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Are you taking the correct medication? One ChronicBabe almost died...

By Shannon Walker

I was very nearly killed this week by a pharmacy error and I wanted to impress upon you all how careful you must be with your medications...

I get my refills by mail (via my HMO) in order to get a cheaper rate. After finishing one bottle of medication, I opened a new bottle on Friday morning for my morning medication regimine. I noticed the pills were different; I didn't think much of it because it has happened at least 3 times before, when my HMO's pharmacy switched to a different drug manufacturer or had gone to a generic drug. I was pleased because the new pill was a little smaller and smoother, not like the normal pill which is huge and rough.

I *almost* took the pill—literally held it up to my mouth before stopping and decided that maybe I should have it checked out. So I pulled out my "emergency rx pill case" and found what I knew was the correct pill, and put the odd pill back in the bottle.

I had to go pick up my MS Contin (time-release morphine) prescription at the Pharmacy that afternoon, so I decided to take the odd pills with me and have them checked then. I really hate going to the Pharmacy—if I hadn't needed to go make the pick-up I might not have gone... and that would have been disastrous.

The pharmacist freaked when he saw the pills and everyone in the pharmacy was staring. He ordered me to go straight to the Emergency Room and it took several minutes to convince him that I hadn't actually taken any of the medication.

He told me it was a very high dosage of high blood pressure/heart medicine. I asked what would have happened if I had taken it with my low blood pressure and other health problems. He said that I would have become critically ill and very well could have died—even if I had taken just one pill!

I was there in Pharmacy for almost two hours, watching the Pharmacist yell on the phone at different departments trying to report the situation and track down how the mistake had occurred. He came out to where I was sitting about every 20 minutes, apologizing a million times, promising to replace my medication and vowing to have the whole incident investigated.

Boy was I shocked. My husband nearly fell over when I told him. Now every time I open the bottle of the correct medication (which I do three times a day) I think about what almost happened. You never EVER know what can happen to you.

PLEASE be careful about your medications!

There is a web site you can go to which will tell you what a pill should look like from each manufacturer. It's a handy web site, also giving info on side effects and drug interactions. (Editrix's note: you can also buy The Pill Book, my fave alternate resource on this topic.) The Arthritis Foundation also has a resource on managing (and identifying) your medications.

I'm still shocked at what almost happened to me and even though I'm always a cautious patient I intend to be even more careful from now on. I hope you will be too!

Posted: 10/16/2007 in Ask the Babe

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