effect: several medicines produce the same effect, such as lowering blood pressure, slowing the heart, causing drowsiness or increasing the risk of bleeding.

This is why a computer-generated prescribing warning is only one part of the safety system. Safe prescribing also requires consideration of the patient’s age, frailty, blood pressure, pulse, kidney and liver function, allergies, test results, symptoms and use of non-prescription products.

Common medication combinations requiring particular care

The following examples are intended to prompt a professional medication review. They are not a list of medicines that must always be avoided.

Patient or clinical situation	Medicines that may require special review	Possible symptoms or harm
Low blood pressure, dizziness or a history of falls	Tamsulosin or another alpha blocker taken with blood-pressure medicines such as beta blockers, ramipril or losartan; diuretics; nitrates such as GTN; or sildenafil	Postural hypotension, light-headedness, blurred vision, fainting and falls
Older or frail patient, particularly someone with reduced mobility or previous falls	Opioids such as morphine taken with benzodiazepines such as diazepam, sleeping tablets such as zopiclone, gabapentin or pregabalin	Excessive drowsiness, confusion, poor coordination, falls, difficulty waking and slow or difficult breathing
Patient with a high anticholinergic medication burden	Bladder medicines such as oxybutynin or solifenacin taken with amitriptyline, certain antipsychotics or sedating antihistamines such as chlorphenamine	Confusion, blurred vision, constipation, urinary retention, dizziness and falls
Patient with diabetes	Insulin or gliclazide taken with other glucose-lowering treatments, beta blockers or systemic steroids such as prednisolone, dexamethasone or hydrocortisone	Low blood sugar or hypoglycaemia, masked warning signs of a hypo, or high blood sugar caused or aggravated by steroid treatment
Patient with asthma or reactive airways	Certain beta blockers, aspirin or NSAIDs such as ibuprofen in susceptible patients	Wheezing, coughing, chest tightness, breathlessness or an asthma attack
Patient receiving anticoagulant treatment	Apixaban, rivaroxaban, edoxaban, dabigatran or warfarin taken with NSAIDs such as ibuprofen, antiplatelets such as aspirin or clopidogrel, another anticoagulant or certain antidepressants	Increased risk of gastrointestinal, intracranial or other serious bleeding, including black stools, vomiting blood, severe bruising, persistent bleeding or a sudden severe headache
Patient with angina who uses nitrate treatment	Glyceryl trinitrate or GTN taken with erectile-dysfunction medicines such as sildenafil or tadalafil	A potentially severe reduction in blood pressure, causing dizziness, fainting, collapse or reduced blood flow to vital organs
Patient with a slow pulse or heart-rhythm problem	A beta blocker taken with verapamil, diltiazem, digoxin or amiodarone	An excessively slow heartbeat or bradycardia, heart block, dizziness, fatigue, breathlessness, fainting or collapse
Patient with heart failure or chronic kidney disease	An ACE inhibitor such as ramipril or an ARB such as losartan taken with spironolactone, amiloride or potassium supplements	High potassium levels, kidney dysfunction, muscle weakness and potentially dangerous changes to the heart rhythm
Patient who is dehydrated or at risk of acute kidney injury	An ACE inhibitor such as ramipril or an ARB such as losartan, combined with a diuretic and an NSAID such as ibuprofen—sometimes called the “triple whammy”	Acute kidney injury, reduced urination, nausea, vomiting, confusion, drowsiness, swelling and electrolyte disturbance
Patient receiving lithium treatment	Lithium taken with NSAIDs such as ibuprofen, an ACE inhibitor such as ramipril, an ARB such as losartan or a diuretic	Raised lithium levels and lithium toxicity, potentially causing diarrhoea, worsening tremor, muscle weakness, drowsiness, confusion, poor coordination or difficulty speaking
Patient receiving methotrexate	Methotrexate taken with trimethoprim or co-trimoxazole	Severe bone-marrow suppression, which may cause mouth ulcers, sore throat, fever, unexplained bruising, bleeding, severe tiredness or breathlessness
Patient receiving simvastatin	Simvastatin taken with the antibiotics clarithromycin or erythromycin	Muscle inflammation or damage, producing unexplained muscle pain, cramps or weakness and, rarely, rhabdomyolysis

Whether any combination is appropriate depends on the patient’s circumstances. The dose, reason for treatment, duration, existing conditions and monitoring arrangements all matter.

