Medication Safety: Watch What You Put In Your Mouth

Patient Expert

Living with a disease such as rheumatoid arthritis can be complicated, both physically and medically.   Not only do we have to balance disease activity, physical disability or discomfort, and daily life, we also need to balance taking several medications.

The various self-injected biologic medications must be stored in the refrigerator, preferably in their original boxes to protect from light until ready to use.   Oral medications should also be stored in their original containers until ready to use.   However, if your collection of medications is like mine, you may have a small pharmacy on hand.

It can be helpful to develop an organized system of handling your medications.   Some people like to use the weekly pill organizers which contain individual pockets for each day of the week into which you can place the pills you need to take at regular intervals during the week.   Some pill organizers are more specific and contain separate A.M. and P.M. pockets for each day of the week.   These organizers can be very useful.

However, I have a number of medications which are taken on an as-needed basis (such as pain medication) or a once-weekly basis (such as methotrexate).   As RA is associated with increased levels of depression and anxiety, you may have other drugs on hand such as the anti-anxiety drug alprazolam (Xanax) as I do.

Last month, I had a scary experience when I mistakenly took 10 pills of alprazolam instead of my weekly dose of 10 pills of methotrexate one late Friday night.   There were several contributing factors to the mistake.

  • Rob and I had been traveling that week and my medication bottles were not in their normal storage locations and my regular routine had been disrupted.
  • I was really tired when I took my meds right before bed and thus wasn't paying as close attention as I normally would when fully alert.
  • The light was dim in my bedroom and I didn't notice that the pills I poured into my palm looked different than normal before I put them all in my mouth and washed them down with a glass of water.

It was the sudden bitter taste which alerted me to my mistake.   First thing I did as soon as I recognized the mistake was to tell a family member what I had just done although I felt really stupid and somewhat embarrassed.   We called poison control who suggested that I go to the E.R. for observation and possible treatment.   My late night was about to become much later.

On the way to the E.R., I wrote down all of the medications I had just taken (in addition to the accidental overdose of alprazolam).   I also wrote down what I had intended to take.   I wasn't sure if I would become too foggy or sedated to be able to tell the doctor this information at the appropriate time and this is not information that my family member would know.

In my case, the accidental overdose turned out to not cause any harm.   But that is primarily due to the fact that I hadn't made the mistake with a much more potent medication.   It could have been much worse.

In thinking about how this happened, I realize that there is one simple thing I can do to help prevent future mistakes.   As most of my medications come in the same sized brown-colored pharmacy bottles and over time the labels can become worn and difficult to read, I have since taken a large felt tip pen and written the name of the drug on each prescription bottle in large lettering.   Now it is easier to quickly identify what is inside each bottle.

When living with diseases such as MS or RA, there are many medications we take on an as-needed basis, some which may be highly potent.   All meds should be taken only as prescribed.   Please be careful and avoid an accidental medication overdose which could be a potentially fatal mistake.   Vigilance is absolutely necessary.

How do you manage your medications?   Do you have any routines or habits which protect you from, or could contribute to, accidental medication overdose?   Sharing your story may help others avoid similar mistakes.