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Overdoses can hurt your health and your finances -- and use unnecessary time. Understanding how overdosing occurs, can help to minimize it.
- Drug reactions are a leading cause of death in the U.S.
- About 75%-80% of adverse drug reactions are dose-related. This means that the dose deemed appropriate by a physician proves inappropriate for a lot of patients.
- Financially, overdosing results in the unnecessary cost of buying the medication and being treated for unnecessary side effects. There is also the unnecessary expenditure of precious time.
Understanding how overdosing occurs, can help to minimize it. Overdoses are frequently built into standard dosages because:
- Drug makers set a dosage that is effecti ve for 90% of the potential users which means 89% of us are receiving more of a drug than we need --with some people receiving much more than necessary.
- A focus-on-the-bottom line goal to accommodate doctors' desire for simplicity and convenience when prescribing drugs.
To help assure that drugs you take on an ongoing basis fit you individually (other than drugs used for in acute, emergency or dangerous situations):
- Step 1: Let your health care provider or pharmacist know your concern about overmedication.
- Step 2: If your health care provider is agreeable to your testing a lower dose and is willing to supervise the test, decide with your health care provider the best alternative for you. Alternatives include:
- Start with the lowest recommended dosage and start increasing the amount of the drug and/or amount of times you take the drug, until it works for you. This is the alternative favored by Dr. Jay S. Cohen, author of Overdose.
- Start with the highest recommended dosage and start decreasing the amount of the drug, or amount of times you take it, until the drug stops working for you. Then increase the level until you find the result you're looking for. For example, if you are prescribed 100 mg. of a medication, start by taking the 100 mg dosage to learn the effect it has on your body. Once you know the effect, take a smaller dose for a period of time such as a week. If the drug remains effective, and symptoms don't increase, decrease the dosage again, and again, until you achieve the minimum dose that works for you.
- If you reduce the quantity of medication you take, keep a calendar which shows:
- All the potential side effects.
- A numbering which shows severity of side effects on a scale of 1 -- 10.
- When you start decreasing the amount of the drug, note the amount to which you decreased and the date.
- Note changes in the side effects on a scale of 1-10. Add side effects if there are new ones.
- Continue with this tracking until you've stabilized at the minimum amount that works for you.
- If you reduce the quantity of medication you take, keep a calendar which shows:
- Ask whether the drug comes in the form of a patch. Patches allow for the use of lower doses.
- The patch provides the medicine through your skin into the bloodstream. Because it doesn't have to pass through the digestive tract and the liver, none of the active ingredients are inactivated by the digestive tract. (If a patch form isn't available from the manufacturer, it may be from a compounder.)
- Many drugs are available in patch form (known medically as transdermal drug-delivery systems).
- A list of 48 major medications with information on lower, effective doses, with an extensive reference list is available to your doctor in the article: "Dose Discrepancies Between the Physicians' Desk Reference and Medical Literature, and Their Possible Role in the High Incidence Dose-Related Adverse Drug Events" by Jay S. Cohen, MD, Arch Intern Med. 2001; 161:957-964. You can see an abstract of the article by clicking here
. You can purchase a copy of the full article at the same link.
For information about adults over age 65 and medications, click here.
For information about children and medications, click here.
To obtain a different dose of a medication:
- Ask. Some drugs are available in many different dosages.
- Pill cutters are available at most pharmacies.
- If a pill is not easily cut: Crush it, weigh the ingredient to assure consistent dosage, and store the medication in gel capsules available at your local pharmacy. You can obtain both the small scale and gel capsules at your pharmacy.
- Consider having the drug compounded to the precise dosage you desire. For more information, see Compounding.
Put overdose cautions on the back burner in acute, emergency or dangerous situations. Where the objective is to stop disease progression or symptoms as soon as possible, there may be no choice but to take the highest dose allowed because taking the time to vary dosage may be dangerous to your health. For example, the risk of testing heart medicines or antibiotics far outweighs any potential reward and should be avoided.
NOTE: Report all unexpected adverse reactions to a drug immediately to your health care provider. Also, report your experience to the FDA's MedWatch at 800.332.1088, a program which monitors patient's adverse reactions to drugs.