To Complete Your Current Drug List: Add Contraindications

This past Monday I consulted my primary care physician (PCP) about a suspected urinary tract infection. I’d been feeling progressively not well, although I’ll admit that I’ve been burning the proverbial candle from every angle imaginable and have earned fatigue and increased MS symptoms. But after experiencing sudden leg weakness, I thought that it was time to take action. If infection was causing a pseudoexacerbation, there was something we could do about it.

My PCP prescribed an antibiotic which I started taking immediately. The next morning I had a routine appointment with my rheumatologist, during which I told her about the antibiotic (eg, Bactrim). My doctor’s eyes got BIG.

“You cannot, MUST NOT, take Bactrim when you are using methotrexate,” she says. “The combination can cause your blood counts to go to zero.”

Hmm. That doesn’t sound good. She told me to stop taking the drug immediately and to call my PCP. Then she discussed potential side effects of other antibiotics that might affect tendons and what I should do if I experienced problems.

Just like I’ve created a detailed list of medications for my mother—including those drugs she cannot use—I need to do the same thing for myself. If I had had this information in front of me on Monday, it would have been easy to ask for an alternative antibiotic on the spot. I know that my doctor did check for drug interactions, but perhaps the extent of a potential interaction is recognized as being more serious by one doctor than another.

A complete drug list should include:

• Brand name
• Generic name
• Dose and frequency
• Reason prescribed
• Prescribed by whom
• Any medications to avoid, and why
• Date of last update to list

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