Understanding Your Prescription: A Patient’s Guide to Safe Medication Use

1. Introduction: Your Journey to Better Health

An essential aspect of managing one’s health is understanding the medications prescribed by a healthcare professional. Medications are powerful tools designed to heal, manage chronic conditions, and prevent illness. However, like any tool, they must be used correctly and safely to be effective. This guide serves as a comprehensive resource to empower individuals to become active and informed partners in their own healthcare journey. The information presented here is not a substitute for professional medical advice, but rather a foundation for understanding prescriptions, asking the right questions, and engaging in open communication with healthcare providers.

The importance of using medication correctly cannot be overstated. According to the Centers for Disease Control and Prevention, medication taken incorrectly causes a significant number of deaths annually and is a major contributor to hospital admissions.¹ The challenge of medication management is often multidimensional, influenced by factors such as the complexity of drug regimens, the cost of medicine, and a patient’s level of health literacy.³ By providing a clear and detailed overview of prescriptions, dosages, interactions, and mechanisms of action, this guide aims to reduce medication-related errors and improve health outcomes.

This document is tailored to be particularly relevant to an African audience while maintaining universal relevance. It acknowledges the diverse cultural contexts of health and medicine, including the widespread use of traditional African medicine. The guide approaches this topic not with judgment, but with a focus on patient safety, aiming to bridge the communication gap that often exists between traditional and conventional medical practices. The ultimate goal is to equip individuals with the knowledge to make informed decisions for their well-being, irrespective of their healthcare traditions.

2. The Fundamentals: Decoding Your Prescription

Understanding a prescription and its corresponding medication label is the foundational step toward safe and effective medication use. The prescription itself is a critical communication tool that ensures the correct medication is dispensed, while the pharmacy label provides the patient with all the necessary instructions for use.

2.1. The Prescription Itself: More Than Just a Note

A prescription is a formal order from a healthcare provider to a pharmacist, detailing the specific medication and instructions for a patient. It typically includes the patient’s name, the name of the medicine, its strength, the quantity to be dispensed, the dosage, and the number of refills.⁴ While a prescription is the starting point, the most current and accurate instructions for taking a medication are not always on the bottle. In some cases, a healthcare provider may adjust a patient’s dosage or schedule between refills, which can lead to a discrepancy between the instructions on the physical bottle and the most up-to-date treatment plan. A patient’s Home Medication List, or the most recent instructions received directly from their doctor, represents the most current information. Always following these updated instructions, rather than relying on an older medication bottle, is a vital part of a patient’s role as a final check in the medication safety process.⁴

2.2. Reading the Medication Label: A Detailed Breakdown

The label on a medication container is a key source of information for the patient. While labels may vary in appearance between different pharmacies, they typically contain the same essential data.⁴ A clear understanding of each component can prevent confusion and potential errors. The table below illustrates the anatomy of a typical prescription label.

Table 1: Anatomy of a Prescription Label

Label Component	Description	Why It Is Important
Medication Name	The generic or brand name of the medicine.	Ensures you have the correct drug. The pharmacist can explain the difference between generic and brand names, which may impact cost.6
Medication Strength	The amount of active drug in each pill, tablet, or dose (e.g., 250 mg).	This is crucial for calculating the correct dosage and should be a point of clarification with your pharmacist.4
Quantity	The total number of pills or tablets in the container.	Helps you track your supply and plan for refills.4
Dosage Instructions	Detailed directions on how, when, and how often to take the medication (e.g., “Take one tablet by mouth twice daily”).	Following these instructions precisely is essential for the medication to be effective and safe.4
Refills Remaining	The number of times the prescription can be refilled without a new doctor’s order.	This information helps you manage your medication supply and plan for future appointments with your doctor.4
Prescription Number	A unique number assigned to your prescription by the pharmacy.	This number is needed when you contact the pharmacy for a refill or to ask questions.4
Pharmacy and Prescriber Information	The name, address, and phone number of the pharmacy and the name of the doctor who prescribed the medication.	Allows for easy contact with the correct healthcare professionals for any questions or concerns.4

2.3. Your Healthcare Team: A Partnership in Safety

The doctor and pharmacist are two distinct but interconnected parts of a patient’s healthcare team. The doctor is responsible for the diagnosis and prescribing of the medication, while the pharmacist acts as a medication expert and a critical final checkpoint in the system. The pharmacist’s role goes beyond simply dispensing medicine; they are trained educators who can provide guidance on proper intake, potential side effects, and drug interactions, which has been shown to lead to improved health outcomes.⁶

An effective partnership between a patient and their healthcare team relies on open communication. The pharmacist, in particular, can be a valuable bridge for patients navigating complex treatment plans, language barriers, or specific cultural beliefs about health and illness.⁷ Research shows that pharmacists should be aware of a patient’s cultural background, beliefs, and attitudes toward their care to provide effective and sensitive education.⁷ The pharmacist’s role is to ensure patients have the knowledge, understanding, and skills to follow their treatment regimens, actively participate in their care, and confidently raise any concerns that may hinder adherence.⁶

3. The Right Amount, The Right Way: Dosage and Adherence

Medication effectiveness is directly tied to a patient’s adherence to the prescribed dosage and regimen. Deviating from the instructions by taking too little or too much medicine can have serious consequences.

