Top Ten Public Medication Tips for the 2024 National Drug Safety Awareness Week

Tip 1: For chronic conditions, don’t just stock up on medication—don’t delay regular follow-up appointments.

Tip 2: Consistently manage your blood pressure; arbitrarily stopping medication can harm your health.

Tip 3: Carotid artery plaques are highly prevalent—exercise strict prevention and control measures; don’t be complacent.

Tip 4: Develop a correct understanding of obesity; don’t blindly trust miracle cures without solid evidence.

Tip 5: In the elderly, hepatic and renal function decline; cautious medication use yields greater benefits.

Tip 6: Oseltamivir is effective against influenza; pediatric use requires careful consideration.

Tip 7: Vitamin D supplementation should be approached scientifically; both deficiency and excess are undesirable.

Tip 8: Premature hair loss before old age—long-term medication to save the hairline.

Tip 9: Check the dosage form before taking medication; avoid splitting tablets arbitrarily.

Tip 10: Avoid sunlight when taking photosensitive medications; be sure to follow all precautions.

Tip 1: For chronic conditions, don’t just stock up on medication—don’t delay regular follow-up appointments.

Some patients with chronic diseases feel well after taking their medication and assume that continuing to take it is sufficient. For convenience, they stock up on drugs and stick to them without scheduling regular follow-up visits and check-ups as prescribed. In fact, even when certain medications for chronic conditions can be prescribed for extended periods, it remains essential to monitor changes in the patient’s condition. If patients self‑medicate over long periods without returning for follow-up, they may fail to adjust their treatment plan in a timely manner, often leading to delays in managing their illness.

Taking the treatment of type 2 diabetes as an example, one of the primary goals of maintaining stable blood glucose levels is to prevent and delay complications. As the disease progresses, if mild to moderate complications develop, it is essential to manage risk factors such as blood glucose, blood pressure, and lipid levels, and to implement therapies targeted at the underlying pathogenic mechanisms. If severe complications arise, patients should seek care in specialized departments—such as ophthalmology, nephrology, neurology, cardiology, or vascular surgery—to receive tailored diagnosis and treatment, thereby preventing disability and mortality associated with advanced complications. Therefore, individuals with type 2 diabetes should attend regular follow-up visits for appropriate assessments, and those with poorly controlled glycemia should have their monitoring frequency and scope increased. Only through comprehensive management—including dietary control, physical activity, blood glucose monitoring, diabetes self-management education, and pharmacologic therapy—can optimal glycemic control be achieved, disease progression be slowed or halted, complications be prevented, and quality of life be improved.

Therefore, patients with chronic diseases should not simply stock up on medications and take them indiscriminately; they must also attend regular follow-up appointments for monitoring, receive education, and undergo ongoing follow-up care. Under no circumstances should they regard these steps as a hassle.

Tip 2: Consistently manage your blood pressure; arbitrarily stopping medication can harm your health.

Hypertension is one of the most common chronic diseases. Some patients with hypertension exhibit poor medication adherence, either by discontinuing their medications long-term without medical guidance or by taking them intermittently, unaware that such practices can pose serious health risks.

Hypertension is the leading risk factor for stroke, myocardial infarction, and cardiovascular mortality. Only by adhering to long-term pharmacotherapy and maintaining blood pressure within the normal range can hypertensive patients significantly reduce the incidence of cardiovascular and cerebrovascular complications such as myocardial infarction, cerebral infarction, heart failure, and atrial fibrillation, thereby lowering both cardiovascular‑cerebrovascular–related mortality and all‑cause mortality. Therefore, hypertensive patients who do not meet the criteria for discontinuing medication should firmly resist the urge to stop taking their drugs and continue treatment.

If a physician determines that medication reduction is appropriate, the principle should be to taper doses gradually and steadily to avoid blood pressure fluctuations or rebound. When multiple drugs are being used in combination, dose reductions should prioritize adjusting the entire regimen rather than discontinuing one agent first. If blood pressure remains within the normal range for at least six months, the original doses may be reduced to the lowest maintenance levels. For example, if a patient has been taking amlodipine 10 mg/day and perindopril 8 mg/day, these can be lowered to amlodipine 5 mg/day and perindopril 4 mg/day. Should blood pressure remain stable for another six months or longer, consideration may be given to discontinuing one of the medications.

It should be noted that for hypertensive patients with baseline blood pressure at Grade II or higher and who belong to the intermediate-to-high risk group, complete discontinuation of antihypertensive therapy is unlikely; therefore, it is recommended to adjust their antihypertensive regimen under the guidance of a cardiovascular specialist.

Tip 3: Carotid artery plaques are highly prevalent—exercise strict prevention and control measures; don’t be complacent.