Low blood pressure medicines, tamsulosin and the risk of falls

Blood-pressure treatment may prevent strokes, heart attacks and damage to the kidneys, eyes and brain. However, the benefit must be balanced against symptoms caused by blood pressure becoming too low, particularly in an older or frail patient.

Medicines that may contribute to low blood pressure include:

ACE inhibitors such as ramipril;
angiotensin receptor blockers such as losartan;
calcium-channel blockers such as amlodipine;
beta blockers such as bisoprolol;
diuretics such as furosemide or bendroflumethiazide;
alpha blockers such as tamsulosin or doxazosin;
nitrates used to treat angina; and
medicines for erectile dysfunction, including sildenafil and tadalafil.

These medicines are not interchangeable and do not all carry the same risk. The concern is often their combined blood-pressure-lowering effect.

The NHS advice on tamsulosin interactions warns that taking tamsulosin with other medicines used for high blood pressure can lower blood pressure too much.

Possible warning signs include:

light-headedness after standing;
blurred vision;
unusual weakness;
fainting;
unsteadiness; or
an unexplained fall.

A fall can be especially serious if the patient is also taking an anticoagulant. A seemingly modest impact may cause substantial bruising or internal bleeding.

A suitable review might involve checking seated and standing blood pressure, recent falls, hydration, pulse, kidney function, the clinical reason for every medicine and whether the doses remain appropriate. It does not necessarily mean withdrawing an effective treatment.

Nitrates and sildenafil-type medicines

This is a particularly important interaction.

The NHS advises that sildenafil is not usually prescribed with nitrates, including glyceryl trinitrate, commonly known as GTN, because the combination can produce a dangerous reduction in blood pressure.

Patients should tell their doctor, pharmacist or emergency clinician that they use nitrate treatment before taking sildenafil, tadalafil or vardenafil. This includes erectile-dysfunction products purchased from a pharmacy or obtained online.

Diabetes medicines: low blood sugar, masked symptoms and steroids

Insulin and sulfonylureas such as gliclazide can cause hypoglycaemia. The risk may increase when doses overlap with other glucose-lowering treatments, meals are missed, food intake falls during illness or kidney function deteriorates.

NHS information about gliclazide identifies low blood sugar as a possible side effect and advises patients to disclose other diabetes medicines they are taking.

Symptoms of hypoglycaemia may include:

hunger;
sweating;
trembling;
dizziness;
weakness;
confusion;
blurred vision;
unusual behaviour; or
loss of consciousness in a severe case.

Beta blockers require separate consideration. They may be essential for a heart condition, but the NHS beta-blocker guidance explains that they can make it more difficult to recognise the warning signs of low blood sugar in someone using insulin.

Steroids can cause the opposite problem.

Prednisolone, dexamethasone and hydrocortisone may raise glucose levels by reducing insulin sensitivity and increasing the release of glucose into the bloodstream. This is explained in NHS guidance about steroid-induced diabetes.

Starting, increasing, reducing or stopping systemic steroids may require an individual glucose-monitoring and treatment plan.

The potential error is not necessarily that two medicines were prescribed together. It may instead be a failure to anticipate their combined effect, provide appropriate instructions, arrange monitoring, adjust treatment or respond to abnormal readings and symptoms.

Asthma: beta blockers, aspirin and anti-inflammatory painkillers

Certain medicines used for heart disease, pain or inflammation can trigger asthma symptoms in susceptible people.

The NHS states that aspirin, ibuprofen and beta blockers can trigger asthma symptoms in some patients.

This does not mean every person with asthma must avoid every beta blocker or anti-inflammatory painkiller. Reactions to aspirin and non-steroidal anti-inflammatory drugs affect only some patients. A clinician may also decide that a cardioselective beta blocker is necessary after balancing the cardiac benefits against the respiratory risks.

The prescriber should consider:

the severity and control of the patient’s asthma;
previous reactions to beta blockers, aspirin or NSAIDs;
whether a safer alternative is available;
the clinical importance of the proposed treatment; and
whether additional monitoring is necessary.