3.1. Underdosing: The Hidden Risk

Underdosing, or underprescribing, occurs when a patient receives a lower dosage or fewer medications than required to effectively treat a medical condition.⁸ This can happen due to a prescription error, a failure to adjust a dose as a condition worsens, or a patient’s intentional or unintentional deviation from the regimen.⁸ The consequences of underdosing are significant and can lead to a failure to optimize the treatment regimen, a worsening of the condition, or a relapse.⁸ For example, a patient with diabetes who does not receive a sufficient dose of insulin due to underdosing may experience hyperglycemia, a dangerously high blood sugar level, which could result in a trip to the emergency room.⁸

Understanding underdosing requires a nuanced perspective. It is not always a simple case of a patient forgetting to take their medicine. It can also be a systemic issue, such as a prescribing fault or a monitoring failure by a healthcare provider.¹⁰ This knowledge is empowering for a patient, as it encourages them to pay close attention to their body’s response to the medication. If a condition is not improving or is actively worsening despite following instructions, a patient should not hesitate to contact their doctor to re-evaluate the treatment plan.

3.2. Overdosing: Recognizing the Signs and Responding Safely

A drug overdose occurs when a person takes too much of a substance—this includes prescription drugs, over-the-counter medications, or illicit substances.¹¹ An overdose is a medical emergency that can lead to severe complications, including death.¹¹ It is crucial to be able to recognize the signs of an overdose and know how to respond immediately.

Signs and symptoms of an overdose may include ¹¹:

• Mental confusion or irrational behavior
• Vomiting
• Inability to wake up or unresponsiveness
• Slow, erratic, or stopped pulse
• Irregular breathing or a gurgling/choking sound
• Pale or bluish skin color

If an overdose is suspected, it is imperative to act quickly. The most important step is to call for emergency medical help immediately (e.g., dial 911 or your local emergency number). While waiting for help to arrive, do not leave the person alone, do not allow them to “sleep it off,” and do not attempt to use home remedies to treat them.¹¹ If the person is unconscious, lay them on their side to prevent them from choking if they vomit.¹² In cases of opioid overdose, an emergency dose of naloxone (Narcan) may be administered if available, as it can block the effects of opioids and restore breathing.¹²

3.3. Taking Your Medicine Correctly: Strategies for Success

Adherence to a medication regimen is crucial for positive health outcomes. However, research indicates that many patients, for various reasons, engage in negative medication-taking behaviors that result in non-adherence.³ It is estimated that up to 75% of adults are non-adherent in at least one way, and this contributes to a significant number of hospitalizations and deaths.¹

Barriers to adherence are multi-faceted and can include forgetfulness, the high cost of medication, a lack of understanding about the disease, or a complex dosing schedule.³ In pediatric cases, parents may stop a child’s medication on weekends or during school holidays, believing it is unnecessary.³ In other instances, a patient may stop taking a medication as soon as they feel better, which can be particularly dangerous for antibiotics and antiviral drugs.¹³

A case study involving a 68-year-old male with influenza provides a clear example of this danger. The patient, who had previously stopped an oral antiviral regimen early after his symptoms improved, was treated with a single dose of an intravenous antiviral to ensure the complete treatment course was administered. This was considered the most fitting choice due to his history of non-adherence to a multi-day oral regimen.¹³

To improve medication adherence, several practical strategies can be employed ¹:

• Create a routine: Connect taking your medication with a daily activity, such as making coffee or eating a meal. Using a phone alarm can also serve as an effective reminder.
• Utilize organizational tools: A weekly or monthly pill box can help track doses and ensure the correct medication is taken at the right time. Calendars can also be used to mark doses and refill dates.
• Do not skip or split doses: Skipping doses to save money or taking a partial dose can render the medication ineffective.¹ Similarly, splitting pills should only be done if explicitly directed by a doctor or pharmacist, as some pills are coated to be long-lasting or to protect the stomach from irritation.¹⁴
• Complete the full course: Continue taking the medicine until it is finished or until a doctor explicitly says it is safe to stop, even if symptoms have resolved.¹
• Never share medication: A prescription is written for a specific person, for a specific condition. Taking medication prescribed for someone else can be harmful and poses a risk of an adverse drug event.¹

A crucial first step in managing medications is to create a complete list of all drugs, vitamins, and supplements being taken and to share it with every healthcare provider. This simple act can help prevent dangerous drug interactions and promote patient safety.²

4. How Your Medicine Works: A Simple Guide to Mechanisms of Action

Understanding how a medication works, known as its mechanism of action, can demystify the treatment process and empower a patient to be more engaged in their care. The body is a complex system, and drugs interact with it through a process that can be simplified using common analogies.

The fundamental principle is often described as the “lock and key” system.¹⁵ The body’s cells have specific receptor sites, or “locks,” that are designed to receive certain chemical signals. A drug acts as a “key” that fits into these specific locks, either to unlock a function (like activating a process) or to block a function (like stopping a signal).¹⁵

4.1. Examples in Action: Common Medications Explained with Analogies

• Painkillers (Analgesics): When an injury occurs or a painful condition exists, the body produces chemicals called prostaglandins that send pain signals to the brain. Painkillers like aspirin, ibuprofen, and paracetamol work by blocking the enzyme that produces these chemicals, essentially acting as a “dam” that blocks the pain signals from reaching the brain.¹⁶ This reduces the feeling of pain.
• Blood Pressure Medication (Antihypertensives): High blood pressure can be thought of like a garden hose with too much water pressure. The high pressure can weaken the hose and its connections, leading to damage.¹⁷ Similarly, high blood pressure can damage blood vessels in the body’s most sensitive organs, such as the brain, kidneys, and heart. Blood pressure medications work in different ways to lower this pressure. Some medications, such as calcium channel blockers, work by widening the “hose” (the blood vessels) to reduce the pressure, while others, like beta-blockers, reduce the “flow of water from the tap” (the heart’s pumping force).¹⁷
• Antibiotics: Antibiotics are a special type of “key” that is specifically designed to fit the unique “locks” found on bacterial cells. These keys either kill the bacteria or stop them from growing.²⁰ This is why antibiotics are only effective against bacterial infections, not against viruses. The problem of antibiotic resistance occurs when bacteria naturally evolve and change their “locks,” making the antibiotic “keys” useless.²⁰ This process is accelerated by the overuse and misuse of antibiotics.