The carotid artery is one of the major arteries in the human body. Carotid plaque refers to a pathological condition in which cholesterol, calcium salts, fibrin, and other substances gradually accumulate in the arterial intima, forming deposits on the vessel wall. When plaque develops in the carotid artery, it is akin to having pebbles blocking the vessel’s lumen, impeding normal blood flow and leading to symptoms of cerebral ischemia, such as dizziness and headache. If a plaque fragment detaches and travels through the bloodstream into the cerebral vasculature, occluding distal vessels that are relatively narrow, it can result in stroke.

Although carotid plaque is highly prevalent and poses significant risks, with effective prevention and control measures and appropriate treatment, the carotid plaque in some patients can be improved.

First, adopt a healthier lifestyle. Controlling your diet, improving its nutritional balance, increasing physical activity, losing weight, and quitting smoking while limiting alcohol consumption can all help lower blood cholesterol levels and prevent plaques from growing further or multiplying.

Second, both hypertension and diabetes are major risk factors for the development of atherosclerotic plaques. Individuals with hypertension or diabetes should actively and appropriately manage their blood pressure and blood glucose levels.

Third, achieving target levels of low-density lipoprotein cholesterol (LDL-C) is key to reversing atherosclerotic plaques. Current research indicates that when LDL-C is maintained below 2.0 mmol/L, most plaques cease to grow; and when LDL-C is reduced to 1.5 mmol/L, the majority of lipid‑rich arterial plaques can gradually shrink.

Statins are the cornerstone of therapy for carotid atherosclerotic plaques. When carotid plaque causes ≥50% vascular stenosis, this constitutes an explicit indication for statin therapy, and patients should receive statins regardless of their cholesterol levels. It is important to emphasize that most patients should take statins long-term, often for life, as this is an effective strategy to inhibit plaque progression; intermittent use is strongly discouraged.

Tip 4: Develop a correct understanding of obesity; don’t blindly trust miracle cures without solid evidence.

Obesity is a chronic metabolic disorder characterized by an increase in the total number of adipocytes in the body, or by localized increases and abnormal distribution of fat. The Body Mass Index (BMI) is currently a widely used international standard for assessing body weight relative to height and determining whether a person is underweight, normal weight, overweight, or obese. BMI is calculated as body weight (in kilograms, kg) divided by the square of height (in meters, m). A BMI ≤ 18.5 kg/m² indicates underweight; 18.6–23.9 kg/m² corresponds to normal weight; 24.0–27.9 kg/m² denotes overweight; and a BMI ≥ 28.0 kg/m² is classified as obesity.

According to statistics from the World Health Organization, obesity is one of the most easily overlooked yet rapidly increasing chronic diseases facing humanity today. The array of conditions it triggers is also posing a serious threat to public health. Obesity can inflict immeasurable damage on multiple bodily systems, particularly the cardiovascular system, and obese individuals are at heightened risk for diabetes, hypertension, hyperlipidemia, and other ailments. Moreover, it can give rise to a host of psychosocial issues.

China has established clinical practice guidelines for the diagnosis and treatment of obesity. When aiming to lose weight, interventions should be conducted under the guidance of a specialist, employing a comprehensive, evidence-based approach that integrates nutrition, physical activity, and psychological support. If pharmacologic weight loss is necessary, it must be prescribed by a physician, with careful consideration of indications, contraindications, and potential adverse effects. The indiscriminate use of weight-loss medications poses significant safety risks. At present, there is no “miracle drug” that is both free of side effects and prevents weight regain. Patients with obesity should avoid following trends or self‑medicating, as this can backfire and harm their health.

Weight loss requires adopting a scientifically sound approach: tailor your diet and exercise plan to your individual needs, and stick with it over the long term. Cultivating healthy lifestyle habits and maintaining consistent effort—rather than relying on quick fixes—are the true “miracle cures” for weight management.

Tip 5: In the elderly, hepatic and renal function decline; cautious medication use yields greater benefits.

As people age, the physiological functions and organ systems of older adults decline to varying degrees, leading to reduced capacity for drug absorption, metabolism, and excretion, which increases the risk of adverse drug reactions and drug‑induced diseases. Therefore, medication safety in the elderly should be given greater attention.

Medication use in older adults can follow these principles:

Rational drug selection: Choose medications with proven efficacy that can alleviate symptoms, correct pathological processes, or eliminate the underlying cause, while adhering to the principle of “the fewest possible drugs at the lowest effective dose.” In general, combining more than four drugs is not recommended to minimize the risk of adverse drug reactions. Whenever feasible, select agents that achieve dual therapeutic effects to avoid concurrently administering drugs with identical mechanisms of action or similar side effects.

