ASK THE PHARMACIST

Q I worry my elderly mother is taking too many pills.

A THIS is a common concern, as older patients often have several conditions treated with both prescription and over-thecounter medicines. Taking lots of pills can lead to interactions between the drugs and possible side-effects. And older patients may not understand why they’re taking certain pills, and keep buying them over-the-counter, for instance, when they were only meant for the short term. As a result, they end up taking more medicines than needed.

To minimise these problems, the NHS advises patients taking multiple medicines have an annual medication review with their pharmacist.

Q Could warfarin be causing my nosebleeds?

A WARFARIN prevents the formation of blood clots and is used to reduce the risk of heart attack or stroke.

However, its anti-clotting action increases the risk of uncontrolled bleeding.

This is why patients taking it have regular blood tests to check their clotting levels — the international normalised ratio or INR. If the INR is high, there’s an increased risk of bleeding and bruising.

Nosebleeds may occur if the delicate nasal lining is damaged in some way; even blowing your nose can do this. The bleeding can also start spontaneously.

Drug interactions can also increase the INR, as can certain foods — for example, cranberry juice.