5. The Big Picture: Navigating All Types of Interactions

A drug interaction occurs when the effect of a drug is altered by another drug, a food, a beverage, or an existing health condition.²¹ Drug interactions can make a medication less effective, cause unexpected side effects, or increase the action of a particular drug, and they are a major cause of hospitalizations.²¹ To mitigate this risk, maintaining a comprehensive list of all medications, including prescription, over-the-counter drugs, dietary supplements, vitamins, and herbal remedies, is a critical step in patient safety.² This list should be shared with every healthcare provider, including doctors and pharmacists, to ensure a complete picture of a patient’s health and treatment regimen.²³

5.1. Drug-Drug Interactions

Drug-drug interactions occur when two or more medications react with each other. While some interactions are intentionally beneficial (e.g., a synergistic combination of two blood pressure medications), others can be harmful.²⁴ For example, mixing an over-the-counter drug you take to help you sleep with an allergy medication can slow your reactions and make driving dangerous.²¹

Two specific examples of dangerous drug-drug interactions include:

• NSAIDs and Blood Thinners: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are common pain relievers. However, when taken with prescription blood thinners (anticoagulants), they can significantly increase the risk of serious bleeding and heart attacks.²⁶
• Antihistamines and Sedatives: Antihistamines, especially older types that cause drowsiness, should not be combined with other depressants like opioids, sleeping pills, or alcohol. This combination can lead to excessive sedation, dangerous slowing of breathing, and an increased risk of accidents.²⁵

5.2. Drug-Food and Drug-Beverage Interactions

Foods and beverages can also impact the way a medication works by altering its absorption or metabolism.²¹

• Grapefruit Juice: This juice can interfere with the breakdown of certain medications, such as some blood pressure and cholesterol-lowering drugs, leading to an increase in their concentration and a higher risk of side effects.²⁶
• Leafy Green Vegetables: Foods high in Vitamin K, such as kale and spinach, can counteract the effects of blood thinners like warfarin.²⁶ Patients on this medication do not need to stop eating these foods, but they should maintain a consistent intake to avoid fluctuations in the drug’s effectiveness.
• Dairy Products: Dairy can decrease the absorption of certain antibiotics, such as tetracycline, making them less effective.³⁰
• Alcohol: Alcohol can increase or decrease the effectiveness of many medications and can cause severe side effects, especially when mixed with depressants that also slow breathing and cause drowsiness.²²

The method of food preparation can also impact drug absorption. For instance, a diet high in fried foods, which is common in many parts of the world, can delay gastric emptying and affect the dissolution of drugs with special coatings, potentially altering their release profile.³² Conversely, a traditional African diet rich in vegetables and fiber has been shown to have positive health effects, but patients should be aware of how dietary changes can impact medication efficacy.³³

Table 2: Common Interactions to Watch For

Interacting Substance	Affected Medication Class	Potential Outcome
Grapefruit Juice	Blood pressure medications, statins, some tranquilizers.	Increased drug levels in the blood, leading to a higher risk of side effects.23
Leafy Greens (Vitamin K)	Blood thinners (warfarin).	Decreased effectiveness of the medication, increasing the risk of blood clots.26
Dairy Products	Certain antibiotics (tetracycline).	Reduced drug absorption, making the antibiotic less effective.30
Alcohol	Painkillers, sleeping pills, antidepressants, certain antibiotics.	Increased drowsiness, confusion, slowed breathing, or a decrease in drug effectiveness.22
NSAIDs (ibuprofen, naproxen)	Prescription blood thinners.	Increased risk of serious bleeding and heart attacks.27
Antihistamines	Opioids, sedatives, some antidepressants.	Excessive drowsiness, impaired coordination, and slowed breathing.25
OTC Drugs with Same Active Ingredient	Any medications sharing a common active ingredient.	Accidental overdose due to taking too much of a single ingredient.2

5.3. Over-the-Counter (OTC) Medication Safety

Over-the-counter (OTC) drugs are readily available and do not require a prescription, but they are still potent medicines with risks. It is critical to read the “Drug Facts” label on all OTC products to understand their active ingredients, warnings, and potential interactions.²¹ One of the most common risks is accidentally taking two different OTC products that contain the same active ingredient, which can lead to an unintended overdose.² For example, a person might take a pain reliever and a cold remedy that both contain acetaminophen, unknowingly exceeding the safe daily dose. Always check the active ingredients to avoid this dangerous mistake.²⁶