Dose individualization: In elderly patients, medication should be initiated at a low dose and gradually titrated up to the therapeutic dose that achieves optimal efficacy. The Chinese Pharmacopoeia explicitly stipulates that individuals aged 60 years and older should receive three-quarters of the adult dose; in general, dosing is also adjusted according to age, body weight, and overall physical condition, following a sequence of one-fifth, one-fourth, one-half, two-thirds, or three-quarters of the adult dose. Doses should not be increased indiscriminately to avoid drug accumulation and serious adverse outcomes. At the same time, close monitoring of therapeutic drug levels is essential, with serum concentrations measured when necessary.

Improving Adherence: Older adults aged 70 and above often experience declining memory and comorbidities, requiring the use of numerous and complex medications. They may easily forget or become confused about the prescribed dosing regimens provided by physicians and pharmacists, leading to medication errors such as missed doses, incorrect administration, or even overdose. To address this, the complexity of the medication regimen can be minimized to enhance adherence among elderly patients.

Tip 6: Oseltamivir is effective against influenza; pediatric use requires careful consideration.

Oseltamivir is a commonly used drug for the prevention and treatment of influenza. It is indicated for the treatment of influenza A and B in adults and children aged 1 year and older, and for the prophylaxis of influenza A and B in adults and adolescents aged 13 years and older.

Children are a special population when it comes to medication. When using oseltamivir for the prevention and treatment of influenza, granules are typically preferred for their ease of administration. The following precautions should be observed:

Timing of medication: As a therapeutic agent, oseltamivir should be initiated within 48 hours of the onset of influenza symptoms; earlier administration yields better outcomes. If treatment is effective, fever typically resolves within 48 hours. For prophylaxis, oseltamivir should be started within 2 days of close contact with an influenza patient.

Dosage: The dosage for children should be calculated based on body weight (refer to the package insert), and parents should ensure that the medication is administered accurately as prescribed by a healthcare professional.

Duration of treatment: It is generally recommended to take the medication continuously for 5 days. Even if a child shows improvement during treatment, the full course should be completed.

Adverse Reactions: The most common adverse reactions to oseltamivir include nausea, vomiting, and abdominal pain; rash and changes in mental status may also occur. Children must take the medication under adult supervision. If suspected adverse reactions arise, healthcare professionals should weigh the risks and benefits and determine whether to discontinue the drug.

Tip 7: Vitamin D supplementation should be approached scientifically; both deficiency and excess are undesirable.

Vitamin D has broad benefits for human health, playing a particularly critical role in musculoskeletal health. It enhances intestinal calcium absorption, promotes the mineralization of newly formed osteoid tissue, and is essential for muscle function.

Measurement of serum 25-hydroxyvitamin D [25-(OH)D] is the most reliable indicator of the body’s vitamin D stores. The reference ranges for serum 25-hydroxyvitamin D in the Chinese adult population are as follows:

Vitamin D deficiency in adults can lead to osteoporosis, which in turn increases the risk of falls and fractures. Vitamin D3 is the preferred treatment; when vitamin D3 is contraindicated, vitamin D2 may be used. Oral administration is recommended as the first-line route, with parenteral administration reserved for second‑line use. Dosage should be individualized, with a treatment plan—defining both a loading dose and a maintenance dose—established by a physician and adjusted according to clinical response.

Vitamin D is not beneficial in excess; short-term intake of high doses or long-term use of excessive amounts can lead to severe toxicity, causing hypercalcemia, which in turn may result in systemic vascular calcification, renal calcium deposition, and calcification of other soft tissues. Hypercalcemic crisis is a life‑threatening condition, and patients may die from renal failure or cardiac arrest.

For healthy individuals, engaging in regular outdoor activities and getting adequate sunlight exposure helps promote vitamin D synthesis, so supplemental intake is generally unnecessary. Only patients with documented vitamin D deficiency and associated symptoms require pharmacologic supplementation. Even after correcting a vitamin D deficiency, it is still advisable to rely primarily on a balanced diet and outdoor activity to prevent toxicity or adverse effects that may result from long-term or high-dose vitamin D supplementation.

Tip 8: Premature hair loss before old age—long-term medication to save the hairline.

When hair follicles lose their normal function due to aging, nutritional imbalances, disease, or other factors, hair loss may occur. Hair loss is classified into non-scarring and scarring types; non-scarring alopecia includes androgenetic alopecia, telogen effluvium, and alopecia areata, among others. Causes of hair loss include genetic predisposition, androgens, and psychological stress. Androgenetic alopecia, also known as seborrheic alopecia, is primarily hereditary. Prevention and treatment can be achieved by using medications to reduce dihydrotestosterone (DHT) levels and stimulate hair growth.

Finasteride is an oral prescription medication with potent efficacy. Testosterone is converted into DHT under the catalytic action of 5α-reductase; finasteride, as a selective inhibitor of this enzyme, blocks this conversion, thereby reducing circulating DHT levels and significantly improving follicular atrophy. It is recommended to strictly follow your physician’s instructions, taking the medication on time, in the prescribed dosage, and for the full course of treatment. If severe adverse symptoms occur, seek medical attention promptly.

