Awake at the wheel: Certain scrips mean no trips

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If someone has a couple of glasses of wine with dinner, he or she will probably feel impaired and know not to get behind the wheel. But many of your patients could be unwittingly taking medications that may slow their coordination and responsiveness or increase fatigue—making it dangerous to drive.

As a pharmacist, you can help patients understand how OTC and prescription medications can affect their ability to drive.

Medications to watch

Inform patients that the following broad categories of medications can impair their ability to drive:

  • Anxiety and depression medications
  • Products containing codeine
  • Some cold remedies and allergy products, particularly those that help you sleep; decongestants and cough suppressants
  • Tranquilizers
  • Sleeping aids
  • Narcotic pain relievers
  • Diet aids
  • Stimulants

Widely used culprits

Patients should be knowledgeable about the adverse effects of two frequently used medications: sleeping aids and antihistamines. 

It is well known that sleeping aids can cause problems when driving. Make sure patients using them know to take most of these medications when they will be able to sleep for a full 7 to 8 hours. If it is a new prescription, you can recommend patients take it on an evening when they don’t have to drive the next morning. FDA has even recommended that people don’t drive the day after taking sleep aids such as zolpidem and eszopiclone.

Pharmacists can also watch for potential dosing problems with these medications. In 2013, in an attempt to cut down on driving problems associated with zolpidem, FDA recommended cutting the dosage of the medication in half. Patients should be taking 5 mg of the immediate-release product and 6.25 mg of the extended-release medication.

Patients taking antihistamines should avoid using alcohol, sleeping aids, and tranquilizers if they plan to drive.

General tips

Here are some general things to remember when counseling patients about taking medications that may affect their driving:

  • Make note of patients who have conditions such as high blood pressure, anxiety, Parkinson disease, or liver problems, particularly if they are taking more than one medication. Be aware of potential interactions that could inhibit their driving.
  • When a medication may cause drowsiness or impair driving, make sure patients know to take only the prescribed dosage. If the medication isn’t effective, tell them to check with their physician instead of adjusting it on their own.
  • Tell patients to monitor their reactions to new medications. Does it make them tired, affect their vision, or make them dizzy, faint, or inattentive? If so, how long does it take to “kick in”?
  • Make sure patients understand that they can likely still drive even if medications are affecting them. They can talk to their physician, who can adjust the dosage, change the time when it is taken, or try another medication that doesn’t cause problematic symptoms.
  • Patients should never combine medication, alcohol, and driving. If a medication can be particularly problematic when mixed with other meds or alcohol, make sure to talk to your patients about adverse effects.

Resources

“Driving While Taking Medication,” a National Highway Traffic Safety Administration publication, can be printed as a brochure or hung in the pharmacy where patients can see it. Roadwise Rx, created by AAA, is an online program that allows patients to enter their medication to find out if it can impair driving.

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