6. A Special Focus: Traditional African Medicine and Patient Safety

For millions of people across Africa, health and healing are understood through a holistic lens that integrates spiritual, social, and physical well-being.³⁵ Traditional African medicine, often involving herbalism and spiritual practices, is a deeply ingrained part of the culture. The remedies, known as

muthi, are believed to have both healing and spiritual significance.³⁶ Traditional healers are often highly respected and use a patient-centered communication style, which may include discussing a patient’s concept of illness, lifestyle, and psychosocial factors, contributing to their popularity.³⁹

6.1. The Communication Gap: A Historical Legacy

A significant challenge to medication safety is the communication gap that often exists between patients and conventional healthcare providers regarding the use of traditional remedies. Research shows that a large percentage of patients in countries like Uganda and South Africa who use traditional or herbal medicines fail to disclose this information to their conventional doctors.⁴⁰ The reasons for this non-disclosure are complex and include a fear of receiving improper care, a perception that conventional doctors hold a negative attitude toward traditional medicine, and a simple lack of inquiry from the healthcare provider.⁴⁰ The historical legacy of distrust in some communities, stemming from events like the infamous Tuskegee Experiment, can also contribute to a reluctance to be fully open with medical professionals.⁴³

This communication gap poses a serious risk to patient safety because it prevents healthcare providers from being able to assess potential herb-drug interactions. By understanding that a patient’s reluctance to disclose is often rooted in fear of judgment, it becomes clear that both the patient and the healthcare provider have a role in bridging this gap. The patient’s willingness to discuss this topic has been shown to be high, with one study indicating that most patients would be amenable to following a physician’s advice if they were directly asked about their use of herbal medicine.⁴⁰

6.2. The Unseen Risks: Herb-Drug Interactions

The widespread belief that anything “natural” is inherently safe is a misconception. Traditional remedies are often complex mixtures with multiple active compounds, and unlike conventional pharmaceuticals, they are not adequately researched or regulated.³⁷ This lack of research and standardization means that the potential for herb-drug interactions is high, and the consequences can be unpredictable and dangerous, including decreased efficacy or increased toxicity of a conventional drug.⁴⁴

The primary mechanism for these interactions often involves the liver’s cytochrome P450 enzymes, which are responsible for breaking down both herbal and conventional drugs. When a herbal remedy influences these enzymes, it can change how quickly another medication is metabolized, potentially leading to harmful or life-threatening results.⁴⁴

A potent example of a clinically significant herb-drug interaction is the use of Sutherlandia frutescens, a popular African medicinal herb, with antiretroviral drugs. Research indicates that this herb can reduce the concentration of antiretroviral drugs like nevirapine in the bloodstream by increasing the metabolism of the drug in the liver and intestines.⁴⁶ For a patient with HIV/AIDS, this interaction could lead to antiretroviral treatment failure and the development of viral resistance, rendering the life-saving medication ineffective.⁴⁶

The following table provides examples of researched or reported interactions with traditional African or commonly used herbal remedies.

Table 3: Potential Interactions with Traditional African Herbal Remedies

Herbal Remedy	Affected Medication Class	Potential Outcome
Sutherlandia frutescens	Antiretrovirals, drugs metabolized by CYP3A4.	Reduces the concentration of antiretroviral drugs, leading to treatment failure and viral resistance.46
Rooibos Tea	ACE inhibitors (high blood pressure medication), statins, drugs metabolized by CYP enzymes.	May increase the effects of ACE inhibitors or increase the level of other drugs in the blood, potentially leading to liver toxicity or other side effects with long-term, large-volume use.48
St. John’s Wort	Oral contraceptives, certain antidepressants, heart disease and HIV medications.	Lowers the plasma concentration of many conventional drugs, reducing their effectiveness.26

6.3. Bridging the Gap: Your Role in a Dual Healthcare System

Navigating a dual healthcare system that includes both traditional and conventional medicine requires a conscious effort toward open communication. A patient’s role is to provide their healthcare provider with a complete picture of everything they are taking, including herbal remedies, supplements, and vitamins. To facilitate this conversation without fear of judgment, a patient can frame their disclosure by saying, “I am also using [name of remedy] and I want to make sure it is safe to use with the medicine you are giving me.” This approach focuses on safety and empowers the patient to take charge of their health.

Healthcare providers also have a responsibility to foster an environment of trust. Research has shown that patients are much more likely to disclose their use of traditional medicine when directly asked by a conventional medical practitioner.⁴⁰ Therefore, normalizing the conversation by including a “herbal medicine history” as part of a routine patient interview is a proactive step toward ensuring comprehensive care.⁴⁰

7. Empowering Yourself: A Checklist for Safe Medication Use

Becoming an empowered and informed patient is a journey. This checklist provides a concise summary of the key takeaways from this guide to promote safe and effective medication use.

• Read Your Label: Always read and understand the information on your medication bottle. If anything is unclear, ask your pharmacist for a clear oral explanation and clarification.
• Keep an Updated List: Maintain a complete list of every medicine, vitamin, supplement, and traditional remedy you use. Share this list with every healthcare provider you see, including doctors and pharmacists.
• Follow Directions Exactly: Take the prescribed dose at the right time, and do not stop taking the medicine until the full course is finished or your doctor tells you it is safe to do so.
• Be Aware of Interactions: Understand that interactions can occur between drugs, with food, and with alcohol. Check the “Drug Facts” label on all over-the-counter medications to avoid taking multiple products with the same active ingredient.
• Ask Questions: Never hesitate to ask your doctor or pharmacist questions about your medication’s purpose, potential side effects, or any concerns you have.
• Communicate Openly: Be honest and non-judgmental in your communication with all healthcare providers, including traditional healers, to ensure they have all the information needed to keep you safe.
• Know the Signs of an Overdose: Be aware of the signs of an overdose and have a plan to call for emergency help immediately if one is suspected.