New wheezing, chest tightness, breathlessness or a reduced response to a reliever inhaler after starting a medicine should be assessed promptly. Severe breathing difficulty is an emergency.

Heart disease: bleeding, a slow heart rate and high potassium

People with heart disease often require several medicines. Many of these combinations are evidence-based and can prolong life. Nevertheless, they may produce significant harm if prescribed without proper assessment and monitoring.

Anticoagulants with NSAIDs, antiplatelets or antidepressants

Anticoagulants such as apixaban, rivaroxaban, edoxaban, dabigatran and warfarin reduce the risk of harmful blood clots.

Combining an anticoagulant with any of the following may increase the risk of bleeding:

ibuprofen;
naproxen;
aspirin;
clopidogrel;
ticagrelor;
another anticoagulant; or
certain antidepressants, including SSRIs and SNRIs.

The NHS Specialist Pharmacy Service guidance on direct oral anticoagulant interactions advises caution or avoidance with NSAIDs where possible. Where an interacting treatment is clinically necessary, monitoring and other protective measures may be required.

Sometimes an anticoagulant and antiplatelet medicine are intentionally prescribed together, such as following particular cardiac procedures. That is not automatically an error.

The relevant questions include:

Was there a sound clinical reason for the combination?
Was the intended duration recorded?
Was the patient’s individual bleeding risk assessed?
Was gastroprotection considered where appropriate?
Was suitable monitoring arranged?
Was the patient told about important warning signs?
Was the need for both medicines reviewed?

Patients taking anticoagulants should check with a pharmacist or prescribing clinician before using over-the-counter ibuprofen, naproxen or aspirin.

Urgent assessment may be required for:

vomiting blood;
black or tar-like stools;
coughing up blood;
severe or unexplained bruising;
blood in the urine;
a sudden and severe headache;
new weakness, confusion or slurred speech; or
bleeding that will not stop.

Medicines that slow the heart

Beta blockers, verapamil, diltiazem, digoxin and amiodarone can each affect the heart rate or its electrical conduction.

Certain combinations may be appropriate for selected patients. However, their cumulative effect can also cause:

an excessively slow pulse;
heart block;
low blood pressure;
fatigue;
dizziness;
fainting; or
collapse.

A suitable review may require pulse checks, an ECG, blood tests and adjustment of the dose or timing of treatment.

ACE inhibitors, ARBs, spironolactone and potassium

ACE inhibitors and ARBs are valuable treatments for high blood pressure, heart failure and kidney protection in selected patients. Spironolactone can also improve outcomes in some patients with heart failure.

When used together, however, these medicines may raise potassium levels or impair kidney function, particularly during dehydration or acute illness.

This is commonly an issue of patient selection, dose and timely blood-test monitoring rather than an absolute prohibition.

Kidney injury and the “triple whammy”

An ACE inhibitor or ARB, a diuretic and an NSAID can combine to reduce the kidneys’ ability to maintain adequate blood flow and filtration. This is sometimes described as the “triple whammy”.

The risk may be higher in:

older or frail patients;
people with chronic kidney disease;
patients with heart failure;
those taking high doses of diuretics;
people who are dehydrated;
patients experiencing persistent vomiting or diarrhoea; or
those with fever, sepsis or poor fluid intake.

NICE guidance on acute kidney injury identifies NSAIDs, ACE inhibitors, ARBs and diuretics among medicines that can cause or worsen kidney injury, particularly where a patient is hypovolaemic.

Patients should not create their own “sick-day” medication plan from information found online. They should ask their clinician for personalised instructions about what to do during vomiting, diarrhoea, fever or another acute illness.

Possible warning signs of kidney injury include:

producing significantly less urine;
persistent nausea or vomiting;
increasing confusion;
unusual drowsiness;
worsening swelling;
breathlessness; or
unexplained weakness.

These symptoms require prompt medical advice.

Sedatives, strong painkillers and anticholinergic burden

Older and frail patients can be particularly sensitive to medicines that cause drowsiness, impaired balance or confusion.

Opioids such as morphine, codeine or tramadol may have an additive effect when taken with:

diazepam or another benzodiazepine;
zopiclone or another sleeping tablet;
gabapentin;
pregabalin;
sedating antidepressants;
antipsychotic medication; or
alcohol.

