The New York Times, April 26, 2016.

Some common combinations that cropped up in the study and could spell trouble: aspirin and the anti-clotting drug clopidogrel (Plavix), both blood thinners that together increase the risk of bleeding with long-term use; aspirin and naproxen (Aleve), over-the-counter drugs that when combined can cause bleeding, ulceration or perforation of the stomach lining. Yet almost 4 percent of the older adults in her study took both drugs. […]though her patient wasn’t experiencing problems, he was also taking garlic and omega-3 supplements, which can interact with prescription medications.

“We’re not paying attention to the interactions and safety of multiple medications,” said Dima Qato, the lead author of the JAMA Internal Medicine article (Dr. Alexander was a co-author) and a pharmacist and epidemiologist at the University of Illinois at Chicago. “This is a major public health problem.”

Users probably believe fish oil helps their hearts. But Dr. Qato pointed out fish oil capsules lacked regulation and evidence of effectiveness, and can cause bleeding in patients taking blood thinners like warfarin (brand name: Coumadin).

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