8. Glossary of Key Terms

• Pharmacodynamics: The study of what a drug does to the body; how it produces its effects.
• Pharmacokinetics: The study of what the body does to a drug; the processes of absorption, distribution, metabolism, and excretion.
• Antiretrovirals (ARVs): A class of medications used to treat infections caused by retroviruses, primarily HIV.
• Analgesics: A general term for medications used to relieve pain.
• Over-the-Counter (OTC): Medications that can be purchased without a prescription.
• NSAIDs: Non-steroidal anti-inflammatory drugs, a class of pain relievers including ibuprofen and naproxen.
• Muthi: A term for traditional African medicine and herbal remedies, often possessing both physical and spiritual significance.

9. References

A.D.A.M. Medical Encyclopedia [Internet]. Johns Creek (GA): Ebix, Inc., A.D.A.M.; c1997-2020. Nail abnormalities; [updated 2019 Jul 31; reviewed 2019 Apr 16; cited 2020 Aug 30]. Available from: https://medlineplus.gov/ency/article/003247.htm.⁵⁰

AHFS Patient Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists, Inc.; c2019. Protriptyline; [updated 2020 Jun 24; reviewed 2018 Jul 5; cited 2020 Jul 1]. Available from: https://medlineplus.gov/druginfo/meds/a604025.html.⁵⁰

British Medical Journal Global Health [Internet]. London (UK): BMJ Publishing Group Ltd.; c2018. Riviere, M., et al. (2018). The use of traditional, complementary and alternative medicine in Sub-Saharan Africa: a systematic review and meta-analysis. [cited 2024 Oct 26]. Available from: https://gh.bmj.com/content/bmjgh/3/5/e000895.full.pdf.⁴²

Cancer.gov [Internet]. Bethesda (MD): National Cancer Institute; c2024. Mechanism of action. [cited 2024 Oct 26]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/mechanism-of-action.⁵¹

Centers for Disease Control and Prevention [Internet]. Atlanta (GA): CDC; c2024. About medication safety. [cited 2024 Oct 26]. Available from: https://www.cdc.gov/medication-safety/about/index.html.²

Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2024. Antihypertensives. [cited 2024 Oct 26]. Available from: https://my.clevelandclinic.org/health/treatments/21811-antihypertensives.¹⁹

Delamere [Internet]. Cheshire (UK): Delamere; c2024. The dangers of mixing prescription drugs. [cited 2024 Oct 26]. Available from: https://delamere.com/help-guides/drugs/mixing-prescription-drugs.²⁹

Drugs.com [Internet]. Auckland (NZ): Drugs.com; c2024. Drug interactions. [cited 2024 Oct 26]. Available from: https://www.drugs.com/drug_interactions.html.²²

Frontiers in Nutrition [Internet]. Lausanne (CH): Frontiers Media SA; c2024. Foteinopoulos, S., et al. (2024). Traditional food processing methods and their impact on drug-food interactions. [cited 2024 Oct 26]. Available from: https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1380010/full.³²

GoodRx [Internet]. Santa Monica (CA): GoodRx, Inc.; c2024. Top 7 questions about mixing NSAIDs and blood thinners. [cited 2024 Oct 26]. Available from: https://www.goodrx.com/health-topic/heart/otc-drugs-to-avoid-on-blood-thinners.²⁷

GoodRx [Internet]. Santa Monica (CA): GoodRx, Inc.; c2024. Antihistamine and sedative interaction. [cited 2024 Oct 26]. Available from: https://www.goodrx.com/classes/antihistamines/interactions.²⁵

Hopkins Medicine [Internet]. Baltimore (MD): Johns Hopkins Medicine; c2024. Food-drug interactions. [cited 2024 Oct 26]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/fooddrug-interactions.³⁰

Journal of Alternative and Complementary Medicine [Internet]. Larchmont (NY): Mary Ann Liebert, Inc., Publishers; c2012. Nsamba, J., et al. (2012). Who’s talking? Communication between health providers and HIV-infected adults related to herbal medicine for AIDS treatment in western Uganda. [cited 2024 Oct 26]. Available from: https://www.researchgate.net/publication/5446676_Who’s_talking_Communication_between_health_providers_and_HIV-infected_adults_related_to_herbal_medicine_for_AIDS_treatment_in_western_Uganda.⁴⁰

MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [updated 2020 Jun 24]. Heart attack; [updated 2020 Jun 10; reviewed 2016 Aug 25; cited 2020 Jul 1]. Available from: https://medlineplus.gov/heartattack.html.⁵⁰

Merck Manuals [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2024. Drug interactions. [cited 2024 Oct 26]. Available from: https://www.merckmanuals.com/home/drugs/factors-affecting-response-to-medications/drug-interactions.²³

Memorial Sloan Kettering Cancer Center [Internet]. New York (NY): MSKCC; c2024. How to read a prescription medication label. [cited 2024 Oct 26]. Available from: https://www.mskcc.org/cancer-care/patient-education/how-read-prescription-medication-label.⁴

Mayo Clinic [Internet]. Rochester (MN): Mayo Foundation for Medical Education and Research; c2024. Beta-blockers. [cited 2024 Oct 26]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/beta-blockers/art-20044522.⁵²