The NHS morphine guidance lists gabapentin and diazepam among the medicines that may not mix well with morphine. It also identifies slowed or difficult breathing as a serious possible side effect.

The combination can increase the risk of:

excessive drowsiness;
confusion;
impaired coordination;
falls;
loss of consciousness; and
respiratory depression.

Some patients will have a legitimate clinical reason for receiving more than one of these medicines. The treatment nevertheless requires careful dose selection, review and safety advice.

Anticholinergic burden

Another concern is the cumulative anticholinergic effect of different medicines.

Examples can include:

oxybutynin or solifenacin for bladder symptoms;
amitriptyline;
certain antipsychotics;
some medicines for Parkinson’s disease;
sedating antihistamines; and
certain medicines used for nausea or dizziness.

Taken together, these medicines may contribute to:

dry mouth;
blurred vision;
constipation;
urinary retention;
confusion;
memory difficulties; and
falls.

A single prescription may appear reasonable when viewed by itself but become problematic when the patient’s entire medication regime is considered.

Three high-risk medication interactions worth recognising

Lithium with NSAIDs, ACE inhibitors or diuretics

Lithium has a narrow therapeutic range. Relatively modest changes in the level of lithium in the bloodstream can therefore become clinically important.

The NHS lithium interaction guidance identifies NSAIDs, ACE inhibitors and diuretics among the medicines that can affect lithium levels.

Possible symptoms of lithium toxicity can include:

worsening tremor;
severe thirst;
nausea or diarrhoea;
muscle weakness;
unusual drowsiness;
confusion;
difficulty speaking; or
problems with coordination.

Appropriate blood tests, symptom advice and communication between prescribers are essential.

Methotrexate with trimethoprim or co-trimoxazole

The NHS Specialist Pharmacy Service advises avoiding trimethoprim or co-trimoxazole with methotrexate because of the risk of severe bone-marrow suppression.

Possible warning signs include:

mouth ulcers;
sore throat;
fever or chills;
unexplained bruising;
unusual bleeding;
severe fatigue; or
breathlessness.

This interaction can sometimes have a delayed effect. Patients should tell any doctor treating an infection that they take methotrexate.

Simvastatin with clarithromycin or erythromycin

Certain antibiotics can increase the level of simvastatin in the bloodstream and consequently raise the risk of muscle toxicity.

The MHRA lists clarithromycin and erythromycin as contraindicated with simvastatin.

Depending on the clinical circumstances, the prescriber may select a different antibiotic or provide specific instructions for managing the simvastatin treatment. Patients should not stop either medicine or make that decision themselves.

Severe unexplained muscle pain, weakness or dark urine should be reported promptly.

When should a medication review take place?

A medication review may be particularly valuable when a person:

takes five or more regular medicines;
takes ten or more medicines of any kind;
is older or living with frailty;
has experienced a fall, faint or episode of confusion;
sees several specialists;
uses more than one pharmacy;
has recently been discharged from hospital;
has moved between different care settings;
has kidney or liver impairment;
has started or stopped a medicine;
has been given a short course of antibiotics or steroids;
regularly uses over-the-counter medicines or supplements; or
develops a new symptom after a prescription change.

NICE medicines-optimisation guidance addresses medication review and medicines reconciliation. The NICE guidance on assessing and preventing falls also recommends a structured medication review as part of a comprehensive falls assessment.

For the review, the patient should provide an up-to-date list of everything they use, including:

prescription tablets;
medicines taken only when required;
inhalers;
eye drops;
patches;
creams;
injections;
pharmacy medicines;
vitamins;
herbal remedies; and
dietary supplements.

Useful questions include:

What is each medicine intended to treat?
Is each medicine still necessary?
Has the dose been adjusted for age, weight, kidney or liver function?
Could two or more medicines be producing the same side effect?
Are any medicines duplicating one another?
What monitoring is required?
When was that monitoring last undertaken?
What symptoms should prompt an urgent call?
Is there a safer alternative?
Could the medication timetable be simplified?

