So I’m standing at the pharmacy in Howell NJ last March, already in a bad mood because I just had a root canal, and I just want my damn antibiotics so I can go home and feel sorry for myself.
The pharmacist disappears with my prescription for like twenty minutes. When she finally comes back, she’s got this look on her face and starts asking me questions about my other medications. And I’m thinking, lady, it’s all right there in your computer, can we speed this up?
“Are you still taking lisinopril for your blood pressure?”
Yes. Obviously. It’s in the system.
“Did Dr. Chen know you’re on that when he prescribed this antibiotic?”
I don’t know, probably? He’s my dentist, not my cardiologist, but sure.
Are You Overmedicating? Let Us Check Your Prescriptions!
Turns out the antibiotic he gave me could’ve jacked my blood pressure up to stroke levels. She had to call him back, wait on hold forever, get a different antibiotic approved. The whole thing took almost an hour.
I was pissed at the time. Now I’m just glad I didn’t end up in an ambulance three days later.
Drugs Do Weird Stuff Together
Here’s what I didn’t understand before all this: medications don’t just sit in your body doing their own thing separately. They interact with each other in ways that are sometimes completely bizarre.
Like, you wouldn’t think an antibiotic would have anything to do with blood pressure medication, right? Different problems, different drugs. But your body is breaking all these chemicals down at the same time, and sometimes one drug changes how your body processes another drug, or they combine in unexpected ways.
The grapefruit juice thing is famous—apparently it screws with something like 85 different medications, and scientists are still figuring out exactly why. Who would’ve guessed that?
Pharmacists think about three main types:
One drug messing with another drug. That’s the obvious one.
Food or drinks messing with your drugs. Not just grapefruit—there’s a bunch of these.
A medication making one of your other health problems worse. Like how Sudafed can spike your blood pressure, which is great if you’re already hypertensive.
What Takes So Long Back There
When you drop off a prescription at your pharmacy near you, the pharmacist runs it through their computer system. The computer flags everything that could possibly be an interaction—and I mean everything. It’s overly cautious because it has to be.
Then the pharmacist has to actually think about it. Is this a real problem for this specific person? Or is this just the computer freaking out over something that’s technically possible but not actually dangerous?
They’re looking at your whole medication list. Your health history. The doses. Whether you’re supposed to take these things together or separately. If there’s a different drug that would work without the risk.
My buddy works as a pharmacy tech and he showed me one of these screens once. There were probably thirty warnings on there for one prescription. The pharmacist had to go through each one and decide which ones actually mattered. It’s not a quick process.
The Usual Suspects
Blood thinners are apparently the worst. If you’re on warfarin or Eliquis or any of those, there’s this huge list of stuff that can interact. Regular over-the-counter ibuprofen can make you bleed too easily. Some antibiotics make the blood thinner work too well, some make it not work enough.
My neighbor Tom—he’s in his seventies, super healthy, very active—he’s on warfarin because of a heart thing. He sees his cardiologist regularly, everything’s fine. Then he starts seeing a new doctor for his arthritis. New doctor gives him a prescription, Tom fills it at a different pharmacy because it was closer, doesn’t think anything of it.
Week later he’s in the ER with internal bleeding. Nobody caught that the two drugs shouldn’t be taken together because nobody had the full picture. He’s fine now, but it was scary.
Antidepressants are tricky too. I didn’t know this until my wife started taking one—they interact with pain medications, migraine drugs, even some supplements you can just buy at the store. There’s this thing called serotonin syndrome that can happen if you mix the wrong things, and apparently it’s really dangerous.
Diabetes stuff gets complicated. My dad’s diabetic, and when he needed steroids for his back last year, it threw his blood sugar completely out of whack. Nobody warned him that would happen. He figured it out eventually but it would’ve been nice to know ahead of time.
And the birth control thing—everyone sort of knows antibiotics can mess with birth control pills, but then when you’re actually sick and the doctor hands you an antibiotic, you forget to think about it. My coworker found out the hard way. She’s got three kids now, the third one was a surprise courtesy of a sinus infection.
What You Forget To Tell Them
Most people remember to tell the pharmacist what prescriptions they’re on. But all the other stuff? People forget.
Vitamins count. Supplements count. That fish oil you take every morning, that calcium tablet, that multivitamin—they’re chemicals that go in your body and they can interact with your medications.