Mayo Clinic Health System [Internet]. Rochester (MN): Mayo Foundation for Medical Education and Research; c2024. Over-the-counter and prescription medication safety. [cited 2024 Oct 26]. Available from: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/over-the-counter-and-prescription-medication-safety.¹⁴

News-Medical.net [Internet]. Manchester (UK): News-Medical.net; c2024. Switching to a Western diet triggers inflammation and weakens immunity. [cited 2024 Oct 26]. Available from: https://www.news-medical.net/news/20250403/Switching-to-a-Western-diet-triggers-inflammation-and-weakens-immunity.aspx.³³

National Library of Medicine [Internet]. Bethesda (MD): NLM; c2024. Pharmacokinetics and pharmacodynamics. [cited 2024 Oct 26]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK595006/.¹⁵

National Library of Medicine [Internet]. Bethesda (MD): NLM; c2024. Nonsteroidal anti-inflammatory drugs (NSAIDs). [cited 2024 Oct 26]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547742/.⁵³

NHS [Internet]. London (UK): NHS England; c2024. Antihistamines. [cited 2024 Oct 26]. Available from: https://www.nhs.uk/medicines/antihistamines/.³⁴

Oklahoma Bureau of Narcotics and Dangerous Drugs Control [Internet]. Oklahoma City (OK): OBNDDC; c2024. Drug overdoses. [cited 2024 Oct 26]. Available from: https://www.obndd.ok.gov/news-and-publications/drug-education/drug-ods.¹¹

Oregon Health Authority [Internet]. Salem (OR): OHA; c2024. Antibiotics and you: speaker notes. [cited 2024 Oct 26]. Available from: https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/COMMUNICABLEDISEASE/ANTIBIOTICRESISTANCE/Documents/Abx_and_You_speaker_notes.pdf.²⁰

Patient Safety Movement Foundation [Internet]. Irvine (CA): PSMF; c2024. Andrew Sheldrick’s story. [cited 2024 Oct 26]. Available from: https://psmf.org/story/andrew-sheldrick/.⁵⁴

Pharmaceutical and Medical Devices Regulation Agency of Japan [Internet]. Tokyo (JP): PMDA; c2024. Communication between traditional medical practitioners and Western medical professionals. [cited 2024 Oct 26]. Available from: https://www.researchgate.net/publication/333932995_Communication_Between_Traditional_Medical_Practitioners_and_Western_Medical_Professionals.⁵⁵

Pharmaceutical Society of South Africa [Internet]. Pretoria (ZA): PSSA; c2011. Drug interactions in African herbal remedies. [cited 2024 Oct 26]. Available from: https://www.researchgate.net/publication/51492085_Drug_interactions_in_African_herbal_remedies.⁴⁵

QJM: An International Journal of Medicine [Internet]. Oxford (UK): Oxford University Press; c2009. Aronson, J. K. (2009). Medication errors. [cited 2024 Oct 26]. Available from: https://academic.oup.com/qjmed/article/102/8/513/1598923.¹⁰

ResearchGate [Internet]. Berlin (DE): ResearchGate GmbH; c2013. The potential of Sutherlandia frutescens for herb-drug interaction. [cited 2024 Oct 26]. Available from: https://www.researchgate.net/publication/233840314_The_Potential_of_Sutherlandia_frutescens_for_Herb-Drug_Interaction.⁴⁷

ResearchGate [Internet]. Berlin (DE): ResearchGate GmbH; c2011. Effect of short term and chronic administration of Sutherlandia frutescens on pharmacokinetics of nevirapine in rats. [cited 2024 Oct 26]. Available from: https://www.researchgate.net/publication/51101413_Effect_of_short_term_and_chronic_administration_of_Sutherlandia_frutescens_on_pharmacokinetics_of_nevirapine_in_rats.⁴⁶

Sa Health [Internet]. Adelaide (AU): Government of South Australia; c2024. Dangers of mixing drugs. [cited 2024 Oct 26]. Available from: https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/drugs/dangers+of+mixing+drugs.³¹

Stadium Pharmacy [Internet]. Dallas (TX): Stadium Pharmacy; c2024. The role of the pharmacist. [cited 2024 Oct 26]. Available from: https://stadiumrx.com/blog/role-of-pharmacist-in-educating-the-patient-on-medication/.⁶

Temple Health [Internet]. Philadelphia (PA): Temple University Health System; c2024. High blood pressure (hypertension). [cited 2024 Oct 26]. Available from: https://www.templehealth.org/services/conditions/high-blood-pressure-hypertension.¹⁷

Tufts Medicare Preferred [Internet]. Watertown (MA): Tufts Health Plan; c2024. Why it’s important to take medicine correctly. [cited 2024 Oct 26]. Available from: https://www.tuftsmedicarepreferred.org/using-your-plan/why-it-important-take-medicine-correctly.¹

U.S. Food and Drug Administration [Internet]. Silver Spring (MD): FDA; c2024. Drug interactions. [cited 2024 Oct 26]. Available from: https://www.fda.gov/drugs/resources-drugs/drug-interactions-what-you-should-know.²¹

WebMD [Internet]. New York (NY): WebMD, LLC; c2024. Interaction checker. [cited 2024 Oct 26]. Available from: https://www.webmd.com/interaction-checker/default.htm.²⁶

Youman & Caputo, LLC [Internet]. Philadelphia (PA): Youman & Caputo, LLC; c2024. Potential consequences of an underdose or underprescribing. [cited 2024 Oct 26]. Available from: https://youmancaputo.com/potential-consequences-of-an-underdose-or-underprescribing/.⁸