Minoxidil is a peripheral vasodilator. When applied topically, it dilates blood vessels, enhances nutrient delivery to the scalp, and prolongs the hair follicle growth cycle, thereby promoting hair growth. Topical minoxidil preparations are over-the-counter medications, making them readily accessible; however, their efficacy is relatively modest, and they are primarily used for preventing hair loss.

Strictly speaking, hair loss cannot be cured completely and requires long-term medication to maintain control. Alongside pharmacological treatment, adopting healthy lifestyle and dietary habits is essential to more effectively reduce hair shedding.

Tip 9: Check the dosage form before taking medication; avoid splitting tablets arbitrarily.

Many people find tablets difficult to swallow because they are large, so they try breaking or crushing them before taking them. However, some medications come in special formulations and should not be split or crushed without consulting a healthcare professional.

Which medications are not recommended to be split before taking?

1. Controlled-release agent

Sustained- and controlled-release formulations are designed to ensure the drug is released slowly in the body, maintaining a stable therapeutic concentration and thereby achieving better treatment outcomes. Unless otherwise specified in the product labeling, these medications should be swallowed whole. Breaking or splitting the tablet may disrupt the sustained‑release mechanism, causing the drug to be released in large amounts over a short period, which can lead to overdose and even toxic reactions.

2. Enteric-coated tablets

Enteric‑coated tablets are a dosage form that does not disintegrate in gastric juice but dissolves and releases its active ingredient in the intestinal environment; they typically consist of a standard tablet coated with an enteric coating. If the tablet is split or crushed before ingestion, the protective coating is disrupted, causing the drug to be degraded in the stomach and losing its intended therapeutic effect. Moreover, the enteric coating’s protective function for the gastric mucosa is compromised, potentially irritating the gastric lining and leading to discomfort.

3. Coated tablets

Some medications are coated with an outer layer to prevent moisture absorption and degradation in humid environments, or to mask unpleasant odors and enhance ease of administration. If such tablets are split before taking, this can not only compromise the taste but also increase irritation to the oral cavity and gastric mucosa, thereby reducing therapeutic efficacy and increasing the risk of adverse reactions.

4. Capsules

The capsule shell is an integral part of the drug formulation, serving to mask unpleasant odors or enhance the drug’s stability and bioavailability. If the capsule shell is carelessly opened and the contents are taken directly, the intended benefits of the capsule are lost.

Therefore, before taking any medication, be sure to read the package insert carefully, understand the characteristics of the dosage form, and do not break or chew the tablets without authorization.

Tip 10: Avoid sunlight when taking photosensitive medications; be sure to follow all precautions.

Moderate sun exposure can help the body synthesize vitamin D and enhance calcium absorption. However, certain medications, when taken and exposed to sunlight or ultraviolet radiation, may trigger allergic reactions; such drugs are known as photosensitizing agents.

Drug‑induced photosensitivity reactions are classified as phototoxic reactions and photoallergic reactions. Phototoxic reactions are non‑immune in nature and can occur in anyone; clinically, they resemble severe sunburn, with edematous erythema and, in severe cases, blisters, accompanied by a burning and stinging sensation. The severity of phototoxic reactions depends on the concentration of the photosensitizing drug, as well as the duration and intensity of light exposure. Photoallergic reactions, on the other hand, are delayed‑type hypersensitivity reactions that occur in a small subset of individuals with an allergic predisposition. Clinically, they mimic contact dermatitis, with papules, erythema and/or scaling, and sometimes blisters, appearing in areas exposed to sunlight. Patients typically experience pruritus without a burning sensation, and in some cases, these reactions may progress to chronic, persistent photosensitivity.

Common photosensitive drugs fall into the following categories:

Antibacterial agents: The most prominent among these are quinolone antibiotics, such as levofloxacin and norfloxacin; and tetracycline antibiotics, including doxycycline, minocycline, and chlortetracycline.

Nonsteroidal anti-inflammatory drugs: piroxicam, naproxen, ibuprofen, and others.

Antiarrhythmic drug: amiodarone.

Antihypertensive medications: nifedipine, captopril.

Diuretics: furosemide, hydrochlorothiazide, indapamide.

To prevent drug‑induced photosensitivity, patients with a history of allergies or photosensitivity should inform their physicians before starting any medication, enabling the physician to select an appropriate drug. If you are taking a photosensitizing medication, take appropriate protective measures during treatment and for five days after discontinuation—such as applying sunscreen, wearing sun‑blocking clothing, and avoiding prolonged sun exposure—or consider taking the medication in the evening.

If photosensitivity reactions such as rash occur after taking the medication, discontinue the drug immediately and seek medical attention promptly; undergo appropriate treatment under the guidance of a physician.

[Editor-in-charge: Wang Yuqi]

Source: Xinhua Net