DEAR DOCTOR: I take about nine different medications and dietary supplements per day. I use a pill container with slots for morning and evening, and it covers a two-week period. Can these meds and supplements be safely stored together? Do they lose potency being stored if they're in the container for two weeks?
DEAR READER: With nine different pills to take each day, our first thought is that you should make sure that each of the medications and supplements is necessary. If your prescriptions have been written by more than one doctor, check with your pharmacist regarding any duplications. It's possible for the same prescription to be filled both with a brand-name drug and a generic drug. What looks and sounds like two different kinds of pills can, in fact, be a double dose of the same medication.
Your pharmacist can also advise you whether any of the meds you are taking have potential for adverse interactions. We recommend that you let him or her know about of all of the dietary supplements you're taking. While supplements don't require a prescription for purchase, they can adversely interact with prescription drugs.
With this quantity of pills in your life, an updated list of all your medications is a good idea. Include the name of the prescribing doctor, when the prescription began, the date of the most recent refill and directions for use. Bring this list to each medical appointment, including the dentist. To be sure you're not putting yourself at risk, show it to your pharmacist when filling a new prescription, and whenever you add an herbal or dietary supplement to your regimen.
And now (we know -- finally!) to your main question.
Assuming your medications and supplements have been cleared for potential interactions, it's fine to store them together. Any powder or residue from the pills or gel caps is small enough not to make a difference. As for potency, two weeks is a short enough time that, as long as you follow the storage specs of each pill, they should be fine.
Which leads us to our next point. How medications are stored affects how well they work. Humidity, light, air and heat can each have a negative effect, degrading certain ingredients in pills. Not only can improper storage make medications ineffective, in certain cases the chemical changes that take place can be dangerous.
For instance, Coenzyme Q10, an antioxidant, can lessen the blood thinning effects of drugs like warfarin. Valerian, which some people use for anxiety, can amplify the effects of muscle relaxants or sleep medications. Antivirals to treat HIV/AIDS, some heart medications and some anti-depressants may be less effective when taken with St. John's Wort.
While the majority can safely be stored at room temperature, read the literature that accompanies them to be sure. Keep your meds in a cool, dry place, away from sunlight and any source of heat or moisture. We advise against bathrooms, with fluctuating humidity from showers and baths, or kitchens, with humidity and heat. Instead, consider a dresser drawer or a closet shelf. Wherever you decide to store your meds, be sure they are clearly marked and safe from pets and children.
Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.
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