Works cited

1. Why Is It Important To Take Medicine Correctly? | Tufts Health Plan …, accessed August 13, 2025, https://www.tuftsmedicarepreferred.org/using-your-plan/why-it-important-take-medicine-correctly
2. Medication Safety and Your Health – CDC, accessed August 13, 2025, https://www.cdc.gov/medication-safety/about/index.html
3. Engaging Providers in Medication Adherence: A Health Plan Case …, accessed August 13, 2025, https://www.ahdbonline.com/issues/2010/november-december-2010-vol-3-no-6/feature-571
4. How to Read a Prescription Medication Label | Memorial Sloan …, accessed August 13, 2025, https://www.mskcc.org/cancer-care/patient-education/how-read-prescription-medication-label
5. How Do I Use Prescription Drug Labeling – FDA, accessed August 13, 2025, https://www.fda.gov/about-fda/oncology-center-excellence/how-do-i-use-prescription-drug-labeling
6. Role of Pharmacist in Educating the Patient on Medication – Stadium Pharmacy, accessed August 13, 2025, https://stadiumrx.com/blog/role-of-pharmacist-in-educating-the-patient-on-medication/
7. Pharmacist-Conducted Patient Education and Counseling – ASHP, accessed August 13, 2025, https://www.ashp.org/-/media/assets/policy-guidelines/docs/guidelines/pharmacist-conducted-patient-education-counseling.ashx
8. Potential Consequences of an Underdose or Underprescribing, accessed August 13, 2025, https://youmancaputo.com/potential-consequences-of-an-underdose-or-underprescribing/
9. youmancaputo.com, accessed August 13, 2025, https://youmancaputo.com/potential-consequences-of-an-underdose-or-underprescribing/#:~:text=Failure%20to%20Optimize%20the%20Treatment%20Regimen&text=If%20a%20doctor%20prescribes%20a,worsens%20despite%20taking%20the%20drug.
10. Medication errors: what they are, how they happen, and how to avoid them | QJM: An International Journal of Medicine | Oxford Academic, accessed August 13, 2025, https://academic.oup.com/qjmed/article/102/8/513/1598923
11. Drug Overdose | Bureau of Narcotics and Dangerous Drugs, OK, accessed August 13, 2025, https://www.obndd.ok.gov/news-and-publications/drug-education/drug-ods
12. What is a Drug Overdose? | Safe Campus, accessed August 13, 2025, https://safe-campus.umn.edu/personal-wellbeing/what-drug-overdose
13. Case study: Focus on compliance with therapy – Rapivab, accessed August 13, 2025, https://www.rapivab.com/themes/rapivab/pdf/Case%20Study_ComplianceWithTherapy.pdf
14. Medication safety tips – Mayo Clinic Health System, accessed August 13, 2025, https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/over-the-counter-and-prescription-medication-safety
15. Chapter 1 Pharmacokinetics & Pharmacodynamics – Nursing Pharmacology – NCBI, accessed August 13, 2025, https://www.ncbi.nlm.nih.gov/books/NBK595006/
16. How painkillers work – when we are in pain or injured, a protein called COX2 releases chemicals called prostaglandins. These c, accessed August 13, 2025, https://www.biochemistry.org/about-us/resources-and-videos/resources/the-journey-of-a-medicine/
17. High Blood Pressure (Hypertension) – Temple Health, accessed August 13, 2025, https://www.templehealth.org/services/conditions/high-blood-pressure-hypertension
18. medical analogies – Bradford VTS, accessed August 13, 2025, https://www.bradfordvts.co.uk/communication-skills/medical-analogies/
19. Types of Blood Pressure Medication (Antihypertensives) – Cleveland Clinic, accessed August 13, 2025, https://my.clevelandclinic.org/health/treatments/21811-antihypertensives
20. Antibiotics and You – Oregon.gov, accessed August 13, 2025, https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/COMMUNICABLEDISEASE/ANTIBIOTICRESISTANCE/Documents/Abx_and_You_speaker_notes.pdf
21. Drug Interactions: What You Should Know – FDA, accessed August 13, 2025, https://www.fda.gov/drugs/resources-drugs/drug-interactions-what-you-should-know
22. Drug Interaction Checker – Find Unsafe Combinations – Drugs.com, accessed August 13, 2025, https://www.drugs.com/drug_interactions.html
23. Drug Interactions – Drugs – Merck Manual Consumer Version, accessed August 13, 2025, https://www.merckmanuals.com/home/drugs/factors-affecting-response-to-medications/drug-interactions
24. Understanding drug interactions – SPS – Specialist Pharmacy Service, accessed August 13, 2025, https://www.sps.nhs.uk/articles/understanding-drug-interactions/
25. 8 Antihistamine Interactions You Should Know About – GoodRx, accessed August 13, 2025, https://www.goodrx.com/classes/antihistamines/interactions
26. Drug Interaction Checker – Check Your Meds First – WebMD, accessed August 13, 2025, https://www.webmd.com/interaction-checker/default.htm
27. www.goodrx.com, accessed August 13, 2025, https://www.goodrx.com/health-topic/heart/otc-drugs-to-avoid-on-blood-thinners#:~:text=Nonsteroidal%20anti%2Dinflammatory%20drugs%20(NSAIDs)%20work%20great%20for%20pain,serious%20bleeding%20and%20heart%20attacks.
28. Top 7 Questions About Mixing NSAIDs and Blood Thinners – GoodRx, accessed August 13, 2025, https://www.goodrx.com/health-topic/heart/otc-drugs-to-avoid-on-blood-thinners