My mom’s doctor put her on thyroid medication. She was taking it every morning with breakfast, along with her calcium supplement and her coffee. It wasn’t working. Like, at all. Took them months to figure out the calcium was blocking the thyroid med from absorbing. She had to start taking it at a completely different time.
Over-the-counter stuff counts too, but people don’t think of it as “real” medicine. Tylenol PM, Advil, Benadryl—these are drugs. The pharmacist at your pharmacy in Howell NJ can’t check for interactions if they don’t know you’re taking them.
Herbal stuff is the worst because people really don’t think that counts. “It’s natural, it’s just a supplement.” Yeah, and belladonna is natural too, doesn’t mean it’s not a drug. St. John’s Wort interacts with a ton of prescriptions. Nobody mentions it because it’s from the vitamin aisle.
When Things Take Forever Because They’re Calling Your Doctor
Sometimes the pharmacist gets your prescription and immediately picks up the phone to call your doctor. This used to drive me crazy. Just give me the pills, why are you calling my doctor?
But doctors are human. They prescribe dozens of medications every day to dozens of different patients. If you see multiple doctors—and most people do—no single doctor has the complete list of what you’re taking unless you specifically tell them. And even then, they might not catch an interaction in the moment.
The pharmacist calls and says “hey, this patient is on Drug X, and you just prescribed Drug Y, these don’t play well together.” Sometimes the doctor says “I know, but in this case it’s the right call anyway.” Sometimes they’re like “oh shit, good catch, let me change that.”
I watched this happen with my wife’s prescription once. We were at the pharmacy for probably forty minutes. The pharmacist was on hold with her doctor’s office for half of that. I was getting annoyed, we had places to be.
Finally she gets through, explains the situation, doctor changes the prescription, we leave with the right medication. Later we found out the original one could’ve caused a seizure given what she was already taking.
Forty minutes suddenly seemed like not that long.
Just Use One Pharmacy
For years I filled prescriptions wherever was convenient. CVS near work, Walgreens near home, the one inside ShopRite when I was grocery shopping. Didn’t think it mattered.
It matters. When your prescriptions are split between three different places, nobody sees the full picture. Each pharmacy near you only knows about the stuff they’ve filled for you.
After the blood pressure scare, I moved everything to one place. It’s sometimes less convenient—occasionally I have to drive past two other pharmacies to get to mine—but now one pharmacist is looking at everything I take. That’s worth the extra five minutes in the car.
Keep a list, too. I’ve got one in my phone of every single thing I take. Prescriptions, vitamins, that aspirin I take most mornings, all of it. When I get a new prescription or go to a doctor appointment, I pull it up and show them.
Am I good about updating it when things change? Not really. I’ve definitely shown up at the doctor with an outdated list. But it’s better than nothing.
Not Everything Is Dramatic
Not every interaction is going to kill you or put you in the hospital. Some just make your medication not work as well. You’re spending money on something that’s basically useless because another drug is blocking it.
Some cause annoying side effects. My sister was getting terrible headaches after starting a new medication. She almost stopped taking it because the headaches were so bad. Pharmacist figured out it was interacting with her allergy medicine—not dangerous, just unpleasant. They adjusted when she took each one and the headaches stopped.
Would’ve been a shame to stop a medication she needed just because nobody realized the timing was causing a problem.
Look, I Get It
When you’re at the pharmacy counter and it’s taking forever and you just want to leave, it’s frustrating. You’ve got stuff to do. The pharmacist is asking you questions you feel like you already answered. Maybe they need to call your doctor and now you’re waiting even longer.
I’ve been that impatient person tapping my foot and checking my watch. I’ve huffed and rolled my eyes when the pharmacist wanted to “have a conversation” about my medications.
But here’s the thing—they’re not doing it to annoy you. They’re not on some power trip. They’re checking to make sure you’re not about to take something that’ll put you in the hospital or make your other medications stop working or cause problems that are totally preventable.
That’s literally what they went to school for. It’s their job. And sometimes that job takes more than two minutes.
The pharmacist who caught my blood pressure thing? I went back a week later and thanked her. Felt kind of dumb about being irritated with her before. She just shrugged and said “that’s what I’m here for.”
Next time you’re stuck waiting at the pharmacy, maybe remember that the person behind that counter might be saving you from something a lot worse than a wait.
At least that’s what I try to remember now. Doesn’t always work—I’m still impatient sometimes—but I’m trying.
