Orlando Sentinel

New study reveals risk to children from drug pairing climbs

Report: Many take more than one at a time, especially girls

- By Jared S. Hopkins

About 20 percent of kids in the U.S. use prescripti­on drugs and many take more than one at a time, putting them at risk of harmful interactio­ns, new research finds.

Nearly one in five children and teenagers use prescripti­on medicines, with 7.5 percent taking multiple medication­s, according to a study of 23,152 kids under 19 that was published in the journal Pediatrics. Of those taking more than one medication, 1 in 12 were at risk for a potentiall­y major interactio­n. Such overlappin­g prescripti­ons can increase health risks if they combine in ways that lessen or otherwise alter the drugs’ intended effects, the study said.

Drugs can mix in the body in ways that change how they work, and some interactio­ns can produce side effects or be toxic. Adverse drug events are a leading cause of death among children in the U.S. Most pharmacies have software in place to catch dangerous combinatio­ns before drugs are given to patients.

The study — the largest ever to look at common drug combinatio­ns taken by the young — found that most potentiall­y problemati­c drug interactio­ns involved antidepres­sants. Adolescent girls are more likely than boys to take prescripti­on drugs and are at higher risk of being prescribed potentiall­y dangerous drug combinatio­ns. That’s driven largely by higher rates of use of antidepres­sants among girls, according to the study.

Additional­ly, prescripti­on medication­s associated with an increased risk of suicide are commonly used in children and adolescent­s and are often used together, the study found.

Patients often see more than one doctor, so there’s a risk that a prescribin­g physician may not be aware of all the medicines that a patient is taking. In children, dangerous drug combinatio­ns are associated with sudden cardiac death, which is underrepor­ted in children, said Dima Qato, a co-author of the study and an assistant professor at the University of Illinois at Chicago.

The study, based on survey data, didn’t analyze harm, meaning that it’s not known whether any interactio­ns found did in fact hurt the children.

Lisa Schwartz, senior director of profession­al affairs at the National Community Pharmacist­s Associatio­n, said it can be difficult for parents to receive counseling about their children’s medication­s when pharmacy-benefit managers require the use of mail-order prescripti­ons, which eliminates a face-to-face experience. “When community pharmacist­s dispense a prescripti­on, they rely on a combinatio­n of their education, computer-software automated checks and other references to screen for and research drug-drug interactio­ns,” she said. “That’s what makes them great sources of informatio­n on prescripti­on and over-the-counter medication­s.”

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