29. Mixing Prescription Drugs & The Dangers | Delamere, accessed August 13, 2025, https://delamere.com/help-guides/drugs/mixing-prescription-drugs
30. Food-Drug Interactions | Johns Hopkins Medicine, accessed August 13, 2025, https://www.hopkinsmedicine.org/health/conditions-and-diseases/fooddrug-interactions
31. Dangers of mixing drugs | SA Health, accessed August 13, 2025, https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/drugs/dangers+of+mixing+drugs
32. Possible interactions between selected food processing and medications – Frontiers, accessed August 13, 2025, https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1380010/full
33. Switching to a Western diet triggers inflammation and weakens immunity – News-Medical, accessed August 13, 2025, https://www.news-medical.net/news/20250403/Switching-to-a-Western-diet-triggers-inflammation-and-weakens-immunity.aspx
34. Antihistamines – NHS, accessed August 13, 2025, https://www.nhs.uk/medicines/antihistamines/
35. The intersection of culture and science in South African traditional medicine, accessed August 13, 2025, https://scielo.org.za/scielo.php?script=sci_arttext&pid=S1445-73772014000100006
36. Traditional African medicine | EBSCO Research Starters, accessed August 13, 2025, https://www.ebsco.com/research-starters/health-and-medicine/traditional-african-medicine
37. African traditional medicine – Wikipedia, accessed August 13, 2025, https://en.wikipedia.org/wiki/Traditional_African_medicine
38. Social Dynamics Muthi, Medicine and Witchcraft: Regulating ‘African Science’ in Post- Apartheid South Africa? – Deep Blue Repositories, accessed August 13, 2025, https://deepblue.lib.umich.edu/bitstream/handle/2027.42/116827/Ashforth%20on%20muthi%20(Social%20Dynamics).pdf
39. (PDF) Bridging the gap: How Traditional Healers interact with their patients. A comparative study in Cameroon – ResearchGate, accessed August 13, 2025, https://www.researchgate.net/publication/44671168_Bridging_the_gap_How_Traditional_Healers_interact_with_their_patients_A_comparative_study_in_Cameroon
40. Who’s talking? Communication between health providers and HIV-infected adults related to herbal medicine for AIDS treatment in western Uganda | Request PDF – ResearchGate, accessed August 13, 2025, https://www.researchgate.net/publication/5446676_Who’s_talking_Communication_between_health_providers_and_HIV-infected_adults_related_to_herbal_medicine_for_AIDS_treatment_in_western_Uganda
41. Views and experiences of healthcare professionals towards the use of African traditional, complementary and alternative medicine, accessed August 13, 2025, https://d-nb.info/1118293460/34
42. Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review | BMJ Global Health, accessed August 13, 2025, https://gh.bmj.com/content/bmjgh/3/5/e000895.full.pdf
43. Adult Meducation, accessed August 13, 2025, http://adultmeducation.com/SocialandEconomicFactors_4.html
44. Patient Counseling about Herbal-Drug Interactions | African Journal …, accessed August 13, 2025, https://www.ajol.info/index.php/ajtcam/article/view/67962
45. (PDF) Drug interactions in African herbal remedies – ResearchGate, accessed August 13, 2025, https://www.researchgate.net/publication/51492085_Drug_interactions_in_African_herbal_remedies
46. Effect of short term and chronic administration of Sutherlandia frutescens on pharmacokinetics of nevirapine in rats – ResearchGate, accessed August 13, 2025, https://www.researchgate.net/publication/51101413_Effect_of_short_term_and_chronic_administration_of_Sutherlandia_frutescens_on_pharmacokinetics_of_nevirapine_in_rats
47. The Potential of Sutherlandia frutescens for Herb-Drug Interaction – ResearchGate, accessed August 13, 2025, https://www.researchgate.net/publication/233840314_The_Potential_of_Sutherlandia_frutescens_for_Herb-Drug_Interaction
48. ROOIBOS: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews, accessed August 13, 2025, https://www.webmd.com/vitamins/ai/ingredientmono-143/rooibos
49. Rooibos Tea | Memorial Sloan Kettering Cancer Center, accessed August 13, 2025, https://www.mskcc.org/cancer-care/integrative-medicine/herbs/rooibos-tea
50. Citing MedlinePlus, accessed August 13, 2025, https://medlineplus.gov/about/using/citation/
51. Definition of mechanism of action – NCI Dictionary of Cancer Terms, accessed August 13, 2025, https://www.cancer.gov/publications/dictionaries/cancer-terms/def/mechanism-of-action
52. Beta blockers – Mayo Clinic, accessed August 13, 2025, https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/beta-blockers/art-20044522
53. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) – StatPearls – NCBI Bookshelf, accessed August 13, 2025, https://www.ncbi.nlm.nih.gov/books/NBK547742/
54. Andrew Sheldrick Story | Patient Safety Movement Foundation, accessed August 13, 2025, https://psmf.org/story/andrew-sheldrick/
55. (PDF) Communication Between Traditional Medical Practitioners and Western Medical Professionals – ResearchGate, accessed August 13, 2025, https://www.researchgate.net/publication/333932995_Communication_Between_Traditional_Medical_Practitioners_and_Western_Medical_Professionals