Take two pills and call me in the morning.
That's what family doctors may have told us at one time, but the tragic deaths of high-profile stars in recent years highlight just how far beyond that simple prescription medication has moved.
"We've seen a significant increase in these types of drugs in the deaths of people," said Bruce Goldberger, director of the William R. Maples Center for Forensic Medicine at the University of Florida. "It's a very common occurrence."
And it could be getting more common.
Each year drug companies put new medications in doctors' offices. On their own, these drugs can cure illness and alleviate pain, but together they can make deadly cocktails.
So if you're taking prescription drugs, here are some important guidelines to follow to avoid tragedy.
Tell your doctor what medications you are on. This seems like a no-brainer, but not providing your doctor with a detailed personal history and list of medications you're already taking can have serious effects, particularly if you see multiple doctors. If none of them has a full, medical snapshot of your condition, the likelihood of drug crossfire increases as different doctors continue prescribing medications.
"People need to understand that the more they are taking different medications for a single indication, the more they need to be carefully supervised," said Dr. Vatsal Thakkar, clinical assistant professor of psychiatry at New York University Medical Center.
In this case, it is important for both you and your doctors to share information about medicines you take.
Get a tip sheet. An information sheet should cover how and when to take the medication. For example, does "take two pills four times a day" mean to take eight pills in a 24-hour period or eight pills during waking hours? The sheet should also describe any side effects that might occur and how to store the medication (typically in a cool, dry place like a closet or drawer). Bathrooms and kitchens are not ideal because the heat and humidity can damage the medication and make it ineffective, or even toxic.
Know what to avoid. Did you know that grapefruit juice can be harmful to your health? Well, it can, mixed with the wrong drug. Drinking alcohol and caffeine, lifting heavy objects and taking over-the-counter medications like Tylenol or ibuprofen can also be dangerous activities when combined with the wrong drug. It is important to be as open and honest as possible when discussing drug options with your doctor so that you know what to avoid.
Do not share medications. In grade school we were taught that sharing was a kind thing to do, something that made others happy. But when it comes to medication, we have to unlearn our school teachings.
"Two people can take exactly the same number and combination of drugs," said Dr. Donna Seger, medical director of the Tennessee Poison Center at Vanderbilt University Medical Center. "One person may be a bit sleepy, and the other may be in a coma."
How drugs react in the body varies from person to person. Medications are prescribed to specific individuals. Taking drugs intended for others, or offering someone drugs meant for you, could have lethal consequences.