In homes around New Zealand, unused medicines lie in waiting just in case we might need them one day. We store them all over the house, often forget what they were prescribed for, and never check expiry dates. Is this safe use of medicines? In this special Family Health Diary report we unravel the facts on safe use of medicines.

Safety is all around us – we wear seatbelts in our cars, we wear helmets on our bikes, we use mouth guards on the sports field, we encourage safe sex, and we install child safety gates on the stairs. But do we apply the same safety logic when it comes to medicines?

Medicine safety involves many things – using your medicines the right way, storing your medicines correctly, keeping medicines out of reach of children, and safely disposing of unwanted medicines.

USING YOUR MEDICINES
Here are some guidelines on using your medicines

• Ensure you know what your medicine is called, why you are taking it, and what it is for.
• Medicines should be taken according to the instructions printed on the label. If unsure how to take your medicine, talk to your pharmacist.
• Labels may also give special instructions such as take with food, or on an empty stomach, or avoid alcohol.
• Some medicines may make you sleepy. When taking these medicines avoid situations where you need to be alert such as driving a car or operating machinery.
• Some medicines, such as eye drops, will have an expiry date after which the medicine should be discarded.
• Some medicines may be labelled swallowed whole which means they should not be chewed or crushed.
• Some medicines can interact with other medicines so that they don’t work as well or cause unpleasant or harmful effects. Tell your doctor or pharmacist about other medicines you are taking including supplements purchased from a pharmacy, supermarket or health food shop.
• Some medicines can also interact with food. Your doctor or pharmacist will tell you which foods to avoid while taking the medicine.
• You should also tell your doctor and pharmacist if you are pregnant, become pregnant while on medication or are breastfeeding, so that a medicine is not prescribed that could harm the baby.

STORING YOUR MEDICINES
Medicines should always be stored in their original containers with their original labels.

Unless stated on the label, store medicines in a dry, cool place such as a high cupboard in a room that isn’t steamy or excessively hot. Some medicines must be stored in a fridge and this will be stated on the label. Ensure they are stored at the back of the fridge, out of sight of children.

Some medicines will have a use by or a discard after date. These medicines should not be used after these dates.

DISPOSING OF YOUR UNWANTED MEDICINES
Most of us have a box of unused, and half-used medicines at home. We hoard old medicines “just in case” we may need them in the future – the painkillers from the dentist, half a tube of cream for that embarrassing rash, and the anti-inflammatories from the netball accident.

Advice from the experts is – don’t! Old medicines may no longer be effective, and chances are you don’t remember exactly what they were prescribed for, and why.
Unused medicines, or medicines past their expiry date, should be be returned to your pharmacy for safe disposal.

The conventional belief used to be that medicines should be disposed of by flushing down the toilet rather than thrown out with the rubbish, to prevent them falling into the wrong hands.

However, it is now recognised the potential impact this has on waterways. Trace elements of medicines have been detected in waterways throughout the world, including New Zealand. These medicines enter the environment in two ways – they are excreted by the human body, or flushed down the toilet or household drains.

Studies in the US and Italy have revealed traces of contraceptive drugs in waterways that can cause sterility in frogs. There is also evidence that the presence of antibiotics in waterways has an impact on the bacteria present and may lead to antibiotic resistance.



CHILD SAFETY AROUND MEDICINES
The most common culprits with childhood poisonings are medicines – both prescription and non-prescription. They account for almost 70% of poisoning hospitalisations. And the medicine most commonly involved is liquid paracetamol, which accounts for 21% of poisonings.

There is only one conclusion from these statistics – we are not keeping medicines out of reach of children in our homes, including the homes of grandparents, relatives and friends.

Grandparents in particular are more likely to have medicines in the home, and may need to be reminded to remove them to a locked cupboard.

Some tablets and capsules are required by law to be supplied in ‘blister’ safety packs, which makes the medicine more difficult for a child to access. Pharmacists are also required to dispense some liquid medicines, considered more toxic to children, in bottles with child resistant closures eg, paracetamol.

If you have young children, talk to your pharmacist about having all medicines dispensed in containers with child resistant lids. These containers are not child proof and care still needs to be taken to store medicines out of the sight and reach of children, preferably in a locked cupboard.

WATCH OUT FOR DOUBLE DOSING
Some medicines contain more than one ingredient, especially cough, cold and flu preparations. Always check the ingredient list when purchasing medicines to ensure you don’t inadvertently double dose. The most common double dosing situation involves paracetamol. You can easily double dose on paracetamol if your cold and flu remedy contains paracetamol, and you then take paracetamol separately for your headaches and muscle aches and pains.

NEVER SHARE MEDICINES
Prescribed medicines should never be shared – they should only be taken by the person they were prescribed for. Some people may have medical conditions, or take other medicines, that make your medicines unsuitable for them.
Children and the elderly should never be given medicines that have not been prescribed for them as medicines work differently in these age groups.


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