Using the BRAN approach

The BRAN approach can help patients participate in discussions about proposed treatment to help train healthcare teams in shared decision-making. To use decision-support tools effectively, clinicians must understand their value and feel confident incorporating them into meaningful discussions with patients. Appropriate training and education should therefore be provided to strengthen the workforce’s skills in shared decision-making and the practical use of these resources.

The Personalised Care Institute offers free e-learning on shared decision-making, together with a recorded webinar covering decision-support tools. Care must be taken to ensure that this approach does not increase existing inequalities, particularly for patients who have limited access to, or confidence in using, digital services. Patients should also be encouraged to participate actively in conversations about their treatment. This can be supported through initiatives such as Ask Three Questions, BRAN — Benefits, Risks, Alternatives and doing Nothing, or an equivalent local scheme.

Benefits: What are the expected benefits of this medicine?
Risks: What are the important side effects and interaction risks?
Alternatives: Is there another medicine or non-medication option?
Nothing: What is likely to happen if the treatment is declined or delayed?

“Doing nothing” means discussing the likely consequences of declining a proposed treatment. It does not mean stopping an existing prescription without medical advice.

The tools should remain available following the consultation so that patients can reconsider the information discussed. Some resources are designed to be printed, completed and retained for future reference, although an electronic version may be more appropriate in certain circumstances.

Make sure the healthcare system supports the process

Decision-support tools should be readily available during consultations. This may involve keeping printed copies in clinics or placing clear shortcuts on clinical computer systems. Digital copies should also be easy to share during video consultations.

Telephone consultations can present additional difficulties. Healthcare providers should therefore put a clear system in place to ensure that both the patient and clinician can access the relevant tool before or during the call.

There should also be a reliable method of recording that a shared decision-making conversation took place, together with the decision reached and any agreed next steps. The Professional Record Standards Body’s shared decision-making standard provides guidance.

When can a medication interaction amount to medical negligence?

The presence of a medication interaction, side effect or adverse outcome does not, by itself, establish negligence.

Many treatments carry unavoidable risks. Some apparently concerning combinations represent accepted clinical practice where the expected benefit outweighs the risk and suitable safeguards are in place.

A potential medical negligence claim requires evidence that the care fell below the standard reasonably expected and that this failure caused avoidable injury or made the eventual outcome materially worse.

Independent medical evidence will usually be required.

Depending on the circumstances, concerns may arise where a healthcare professional or organisation:

prescribed a contraindicated medicine without a reasonable clinical basis;
failed to check the patient’s current medication list;
failed to consider known allergies or existing medical conditions;
overlooked recent test results;
failed to consider kidney or liver impairment;
overlooked duplicate treatment;
failed to assess the cumulative effects of several medicines;
failed to reconcile medicines following hospital discharge;
did not communicate changes between specialists, the GP and the pharmacy;
failed to arrange appropriate blood-pressure or pulse monitoring;
failed to arrange necessary ECG, glucose, kidney, liver or blood-count tests;
failed to warn about a material interaction with an over-the-counter product;
continued treatment without review after falls, fainting, bleeding or wheezing were reported;
failed to act on abnormal test results;
supplied the wrong medicine;
supplied the wrong strength or dosage instructions; or
dispensed medicine intended for another patient.

Responsibility may rest with a GP practice, hospital trust, independent prescriber, pharmacy or another healthcare provider. This will depend on where the failure occurred and which professional was responsible for checking, prescribing, dispensing, administering or monitoring the medicine.

A mistake that causes no injury may justify a complaint or patient-safety investigation. It will not ordinarily result in an award of compensation.

For a compensation claim, it is usually necessary to establish:

the healthcare provider owed the patient a duty of care;
the treatment fell below the reasonably competent standard;
that failure caused or materially contributed to an injury; and
the injury resulted in pain, disability, expense or another identifiable loss.

What injuries can medication errors cause?

The consequences depend on the medicine, dose, duration and patient’s underlying health.

Medication-related injuries may include:

falls and fractures;
head injuries;
gastrointestinal bleeding;
intracranial bleeding;
severe hypoglycaemia;
diabetic emergencies caused by high blood sugar;
asthma attacks;
respiratory depression;
acute kidney injury;
liver damage;
abnormal heart rhythms;
heart block;
lithium toxicity;
bone-marrow suppression;
infection or sepsis following reduced blood-cell production;
permanent disability; or
death.

