Older Kiwis risking ‘triplewhammy’
‘‘Used together, the combination of medicines can cause significant harm.’’
Thousands of older New Zealanders could be risking their kidneys, if not their lives, with a dangerous mix of common medications.
More than 22,000 people aged 65 and over have been taking a ‘‘triple whammy’’ of medications, which puts them at risk of kidney failure, according to the the Health Quality & Safety Commission’s Atlas of Healthcare Variation.
The combination of heart and blood pressure medication, diuretic water tablets, and nonsteroidal anti-inflammatory painkillers such as Nurofen or Aspirin was involved in more than half of reported cases of treatment-related acute kidney failure, Dr Alan Davis from the commission said.
‘‘Some of the medicines used to treat pain and swelling are available on prescription, and others are available to buy from pharmacies and supermarkets.
‘‘Used together, the combination of medicines can cause significant harm.’’
Doctors are advised not to give the medicines to people with a risk of kidney failure such as older adults, people with some kidney failure already, those at risk of dehydration from vomiting, diarrhoea or inadequate fluid intake, and hypotensive patients.
New Zealand’s Centre for Adverse Reaction Monitoring received 119 reports of kidney adverse reactions from 2000 to 2012 that were associated with the use of pain relief or antiinflammatory medicines, including four deaths and 12 lifethreatening cases.
The Commission’s Atlas of Healthcare Variation report shows 3.2 per cent of those 65 and over were dispensed these three medications in the same quarter.
While that equalled 22,000 people in 2016, it did not count those who bought an antiinflammatory over the counter or had a prescription from a previous period – meaning it was not known how many people actually took them as a combination.
Rates were significantly higher in younger Ma¯ori and Pacific people.
Davis urged people to ask doctors about their medication.
Royal New Zealand College of General Practitioners medical director Dr Richard Medlicott said caution on the part of doctors and patients was key as an aging population gave more opportunity for error.
‘‘Most people will be okay, but some people are going to be really sick and it’s hard to determine who those people will be.’’
People could also consider other forms of pain relief such as stretching, yoga, or paracetamol.
Wellington pharmacist Ant Simon said he would check what drugs a person was taking before giving them a non-steroidal antiinflammatory.
Having access to a person’s drug history was a big help, he said, and any concerns about appropriate medication could be shared with the person’s doctor.
The Commission, in partnership with ACC, is highlighting the risk of the combination as part of Patient Safety Week, which runs from November 5 to 11.