COMBINATION RISKS: It’s essential to understand how medications react when taken with other drugs (Image: Getty)
A warning has gone out to millions who rely on a combination of everyday medications. Used to treat a range of ailments from the common cold and allergies to serious heart disease and diabetes, many of these drugs are available without a prescription, yet if mixed with other drugs could cause health issues.
A report by Age UK estimates that almost two million people over 65 are likely to be taking at least seven prescribed medicines. They say this figure doubles to approaching four million for those taking at least five medicines.
Called polypharmacy, taking a combination of medications, both prescribed and over-the-counter, can potentially have side effects. Lee Cartwright, specialist at Mobility Solutions Direct, highlighted the most worrying medication pairings that elderly patients and others must be vigilant about.
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Furosemide and Indapamide (heart condition medications): “Medications prescribed for heart conditions such as heart failure or high blood pressure, like furosemide or indapamide, can cause sudden drops in blood pressure, meaning patients need to maintain consistent hydration. For older people, this can become risky quite quickly. If, for example, someone taking these tablets begins sweating more than usual, their blood pressure can fall sharply, raising the likelihood of dizziness and falls.”
Metformin and Furosemide: Metformin, a widely used treatment for Type 2 diabetes, can trigger a severe condition known as lactic acidosis if the patient becomes dehydrated. Symptoms include extreme fatigue, muscle pain, nausea and cramping, reports the Mirror.
“The risks are amplified when metformin is taken in conjunction with heart medication such as furosemide, particularly in older patients, as dehydration can rapidly increase their susceptibility to falls,” says Cartwright.
Antihistamines and Benzodiazepines: A good proportion of hay fever medications contain antihistamines, which are effective in alleviating symptoms but are also known to induce drowsiness. Older people who are already unstable on their feet could be at risk of a fall if combining these with other sedative medications.
Cartwright warns: “Benzodiazepines such as temazepam, diazepam and nitrazepam, frequently prescribed for anxiety or sleep disorders, can exacerbate drowsiness and confusion. Therefore, using these medications together should be done with caution.”
SSRIs (antidepressants) and decongestants: “Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, sertraline or citalopram, are widely used to treat depression and anxiety. However, they can sometimes lead to drowsiness, slower reactions and confusion.
“When combined with decongestants found in cold and flu products, like pseudoephedrine or phenylephrine, they can also affect blood pressure, sleep and mood. Without proper monitoring, this interaction may result in unusual behaviour that can be distressing both for the patient and those around them,” said Cartwright.
Multiple medications (SSRIs, sedatives, antihistamines): “When confusion and slower reactions set in, the risks to a person’s safety rise considerably. They may misjudge their environment, take unnecessary risks, or, in more severe cases, fail to recognise or treat injuries. This danger is particularly acute for people living with dementia or Alzheimer’s, as medication side effects can add to existing vulnerabilities.”
If you experience side effects
“Medication-related confusion may cause sudden changes in behaviour such as irritability, aggression, altered personality, rambling speech, or difficulty concentrating. Keep a careful eye on those showing these symptoms, as they may be more vulnerable to accidents,” Lee said.
“Practical steps within the home can greatly reduce these risks. Checking for hazards such as loose rugs, poor lighting on stairs, or slippery floors is essential. Simple measures, like securing rug edges with tape, installing non-slip mats in bathrooms and kitchens, and improving visibility, can have a significant impact on safety.
“While the prospect of falls can understandably be worrying, the key point is that straightforward, preventative action can make all the difference. By addressing these risks early, older adults can remain safe and independent in their own homes for longer.”
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