It is necessary to distinguish between harm caused by the medication and symptoms resulting from the patient’s underlying disease. This is one reason expert medical evidence is usually central to a medication-negligence claim.

What should you do if you suspect a medication error?

Put medical safety first

Seek urgent medical assistance for serious or rapidly worsening symptoms. Do not delay medical treatment while attempting to obtain legal advice.

Do not change the treatment yourself

Stopping some medicines abruptly can be dangerous. This may apply to beta blockers, steroids, antidepressants, benzodiazepines, opioids and other long-term medication.

Speak to the prescribing clinician, GP or pharmacist before changing a dose or stopping treatment unless an emergency clinician gives different instructions.

Request a medication review

Provide the exact names, strengths, doses and times at which the medicines were taken. Include over-the-counter products, herbal remedies and supplements.

Photographs of the boxes and pharmacy labels can help ensure the information is accurate.

Preserve relevant evidence

Keep any:

medicine boxes;
blister packs;
pharmacy labels;
repeat prescription slips;
discharge summaries;
medication charts;
text messages or emails;
photographs of visible injuries;
appointment records; and
receipts for related expenses.

It may also help to write a short chronology recording when each medicine was started, when symptoms first appeared and what was reported to the healthcare provider.

Report suspected side effects

Patients and professionals can report suspected medication side effects through the MHRA Yellow Card scheme.

A Yellow Card report supports medication-safety monitoring. It does not replace clinical assessment, emergency treatment or a formal complaint.

Consider a complaint or legal advice

Where avoidable harm has occurred, a clinical-negligence solicitor can obtain the relevant records and assess the prescribing decision, monitoring arrangements, causation and resulting losses.

Legal time limits apply, so it is sensible to obtain advice at an early stage.

Frequently asked questions

Are five or more medicines automatically unsafe?

No. Multiple medicines may be appropriate, evidence-based and medically necessary.

The risk depends on the particular medicines, doses, underlying conditions, kidney and liver function, age, frailty and monitoring arrangements.

The aim of a medication review is not simply to reduce the number of tablets. It is to ensure that every medicine remains necessary, effective and as safe as reasonably possible.

Is every drug interaction a prescription error?

No. An interaction may be known, clinically justified and properly monitored.

Negligence may become an issue where the standard of assessment, prescribing, communication or monitoring was unreasonable and caused avoidable harm.

Can over-the-counter medicine cause a serious interaction?

Yes. Ibuprofen, naproxen, aspirin, sedating antihistamines, herbal remedies and supplements can interact with prescribed treatment.

Patients should tell their pharmacist or prescribing clinician about everything they take, including products used only occasionally.

Should I stop a medicine if it appears in this article?

No. Speak to a GP, prescribing clinician or pharmacist.

Stopping medication suddenly may be more dangerous than continuing until proper advice has been obtained. Contact NHS 111 if the concern is urgent or call 999 for a life-threatening emergency.

Is a pharmacy responsible for detecting medication interactions?

Pharmacists play an important role in identifying interactions, incorrect dosages, duplicate treatments and contraindications. However, responsibility will depend on the circumstances.

A prescribing clinician may hold information about the patient’s diagnosis, blood tests and clinical reasoning that is not available to the dispensing pharmacist. Conversely, the pharmacist may know about over-the-counter purchases that do not appear in the GP records.

The responsibility of each professional must therefore be assessed from the available evidence.

Can I claim compensation after being harmed by mixed medicines?

Possibly.

A viable claim generally requires evidence of substandard care, avoidable injury and a causal connection between the two.

The fact that medicines were taken together is not enough on its own. The prescriptions, clinical reasoning, warnings, monitoring, medical records and resulting harm must all be investigated.

Speak to a specialist medical-negligence solicitor

If you or a relative has been injured following a prescribing, dispensing or medication-monitoring failure, R. James Hutcheon Solicitors can assess the circumstances and explain the available options.

Contact our medical negligence solicitors in Liverpool, assisting clients nationwide or telephone 0151 724 7121 for an initial discussion.

Dangerous Medication Combinations and Prescription Errors