Medication Mistakes We See Every Week (And How to Avoid Them)

After years of dispensing, you start to notice patterns. The same small mistakes, over and over, sometimes with big consequences. None of them come from people being careless — they come from the system being complicated. Here are the ones we see most at Brookfield Pharmacy, and the small habits that prevent them.

Mistake 1: Taking paracetamol plus "that cold and flu powder"

The scenario: you've got a cold. You take paracetamol for the headache. You also dissolve a Lemsip sachet. Then maybe a couple of co-codamol later because you have some lying around.

You've now had 4+ grams of paracetamol in a few hours without realising — because Lemsip contains paracetamol, and co-codamol is paracetamol plus codeine. Paracetamol overdose is silent, doesn't make you feel ill immediately, and it's the leading cause of acute liver failure in the UK.

The rule: never take two different branded painkillers together without checking the box for "paracetamol" on both. Maximum adult dose is 4g in 24 hours (that's 8 × 500mg tablets), spread across at least 4-hour gaps. Less if you weigh under 50kg or have liver issues.

Mistake 2: Stopping antibiotics when you feel better

Classic scenario: 7-day course of amoxicillin. By day 4 you feel fine. You put the rest in the cupboard "in case it happens again."

Two problems. First, the infection may not be fully cleared and can come back worse. Second — more importantly — incomplete courses are a major driver of antibiotic resistance. We end up unable to treat serious infections because the bugs have learned.

The rule: finish every antibiotic course unless your prescriber specifically tells you to stop. And don't hoard them for later use.

Mistake 3: Not telling us about supplements

A patient came in last month on warfarin, worried her INR was bouncing around. Turned out she'd started taking St John's Wort for low mood. Nobody asked, so nobody knew.

Supplements, herbals and "natural" products interact with prescription medicines all the time. The bad ones:

• St John's Wort — interacts with antidepressants, warfarin, the pill, and loads more
• grapefruit juice — boosts levels of statins, blood pressure meds, some antihistamines
• high-dose vitamin K (leafy greens, certain supplements) — messes with warfarin
• iron, calcium, magnesium — block absorption of some antibiotics and thyroid medicines
• fish oil, vitamin E, high-dose aspirin — thin blood more than expected together

The rule: when we ask "are you taking anything else?" we mean anything, including the multivitamin, the supermarket cod liver oil and the dubious thing your mate recommended. Bring the packets.

Mistake 4: Using the wrong spoon

NHS figures suggest kitchen teaspoons deliver anywhere from 2.5ml to 7ml depending on the spoon. Medicine labels assume 5ml exactly. For a child on antibiotic liquid, that difference matters.

The rule: use the oral syringe or measuring cup the pharmacy supplies. Every medicine liquid should come with one. If yours didn't, come back — we'll give you one free.

Mistake 5: Storing medicines in the bathroom

The warm, damp air from showers is the worst possible environment for most tablets. Blister packs fare better than loose tablets, but everything degrades faster.

The rule: a dry drawer in a cool room (bedroom, living room) is better than the bathroom cabinet. Out of reach of children, obviously. Some medicines (certain insulins, some eye drops, most antibiotics in liquid form once made up) need the fridge — the label will say.

Mistake 6: Sharing medicines

"My neighbour had the same thing and she gave me a couple of her tablets."

Please don't. Even if the name looks right, the dose may not suit you, you might have allergies or interactions nobody has checked, and if something goes wrong nobody will know what you took. Borrowing antibiotics is especially bad — doubly so with the resistance issue above.

The rule: Pharmacy First covers seven common conditions free on the NHS at Brookfield Pharmacy. Walk in, we can usually prescribe something the same day. No borrowing needed.

Mistake 7: Crushing or splitting tablets

Some tablets are designed to release slowly over hours — crushing them releases the whole dose at once, which can be dangerous. Others have an enteric coating that stops them irritating your stomach; crushing them removes the protection.

Rules of thumb:

• don't crush tablets with "MR" (modified release), "SR" (sustained release), "XL", "CR" or "EC" (enteric coated) in the name
• can be split only if the tablet has a clear score line down the middle
• can sometimes be dissolved in water if the manufacturer lists this as an option

If a tablet is too big to swallow, there's often a liquid or smaller-strength version. Ask us.

Mistake 8: Not flagging side effects

People assume side effects are just something they have to live with. Often they're fixable — by changing the time you take it, taking it with food, switching formulation, or occasionally changing to a different drug altogether.

The rule: if a medicine is causing anything worse than mild, come and tell us. Don't just stop taking it silently — some medicines (certain antidepressants, beta-blockers, long-term steroids) need to be tapered, not stopped cold.

Mistake 9: Expired medicines

Most tablets are still usable a bit past their expiry date, but some aren't:

• antibiotics, eye drops (4 weeks after opening), insulin (28 days at room temp), nitrate spray for angina — respect expiry strictly
• EpiPens — always in date
• tablets in a blister pack, stored properly — usually fine up to about a year past, but not worth gambling on anything you need urgently

The rule: we take back any out-of-date or unwanted medicines for safe disposal. Don't flush them and don't put them in the bin — bring them to us.

Mistake 10: Not asking the pharmacist

You can walk in and ask us anything without an appointment. "Is it normal that this makes me itchy?" "Can I take this with my blood pressure tablet?" "What should I do if I miss a dose?" That is genuinely the main reason we're here.

A simple habit that prevents most of these

Keep a current medicines list on a piece of paper in your purse or wallet, or a note on your phone. Include:

• every prescription medicine, with strength and dose
• any supplements and herbals
• any regular painkillers
• any allergies

Update it whenever something changes. Show it to every GP, pharmacist and hospital team who asks about your medicines. Takes 5 minutes to write; can save your life.

Come and talk to us

Any questions about your medicines? Walk in to Brookfield Pharmacy at 5 Brookfield Road, Hucclecote, GL3 3HA during opening hours (Mon–Fri 8:30–18:00, Sat 9:00–12:00), ring 01452 618377, or email pharmacy.FGQ38@nhs.net. There's no silly question — promise.